PRODUCTS AND SERVICES 

We start every business relationship by listening and learning what matters most to you. Each service agreement is crafted to meet your individual needs and to commit to specific standards that guarantee your satisfaction.

The insurance products we adjust include:

General liability
Bodily injury, personal injury, property damage, guest’s property, premises damage, medical payments, products & completed operations, liquor liability, advertising, business income and extra expense, garage keepers, umbrella and excess.

Construction defect
We adjust claims involving all aspects of construction liability and construction site accidents including bodily injury, property damage, fire legal liability, medical expenses, personal and advertising injury.

Automobile liability
Bodily injury, property damage, collision, comprehensive, med pay, no fault BI and PD, and uninsured/ under insured motorists

The services we provide
We offer cost-effective “cradle-to-grave” claims management to buyers who place value on service, information, and bottom-line results. Our services include:

1: Taking initial report of claims
2: Investigation & recorded statements
3: Medical evaluation
4: Surveillance & fraud resistance
5: Expert testing and witnesses
6: Reserves and payments
7: Alternative dispute resolution
8: Hearings and arbitration
9: Settlement conferences
10: Attorney selection and oversight

SERVICE DETAILS

Claim reporting
You can report claims 24-hours a day, 365 days a year. We make it easy with three different methods: email, fax, and phone. Within three working days of receipt of the first report, your specialist will be assigned and initial calls will have been made.

Claim investigation
You want to know that we have mastered all the facts of each case as quickly as possible. This begins with a thorough investigation of the incident. We contact your facility, and any injured claimant, within two working days of receipt of the first report. When circumstances dictate, we will personally inspect the site, or hire trusted investigators to do so. If expert testimony will be critical to determine liability, or build a defense, we bring in the best available. When a medical evaluation is crucial, we use proven physicians to conduct independent medical evaluations. We hate fraud as much as you do, and will detect and work with you and your carrier to prosecute it to the full extent of the law.

Subrogation
We look at every possibility for reducing your claim burden. On every claim, we identify those who bear responsibility and aggressively subrogate and seek contribution on your behalf.

Litigation management
It is a stressful moment when you receive notice of a lawsuit. Certus Claims is immediately by your side to turn the focus to what must be done to resolve the issue in a cost-effective, timely manner.

You don’t have to worry about assembling a team of professionals who are every bit as tough-minded as the plaintiff’s counsel; we do that for you. We monitor expenses, find the right strategy to settle or defend, and look for creative ways to make use of alternative dispute resolution.

We manage all litigation. Our specialists put together a litigation plan of action and team up with skilled regional defense attorneys. We know local law and case precedent as well as jury and judicial tendencies.

Self-insured retentions
If your insurance program includes a self-insured retention, we are the TPA of choice. We establish and manage trust funds, and we have designed custom modules in our claims management system so that we can provide you with detailed reports on what has been paid within, and outside, your retention. You choose the account type, including zero balance, wire transfers, ACH accounts, or traditional checking accounts.

Information systems
You can’t afford to be in doubt about the status of claims, what caused them, and what they are costing you. We answer all these questions and more with one of the most advanced, flexible computer claims systems available. With the Certus claims system:

• We are “scalable” which means we can meet your needs no matter how large you grow

• We can send you reports in a pre-arranged format of your choosing

• You can download information into tables or spreadsheets that you manipulate

• You can access your account on-line

• You can choose from over 100 standard reports, including claim trends and graphs

• Data is current the moment the report is run, or a date in the past you pick “as of”.

• If you have an SIR or deductible, our reports let you know the status of your funds

Claim reviews
You can arrange to discuss claims with your specialist face-to-face. We are available for periodic claims reviews to provide you with complete updates and insight into our plan of action for your claims.

Training & workshops
If you have a specific training need, we can meet it. You may want to improve your results with better in-house procedures, claim supervision, litigation strategies, crisis management, or claim auditing. We can provide the professional training and consulting you need.