Cleanfax, September 2019
the restoration contractor There are some questions to consider here 1 Are the time and resources spent on these unscheduled administrative requests simply the cost of doing business or are they billable expenses to the total cost of the project 2 Should there be established ground rules for these interactions 3 Should consultants be expected to provide evidence of their qualifications to serve in any capacity on an insurance claim 4 Should a consultant be required to disclose their financial interest in successfully reducing the cost of the claim Example 3 TPA involvement and expanded influence Technically what we call a third party administrator or TPA should more accurately be referred to as a contractor network but for the sake of clarity well refer to these as TPAs The expansion of TPAs continues at an incredible rate and the reason for this is logical and predictable Insurance carriers are focused on reducing loss adjustment expense and limiting claim severity Field adjusters are costly and with drive time between claims very inefficient The trend of carriers assigning claims through a TPA is likely going to expand significantly over the coming years however this expansion is increasing the pressure on restoration contractors disproportionately to the opportunity At a recent contractor network annual conference the message from the network leadership was clear We need you to get your work done more quickly provide more detailed documentation increase customer Net Promoter Scores and do all of this for less money Some questions to consider involving TPAs are 1 What are TPAs hearing from contractors prior to negotiating contracts with carriers 2 Are TPAs conveying contractor concerns to carriers in good faith or with any sense of urgency 3 How can claim disputes be resolved in a way that honors the contractors integrity while still protecting the interests of the client as the insured 4 Are TPA programs in alignment with accepted restoration industry best practices and published guidelines that have been established as the standard of care SEP 2019 cleanfax com 19 FREE INFO Reader Service 226 at Cleanfax com freeinfo
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