Claim Audits & Claims Handling
Claims Handling – Third Party Administrator (TPA)
We utilize a number of Third Party Administrators that can demonstrate the ability to successfully adjudicate claims for the restaurant industry. We have developed a number of strict claim protocols, which all TPA’s we utilize are required to follow, specifically designed to assist our clients and prevail in the case of a claim. The net result has been exceptional.
Over last 15 years of working with large national accounts within the restaurant industry, we have developed claim protocols that have produced the following successes:
- 98% of all Food Spoilage claims have been closed with $0 payment
- 92% of all Foreign Object claims have been closed with $0 payment
- 72% of all Trip & Fall claims have been closed with $0 payment
Understanding your exposure and how your claims will be handled will provide you with the tools to control your pricing.
“Don’t expect what you don’t inspect”. Every company is trying to improve margins every day. Third Party Administrators are not different. Even with the most definitive protocols and pay for performance contracts, do not expect anyone to handle your claims the way you may have if you were trained to do so.
When we hire a TPA for a client, or place coverage on a guaranteed cost basis, we are intimately involved in claims administration. We prepare claim audits for clients regularly and the results can be shocking. Keep us in mind the next time you look at your loss runs and realize the reserves posted will dictate you’re pricing.