Insurance Company Audits

The primary purpose of plan audits or claims activity analysis is to complete a comprehensive independent review of disability or WSIB / WCB plans and their administration. An in depth claims analysis can assist in ensuring all claims are managed to minimize cost and reduce ongoing lost time. Claim reviews can also result in spotting trends that may otherwise go unnoticed. Once errors and trends are identified a program can be developed to improve processes and reduce costs.

Organizational Audits

Organizational Solutions assessments can be used to obtain a baseline for your organization and compare your disability management program to industry best practices. It identifies gaps and results in the formulation of solutions to more effectively manage disabilities and the resultant costs.

The key objectives of these reviews include:

• Problem and solution identification
• Claims Activity Analysis
• Review of work practices & procedures
• Identification of trends for development of prevention programs
• Establish baseline performance and benchmarking with best practices
• Financial Analysis
• Action plans to improve claim handling and contain costs

Benefits of Audit and Claims Activity Analysis include:

• Improved efficiency by the insurance carrier
• Realignment of roles and responsibilities to improve efficiency (internal or external)
• Correction of erroneous claim handling issues (WSIB / WCB or Insurance)
• Recommendations for a superior system of handling claims
• Reduction in LTD reserves and the resultant premium costs
• Reduction in WSIB / WCB costs

Audits and Gap Analysis are an essential part of efficiently operating your business.