Third-Party Claim Administrator
What sets one claim administrator apart from
the others?
- Years of
experience?
- Claim reporting
capabilities?
- Cost of
claim handling?
Actually most third-party claim administrators “process” claims instead of thoroughly
investigating and properly managing
them. Therefore, delineating the differences,
experience and capabilities of various administrators can be extremely difficult and costly in the end.
Unfortunately, and all too often, third-party administration
services are selected based on what appears to be an attractive and inexpensive
upfront cost, charged on a per claim basis.
But don’t be fooled!! Look towards
the back of their proposal/contract and you will find all of those costly extra
add-on charges you are not aware of but will also be paying.
Just a few of these include:
- Per line medical review charges
- Charges to set-up the physical
claim files
- Additional charges for companion
file
- Hourly charges for claim reviews
consulting and any number of other services.
Wramsco’s
Approach
Common sense would dictate that all available facts
concerning a claim must be obtained in order to make informed and cost effective
decisions. With this in mind Wramsco’s approach
to claim administration is one of thorough investigation coupled with aggressive
management culminating in a fair and equitable resolve for both the injured employee
and his/her employer. Legitimate claims
will be managed and paid expeditiously while aggressively defending against fraudulent
claims.
Although Wramsco uses many different tools and techniques to accomplish
the preceding a few of these would include all lost time claims being investigated,
recorded statements taken from claimants and all witnesses, medical treatment to
evaluate for diagnosis, necessity, duration and prognosis by Wramsco’s Board Certified Medical professionals and Board
Certified Forensic Medical consultants.
Example:
For the past 11 years Wramsco has been adjusting and managing the claims for a pooled self-insured workers’ compensation
program involving some 15 to 20 residential, commercial and industrial contractors. A few of the trades include rough/trim
carpentry, concrete, excavating, HVAC, plumbing, flooring, etc.
Result: Average incurred
pure loss ratio for past 11 years is 35.68% with the worst year being 58.17%
630-960-1020
630-960-9725 (fax)
tlwalker@wramsco.com
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