Claims Management

What is Claims Management?
Claims management is the process of assessing, documenting, administrating and receiving fair settlement of legally payable compensation by third parties for damages incurred.

1. Assessing: The damaging events as they occurred have to be checked against the contractual obligations to pay for such damages by third parties. Usually this is contained in written contracts, such insurance policies, warrants or employment contracts for example. In short: Do you have a claim?
2. Documenting: Collect all documents necessary to confirm that the claim exists, to show what damages have incurred where and when, to estimate costs (direct & indirect), to identify who are the parties responsible, to assess the most efficient way of processing the claim
3. Administrating: Processing all required documents in a timely and the appropriate and required manner with the involved parties. You have to a make sure that all legal requirements are met to enforce the claim. For example: most insurance companies require that they be notified of the possible claim within a very limited time frame following the damaging event.
4. Receiving fair settlement: Claims have to be explained to claims adjusters and payments schedules have to be negotiated in order to obtain the maximum allowable compensation within the shortest time possible. This process of course may have to be brought to the courts if the third party refuses to execute its legal obligations.

Where does Claims Management start?
Claims Management does not start when a damaging event occurs but really starts at the time a contract is negotiated for protection against such damages. For example, a business decision is made to purchase insurance for a building. At this point it is a management responsibility to define:

• which parts of the building are to be included (especially infrastructure),
• what particular features are important to the owner,
• what risks are to be protected against,
• what amounts are reasonable to insurance,
• what deductibles are acceptable,
• which insurance company can be trusted with the contract
• what is the best wording for the contract clauses
• does the contract accurately reflect what has been negotiated.
  and many more………

A properly thought out and executed insurance purchase program will contain few if any nasty surprises at claim time. On the contrary, a hastily conducted purchase process (invariably focussing on price only) will have plenty of surprises. For more details, please see our documentation on Insurance Management below.

What kinds of claims need professional management?

• Insurance companies refuse to pay or settle for the full amount
• Hospitals refuse to compensate for malpractices occurred on their premises
• Companies refuse to pay compensation for malfunctioning articles and the damage they have cause to people or other property.
• Public authorities refusing responsibility for faulty public services, which they are required to deliver
• Financial companies processing errors, committing fraud or abusing their authority
• Legal contracts, such as property, employment, professional services, joint ventures, partnerships, which are unilaterally broken or illegally terminated prematurely.

What does claims management cost?
Our basic principle for compensation is that we work on a performance basis. This means that we get paid for success and you don’t pay for failure. Essentially this means that a percentage of the settlement is being used to pay for our compensation. The percentage itself will vary depending on the many factors affecting the claims process. However we will clearly define it with you before commencing the claims management process for you. We are committed to a no-fee opening consultation in which we assess the claim made, the potential for settlement, time frame, expenses, available expertise, international implications, etc. If we accept to proceed we will negotiate a detailed contract with you, outlining our responsibilities, compensation, timing, reporting, etc.

Do we have what it takes to assist you in your claims management?
PT. Usaha Tepat Guna is manned by professionals with decades of experience in insurance matters. Most claims have a connection to insurance contracts unfortunately. Moreover we are extremely well connected, nationally and internationally to organisations and professionals in claims management and related fields.
Our professional commitment will not allow us to accept cases where we feel that our knowledge or competence is inadequate. All our clients are being handled in the most private and confidential manner possible in order to protect them from third party interference.

Insurance Management

What is Insurance Management?
Most individuals and companies purchase insurance in their life time in order to protect themselves against unforeseen disasters which could cripple them financially or wipe them out completely.
An insurance contract in its essence is based on trust. I, the client, pay now on the promise that you (the insurance company) will may-be pay me later.
Entering into this contract the client finds himself involved in complex issues, language, legalities, professional jargon and financial implications far beyond the comfort level of most. The insurance companies on the other hand have dealt in this area for centuries and are very comfortable. Hence this does not present a level playing field for the two parties.
Most insurance contracts tend to cover substantial financial and personal resources. Otherwise insurance protection would not be necessary.
Insurance brokers try to fill this gap, but doing so create their own problems. Brokers are paid by the insurance companies and invariably end up representing these interests, rather than the clients’. Hence this still leaves the client fending for themselves.
Insurance Management solves this problem, by putting an insurance professional on your side of the table. This professional must be

• knowledgeable,
• fee based and
• completely independent

in order to properly assist the client in purchasing the right kind of insurance, at the appropriate amounts and conditions, from the most reputable insurance companies.
Please se above “Where does Claim Management start?” for some of the details involved in proper insurance buying.
Insurance Management puts the required expertise and knowledge on your side of the table in order to create a level playing field when negotiating with the insurance company.
It is recognised world wide as the only and best solution to the century old problem of dealing with insurance companies.

Is Insurance Management expensive?
Insurance Management must be fee based in order to assure that they remain independent and unbiased in their recommendations and work for the client only.
Most people consider this fee an expense. They are correct in this assessment.
However this fee is more than offset by the savings an Insurance Management professional will realize for the client. Insurance Management professionals work on a “net of commission” basis when negotiating with insurance companies on your behalf. These commissions can be as low as 5% and as high as 40%.
At this rate it is not very difficult to earn back the fee charged even in the first year and put you, the client in a net profit situation. Furthermore, the insurance premiums and their built in savings are payable very year. Management fees for renewals will either be very low or disappear completely.
Hence, we think Insurance Management is profit driven, not expense driven.

Can PT. Usaha Tepat Guna do the job?
We would like to refer you the Risk Management section of this website for all necessary information about our company. We think we can do the job. Our clients think we can do the job. We hope you think we can do the job.

For further contact: service@insurance-shop-intl.com or phone: 515-7750, fax 766-2736, international fax: (1-916) 405-3711

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