Solution

Claim Consulting Practice

CCP focuses its claim and program management expertise to assist clients in identifying, analyzing, and reducing their exposure, minimizing cost of risk.

Marsh Advisory's Claim Consulting Solutions is one of the pre-eminent consulting teams for casualty-related claim solutions. Our team focuses its claim and program management expertise across the gamut of casualty claims to assist clients in identifying, analyzing, and reducing their exposure, thereby minimizing their total cost of risk. We concentrate on highly-specialized product offerings, supported by proprietary technology and executed by the top claim and risk consulting professionals in the industry.

Organizations face a number of exposures when it comes to casualty claims and have developed varying capabilities in addressing these exposures. Marsh Advisory can supplement these capabilities with specific expertise in each of the casualty lines to help our clients identify issues and strengthen their programs.

The following service offerings are provided by Marsh Advisory's Claim Consulting Solutions:

Claim Inventory Workout

We bring a focused approach to claim closure, designed to reduce legacy liabilities and improve the balance sheet. Our claim inventory workout tool works well with any line of casualty claims, although a primary focus is on workers’ compensation where tail claims and regulatory requirements make prompt and efficient claim resolution a greater challenge for organizations. We utilize line-specific and jurisdictional expertise to assess outstanding claims and bring a fresh perspective to resolving older claim files. This approach can: minimize administrative involvement in claims programs; reduce internal and external claim administrative costs; avoid deterioration of an organization’s claims inventory; improve insurer performance and reduce collateral requirements; reduce liability from discontinued operations; and impact and reduce costs associated with chronic medical pain cases.

Workers' Compensation Assessment

Our proprietary outcome-based audit tool is designed to identify excessive costs in a workers’ compensation program. The tool calculates lost economic opportunity and provides a quantified result, which can lead to implementation of process changes designed to improve financial results. Through the assessment, our consultants can help organizations make better business decisions on where to invest in program improvements, based upon identification of potential savings opportunities.

Operational Assessment

Through assessment of an organization’s policies, procedures, and practices, Marsh Advisory will help identify areas where improved performance equals reduced costs. We will assess the quality of written programs, as well as measure the effectiveness of and compliance with these programs. In addition to a review of written material, our consultants will complete interviews of key personnel and often conduct a claim audit utilizing the workers' compensation assessment tool. The operational assessment can also be expanded to include pre-loss efforts to address the complete impact of program strengths and opportunities for casualty claims.

Claim and Managed Care Vendor Selection

When selecting a new program vendor—whether claim administrator or managed care—Marsh Advisory can assist an employer with its decision making using a multi-phased vendor selection process. Our process identifies the vendor that can best provide quality service, aggressive pricing, and both positive claim and medical outcomes. This includes a needs assessment, development of the request for proposal, identification of vendor candidates, and scoring of written and oral responses. We have streamlined the RFP process by leveraging our proprietary vendor analysis and selection tool, which contains a database of all major insurers and claim administrators with standard company information to allow for the creation of an RFP tailored to an organization’s specific needs.

Variable Cost of Risk Evaluator

In the final stage of the vendor selection process for a workers’ compensation program administrator, organizations can rely on Marsh Advisory’s proprietary variable cost of risk evaluator assessment to help them evaluate vendor outcomes and identify project costs. This assessment leverages our database of most major vendors’ book of business data to determine paid medical costs and claim administration fees for competing finalists. We also assists in contract negotiation and implementation of the new vendor program.

Renewal Evaluator

Our proprietary Renewal Evaluator tool allows our consultants to specify the effect of implementing a new price option on a company’s annual medical cost and helps a risk manager make the right price choice for its program. The analysis is done specifically for each company, using actual medical bill history, instead of an estimate of medical charges.

Texas Non-Subscription Feasibility Evaluation and Implementation

Opting out of workers’ compensation is an intriguing, yet daunting, proposition for many Texas employers. We have developed a process to assist employers in: evaluating the feasibility of becoming a non subscriber; assessing an existing non subscriber program; and program implementation. Specific product offerings include a baseline assessment of all pre- and post-loss activities, economic modelling, and a process to set up and launch new programs.

Case Management Assessment

Marsh Advisory has developed a case management assessment tool, leveraging a proprietary methodology to evaluate the quantity of case management referrals and the quality of those services. This platform combines data analytics and auditing to quantify the value and impact of nurse case management services and to identify any medical leakage. Using these outputs, organizations can focus on improving their workers’ compensation program outcomes and their overall ROI.

Return-To-Work Program Solutions

Marsh Advisory's consultants have a number of product offerings to deliver return-to-work solutions to a variety of buying styles and employer needs. From frontline supervisor training to customized return-to-work programs, our consultants can assist with: evaluating the needs of an organization’s employee occupational absence issues; analyzing the effectiveness of an existing return-to-work program (in both program design and execution); and recommending program options that meet the goals of the organization.

Claim Audits

We offer a variety of workers’ compensation, general liability, and auto claim audits including: a best practice audit, which evaluates claim handling against industry-recognized best practices; a reserve analysis, which focuses on the adequacy of reserves; and a financial process audit, which specifically targets the policies and practices utilized for claim payments and reserving that can impact Sarbanes-Oxley requirements. While there are standard protocols built into each of these audits, they can be expanded and customized to meet specific needs.

Custom Consulting Solutions

Marsh Advisory can work with an organization in support of any claim program issues through our custom consulting solutions approach. This can be achieved through a blend of any of the aforementioned product offerings, as well as through outsourcing, data analysis, and the development of customized solutions focused on gaining a greater understanding of program issues and overall program cost reduction. Our consultants also can focus on medical treatment and medical costs, helping an organization develop strategies, address cost drivers, and integrate solutions into its workers’ compensation program.