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Claims Services

Whether you require market share reports by line of business or need to identify companies that write certain coverages, Munich Reinsurance America can help. Our state profiles consist of a compilation of facts and figures, regulatory and industry issues, and trends for specific states and lines of business including commercial multiperil, workers' compensation, commercial and personal auto, homeowners, and farmowners. Our State Profile reports can assist you to:

  • Ensure the adequacy of your reserves
  • Better negotiate rates for catastrophic injury
  • Analyze treaty commutation claims
  • Successfully resolve coverage issues
  • Review policy exclusion language
  • Improve settlement evaluation and negotiation processes
  • Enhance effectiveness of a claims unit through due diligence reviews, claims and operational audits and similar activities

Consulting Services and Seminars
Consulting services and seminars are available in the following areas:

Construction Defects Claims Management
Construction defects claims against builders have soared nationwide in recent years. Because the cost of defending these types of claims has become a significant problem for insurers, Munich Reinsurance America has a construction defects specialist on staff to assist our clients. Our actuarial and claims consultants can help clients to quantify their ultimate construction defects liabilities, establish dedicated construction defects claim units, develop claims-handling “best practices,” and create litigation and case management strategies, all of which can result in significant cost savings.

Developing Exposures
As a leading reinsurer, Munich Reinsurance America has the opportunity to view developing exposures from the diverse perspectives of our clients. Exposures we are currently monitoring include: advertising liability/intellectual property, toxic mold, and genetic engineering. Our claims consultants can be invaluable resources to our clients who need up-to-date information on the legal, insurance, reinsurance and contractual issues surrounding developing exposures. Our claims professionals are often teamed with underwriters, actuaries, and contract wording specialists to help clients develop comprehensive solutions as new issues arise.

Asbestos, Environmental, Other Latent and Mass Tort Claims Management
Our A&E, Other Latent and Mass Tort claims staff brings two decades of experience in managing, evaluating and resolving these difficult and complex exposures. They share their experience with clients and can assist them in a variety of ways, including:

  • Seminars on all aspects of these claims
  • Analysis and evaluation of claims operations, processes and procedures
  • Coverage issue analysis and defense
  • Exposure and reserve analysis assistance on a single claim, group of claims or entire claims portfolio
  • Assistance with claim and / or litigation management strategy These services will help you to more efficiently and effectively manage these high-impact claims.

Litigation Cost Containment
By improving your company's lawsuit management processes, you can lower litigation expenses and claims costs, and help avoid surprise verdicts. Our claims professionals assist clients by: conducting on-site reviews of litigation control, data collection and reporting procedures and making recommendations for changes; and providing hands-on trial strategy assistance.

Negotiation Skills Training
Our claims professionals offer basic and advanced workshops on the art of claims negotiation. Both workshops provide in-depth analysis of the claims negotiation process by examining a variety of successful techniques, strategies and negotiation psychology. Attendees gain experience and confidence through hands-on participation in staged negotiations. The goal of the workshop is for attendees to effect more favorable settlements, thereby containing loss and expense dollars for their companies.

Policy Language Reviews
Munich Reinsurance America's claims specialists, experienced in evaluating coverage issues, will assist clients in reviewing proposed or existing wording of policy forms and agreements. We will offer comments, suggestions and practical insight on contract language. The process includes comparisons with other available contract language and culminates in a meeting with the client to discuss our findings. Our comments, suggestions and recommendations should be viewed as an additional resource for consideration by the client company and are not to be considered as a legal opinion or a substitute for legal counsel.

Medical Claims Services
Munich Reinsurance America offersa portfolio of services that can help clients significantly reduce the cost of their medical claims. These services include:

Catastrophic Care: Best Doctors ® Catastrophic and Legacy Case Services
Munich Re America Services are available exclusively to clients. Our catastrophic care program improves the medical and cost outcomes of high acuity, legacy claims and workers' compensation catastrophic injuries. We achieve optimum results by using the top medical experts from Best Doctors ® CatCare, Legacy and medical consulting services as well as individually selected nurse case managers who undergo a rigorous credentialing process in order to participate in the CatCare program.

These premier physicians and individually selected nurse case managers are assigned to every case and work in tandem to evaluate and guide a patient's medical care. They work with all parties, including the injured worker, their family, employer, claims payer/adjuster and treating medical providers. Best Doctors CatCare services are available for cases ranging from acute injuries that have occurred within the prior 24 hours, to legacy cases with serious or chronic problems that could benefit from a comprehensive review. The average savings achieved on catastrophic cases is $456,000.

Medical Bill Negotiation
ReSource – Munich Re America's out-of-network savings program affords our clients a risk-free opportunity to achieve savings on out-of-network medical bills that are often paid on a retail basis. The program uses state-of-the art databases and professional negotiators to achieve savings on the full spectrum of medical bills received by a client: hospital, physician, therapy, diagnostic, DME, and more. ReSource – Munich Re America is capable of providing services nationwide and works in conjunction with existing managed care programs. Savings range from 10% to 90% on an individual bill. If done systematically by sending all bills exceeding $1,000, a company's total workers' compensation costs can be reduced by 4.5% to 9%. Other benefits of this turnkey service include:

  • Immediate program access - no contracts to sign, no minimum number of referrals
  • Negotiations performed on both a prospective and retrospective basis
  • You select the referral threshold levels
  • Risk-free savings opportunity: No Savings - No Fee
  • Rapid turnaround time - referrals completed within 5 - 7 days of referral
  • Quarterly client savings reports
  • Service fees equal to percentage of actual savings negotiated (capped at 25%)
  • EDI capability

Download the ReSource - Munich Re America Bill Referral form

 

 
 
 
 
 
 
 
 
 
 
 
 
Publications
Bad Faith Compendium 2008 (pdf)
Environmental Coverage Case Law 2007 (pdf)
Litigation Management - Ideas for Claims Professionals (pdf)
Post Judgment Interest/Prejudgment Interest/Punitive Damages 2008 (pdf)
Schadenspiegel 1/2007 [Munich Re] (pdf)
See Also

ReSource Referral Form (pdf)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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