Claims

Claims Management Oversight

Our Claims Management Oversight services support client organizations that cannot commit staff to this activiryAttention can be directed to all claims or high exposure claims. Vision Risk can offer reserve guidance, investigative recommendations, settlement evaluations, defense attorney action plans, coverage analysis and overall resolution strategies.

Services can be delivered on-line or at the client’s site. Vision also assists in developing the skills of in-house oversight staff and in determining the number of staff required for oversight.

Vision Risk recognizes that a second set of expert eyes can provide a claims examiner with the proper guidelines for bringing a claim to conclusion.

Self-insured entities that choose to self-administer their claims, may find this services very beneficial.

Claim Auditing

claim-auditingThe audit process is an excellent tool for development and improvement of your overall claims administration process. An while we recognize that no two organizations are exactly alike, the Vision claim auditing process helps you benchmark your performance against peer organizations.

We take a team approach in designing a review structure that addresses our specific auditing objectives. This approach also enhances learning and can improve overall operational efficiency. The overall speed of the process and accessibility of the report is increased by the use of Vision’s automated information system.

Periodic Claim Reviews

periodic-claim-reviewsSo much can be gained through teamwork between the adjuster and risk management divisionA structured claim review process is an excellent way to establish true collaboration. Effective claims review, however, requires detailed planning, preparation and coordination. Vision Risk establishes claim review programs that offer risk managers and adjusters the opportunity to discuss, analyze and strategize the resolution of high profile losseslosses that require a more advanced review and resolution plan.

Third Party Claims Administration

third-party-claim-adminVision Risk Services, LLC offers complete third party claims administration that surpasses the leaders in the industry in terms of quality, expertise and technology. We provide a comprehensive claims management program that is customized to meet your organizations’ needs. Our industry experts are facilitated by technological tools that focus on accuracy and efficiencyThe Vision team partners with its clients, creating a seamless claims management program. Our claim data is completely open to our clients, eliminating communication barriers that can hinder the success of TPA program. RMIS reporting has never been easier, ranging from instant desktop views directly from your PCto rich analytical reporting through a sophisticated report writer. We understand your need for prompt and accurate reporting Our collection of data on the front end is supported by intricate table designs, which insure that the data entered is accurate, and supports the integrity of our reports.

Third Party Claims Administration Workers Compensation

third-party-worker-claims-workers-compWe manage our workers compensation losses with the utmost of diligence and attention. The costs associated with workers compensation requires expertise, efficiency and detailed analysis. Our claims examiners fully investigate every loss within 72 hours. Contact is made with the employee, supervisor and physician within 48 hoursCompensability decisions are concluded within 14 days of receipt of assignment. Our emphasis is on return ing the injured worker back to full duty, not on the mere processing of the claim. We measure our results not just on how timely we perform activities, but on the overall quality of our performance and our ultimate resultsA solid technology platform is essential in managing a successful Workers Compensation program. Our information system provides efficiency tools for our professionals to make their jobs much easier.

  • 24 hour claim reporting
  • Work flow rules integration with electronic diary and e-mail
  • real time access to adjuster notes and financials
  • Imaged documents as attachments to electronic claim file
  • Electronic interface between medical authorizations and payments
  • medical authorizations and payments
  • medical management integration
  • Medical bill review and PPO integration

Third Party Claims Administration General Liability

third-party-worker-claims-general-liabilityImmediate investigation is the key to successful management of liability losses. Our standards require that contact is made with the insured and claimant within 24 hours of loss notification. Our field investigators are available 24 hours a day to conduct complete scene analyses and statements. Photographs, statements and any other evidentiary documents are electronically attached to the claim file, making investigative results immediately accessible to authorized users. Our examiners utilize the necessary resources to assess and evaluate liability exposure within 14 days of loss notification. We manage each loss throughout the entire adjudication process, including litigation. Our expertise extends within various industries, including but not limited to, construction, retail, petroleum, medical malpractice, transportation, and municipalities.

Our approach to litigation management involves more than legal budgets and bill review. Our knowledge of the litigation process facilitates our ability to direct discovery, prepare for trial, and appropriate resolutions.

  • 25 hour claim reporting and scene investigations
  • Work flow rules integration with electronic diary and e-mail
  • Real time access to adjuster notes and financials
  • Imaged documents as attachments to electronic claim file
  • Medical bill review integration

Third Party Claims Administration Auto Liability/NoFault

third-party-worker-claims-autoOur team of examiners possess extensive experience in Auto Bodily Injury and Property Damage losses. We contact the insured driver and all claimants within 48 hours of loss notifications. Detailed accident scene investigations are conducted also within 48 hours. Our field investigators photograph and diagram all scenes, and attach their results to the electronic file, creating a virtual description of all accident details. In cases of emergency, we are available 24 hours a day.

We analyze property damage losses and insure that storage and rental car costs are minimized. Our assessment of liability occurs within 14 days of loss notification. We will consult with our clients to insure that appropriate resolutions are reached quickly to avoid unnecessary litigation. Should the case result in litigation, our seasoned claims professionals are prepared to direct the entire process and effectively manage all legal costs.

Administration of No Fault losses is managed very carefully, to iinsure that claim costs are contained. Timely IME’s, thorough iinvestigations and consistent use of the NY fee schedule proves to reduce No Fault costs. sts are contained. Timely I ME’s, thorough iinvestigations and consistent use of the NY fee schedule proves to reduce No Fault costs.

  • 24 hour claim reporting and scene investigations
  • Work flow rules integration with electronic diary and e-mail
  • Real time access to adjuster notes and financials
  • Imaged documents as attachments to electronic claim file

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