Claims Process

1. Claims Process LIFE OF A CLAIM Intakeand Assignment Investigation Evaluation Resolution BeginningEnd

2. Claims Process Report of Claim Contact With Insured Assignment Of Defense Counsel Assignment to Claim Analyst Contact With Claimant INTAKE AND ASSIGNMENT Assignment Of Defense Counsel File Responsive Pleading Initial Meeting with Insured Obtain Authorization Or HIPAA Order Claims

3. Claims Process Acquisition of Medical Records Medical Reviews Medical Research INVESTIGATION Initiate Written Discovery Initiate Depositions Of Fact Witnesses Depositions of Expert Witnesses Identify and Designate Expert Witnesses Claims

4. Claims Process Evaluate Potential Damages Other Factors Evaluate Liability Exposure EVALUATION Motion for Summary Judgment Evaluate Potential Damages Evaluate Liability Exposure Other Factors Claims

5. Claims Process Claim Analyst Recommendation Claim Decision Claims Meeting RESOLUTION Recommendation To Claim Analyst Pretrial Conference Trial Appeal Settlement Conference/ Mediation Trial Preparation Claims

6. Report of Claim • Sources include insured, HCSF, Petition, Plaintiff Attorney • Obtain pertinent information • Verification of coverage Claims Intake

7. Contact With Insured • Initial confirmation by telephone • Initial meeting • verify facts • obtain copy of medical records Claims Intake

8. Contact With Claimant • Explain claim procedure/timeframe • Confirm facts and allegations • Obtain authorization to obtain medical records Claims Intake

9. Assignment of Defense Counsel • Only for screening panels or lawsuits • Prior representation of insured • Geographical location • Area of expertise Claims Intake

10. Acquisition of Medical Records • Collection of medical records • Organize and Bates-stamp records by provider • Internal review of records Claims Investigation

11. Medical Research • Internal research • Medical Library Claims Investigation

12. Medical Reviews • Copy of medical records forwarded to reviewer • Telephone interview of reviewer • discussion of facts • standard of care • opinions • questions Claims Investigation

13. Evaluate Potential Damages • Medical bills – past and future • Lost wages – past and future • Non-economic damages – pain and suffering; mental anguish, etc. • Other Claims Evaluation

14. Evaluate Liability Exposure • Was there a deviation from the Standard of Care? • Was there comparative fault of others? • Was there contributory negligence by the Plaintiff? • Was there a superseding, intervening event? • Did the deviation, if any, cause the Claimant’s injuries? Claims Evaluation

15. Claim Analyst Recommendation • Defend • Settlement • Tender to HCSF Claims Resolution

16. Claims Meeting • Medical/Legal evaluation • Team approach • Physicians/Lawyers/RNs/Claim Analysts Claims Resolution

17. Claim Decision • Deny/Defend • Initiate settlement discussions • Tender to HCSF Claims Resolution