Share This Article:
General Liability TPA Should Have Specific Plan of Action (SPOA)
10 Jan, 2011 WorkersCompensation.com
Employers: — In the never-ending quest to lower business costs, consider using a fully integrated general liability service provider with solutions unique to your business. By fully integrated we mean a service covering everything from property damage to bodily injury to product liability designed for your company, your risk management program and you.
Employers must protect their brand by employing:
1. Thorough investigations.
2. Optimal negotiations.
3. Reduced cost of risk. (WCxKit)
When looking for a general liability service provider look for one who will design your program unique to your business by becoming completely familiar with what you do, how you do it, the legal issues and your vision for success. Then expect them to create an integrated claim service team who can meet your needs. Select an account manager based on chemistry and experience, supported by a multitalented team of:
1. Claims professionals.
2. Medical professionals.
3. Subject matter experts.
4. Senior risk analysts.
A successful program optimizes the claim process starting with 24/7 intake system, creating a specific path for your claims and your custom escalation protocols. The customer service representatives should be employees of the service company, trained to capture the data you need and the information necessary to allow the claim professionals to act quickly. These professionals must also be appropriately licensed and supported so they can perform thorough investigations.
After analyzing the facts and issues, the claim professionals work with physician advisors, subject matter experts and supervisors as needed to create a Strategic Plan of Action (SPOA). The Strategic Plan of Action sets goals and identifies the steps necessary to assist those presenting legitimate claims and protects you from those trying to take advantage of you.
The SPOA prepares for litigation early on by employing a multifaceted litigation management program designed to minimize legal costs and create the optimal outcome. The claims professional creates a proactive litigation plan and budget and is involved in all decisions regarding the case.
Your service provider makes clinical expertise one of your greatest strengths by using medical bill review, physician review services, critical incident review, pharmacy protocols along with the review of specials packages to help discover the true value of each claim. Should legal counsel be needed, legal bill review can help ensure defense fees are appropriate and within reason.
Senior risk analysts provide an added tier of expertise. Each analyst typically has more than 25 years of experience and extensive training in handling complex claims. If a claim meets a certain requirement such as a catastrophic loss or high-exposure, it can trigger the senior risk analyst's involvement. They offer a broader analysis of the claim and advise the claim professional on coverage, reserves, litigation strategy and proper disposition. Your senior analysts have the ability to take on several advanced roles. They can handle special projects, train your staff, manage inventory, and look for trends within the data to lower the overall cost of risk. (WCxKit)
Remember, you want a program using tools tailored to your systems, processes and expertise to complement your needs. If your company experiences a large volume of liability claims, your provider must be able to establish a client-dedicated service team at a centralized location. The benefits to you include:
1. Day-to-day communication.
2. Developing expertise specific to your business.
3. Full operational and technical support.
4. Pricing options.
5. Lower loss costs.
The right result requires the execution of a thoughtful game plan.
Contributor: Broadspireproviding workers compensation third-party administrative services. For more information, contact Broadspire by calling 1-866-625-1662 or emailing us at Broadspire_Info@choosebroadspire.com; www.choosebroadspire.
WORK COMP CALCULATOR: http://www.LowerWC.com/calculator.php
MODIFIED DUTY CALCULATOR: http://www.LowerWC.com/transitional-duty-cost-calculator.php
WC GROUP: http://www.linkedin.com/groups?homeNewMember=&gid=1922050/
SUBSCRIBE: Workers Comp Resource Center Newsletter
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
SUBSCRIBE: Workers Comp Resource Center Newsletter
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Read Also
- Jul 01, 2024
- Frank Ferreri
- Oct 19, 2023
- Bill Zachry
About The Author
About The Author
- WorkersCompensation.com
More by This Author
- Jun 24, 2024
- WorkersCompensation.com
- May 11, 2023
- WorkersCompensation.com
- May 10, 2023
- WorkersCompensation.com
Read More
- Jul 01, 2024
- Frank Ferreri
- Oct 19, 2023
- Bill Zachry
- Oct 12, 2023
- Liz Carey
- Sep 28, 2023
- F.J. Thomas
- Sep 28, 2023
- WorkersCompensation.com
- Sep 15, 2023
- Chris Parker