Other Services

Code of Practice Auditing Solutions

PLS Claims' audit program will allow you to have your cover holders or TPAs audited in an efficient and cost-effective manner.

Our experienced team is positioned to help you with your audit and/or claims management requirements in the US and on most classes of non-marine based business.

Our core insurance solutions

Some of the core areas reviewed are:

Timeliness of reporting, reserving, investigations, and settlement of claims
Frequency of claim review
Selection, monitoring, and management of third party experts
Coverage analysis
Bordereau Management
Accuracy of reserving
Pursuit of Recoveries where appropriate
Quality of customer (policyholder) service
Procedures for proactive claims management
Systems
Compliance
Breaches in terms of a delegated contract
Open caseloads by an adjuster
Involvement of senior staff in claims process where appropriate
Access to and familiarity of agreements by staff

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Our process

PLS Claims will initially have a meeting with you to get your specific instructions and report format requirements as we will provide the report to you in the format of your choice. Following the initial meeting, we will send a detailed questionnaire to the Cover holder or TPA being audited to gather as much information as possible before the audit commences. This allows PLS Claims to review procedures and all the key areas of claims management before we arrive on site.