Praxis Claims Consulting
Captive Layer TPA Management & Oversight
How devastating is the cost of a claim to the bottom line? While it is easy to see the premium dollars going out the door annually, it may not be so easy to appreciate the true cost of claim payments made within the captive layer.
If a captive settles and pays a claim at $25,000, it would take $500,000 of gross revenue to replace the lost profit assuming a profit margin of five percent.
The management and oversight of claims being handled by a either a captive claim staff or TPA can consume a large amount time and resources that may not be readily available or exist within your captive layer.
Praxis can fill this void by providing some or all of the following services:
- Periodic claims & operational audits to ensure compliance to claim service standards and best practices
- Establishment of minimum TPA standards of performance
- Oversight and direction for specific losses that exceed the TPA’s settlement authority (either by reserve value or category).
- Vet the TPA’s vendor list and monitor the TPA's performance and impact on expense management.
- Establishment of a litigation management process and monitor its use and effectiveness.
- Provide training to the claim staff in the areas of injury evaluation and litigation management.
- Monthly reporting tailored to your needs.
- Provide insight and recommendations as well as preparing an RFP for distribution if changing TPAs
- Review and confirmation of services on any potential TPA that you may be considering
- Attend trials, mediations or settlement conferences
- Monthly data reviews to identify potential issues or trends
- Complete TPA management and oversight
Any of the above services can be individually carved out or customized to fit your specific needs or budget.