In early 2019, a physician insurance carrier that self-administered their medical professional liability claims for physicians across all specialties took a hard look at their results and found
Their efforts to improve underwriting policies and results were hindered by their inability to utilized data and analytics effectively. That, in turn, made it difficult to support a desired investment in risk control, underwriting, and innovative technology solutions to improve program results and member satisfaction.
The client chose ESIS ProClaim as their new outsourced claim administrator and charged ESIS with two goals:
ProClaim reengineered the client’s claim processes and policies, driving improved outcomes while simultaneously delivering great service.
Over a 12-month period the ESIS ProClaim team:
As a result of ESIS ProClaim taking over their claim management, the company showed an underwriting profit for the first time in several years.
A global entertainment company had a large self-insured retention – and a problem with escalating legal expenses. Their general counsel identified recent increases in outside insurance defense legal expense as an area where better management would improve profitability. Specifically, Counsel was concerned about poor management of assigned defense counsel on litigated claims by the incumbent TPA. Counsel believed the TPA was allowing claims to unnecessarily become litigated by failing to resolve legitimate claims and failing to detail claim denials appropriately.
To help them reduce legal expenses, the company selected ESIS ProClaim as their new TPA.
ESIS ProClaim instituted our proactive early resolution approach, which includes litigation avoidance where appropriate. In addition, the ProClaim team understood that our interactions with the client’s guests are an extension of the guest’s overall experience. Our commitment to delivering an exceptional customer experience to the guests reinforced our client’s brand and their commitment to their guests, which further helped to reduce litigation and litigation expenses.
A one year look back of closed claims shows significant improvements in the client’s claims program:
A leading London syndicate and the following markets conducted an analysis of their 2019 claims for a miscellaneous professional liability program handled by their current TPA and found a number of issues:
The markets agreed that a change was necessary to improve their results. After interviewing multiple TPAs, they selected ESIS ProClaim to serve as the their new TPA to manage both new and legacy claims.
The ProClaim team delivered immediate improvements in program results. Within one year:
We start with a dedicated team of specialists — comprised of attorneys, nurses, and adjusters with an average of 25 years of experience. The ESIS team’s expertise means they understand how to
The team is backed by a dedicated account and data management team. In addition, ESIS ProClaim’s client-focused risk consulting practice helps clients effectively manage their risk management program. Our consulting and assessment services complement your ongoing safety and improvement efforts while addressing key areas of risk.