Claims management commitment

  • Our TPA services are unique because of our unwavering focus and proven record of improving our clients’ Total Cost of Risk Management (TCRM)
  • An unequaled combination of people, systems and processes focused on all of the components that impact our client’s TCRM – indemnity costs, adjuster and related expenses, outside experts and attorneys fees, subrogation, etc.
  • Responsiveness, timeliness and expertise in claims handling, management, negotiation and settlement: we don’t talk about better processes and systems, we deliver better results

Services

  • We have a full TPA structure in place to handle all of the operational issues involved in managing commercially insured, self-insured and public entity programs across multiple insurance lines:
    • Dedicated account managers
    • Broad geographic coverage
    • Experienced desk and field adjusters
    • Robust and flexible claims management systems
    • Customized reporting capabilities
    • Payments and fund management
  • We offer the services of specialized claims management professionals, who provide unparalleled expertise in the following areas, among others;
    • General liability
    • Litigation management
    • Product liability
    • Public entity
    • Property
    • Liquor liability
    • Automobile bodily injury
    • Automobile accident benefits
    • Civil rights litigation
    • Employment practices
    • Construction defect
  • In a full service role, we provide the following services:
    • Coverage analysis
    • Loss and expense funding
    • Reserve recommendations
    • Issue analysis
    • Investigations
    • Loss run production
    • Claims management before suit
    • Resolution
    • Litigation management recommendation
    • Periodic claim meetings
    • Reporting

Our TPA program management services are customized to meet the needs of our clients. All of the key operating protocols and service standards for each of our programs are mutually determined by the client and Sedgwick’s account management team.

Our services begin with a planning and implementation meeting, at which the client meets with our account management team to determine the key operating protocols and service standards. The issues addressed cover many of the following items:

    • Claim notification procedures
    • Contact and inspection standards
    • Staffing
    • Authority levels
    • Reporting requirements, including data needs and format preferences
    • Claims system access
    • System interface protocols
    • Payment procedures for claimants and outside experts and vendors.
    • Other client specific requests

Advantages:

    • Unparalleled claims handling excellence and performance
    • Consistently excellent audit results in all areas of claims handling:
      • Coverage
      • Investigation
      • General file handling
      • Reserves
      • Resolution
      • Litigation management
      • Overall
      • A unique combination of desk-top claims handling capabilities and nationwide coverage for field investigations and adjusting.
      • National coverage
      • Licensed adjusters nationwide
      • Superior quality control of field work
      • Superior indemnity and expense control of adjusters, investigators and experts
      • Largest roster of highly experienced field adjusters and investigators in the industry

Read more about our casualty claims services here and our automotive claims solutions here.