Claim Audit and Premium Analysis Services Company




WAS PLAN “A” BY YOUR COMPANY TO PURCHASE A WORKERS’ COMPENSATION POLICY TO PROTECT ITS INTERESTS, CONTROL ITS LOSSES, LIABILITIES AND PREMIUM?


HAS IT WORKED???


Has plan A worked?

DOES YOUR COMPANY CURRENTLY:


  • Have a concern over increased premiums?

  • Have a premium dispute with your carrier?

  • Have an issue pertaining to Class Codes, Class Rates or Payroll Audits?

  • Have issues with Collateral Requirements?

  • Have a dispute pertaining to policy interpretation?

  • Have a concern over an increase in its Experience Modification Factor?

  • Have a concern over claims being handled reasonably/properly by your carrier or third party administrator?

  • Have a concern with your carrier or third party administrator’s explanation for excessive claim payments?

  • Have a concern that unreasonable/improper claim handling is negatively impacting your premiums?

  • Have a singular problematic claim, or claims, that remain open with no direction for resolution or closure?


DOES YOUR COMPANY FEEL AS THOUGH NO ONE IS LISTENING OR ADDRESSING THE ISSUES???

MAYBE IT’S TIME TO INVESTIGATE PLAN “B” WITH AN INSURANCE PROGRAM REVIEW AND CLAIM AUDIT THAT WILL PROVIDE YOUR COMPANY WITH AN ACCURATE ASSESSMENT OF RISK, CLAIM LIABILITY EXPOSURES AND MONETARY DAMAGES.

CAAPASCO is a Claim Auditing and Premium Analysis Company that uses claim file auditing and insurance program reviews to ensure that complex insurance issues and claim exposures are being addressed with sound risk and claim management techniques


Claim Audit and Insurance Program Review Services

A Claim Audit and Insurance Program Review by CAAPASCO will include a comprehensive review of the Insurance Policies, Side Agreements, Policy Interpretation, Loss Summary Reports, Experience Modification Worksheets, Payroll Audits, Classification Codes, Classification Rates, Billing Invoices, Retrospective Adjustments and claim files that are identified for auditing in order to analyze whether the carrier and/or third party administrator have complied with their contractual obligations and the correct amounts are being charged to the policyholder. It will analyze if claims have been handled reasonably/properly, if a liability was established prior to making claim payments, if the payments made were accurate, and if the workers’ compensation injuries claimed were causally related to the work accident. It will identify and quantify the costs and damages associated with insurance program irregularities and unreasonable/improper claim handling not only in the policy year in question but also in subsequent years.



PAST PERFORMANCE

While every case is different and there can’t be any guarantee pertaining to an outcome, a CAAPASCO Insurance Program Review and Claim Audit is an unbiased examination to investigate and analyze the issues confronting your company. The principal at CAAPASCO has participated in over 45 litigated cases against various workers’ compensation carriers, has given numerous depositions, has given testimony in numerous cases in Federal and State Court, as well as Arbitration, as an expert witness in matters related to workers’ compensation with over $33,000,000.00 recovered on behalf the insured/employer. (See Litigated Cases for a listing of cases where Mr. Wills has provided worker’s compensation expert witness services. References can be provided upon request).