CLAIMS SPECIALISTS

At Your Service

claims resource management, inc. was established in 1988 as an independent claims services provider to insurance companies and to companies who self-insure. Our mandate then and now is to provide quality claims handling, using only experienced claim professionals, with specialized knowledge for our clients’ special needs, backed up by state-of-the-art technology.

We began with three people, and have grown to employ over forty. In 1991, we acquired a Third Party Administrator, now known as ACCLAIM Administrators ® , and thereby broadened the services we can provide. claims resource management, inc. serves as a Third Party Administrator for general liability, auto, professional liability and property programs, and ACCLAIM has acted as a Third Party Administrator for certain professional liability programs. We also provide full claims adjustment on an individual assignment basis, reporting back to our clients with details, evaluations, and recommendations for resolution.

Whether you need limited assistance on one claim, or complete turn-key administration of a program or book of business, we can help. For example, we provide the following specialized services:

Further on in thispresentation,we providea detailed description ofour Third Party Administrator capabilities. Many insurers and self-insureds have found the Third Party Administrator to be an efficient, cost effective alternative to more traditional claimsstaff. Whether you are a self-insured without the facilities and experience to recruit, train and house a claims department, or an insurer considering alternatives to adding staff and possibly opening branch offices, we are worth considering. We can serve as an extension of your senior claims management staff, freeing them from routine personnel matters, administration problems and routine claims, allowing them to utilize their talents to the fullest -supervising and managing the high exposure claims that do make a difference to the bottom line.

At claims resource management, inc. we utilize modern communication resources and computer technology to assist in serving your needs. With our state-of-the-art computer system, we can interface with your office via disk, electronically, or even by real time access to our electronic claim and file notes systems.

claims resource management, inc. was founded on the knowledge and experience of its President, Edward J. McKinnon, and continues to engage only the most capable and proficient personnel. With the wide variety of experience our professionals have to offer, you are assured to receive the highest quality claims handling expertise, which can be tailored precisely to your business needs.

If you add up the years of claims experience of just our most senior people, you get close to 150 years of claims handling expertise! In those many years of experience, we have probably seen most every type of property and casualty claim. We have recent experience and expertise in the following specialized areas:

General Liability, Auto Liability, and Property coverages for:

Professional and D& O Liability, including:

Resumes of key staff members are included at the end of this presentation.

INDIVIDUAL CLAIMS EVALUATION

The Cornerstone Of Our Claims Service

Whatever your individual claims needs are, you can count on claims resource management, inc. for quick and knowledgeable solutions, in-house or on-site anywhere in the world. Our innovative approach to tough problems can be illustrated by some very real examples:

Your Problem

Our Solution
You are an excess carrier and you receive notice of a catastrophic injury claim two weeks before trial in a city 2,000 miles from your office. None of your examiners can spare the time necessary to get the complete picture from the primary carrier and its defense counsel. We can have an experienced claims person on the scene within 24 hours, reporting the pertinent facts, as well as giving you a subjective analysis. You will have accurate information and much-needed first-hand impressions to make an informed impressions to make an informed
You are a primary carrier, excess carrier or self-insured, and a Federal Judge on the opposite coast mandates that you have a representative present for a settlement conference; however, your staff is committed to other tasks. A member of our staff can attend on your behalf, follow your instructions during negotiations and give you the crucial benefit of a claims person’s perspective on the events and positions of the parties.

We Protect Your Interests

Our goal is simple: to protect your interests. Whereas a lawyer will evaluate your claim from the viewpoint of an advocate, claims resource management, inc. gets right to the facts. We scrutinize the merits of a claim while keeping an eye on the bottom line. Our review will be candid, balanced and comprehensive, encompassing the downside as well as the upside. Our recommendations will focus on how to achieve the quickest and most economic resolution of your claim.

PROGRAM ADMINISTRATION

A Complete Turn-Key Operation

For clients who want more than individual claims handling, we can handle every aspect of claims administration, from the time claims are first reported to the final conclusions. claims resource management, inc. also serves as a third-party administrator for multiple clients involved in auto and general liability lines.

Much like an insurance company claims department, we conduct full investigations, assign counsel if necessary, handle settlement negotiations, manage payments and prepare reports needed by claims and underwriting.

In other words, we will manage the whole claims program for you, tailoring all features to your requirements.

Current and recent programs include:

We can also help our clients with risk management and loss control, either in seminars or individualized meetings.

We maintain state-of-the-art computer capabilities, and maintain claim files and file notes electronically. We can interface with your claims management system via disk or electronically. We also have our own claims administration program, which can be customized to meet your needs.

Run-Off Management

With our program capability, think of us when you have a book of business to run off. Keeping a division office open when existing claims are in run-off is rarely cost effective. We will handle your run-off quickly, efficiently, and at great savings to you.

OUR CLAIMS HANDLING PHILOSOPHY

You could say we are old-fashioned. Although we use all the latest technology to assist us in our work, we believe that the best way to get the full story, evaluate the damages, and fairly resolve claims is person to person.

We strongly believe in a pro-active approach to claims. Experience has shown us that the only way to achieve appropriate, cost-effective resolution of claims is to promptly and throughly investigate, and aggressively pursue resolution. It is the rare claim that gets better with age!

So, when a claim is reported to claims resource management, inc., you can expect the following to occur:

As we said above, we are old fashioned. None of the above is new. The difference is, we practice it - every day, on every claim. We employ only experienced claim professionals, and management supervises closely to ensure that our standards and goals are more than just a promise - we live them!

There are many ways to reach us to get the process started.

Call 

toll-free at 800-362-4861, or 
direct at 661-265-6400.
Fax to 661-265-6450.
Write

P.O. Box 250, 
33345 Santiago Road, 
Acton, California 93510.

CONSTRUCTION DEFECTS

Expertise Equals Quality

In the last 15 years there has been an explosion of construction defect litigation and resultant insurance claims, particularly in California,aswellasNevada, Oregon, Washington and Arizona. Many of our claim specialists here at claims resource management, inc. have a high level of expertise in this field. CRMI holds licenses in Alaska, California, Florida, Nevada, North and South Carolina, Texas, Utah and Washington.

We can handle construction defect claims of all types, from the first report to file closure, or we can perform individual tasks. For some clients our investigations include on-site inspections of defects, document depository reviews, and statements from appropriate parties. In our reports we provide a thorough analysis of coverage, liability and damages issues, as well as recommendations for reserving and settlement. We can draft reservation of rights and disclaimer of coverage letters, when requested, and negotiate with other insurers whose policies have been triggered by a claim situation. We also attend and provide detailed reports on settlement conferences, carrier meetings, and the like.

For other clients we tailor our efforts to specific tasks. A typical, specific task assignment is a document depository review. We perform depository reviews in a thorough, yet efficient manner. Our reports include charts summarizing the information obtained and, if requested, an analysis of any coverage issues apparent after the review.

Another common task assignment is attending settlement conferences. Several California courts have used the multi-day settlement conference to resolve construction defect claims. Typically, all potentially involved carriers must attend, regardless of coverage issues or remote attachment points. These conferences can be most disruptive to a claims department. By attending on a client’s behalf, we allow the client’s claims staff to remain productive, yet stay abreast of the situation with oral and written reports, as needed.

Whatever the nature or complexity of the assignment, we are confident our experienced claim specialists can provide you efficient, high quality service on your construction defect claims.

AUDIT CAPABILITIES
(Excess, Self-Insured And Reinsurance)

Sacrificing valuable claim personnel to perform the occasional audit is not a practical solution; and, the expense of having an in-house audit staff can be prohibitive.

The solution? Call claims resource management, inc. With our extensive claims experience, we will hit the ground auditing. No time will be wasted and, because an audit is more than the sum of itsfiles,we willgiveyousomething that no by-the-numbers auditor can: the big-picture perspective. Our summary will let you know exactly where you stand and what needs to be done.

Your Problem Our Solution

You are an excess carrier and a primary We can have a team in the field within days carrier tells you its products aggregate is just to audit the primary's files, confirming the days away from exhausting. Your staff is exhaustion. We can arrange for an orderly already working at capacity and cannot transfer, handling any and all phases, possibly absorb 50 new primary files at once, including initial review of incoming files, much less audit to confirm that the prioritizing files and handling claims on an exhaustion is valid. interim basis or through to conclusion.

You are a reinsurer. Your underwriter is preparing to quote a renewal of a casualty excess of loss treaty for an insurer located three states away. You need a detailed audit of their pending claims and your staff is two people short.

We can have one or more of our staff at the company within days. A detailed analysis of pending claims and operations of the insurer will be in your hands well before the deadline.

You are responsible for the claims of a large Our claim professionals can analyze a self-corporation, self-insured for its public liability insured's claims handling service, identifying exposure. Senior management is concerned its strengthsand weaknesses. We can provide about the adverse development of the three anything from reserve analysis to serious case and four-year-old claims. They want identification and control, individual case explanations and solutions. monitoring and detailed consultation on therevamping of a claims operation.

Remember, many auditors go years without handling claim files, whereas ours have continual hands-on claims experience. It is something to consider when you need fast, accurate solutions.

OUR BILLING PHILOSOPHY

As claim professionals, who also pay vendor bills, we are always sensitive to the importance of accurate, fair billing practices. Consequently we have adopted a billing philosophy that we hope our clients will find easy to understand and fair.

Many independent adjusters advertise low hourly rates and then supplement those “low” rates by adding charges for such items as “overhead,” “clerical,” “word processing,” “file set up,” etc. Obviously, all independent adjusters must charge enough to recover such expenses and other overhead, to compensate staff and, hopefully, to make a reasonable profit. We do a lot of work as Third Party Administrators. In that capacity we have retained independent adjusters from all over the country, and in the normal course of business reviewed a lot of bills. If there is any way to predict what such charges will be from adjuster to adjuster or even from file to file with one adjuster, we have never found it. What we do see is that such “overhead” charges add anywhere from 20% to 30% to advertised hourly rates.

When we quote an hourly rate, that is the rate that we actually charge. It may sound higher, but any comparison to our competition’s actual hourly rates reveals that we are very competitive and, more importantly, predictable. The only add-ons you will find on our bills are for actual out-ofpocket expenses such as parking, police reports, actual mileage (at the IRS allowed rate), etc. Our competition charges for these expenses, too. Even here we depart from many of our competitors since we add no mark-up to out-of-pocket expenses. For expenses incurred by our staff, you are charged exactly what we have paid them as reimbursement. For such charges as photocopying and faxes we charge our historic actual costs. Our goal is to make a fair profit from handling claims, not from faxing and photocopying.

Hourly rates are only one component of the final bill. Just as important is the number of hours. Over the years we have interviewed a number of employment candidates with previous independent adjuster experience. Many boast that they consistently billed 80 to 90 hours per week. Our experience has been that we have to work nine or ten hours to legitimately bill eight. Our time billings reflect only actual time and, in many cases, the time we believe an activity should have taken, if that is less. Our minimum time increment is .1, not the .25's we often see. We do not bill for travel outside of normal business hours. If we have to drive two hours to be at an 8:30 a.m. mediation that lasts all day, we might not get back to the office until 7:00 p.m., but you will not see 12.5 hours on your bill.

Our goal is that you will always find that the time billed is appropriate for the task. We always strive to be cost-effective. After all, it is your money that we are spending.

WORLDWIDE CLAIMS ASSISTANCE
As Near As Your Telephone

No doubt by now you have identified a need or two of your own.

No matter what your needs are, you will find our prices to be competitive and flexible. Our services are available on a time-and-expense basis, or flat rates can be arranged when appropriate.

Whether the problem is immediate or upcoming, in-house or on-site, anywhere in the world, call 661-265-6400 and we will be glad to brainstorm with you on the many ways claims resource management, inc. can provide special services designed to meet your needs.



claims resource management, inc.
License No. 2B35861

P.O. Box 250 California
33345 Santiago Road 
Acton, California 93510 
Telephone: 661-265-6400 
fax: 661-265-6450
email: info@crmi.com

claims resource management of nevada, inc.
Nevada License No. 10860

P.O. Box 34510  #298 
Las Vegas, Nevada 89133-4510 
Telephone: 702-639-9178 
email: info@crmi.com

ACCLAIM Administrators®

P.O. Box 250 
33345 Santiago Road 
Acton, California 93510 
Telephone: 661-265-6400 
Fax: 661-265-6450 Internet: 
email: info@crmi.com