Claims Management

Workers Compensation Claims Advocacy

Workers compensation claims advocacy is very important. With today’s trending medical cost containment factors, this could negatively impact the bottom line of any business. We walk our clients through a workers compensation claims implementation plan. Our strategic plan is comprised of several stages.

“ We create a clear understanding of workers compensation premium drivers, reduce reserve sets and modification factors with a healthy workers compensation process.”

— First Foundation Insurance Services
  • First, we coordinate implementation meetings with carriers and our risk and loss advisory team in person, via the phone or through the internet. However our clients want to utilize this service, we deliver.
  • Then, we confirm the carriers claim reporting procedures, and through our service platform and client portal, we simplify HR’s requirements with the reporting process.
  • A confirmation of the Medical Provider Network roll out with our clients carrier team will be performed, including participation in claims reviews.
  • Our claims advisors work in tandem with our clients on scheduling claim reviews and put forth a service plan for HR efficiencies for the entire policy period.
  • We provide detailed reports, including historical claims reviews of all open indemnity claims analyzing where improvements can be addressed for our clients. We make recommendations continuously and our team submits these recommendations to adjusters to overcome and challenge any over-reserving. We communicate these recommendations and together, we put forth our action plan.
  • During the claim review process, we strive to close and reduce as many claims and reserves as possible to help minimize the impact to the premium at renewal.
  • We produce action summaries for all parties noting the projected outcomes and expected results.

Property & Casualty Claims Advocacy

Our property and casualty advocates help guide our clients through the tricky process of claims scenarios. We help them avoid surprises within their policy language on potential future claims.

“By defining the reporting requirements of each policy, and providing vendor contract reviews, our clients avoid surprises should a claim result”

— First Foundation Insurance Services

Our clients benefit from a better understanding of the policy language, and the respective rights and duties of each party. We clearly define our clients’ reporting requirements with each policy. We discuss the consequences of not reporting, review defense expense as it relates to the policies, and explain options for selecting counsel to help avoid surprises.

Our team of professionals along with our key strategic partners, provide a deep bench of resources for our clients. This translates to support our clients can lean on for guidance.

There are special claims handling instructions that we help our clients with so they can continue to focus on business operations, rather than spending their time on pursuing a satisfactory insurance settlement. Some of these activities include the initial tender, or claim, or preparing a thorough and effective proof of loss for the claim. We also help guide our clients through the recovery to help the firm's management determine, and then achieve, their post-loss priorities, even when there is no disaster recovery plan to follow.

Communication is key when a claim is tendered to a company. We provide our clients with the proper tools to arm themselves against a claim.

“Many businesses insurance transactions are simply a piece of paper and a promise. A commodity. We view it as a partnership. We believe in understanding our clients’ financial health, and work together on designing a comprehensive risk management program. Doing more than the customary amount of service is expensive, time-consuming and hard to sustain, however this is exactly what we do.”

— Tony McIntosh, SVP, Managing Director