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Regardless of the coverage involved, those analyzing claims files can take two different approaches—either quantitative or qualitative auditing. The best audit involves both, whereas inferior audits involve only one.

Too often, auditors, especially those who do not come from an adjusting background, may tend to look at claims files only quantitatively, and may therefore declare an excellently adjusted file “inferior,” simply based on quantitative factors. Let’s look at both types of analyses to determine what an auditor must consider when reviewing a claims file.

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