Services Inspection of Records

Third Party Administration Review

Many captive managers, self-insureds and insurance companies do not have the resources to review the claim handling capabilities of the Third Party Administrators who are handling their claim portfolios. A periodic audit of your Third Party Administrators is the best way to ensure your claims are being handled according to accepted industry standards.

Chiltington’s team of consultants provides assistance to our clients by conducting claims audits of your Third Party Administrators, and our claim consultants assist claim managers by evaluating overall claim practices and procedures.

This includes a review of the following general categories.

• Organization chart
• Best practices
• Flowchart of claim handling practices
• Claim handlers’ experience levels
• Claim processing walk-through example
• Turn-around time
• Diary and follow-up procedures
• Authority levels and sign-off procedures
• Investigation procedures
• Quality assurance guidelines and processes
• Claim system review File maintenance and storage guidelines
• System back-up and disaster recovery plans
• Claim bordereau and check register processing
• Claim check signature levels
• Computer system and passwords
• Privacy policy and education T
• ime and expense charge evaluation
• Remuneration arrangement

Upon completion of our evaluation, Chiltington’s consultants provide an Executive Summary to our clients wherein we recommend a strategy for our clients to address any areas of concern. Ultimately, our goal is to ensure that your Third Party Administrators remain financially accountable and are handling your claims in compliance with accepted industry standards.