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We were flipping through an older issue of Insurance Journal the other day and came across an article with this headline: “The Complicated Risk Exposures of Property Managers and Investors”. We were okay at first, especially when we read this:

Property managers and real estate investors face bedbug exposures, mold behind the dishwasher, tenant and vendor service issues, tenants without insurance, vetting contractors, insurance claims, property inspections, tax authorities, tenant harassment and discrimination claims, and more.

That’s nothing but true, fair, and accurate. But this part freaked us out a little bit:

In most cases, the property manager is responsible for tenant screening and placement of the tenant in the investor’s property, which leads to another potential financial exposure for the property manager … Medical payments, property damage to others, additional living expenses, and contents coverage are not required or reviewed.

The fact that property managers may not be aware of the extent of their exposures is bad enough. But what really freaked us out was the reality that all those claims — whether the property manager saw them coming notwithstanding — will have to be managed.

If you were using Excel, you could record an incident. Then, if you were able to tell what claims resulted from that specific incident, you could put links to those claims in other spreadsheets or documents. That feels like a dicey proposition because it feels like a pretty big if.

When we got to this part of the article, we completely flipped:

Property management firms often assume that by having their investor add the property management firm as an additional insured on the investor’s personal homeowners or commercial multi-family policy they can mitigate all their liability exposures related to the servicing of the individual property … [but] they may be facing uninsured losses due to vacancy clauses, intentional acts or damage by the tenant, and “service animals” that could take down a moose.

The potential liability inherent in vacancy clauses and intentional acts or damage is scary enough. But the idea of heading out to a property inspection and having to face off with a service animal that could take down a moose, is terrifying — especially if the resulting claims have to do with a leg in the service animal’s choppers.

You could trust all that to Excel. Or you could use Cloud Claims. Cloud Claims won’t protect you from a service animal that could take down a moose. And it won’t read your policies for you. But since it connects incidents to claims — and claims to policies — it will protect you from disorganization and inefficiency. And it’ll help you identify patterns, assess risks more effectively, and mitigate them accordingly.

Note to Self: Give service animals a much wider berth.

Especially for workers comp claims — and especially for companies that use TPAs (third-party administrators) — it’s crucial to have Total Processing Adaptability.

What we mean is that your claims system should let you manage everything you want to manage and to have an optimally flexible relationship with your TPA(s). And it entails the ability of that system to give you the reports you need to enable you to spot trends in your claims experience. Are claims being reported properly? What kinds of claims are prevalent? What types of injuries are most common? What body parts are most likely to be injured? What are the most common complications? What are typical recuperation or rehabilitation times for particular types of injuries?

Beyond that, Total Processing Adaptability means your claims system lets you control the flow of information. We’ve seen setups in which accident reporting goes straight to the TPA because the organization in question doesn’t have the technology to capture accidents. If you’ve got Total Processing Adaptability, you have first-report capability and can route accident reports to TPAs automatically, based on your business rules. The right choice of unbundled software — with no reliance on software provided by a TPA — means your data is yours. If you have multiple TPAs or want to switch TPAs, having your own claims software gives you a layer of protection; that is, an element of risk management that helps normalize your reporting and operations. That ensures one view of your data, regardless of TPA, insulating you from the negative effects of changing TPAs.

When we created Cloud Claims, we knew we wanted to give our customers Total Processing Adaptability. We wanted to ensure a first-class claims experience for claims managed in-house and those managed by a TPA. We wanted to automate workflows to eliminate manual processes. We wanted sending files to TPAs to be as easy as clicking a button. By freeing adjusters from administrative tasks, we wanted to let them concentrate on critical decision-making — and we wanted to supercharge every risk management department’s productivity.

You can’t completely manage the safety of your workers. But you can manage your workers comp claims. With the right TPA and Total Processing Adaptability, you can effectively manage those claims and reduce the costs of the claims that occur.

With the right claims system, you’ll be on your way to more efficiency, better outcomes, and fewer headaches.

The challenges in claims management are fairly common. While this list might not be exhaustive, those challenges include:

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If you’re required to comply with the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of the Centers for Medicare and Medicaid Services (CMS) — and its Section 111 reporting requirements — things have the potential to get significantly more complicated. That’s because on December 11, 2020, The Provide Accurate Information Directly (PAID) Act was signed into law. Read more