Claims Resolution Critical in Selecting an Insurance Program and Carrier

December 23, 2016

When selecting an insurance program and carrier to protect against the many risks a home health care agency faces, there are several key factors to consider. Among them are the insurance provider’s breadth and depth of experience and expertise in the home care industry and the scope of the insurance solutions offered, as well as the program’s flexibility in tailoring coverage to fit the risk profile of a specific operation, the insurer’s financial strength, and the cost of the program. Also critical in the insurance decision-making process is the insurance company’s claims handling. After all, this is when “the rubber meets the road” and determines how satisfied a client is in the event of a claim and an accident, injury or loss.

There are several factors that go into how well an insurer handles its claims. The first factor involves how easy it is to contact an agent or broker and to report the claim to the insurer when a claim occurs. Also important is making sure you understand the claims procedures involved in the event of a loss, which depends on the type of claim. For example, in a Workers’ Compensation claim, an employee should immediately report his or her injury to the employer, who in turn will send the Report to Injury claim to the insurer or third-party administrator. Reporting a claim immediately averts any potential problems in getting benefits started in a timely manner for the injured employee. In a Directors’ and Officers’ Liability loss, individual policy wording identifies how coverage will be triggered, and includes the time frame in which a claim needs to be reported and the notification process. A professional insurance agent and broker will go over the details of the policies before a claim occurs to help avoid any pitfalls or potential disputes.

Once the claim is filed, how well it is managed and resolved makes a world of difference in the experience a client has with an insurer. This naturally includes the speed with which the claim is handled. If there is a property loss, for example, how quickly an adjuster shows up at the location to determine the extent of the damage is important in expediting the claim process. Claims technology and databases used by an insurer also facilitate the process by providing tools to help manage the staff’s workflow and their communication with insureds. Strong communication with a client and timely updates during the process make a positive claims resolution. Clients want a smooth and stress-free experience and to be kept in the loop with what’s happening.

The claims-handling process is an integral part of an insurance company’s obligation to its insureds. At Manchester Specialty, we are committed to not only offering specialized competitive insurance solutions for the home healthcare industry but also to providing a streamlined, responsive claims-resolution process through our partner insurance carriers. We work with our carriers,  brokers, and agents to help get injured employees back to work as soon as they are able, resolve liability-related disputes, and assist insureds in operating again as soon as possible after a property loss for example. For more information about our insurance solutions, you or your local agent/broker may contact us at 855.972.9399.