PROTECTING YOUR ASSETS

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PROTECTING YOUR ASSETS

• October 19, 2004
• Presented by

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MODERATOR Kim Riter, VP Business Development
York Insurance Services Group,
Inc. PRESENTERS Robert C. Foglio, VP Property
Casualty Claims Bollinger Insurance Guy
Mastrangelo, VP Client Services York
Insurance Services Group, Inc. Richard McKinley,
VP Product Management York Insurance
Services Group, Inc.
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B Foglio

• Kick-off Meeting Expectations, Partnership,
  Attendance
• Best Practices Special Claim Handling
  Requirements (Hand-out)
• Claim Reporting Emergencies, dedicated contacts,
  telephone/fax, beeper/cell-phone service,
  seasoned and tested CAT team

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TEAMWORK
B Foglio

• Open communication
• (underwriting partners), regular performance
  feedback, access to carrier website
• Claim segmentation strategy
• Supervisor review, assignment based on
  complexity, Independent Adjuster assignment
• Large Loss Reporting
• Notice, content, dollar threshold, distribution
• Personal client contacts
• Agent/carrier, check issuance

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B Foglio
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B Foglio
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B Foglio
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COMMITMENT TO PROFITABILITY (Quality/Expense
Control)
B Foglio

• Strong management review process
• Ensure standards of performance met (SOP)
• Litigation Management Program
• Defense counsel evaluations, legal bill review
• Claim Audits  
• Internal/external, by line of business (LOB),
  Quality Assurance-re-inspection program
• Data Support 
• Specialty reports, change of incurred,
  subrogation, loss prevention services  
• Recoveries 
• Dedicated subrogation unit/ Special
  Investigations Unit (SIU)

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ROLE OF CLIENT SERVICES
G Mastrangelo

• Your Conduit to Service - Use Them!
• DUTIES
• Responsible for client satisfaction/business
  relationship
• Partner with you Understand your business
• Determine what is important to you
• Match service capabilities to client needs

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YOUR ROLE
G Mastrangelo

• Stay involved
• Involve client services/TPA in other parts of
  your program
• Partake in creating protocol
• Learn how your TPA functions
• Claim Reporting
• Internal Guidelines
• Quality Control (claims and financials)

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VALUE OF DATA
G Mastrangelo

• Matrix to measure TPA performance
• Ability to capture program specific data
• Loss reports
• Claim reporting time lag
• Reserve ratio

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CLAIMS REPORTING LAG ANALYSIS
G Mastrangelo
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RESERVE RATIO ALL LOB SUMMARY
G Mastrangelo

• Based on closed claims data
• Measures reserves at different points in time
  versus ultimate outcome
• Can be indicator of development of remaining open
  claims

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RESERVE RATIO ALL LOB SUMMARY
G Mastrangelo
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DESIRED OUTCOME
G Mastrangelo

• Improved claim process and results

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R McKinley
BEST CLAIMS PRACTICES
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COVERAGE INVESTIGATION
R McKinley

• Coverage
• - Prompt Demonstration of good faith
• determination
• - Timely ROR or declination
• - Compliance with Fair Claims Practices
• - Retention of counsel if warranted
• Investigation
• - Timely
• - Thorough vs. Selective

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VERIFICATION OF UNDERWRITING INFORMATION
COMMUNICATION
R McKinley

• Verification of Underwriting Information
• - Is loss information consistent with
  Declarations
• - Does index information indicate need for
  additional investigation
• - Are all insurable interest disclosed

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R McKinley
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R McKinley
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VERIFICATION OF UNDERWRITING INFORMATION
COMMUNICATION
R McKinley

• Communication
• - Adjuster with producer
• - Adjuster with insured or insureds
  representative
• - Adjuster with experts
• - Adjuster with carrier

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CONTROL OF OUTCOMES
R McKinley

• Control of Outcomes
• - Appointment of the right adjuster
• - Retention of the right experts
• - Coverage Counsel
• - Cause Origin
• - Construction Consultants
• - Accountant
• - Subro Counsel
• - Salvors
• - Action Plan for claim resolution
• - Clear communication in the file notes
  reporting
• - Effective communication to decision
  makers

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RECOVERY
R McKinley

• Recovery
• - Subrogation
• - Preservation of evidence
• - Plan of action/strategy
• - Early involvement of trained
  specialists
• - Aggressive pursuit
• - ADR
• - Mediation
• - Arbitration
• - Appraisal
• - Salvage
• - Protection/Mitigation
• - Salvor
• - Leave with insured with
  appropriate adjustment credit

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PROTECTING YOUR ASSETS

• October 19, 2004
• Presented by