Reduce total incurred, control reserves, and improve claim outcomes with real-time oversight.
Real-Time Claims Oversight to Reduce Total Cost of Risk
Bowen, Miclette & Britt offers corporate claims monitoring services in all 50 states. Our consultants and experts organize and monitor claims to ensure efficient settlements with minimal employer risk. We are available to monitor insurance claims for companies of all sizes, so contact us to request a quote.
Our Claims Monitoring Process
Our claims professionals assist with the following processes:
Claim Examination
We receive the claim and analyze its details to understand the incident and how it relates to your policy’s coverage. We also verify the claim’s legitimacy to prevent losses from fraudulent claims.
Policy Review
A claims monitoring consultant will delve into the policies your organization holds. Our associates will understand the types of incidents your policies cover to gauge liability and resolution expectations. A thorough review allows us to respond to claims quickly and accurately.
Claim Adjustment and Resolution
After passing an initial examination, a claim moves into the adjustment phase. Your insurance provider will determine if it will cover the claim and the extent of the compensation. Adjustment establishes the exact amount due to the customer.
From there, we ensure a swift and accurate resolution to the claim. We will mobilize medical and legal professionals to review the claim and ensure the compensation agreement matches the circumstances. Your claims monitoring consultant will complete all paperwork and submit all payments on time to expedite the resolution.
Record Keeping
We enter each claim that we process into a database alongside past claims. Our database contains information such as the reason for the claim and its outcome. Maintaining detailed records allows us to compare new claims to past situations. We will determine inefficiencies and common risks that result in insurance claims.
Schedule a Claims Strategy Call
What’s Included in BMB Claims Monitoring
We offer claims monitoring services that help businesses reduce claims expenses, satisfy legal requirements and restore workplace productivity. Our claims management capabilities include:
Open Claims File Review
A report is generated showing all claims currently open under all lines of insurance. The report will detail facts of the claimant as well as show amounts paid to date and reserves set by the carrier. A claims manager will meet with the client to provide up-to-date information and discuss possible resolution strategies. The report also shows loss trends over the past 5 years to help assess emerging risk management and safety concerns or to demonstrate that risk management awareness and efforts are yielding positive results.
Catastrophic Loss Response
Clients are provided 24/7 Emergency Response Contact Cards. We respond to all large losses immediately upon notification. We have an established network of professionals including attorneys, accident reconstruction experts, engineers and adjusters. When a large or unusual loss occurs, we dispatch our network of professionals and immediately notify the insurance carrier.
Integrated Claims Monitoring System
Financial data is updated monthly from the TPA (third party administrator) or carrier. Loss runs and loss graphs can be created. Loss runs also contain the availability of a claim allocation system and tracking of claim handling fees. The Integrated Claims Management System allows for:
- Access to individual claims and claim analysis reports
- Claims and claim analysis reports are available 24/7
- Assists Claims/Risk Management/Fleet/Accounting by providing information to increase productivity and efficiency
- Interactive claim management systems allow:
- Ability to categorize claims for managing and specific reports
- View and add activity notes
- View reserve history for tracking increase/decrease in exposures
- Capability to report claims online
- Established triggers to provide e-mail notification for new claims established; reserve threshold exceeded
Management Reports
Claims information is consolidated and distributed in the form of customized reports to allow for internal claims allocation, monitoring of financial activity and loss analysis. Example reports:
- Claims Financial Summary – A one-page “snapshot” by policy year, coverage, open, closed, loss type and large claims limited at deductible levels. This report also includes a summary recap by policy year and coverage to track monthly changes.
- New Claims Activity – A detailed list of new claims reported in a given month
- Closed Claims Activity – A detailed list of closed claims in a given month
- Change in Total Incurred 10K – A detailed list of claims where the reserves were increased or decreased in excess of $10,000
- Open Claims Report 25K – A detailed list of open claims, at the accident level with total incurred reserves in excess of $25,000
Benefits of Claims Monitoring (Faster Closures, Better Reserve Control)
Maintaining an efficient and accurate claims management process is critical for any business.
- Settle claims faster and at a lower cost by gathering complete, accurate information and reviewing the information to prevent backtracking
- Prevent insurance fraud by analyzing claims under a fine microscope
- Resolve each claim within a policy’s parameters without overpaying or underpaying
- Resolve claims faster so that employees can return to work sooner and productivity can resume
- Ensure customer satisfaction by returning your workforce to its most efficient form
- Secure sensitive company and customer data
What is Insurance Claims Monitoring?
Insurance claims monitoring is an ongoing process where a dedicated team tracks open and closed claims, reviews documentation, and analyzes reserves and total incurred to improve outcomes. The goal is to identify red flags early, reduce unnecessary claim costs, and support faster, cleaner claim resolution, without disrupting the normal adjuster process.
How is Claims Monitoring Different from Claims Management?
Claims management typically refers to the overall handling of a claim from intake through settlement, often led by the carrier or TPA. Claims monitoring is more like oversight and optimization, reviewing claim progress, reserve changes, documentation, and strategy to ensure the claim is trending toward the best outcome for the employer.
Which Types of Claims Can You Monitor?
Claims monitoring can apply across multiple lines depending on your program, commonly workers’ compensation, auto, general liability, and other high-frequency or high-severity exposures. The right scope depends on where you see the greatest financial risk, operational disruption, or litigation exposure.
What Does an Open Claims File Review Include?
An open claims file review typically includes a report of all open claims with amounts paid to date, current reserves, total incurred, claim status, and key claim facts. It also highlights loss trends over time and identifies claims that may require strategy changes, additional documentation, or escalation due to severity or reserve movement.
Why is Reserve Control Important?
Reserves impact your total cost of risk and can affect how carriers underwrite and price your program at renewal. If reserves are set too high without proper support, it can make your loss experience appear worse than it is. Monitoring reserve changes helps ensure reserves are aligned with facts, documentation, and realistic outcomes.
How Often Should Claims be Reviewed?
For most organizations, monthly monitoring with periodic deeper reviews works well, especially when financial data updates monthly from the carrier/TPA. Higher-risk programs or severe claims often benefit from more frequent check-ins and rapid response protocols when specific triggers are hit.
Can Claims Monitoring Help Reduce Fraud?
Yes. Claims monitoring can help identify inconsistencies in claim details, patterns across claimants, or documentation gaps that could indicate potential fraud or exaggerated claims. Early detection allows employers and adjusters to take appropriate steps quickly, which can reduce unnecessary payouts and administrative burden.
Request a Claims Review
Reach out to our team today to see how our corporate claims monitoring services can help your organization.
