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HM Risk and Benefits HM Risk and Benefits
  • About HM
  • Property
  • Employee Benefits
  • Personal
  • Claims
  • ​Specialty
  • ​Industry
  • Contact HM

Claims Management & Loss Prevention

  • Claims Management
  • Loss Prevention
  • Claims Cost Control
  • Alternative Claims Solutions

Claims Management

HM’s claim department will work as your liaison to assure that the provider(s) are managing your claims appropriately. Most importantly, we will work with you to develop special account instructions for the provider(s) to follow which will include their commitment to claim reviews, reserve and settlement authority levels, reporting requirements, system access, and other issues of significance to your company.

In conjunction with your direction and needs, dollar thresholds will be set and agreed to by the provider(s). Our claims department will develop protocols to follow the handling of claims exceeding those thresholds and keep you informed of significant developments. Settlement authority levels will be agreed to and provider(s) will be required to notify both you and HM when claim facts develop which indicate that such levels may be surpassed.

The team member assigned to your account will proactively review claims above specified dollar levels and those that are of special interest to you on an on-going basis. Along with the claim provider(s), we will keep you informed of significant developments and issues. By doing so, we focus our efforts on avoiding any surprises as a claim progresses. An eye will be kept on reserving practices of the provider(s) and as claims are consistently reviewed, reserves will be examined.

HM will coordinate formal claim reviews with the provider(s) at a frequency agreed to by you. We will require that the provider(s) prepare written status reports on qualifying claims and discuss their status with representatives of each of our companies. By doing so, we can assure that the provider(s) has adequately handled and reserved the claim.

We are available to offer guidance on the administration of self-insured claims. We will discuss specific claim issues of concern to you and provide recommendations on plans of action. Our breadth of experience and variety of clients provides us the opportunity to present various approaches to claim resolution.

The combined experience of the HM claim service team covers all facets of the claim handling process. We have participated in claims from the perspective of a client, a carrier, a third-party administrator, and a broker. This well-rounded knowledge provides us the insight to proactively oversee your claim management process and provide advocacy on your behalf.

Loss Prevention

​Loss prevention is a critical aspect of any risk management program.  While each industry has special needs and unique challenges regarding safety; HM is dedicated to assist with your specialized needs. We will evaluate and assist you in developing a program designed to meet those specific needs.  Aside from program reviews, we have the expertise to perform on-site audits and conduct targeted training designed to address any deficiencies. HM not only focuses on workers’ compensation loss prevention but routinely conducts analysis for general liability and auto liability exposures. We will perform a detailed in-depth data loss analysis to identify any adverse trends and patterns while working with you and your carrier to develop a financially feasible program designed to address any adverse trends identified.

Claims Cost Control

HM will assist you in establishing claim handling procedures for all types of claims while keeping your company’s best interests in mind.  We will evaluate existing and prospective claims departments and third party administrators (TPAs) and recommend the provider(s) best suited to meet your claim and information requirements.  Emphasis will be placed on a comparison of the medical management and cost containment attitudes and protocols of the provider(s) to ensure that they fit into your company’s insurance and claim philosophies.

We will require that the provider(s) selected to handle your claim needs provide both you and HM with access to their claim and analytical systems.  Access to real-time claim adjuster notes will allow us to analyze the claim handling process to determine if the provider(s) are managing the claims appropriately which has a bottom-line effect on your overall insurance costs.  In addition, reporting capabilities will allow us to examine the point-in-time financial impact on your program.  It will also enable us to review claim data for accuracy on issues such as site codes, cause of loss, allocation tagging, loss reserving, and claim settlement.

Alternative Claims Solutions

Through our partnerships, HM provides clients with open insurance claims in excess of $250,000 options to monetize those claims rather than wait for the carrier to offer a settlement. These solutions provide a guaranteed recovery for businesses with insurance claims, thus offsetting the insurance companies’ attempts to delay and discount the payment of those claims.

Often times insurance companies simply cannot settle a claim in a timeframe that meets the needs of insureds due to the volume of claims or the complexity of a particular loss. These options provide an alternative to playing the insurance companies’ waiting game by monetizing claims immediately. These financial solutions allow our clients to recover an immediate cash infusion to get their operations back up and running, to add to the bottom line, or to clean up the balance sheet. Our clients can then return to their core competency of running their business.

Many businesses do not have the luxury of time to wait for a settlement or do not want to hire expensive lawyers to prosecute their claims. Business owners also understand the lost opportunity costs associated with a delayed settlement and the resources and time required to chase payment for a claim. These solutions are ideally suited for businesses that recognize that certainty of a hassle-free result is often more valuable than allocating resources to pursue an uncertain potential future recovery.

Whether you are faced with operational survival as a result of an insured incident or simply a need to clean up your financial statements, our partners provide solutions to remove the risk and uncertainty of the claim. These alternatives guarantee immediate value to our clients allowing them to recognize the revenue from their insurance claim on a real-time basis. Simply stated, this allows a company to monetize the asset of its insurance claim NOW so our clients can get back to business.

  • Solidify financials prior to your next reporting period
  • Keep your company in business
  • Combat “claim fatigue”
  • Monetize previously abandoned claims

These solutions can provide alternatives for several types of claims, including:

  • Property
  • Business Interruption
  • Employee Theft/Crime
  • Liquidated Liability
  • Transactional
  • Representations/Warranties

Feel free to contact us to discuss your claim with one of our professionals.

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HM Risk & Benefits

  • St. Louis Headquarters
  • 8235 Forsyth Boulevard, Suite 1200, St. Louis, Missouri 63105-1643
  • Toll Free: 800-489-6626 | 314-746-4700
  • 314-889-3700
  • https://hmrisk.com/
  • Springfield, MO Office
  • 2925 E. Battlefield, Suite 120, Springfield, Missouri 65804-4020
  • Toll Free: 844-432-1010 | 417-895-4600
  • 417-895-4602

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