About This Product
Claims Operations: A Practical Guide will help you navigate the complexities of claims operations, whether you are a risk manager trying to evaluate a TPA, an agent trying to set up an in-house claims advisory service, an experienced P&C claims executive, or a newcomer to the claims side of the business.
Written for both experienced and new insurance professionals, this book provides a comprehensive overview of how the claims process is handled, controlled, and managed, and its interrelationship with other functional departments.
Nonclaim professionals will gain a better understanding of how to improve profitability through effective technical claims handling and claim management (including proper caseloads) and recognize when and why a claims operation or TPA is not meeting industry quality standards.
Claims Operations: a Practical Guide covers these topics.
- Claims Operations Overview
- Types of Claims Operations
- Core Operational Issues
- Claims Management Overview
- Management Controls
- Recruitment and Retention
- Financing and Banking
- Claims Process Overview
- Investigation and Adjustment
- Statements and Interviews
- Coverage Issues
- Evaluation and Resolution
- Going to Court
- Reserve Management
- Third-Party Administrators Overview
- Legal and Regulatory Compliance
- Claims Handling Guidelines Overview
- Auto Physical Damage
- Auto Liability
- First-Party Property and Inland Marine
- General Liability
- Professional Liability and Management Liability
- Public Entity
- Workers Compensation
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