The claims services administration and advocacy practice at The Plexus Groupe provides clients with a single, readily available point of access to carriers in all lines of business. As part of our commitment to service, we assure that all necessary claims resources are made available and coordinated to help you through any claim or potential claim situation. We have the claims and legal expertise to address the diverse types of losses you may encounter and the industry relationships to work with underwriters, adjusters, TPAs, attorneys and others to make certain that claims are handled timely, efficiently and in your best interest under the terms of coverage.
Moreover, prior to a claim, the Plexus Claims Services Team will invest the time to understand your internal policies, procedures and programs to assist in best positioning you to deal with anticipated risk. We can help guide you through the various coverage options and wordings available in order to prioritize insurers and fashion an approach to overall claims management tailored to specific objectives.
The Plexus Claims Services Team brings decades of legal and claims experience specializing in a broad range of risks including professional liability, management liability, general liability, product liability, business, automobile, property, inland marine, medical malpractice, workers’ compensation, and employee benefits stop loss coverage. Plexus claims services include:
- Review of emerging case law and other trends impacting claims incidence and severity
- Explanation of policy provisions and advocacy of appropriate alternatives
- Guidance through the complex legalities of Directors and Officers and other management liability or specialty insurance contracts
- Contract review addressing contractual obligations and risk transfer recommendations
- Timely, accurate loss reporting and monitoring, including availability 24/7 for emergency and disaster response, monitoring of liability, reserves, and timeliness of payment, and resolution of issues with carriers and outside adjusters
- Management and coordination of claims reviews and audits, including focus on resolution strategy and accelerated claim closure
- Client-focused in-house risk management services, such as analytics on claim trends and recurring injury/loss patterns, evaluation of defense counsel, third party administrators, emergency response procedures, crisis management, property damage mitigation, and OSHA reporting
- Advice on carriers’ coverage positions
- Intervention to resolve areas of disagreement, including coverage denials
- Discussion with underwriters, senior management, claims staff and outside claims counsel
- Evaluation of choice of counsel, conflict issues, claims strategy, scope of work and costs
- Communication on significant claims developments
- Monitoring of liability, reserve and payment issues
- Management of the entire claims process, including negotiation of claims resolution
Our organizational structure allows us to tailor the appropriate personnel and service model to your account.
Plexus Claims staff includes:
- A senior claims and litigation attorney with over 25 years of experience with an internationally-recognized law firm practicing in claims consulting and coverage litigation for major domestic and global insurance carriers dealing with high-exposure lines of professional, corporate governance, property and casualty, and errors and omissions liability.
- A senior claims analyst bringing 20 years of claims handling experience in diverse specialties including general liability, medical malpractice, workers’ compensation and product liability, and possessing an excellent understanding of the large property damage and business income exposures facing our clients, as well as significant prior experience with insurers and third party adjusters.
This wealth of insurance industry experience is now available to Plexus clients.