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 / CSST plans and their administration. An in depth claims analysis can assist in ensuring all claims are managed in accordance with the contract / legislation in order to minimize cost and reduce ongoing lost time. Claim reviews can also identify 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 Inc.'s  CADMAT©. tool uses evidence based best practice to evaluate your disability management program.  It identifies strengths and 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
• Formulation of 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 / CSST or Insurance)
• Recommendations for a superior system of handling claims
• Reduction in LTD reserves and the resultant premium costs
• Reduction in WSIB / WCB / CSST costs

What gets measured gets done, what gets audited gets done right.