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We handle Workers’ Compensation claims

All aspects of WC claims to handle from initial contacts, investigation, reserving, client and reinsurer reporting.

We handle all other P&C multi-line coverages

including claims adjustment for auto liability, auto property, general liability, legal liability, police professional, property, school board liability. We are also licensed to handle this line of business in New York.

We provide P&C audit services

Bob, Linda and Lisa have audited more than fifty TPAs servicing large commercial accounts including public entities throughout the United States. Collectively we have audited more than fifty TPAs servicing public entity and other large commercial accounts throughout the US.

More about audit services:

In addition to the minimum audit requirement, the workers’ compensation auditor will review both traumatic and occupational claims for coverage, causality, reserves, and reinsurer reporting. When reviewing occupational claims, the auditor will also review the Fund’s period of coverage, the injured worker’s date of hire and date of termination, if applicable, date of manifestation and determine if the claim was set up during the proper policy period, the proper reinsurer was put on notice and if any carriers/TPA were or should have been impleaded. For all traumatic claims, the files will be audited for accident investigation and statements as well as investigation prior treatment and process, quality and timeliness of prior records, claim decisions were made timely, subrogation identified and pursued, PAR quality and timeliness, and reinsurance reporting.

Our experience has helped other TPAs to develop internal controls that reduce the opportunity for error and better serve their clients and improve their performance.

 

More about our claims management:

We take pride in the professional quality of our work and the relationships we form with our business partners. Every claim is thoroughly investigated from inception. Our files are audited internally by our supervisors as well as individually by each adjuster on a monthly basis to make certain we do not become complacent on this important task. Our experienced adjusters are able to quickly identify fraudulent or suspicious claims. We care and we want to be with our clients for many decades.

Our devotion and experience has helped our clients realize the following successes:

Our Fund Clients have never lost a jury trial;
Return-to-work programs. 98% of our members offer light duty positions resulting in considerable savings for our Funds;
Creation of the Recidivist Interview has resulted in significantly less repeat claims;
In 2011 HCS effectively adjusted more than $10,000,000 in storm related damage and reconciled the payments with reinsurers to the exact amount.
We handle all aspects of MMSEA Section 111 reporting at no cost to our clients.
We are very experienced. Collectively our team has handled more than 30,000 workers’ compensation, 10,000 general liability and 3,000 property claims to conclusion for NJ Joint Insurance Funds.

Providing claim services independently allows Bob and his team to control costs and provide the best representation for their clients. We do not charge or receive compensation for anything other than the third party claims adjusting services we provide pursuant to our contract with each client.