1 / 22

The Claims Process

The Claims Process. Bryan J. Graff Director, Client Services Sedgwick Claims Management Services, Inc. The Claims Process – Beginning. Incident or Event occurs Claims reporting plan in place Information needed Confirmation Submit information. Reporting a claim.

porters
Download Presentation

The Claims Process

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Claims Process Bryan J. Graff Director, Client Services Sedgwick Claims Management Services, Inc.

  2. The Claims Process – Beginning • Incident or Event occurs • Claims reporting plan in place • Information needed • Confirmation • Submit information

  3. Reporting a claim • Web Enabled : ClaimCapture™ • Email: 6410stateoflouisiana@sedgwickcms.com • Fax: 855-563-2447 • Phone: 855-267-4400

  4. www.laorm.com

  5. Access to ClaimCapture™ ClaimCapture Access form (Only for ClaimCapture Access) Location Codes

  6. Line of Coverage Location(s) Authorization

  7. Transportation Claims Reporting • Accident Report Louisiana State Driver Safety Program Form: DA 2041 • Vehicle Glass Repair/Replacement Loss Notice: DA 2073 • Email or fax form • Send further evidence to brxmail@Sedgwickcms.com

  8. Agency Information Vehicle Identification Number Accident Description Other Vehicle Information Passenger and Witness information Submit claim

  9. Agency Information If not owned by reporting Agency Description Windshield

  10. Workers’ Compensation Claim Reporting • In an Emergency, get injured worker assistance ASAP • Log into ClaimCapture™ • Answer to the best of your ability • Receive confirmation with Claim Number • Send further evidence to brxmail@sedgwickcms.com • DA2000 completed (Safety)

  11. General Liability Claims Reporting • Link to ClaimCapture™ http://claimcapture.sedgwickcms.com/ • Answer questions • Tutorial available • DA 3000 completed (Safety) • Send further evidence to brxmail@sedgwickcms.com

  12. Property Claim Reporting • Form located at www.laorm.com • Location • Type of Loss • Description of loss • Disaster Recovery and Emergency Remediation Guide http://www.doa.la.gov/Pages/orm/Property-Claim-Reporting.aspx • Send further evidence to brxmail@Sedgwickcms.com

  13. Agency Information Building Information Type of Loss Description Submit Claim

  14. Life Cycle of a Claim – Conclusion • Submission • Processing/Evaluating/Investigation • Adjudication • Resolution (payment/denial)

  15. Loss Analysis • Available Reports • Monthly Pending Claim Report • Monthly Opened Report • Monthly Closed Report • Weekly Leave Buy Back Report

  16. Opened Report (sample) File Number Claim Name Descriptions and Cause

  17. Pending Report Indemnity or Loss Paid as of As of Date

  18. Closed Report Total Indemnity/Loss Paid Date claim Closed

  19. Weekly Leave Buy Back Payment Period Payment Amount Payee Name

  20. Loss Analysis • To Register (separate process than ClaimCapture request form) • www.laorm.com • Loss Analysis • Request Form

  21. Types of Reports Lines of Coverage Location Information Authorization

  22. Questions???

More Related