Claim Consulting Practice
Marsh Risk Consulting’s Claim Consulting Practice (CCP) is one of the pre-eminent consulting organizations for casualty-related claim solutions. CCP 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. CCP concentrates 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. CCP 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 MRC’s Claim Consulting Practice:
- Claim Inventory Workout.
- Workers’ Compensation Past PerformerSM.
- Operational Assessment.
- Claim and Managed Care Vendor Selection.
- VCORESM (Variable Cost of Risk Evaluator).
- Renewal Evaluator.
- Texas Non-Subscription Feasibility Evaluation and Implementation.
- Case Management Assessment.
- Return-to-Work Program Solutions.
- Workers’ Compensation, General Liability, and Auto Claim Audits.
- Custom Consulting Solutions.
Claim Inventory Workout (CIW)
CCP brings a focused approach to claim closure, designed to reduce legacy liabilities and improve the balance sheet. Claim Inventory Workout (CIW) 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. CCP utilizes 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 Past PerformerSM
Workers’ Compensation Past PerformerSM (WCPP) is MRC’s proprietary outcome-based audit tool designed to identify excessive costs in a workers’ compensation program. The tool calculates lost economic opportunity (or “leakage”) and provides a quantified result, which can lead to implementation of process changes designed to improve financial results. Through use of WCPP, our consultants can help organizations make better business decisions on where to invest in program improvements, based upon identification of potential savings opportunities.
Through assessment of an organization’s policies, procedures, and practices, CCP will help identify areas where improved performance equals reduced costs. CCP 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 WCPP 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—CCP 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. CCP has streamlined the RFP process by leveraging its proprietary Vendor Analysis and Selection Tool (VAST), 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.
VCORESM (Variable Cost of Risk Evaluator)
In the final stage of the vendor selection process for a workers’ compensation program adminsitrator, organizations can rely on CCP’s proprietary tool, VCORESM, to help them evaluate vendor outcomes and identify project costs. VCORE leverages its database of most major vendors’book of business data to determine paid medical costs and claim administration fees for competing finalists. CCP also assists in contract negotiation and implementation of the new vendor program.
Renewal Evaluator, a proprietary tool designed by CCP, 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. CCP has 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
CCP has developed a case management assessment tool (CMAT), leveraging a proprietary methodology to evaluate the quantity of case management referrals and the quality of those services. The CMAT platform combines data analytics and auditing to quantify the value and impact of nurse case management services and to identify any medical leakage. Using CMAT outputs, organizations can focus on improving their workers’ compensation program outcomes and their overall ROI.
Return-To-Work Program Solutions
CCP’s consultants have a number of product offerings to deliver return-to-work (RTW) solutions to a variety of buying styles and employer needs. From frontline supervisor training to customized RTW programs, our consultants can assist with: evaluating the needs of an organization’s employee occupational absence issues; analyzing the effectiveness of an existing RTW program (in both program design and execution); and recommending program options that meet the goals of the organization.
In addition to WCPP, there are a variety of Workers’ Compensation, General Liability, and Auto claim audits available through CCP 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
CCP 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 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.