How are Proclaim’services in Personal Accident claims different to the market ?
- Our commitment to technical excellence - we have on staff the most experienced Account Managers in the country, so we understand this business.
- Our service commitment means you will get exceptional claims service - that is our promise
- We utilise superior systems and sharp people to build better processes for managing claims - including utilising the web for claim lodgement and reporting.
As a result you can rely on us to get you better results, to provide the reporting you require and to partner with you to meet customer expectations and manage your risk exposures.
Case studies – The Proclaim Edge in action
A tailored project
In 2005 we were asked to design and resource a compensation scheme for income lost by drivers who had lost their licenses due to faulty speed cameras. In conjunction with PWC, we built a business unit with a dedicated claims system with all reporting tools, interface to a call centre and Road Traffic data, as well as a customized cheque issuance process. We processed over 3000 claims for loss of income in a six month period and ensured the client avoided litigation and bad publicity through an efficient and fair system of claim management.
a. A claimant was involved in a Motor Vehicle accident sustaining a broken leg and back injury.
His Doctor stated the claimant will be off work for at least 12 weeks. Investigation by the Proclaim Account Manager ascertained that the accident was caused by a Third Party Driver who went through a red light at an Intersection striking our claimant’s vehicle and causing the injuries to the claimant. The claimant was made aware that another avenue of claim was open to him, and that he could lodge a claim against the Third Parties Compulsory Third Party Insurers where the Benefits are higher. The claimant decided to pursue the claim against the CTP insurer and withdrew his claim against our Insurers, with savings to the insurer of AUD 10,000.00.
b. We were instructed by a London Insurer to review a claim in Australia. A Claimant had suffered a major illness and had been on Loss of Income benefits for well over 12 months. The Policy covered Loss of Income for 104 weeks plus benefits for Permanent Total Disability. Proclaim immediately arranged a medical assessment with the claimant and was able to ascertain that the claimant did suffer the illness and his chance of working again was remote. The Insurers instructed Proclaim to settle claim for USD 142,898.00. Proclaim were of the Opinion, based on the medical opinion. that this amount was inflated and the Insurers agreed for Proclaim to settle up to USD 142,898.00.After several discussions with the claimant, Proclaim was able to negotiate a settlement with the claimant amounting to USD 120,000.00. A saving to the Insurer of USD 22,898.00.
c. The claimant submitted a claim for a back injury sustained when he changed a tyre on his vehicle. A doctor confirmed the injury on the claim form and stated the claimant had never suffered a similar injury before and issued a medical certificate for 4 weeks off work. Proclaim immediately had the claimant examined by our specialist who was of the opinion that the claimant, if he ever had a back complaint, had totally recovered from it. Further investigation revealed that the treating doctor had only seen the claimant once before and stated to Proclaim off the record that he only issued the certificate as he was afraid of the claimant. Proclaim the claimant and the claim was withdrawn. Savings to the insurer of $10,000.00.
Renato Foenander, Claims & Finance Manager, Accident & Health International Pty Ltd
“I have known Russell Walker for 10 years as a colleague in the general insurance industry. In particular, my association with him has been primarily concerned with claims and general operations management in the specialist area of accident and health field of insurance.
During my association with Russell he has held several important roles that have included:
• Regional Claims Manger for Ace Insurance.
• Claims and Operations Manager for Corporate Services Network, who are a third party assessor for claims services. Russell’s experience in dealing with clients extends from small enterprises through to the large multinational corporate sector. Russell and also the teams that he has managed have always settled claims in a competent, and diligent manner and this service ensures a strong level of trust from his clients. At an individual level Russell also has the commercial ability to settle claims on “best terms” in a manner that can satisfy both claimants and also his Clients. In his roles as a third party facilitator he has also developed many procedures for his Clients that have simplified their insurance processes”.