Claims Management definition

Claims Management means the process of identifying, controlling and resolving demands by individuals or public entities to recover losses from any Member of the Association. Disposing of such demands for payment requires skills in insurance law, adjusting/investigation, loss control engineering and general business. Claims management is the function of supervising legal, adjusting, investigation and engineering services to resolve such demands.

Claims Management means handling matters related to customers or third parties bringing a claim against a Party or claims by a Party against customers or third parties, including investigations, litigation support, and settlements.

Claims Management means the entirety of the functions which are necessary for or incidental to the receipt, assessment, determination, payment, administration, review, finalisation and recording of a Claim.

Examples of Claims Management in a sentence

• The reporting requirement will be documented in the Claims Management System.

• Under a Claims Management Agreement entered into by the Company, AICF manages and resolves claims and pays payable liabilities on behalf of the Company.

• Claims Management in DPS enables the customer to work directly with the TSP to obtain settlement for any loss, destruction, or damage to their belongings while the goods were in the possession of the TSP.

• Provide an overview of the Claims Management Program that your organization would use.

• Claims Management To reduce the risk exposure of the Syndicate, HMA has put in place strict claim review policies to assess all new and ongoing claims.

• As part of this Electronic Claims Management (ECM) function, the Contractor shall also provide on-line and phone-based capabilities to obtain Claims processing status information.

• The County hired a third-party administrator, Sedgwick Claims Management Service, Inc., to review and monitor all claims on behalf of the County.

• Provide an overview of the Claims Management Plan that your organization would use.

• I understand and agree to let the University of Illinois Claims Management office adjudicate the claim and will abide by their findings.

• More specifically, patient information should only be relayed to those persons involved with the patient’s treatment; persons designated by Baptist Health Lexington who are responsible for quality improvement; or as requested by Risk Management, BHS Legal Department and/or the hospital’s defense firm as necessary for Risk and Claims Management activities.

More Definitions of Claims Management

Claims Management. To the extent different from Operational Accounting, Prudential Management and Underwriting Management, any System or Control and/or Mediation Activity in order to identify, account for, audit or otherwise analyse or verify, reserve against, settle, indemnify for or otherwise pay, or receive, any incurred or potential Flood Risk, including by way of any claim on any Inwards Reinsurance, Retrocession and/or ART Contract, including by reference to any event or circumstance which constitutes, gives, has given or may give rise to any Flood Risk in whole or in part, as further particularised in SOR section 5.4

Claims Management means Third Party Claims Management, Inc., a Connecticut corporation and its successors and assigns.

Claims Management means if you can’t prevent an injury, you can at least contain the financial damage. The employer has the onerous “burden of proof” meaning if you don’t have paper, you don’t have a leg to stand on. To avoid getting caught in a whirlwind of stories and injury causes that can change on a dime leaving you without support always address the following:1) Accident Investigation – Your way to guard the truth. Never forget the devil is in the details.2) Light Duty – Your only way to stay in control no matter how difficult it may be. Remember, the system makes the rules and has both the ability and the desire to enforce them whether you agree or not. In the end, don’t bepenny wise and pound foolish. Be smart and not predictably reactionary.3) Injured Worker Contact - Your way to learn of and report to your carrier unusual events, oddities of timing or observations that contradict the employee’s injury condition whether at work or if they are seen around the local area.

Claims Management means the effective coordination of all activities associated with the just and economic resolution of an injured Worker’s Claim and includes activities associated with determining liability, providing Benefits and processing the Claim.

Claims Management or "Claims Management Services" shall mean the process by which claims for payment are paid to Network Providers (but not non-Network Providers or non-Participating Providers) for Home Health Services provided to Network Members, including emergency and urgent services as defined by the Health Care Financing Administration, and records that are to be maintained of claims and payments for such services. Network shall provide Claims Management Services in accordance with Company standards, subject to Network's ability to cure pursuant to section 6.F hereof. Network represents, warrants and agrees that at all times its provision of Claims Management services meet or exceed (i) all Company standards, policies and procedures; (ii) all applicable state and federal statutes and regulations, including but not limited to, Medicare statues and regulations and all fiduciary obligations under ERISA; and (iii) the standards of any applicable accrediting organization, including, but not limited to, NCQA. In the event that Company or an accrediting organization's standards or any state or federal statutory or regulatory provisions are materially changed or revised, Network agrees, without limiting the Parties' rights and obligations pursuant to section 6.G hereof, to comply with or implement, as applicable, and to the reasonable good faith satisfaction of Company, any such change or revision within the earlier of sixty (60) calendar days of receiving notice of such change or within such time frame as may be required by the accrediting organization or applicable law or regulation. Company agrees to promptly notify Network of any and all such changes, whether through written communication or through the Operating Committee.

Claims Management shall have the meaning set forth in the Recitals.