TOP TEN DESIRED CLAIMS ADMINISTRATOR CHARACTERISTICS
No.	Desired Characteristics	Components
1	Expertise in the types of claims that you need managed	· The expertise and the capacity to manage liability, workers’ compensation, property, or other specialty claims, depending on your risks, exposures, and needs
2	Manages claims efficiently and assertively	· Uses an efficient claims system and has efficient processes that help to reach resolution promptly · Provides claims management, not just claims processing, to achieve better outcomes · Manages your claims with a sense of urgency to take them to cost-effective resolution as soon as practicable
3	Has locations that match your geographic footprint to the extent needed	· Has regional offices to optimize workers’ compensation management if that is your need · Has central or regional offices for liability claims as you need · Is flexible to meet your company’s needs
4	Wants to develop a long-term relationship	· Wants to be a partner with your company for many years · Grows to the role of trusted advisor through demonstrated expertise, integrity, and emphasis on exceeding your expectations
5	Works well with your company representatives and employees	· Works hard to get to know your company, its people, and its exposures · Responds quickly when needed and often anticipates your company’s needs relative to claims administration · Coordinates activities with your personnel to meet agreed-upon goals · Treats all your employees with respect, including injured employees, if the claims administrator is managing your workers’ compensation claims
6	Provides advice and counsel on industry, legislative, statutory , and claims program needs	· Keeps abreast of important issues and decisions that can affect the outcome of your claims · Provides recommendations to enhance your company’s program when opportunities are identified · Offers additional services when they would benefit your program, including the services that can be provided by vendors
7	Has a strong Quality Assurance program	· Maintains a regular QA program that includes: o Ongoing claims audits (random selection) of all insurance lines o Reasonableness tests of financial transactions o Separation of duties to discourage or eliminate defalcation o Focused claims audits on claims offices, positions, and/or personnel, to ensure compliance with required standards o Development of corrective action plans to remedy any issues identified in audits, including issues identified by any vendors used by the claims administrator o Development and review of exception reports to identify transactions outside the norm or that may indicate non-compliance
8	Provides meaningful information/reports that keep you informed and help you better manage your company’s claims	· Provides information in the formats that you have requested (e.g., reserves advisories, large losses, settlement authority requests) · Provides standard loss reports and is willing to customize them to meet your needs · Creates ad hoc reports and/or provides a user-friendly report production method · Leads and participates in periodic meetings on specific claims and procedural improvements, and provides an annual stewardship report to measure accomplishments against stated goals
9	Uses credentialed partners if needed to augment their services	· Transparency of the vendor services it uses · Confirms the credentials of the vendors in the services they are intended to provide, and updates the credentials at reasonable intervals · Monitors the vendors’ performance, ensures open communication, and develops correction action plans if the vendor(s) slip in the quality and/or delivery of their services · Removes vendors if the vendors provide service that does not meet agreed-upon standards
10	Charges reasonable fees for the agreed-upon services it provides	· Transparency regarding the services and fees that it and its vendors charge to provide your company with the contracted services o The claims administrator and its vendors partners provide services at fees that are open for your company’s inspection o Provides auditable fee reports, invoices, and/or payment records that can be clearly confirmed by your company representatives · Monitors expenses closely, and spends expense dollars like they were their own

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Top 10 Characteristics to Look for in Your Claims Administrator

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