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The annual directory of claims specialists lists companies that generate at least $500,000 of their gross revenues from handling claims for self-insured clients. Companies were required to report gross revenues in order to be included.
The directory is published as an editorial service; there is no charge for companies to be included.
Companies are organized into three categories according to type of claims handled. The categories are: employee benefits/group insurance only; property/casualty (including workers comp) only; and both employee benefits/group insurance and property/casualty claims.
Organizations are asked to use these definitions: claims administration includes overseeing control of claims files, directing adjusters and paying claims; adjusting includes investigating claims and making recommendations to the claims administrator but does not include paying claims; claims auditing includes reviewing the overall integrity of the claims file operation, verifying the accuracy and direction of claims payments and recommending solutions to claims administration problems.
Listings begin with the company name, address, phone and fax number. Following is financial/statistical information. This section includes: total 1996 gross revenues along with the revenue generated by claims services for self-insured clients in 1996; and the percent attributed to claims administration, adjusting and auditing for self-insured clients.
Other information in this section includes: claims business by type, a percent breakout of total claims dollars handled by type. If health plan administration is a large percent of the business, the number of employees and dependents covered is listed. Claims business by volume lists the dollar amount of claims paid and number of auditing projects conducted in 1996. Clients includes the number of administration, adjusting and auditing clients in 1996. Staff data is given in full-time equivalents and lists the number of total employees and employees assigned to self-insured claims services.
The text section of each listing includes the year claims services began; parent company, if applicable; service area; branch offices, both administrative and sales; claims subsidiaries; PPO access, if applicable; officers; and a contact for readers seeking additional information.
Information reported is based on each company's responses to a BI questionnaire. Although every effort is made to publish complete and accurate listings, BI is unable to verify all information.