Consulting

Claims Auditing

Risk Retention Services has managed thousands of claims and lawsuits. This has provided us the expertise to audit your claims system and identify areas of potential loss or improvement. These can include systemic recommendations, or control recommendations, that can minimize your losses through enhanced performance.

  • Performance Audits. It is not unusual for a prospective client to tell us that their claims costs “seem to be too high.” The question becomes whether your claims manager is maximizing resources to achieve the best possible results.
  • Our Performance audits focus on the following areas:

    • Investigation Process and Performance. The first step in any claims process includes appropriate investigation of a claim. Are your investigations complete and cost-effective? If not, is the problem one of procedures or implementation? Our review will identify areas of improvement in this critical first step.

    • Systems Review. Our audits will identify patterns or areas where improvements may be possible. Often, relatively simple procedural improvements and controls are required. Sometimes implementation of stated policies is the exception instead of the rule. In those instances, whether it is internal personnel or third party vendors and professionals, methods and controls are recommended to maximize your results.

    • Liability Analysis. Even if you properly investigate a claim and have the procedures in place, a proper system of liability analysis is essential. Are you settling cases that should be denied? Are you denying claims that should be settled? Are you settling cases that should be resolved early – before the expenditure of substantial sums on defense? Our performance audits will evaluate your liability analysis and suggest proven methods of reducing your indemnity payments.

    • Damage Assessments. Where settlement is appropriate (either because of a business’s preference toward settlement, or the liability analysis shows that a successful defense is unlikely), an accurate damage assessment is essential. An undervalued claim can result in increased costs because of the protracted time required to reach settlement (taking you to where you should have started). An overvalued claim can result in over-reserving the file, as well as paying too much in indemnity payments. We evaluate damage assessments, both in the procedures utilized and the outcome, and recommend ways to improve results.

    • Legal bill audits. Regardless of the procedures employed, legal representation is expensive. Our legal bill audits are tailored to our clients needs. Our services may include attorney time, as well as litigation process reviews. When an attorney knows that all bills are carefully reviewed, they do not pad those bills, or charge for unnecessary (and unapproved) services. Risk Retention Services has effectively managed hundreds of litigation cases, and knows how long tasks and efforts should take and charges that are reasonable.

    • Litigation Procedures. We review your litigation procedures to ensure that your expectations are clearly delineated and communicated to the attorneys. Where the procedures are not clearly articulated, we work with you to ensure that such procedures are set forth in a way that states your business philosophy, your expectations, and which tasks that will and will not be paid for, as well as the basis for that payment. Traditionally, attorneys send a letter of retention to clients setting forth their expectations. When billing disputes arise, you will hear “this is how we do it and it is in the letter of retention.” We help you take control of the litigation – and the attorneys – by sending out your expectations and your terms. When an attorney fails to follow these procedures, the task is not compensable.

    • We recognize that management procedures, effectively implemented, can help you ensure that the legal fees paid are for tasks that advance the litigation, serve your interests, and are not needlessly increased by questionable tasks or fees.