Sample claims Administration rfp provided to agrip in January 2005 by



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SAMPLE Claims Administration RFP provided to AGRIP in January 2005 by:

Lou Freiheit

Vice President

New Business Development Leader

Carl Warren Company

1-888-845-4798



lfreiheit@carlwarren.com
(Please insert your responses directly beneath each question in a manner that is easily distinguishable from its corresponding question.)
1. Provide a brief history of your company.
Carl Warren & Company was founded in Los Angeles in 1944. Originally an independent adjusting company, in 1973 we began work as a Liability TPA serving both corporations and public agencies.
Also in 1973, we became an employee-owned company through an ESOP and are now entirely owned by the 300 people who work here. Those employees are located from Honolulu to Vermont and serve an extremely prestigious list of national accounts.
2. How many years of experience does your company have handling self-insured and large deductible programs?
We have been managing large self-insured liability programs for public entities and national accounts since 1973. We represent hundreds of public entity clients across the United States, including the Count y of Los Angeles. We also represent many of America’s greatest corporations, including the Bank of America.
3. Attach a map, which sets forth all primary, secondary, and/or field offices. Please include those locations where adjusters work from home offices
The requested map can be attached as a separate document. You may also visit our web site at www.carlwarren.com for a complete list of our locations.
4. How do you set yourself apart from your peers from a culture and management style?
Carl Warren is entirely employee-owned and totally focused on managing a single line of business, liability claims. That alone makes us unique for a company our size. In addition, our entire management team rose up through the ranks of our company and all started as liability adjusters. We are driven to be the best in our chosen field, without distractions of any type from other business ventures. Our claims professionals are empowered to work directly with our clients, meeting their customized needs, and resolving matters to the extent the client allows them to do so.
5. Please state your company’s claims handling philosophy and/or mission statement.
We are in the business of delivering highly customized claims solutions to each of our varied customers. For that reason, it isn’t our claims philosophy that is important, it’s theirs.
When we are chosen for a project, it becomes our mission to see to it that all of the client’s strategies are implemented and that they receive outstanding service when measured by each of the metrics that are important to them.
6. Please provide a list of insurance companies wherein your company is an approved TPA.
Our firm is approved by just about every insurance company involved in the unbundled business. This would include Old Republic, Hartford, CNA, St. Paul, Zurich, Royal, ACE, American Re, Discover Re, and Genesis.
7. Please list all states your company holds required state licenses to adjust claims.
Carl Warren as a company or Carl Warren employees are licensed in nearly every state that licenses adjusters, including Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Hawaii, Idaho, Maine, Michigan, Minnesota, Mississippi, Montana, New Hampshire, New Mexico, Oklahoma, Oregon, Texas, Vermont & Washington. You can be certain that regulatory issues will be monitored carefully.
8. Please provide the name, address and telephone number and contact for at least three companies and/or public entities for which you provide claims handling services.
1. Williams-Sonoma, Inc. Williams-Sonoma is a high-end retailer of home furnishings and cookware with locations throughout the United States. Their address is:
Williams-Sonoma, Inc, 3250 Van Ness Avenue, San Francisco, CA 94109. We handle all liability claims in the US for them and our contact is Teri Bosworth at (415) 616-8768.
Williams-Sonoma is a Marsh San Francisco client.
2. Maine School Management Association, 49 Community Drive, Augusta, ME 04330-9405, is a Trust Fund created to provide insurance to over 400 schools in the State of Maine. We handle Property, Liability, Automobile, Boiler & Machinery, School Legal Liability and Products Liability for their members. Our contact is Susan Avery, (207) 626-2953-(x109).
3. Longs Drug Stores, Inc. One of the top 10 retail drug companies in the country, Longs has 370 locations around the US. It is a client of Marsh San Francisco and can be reached at: 141 North Civic Drive, Walnut Creek, CA 94596. Our contact is Mr. Alan Pope at (925) 210-6338.


  1. Please include the name, address and telephone number and company contact for at least three companies you no longer provide claims management services for and the reason that you are no longer servicing that account.


1. Wells Fargo Bank. Wells Fargo was a client of our Sacramento Office for a number of years but went away when the Bank was purchased by Norwest and moved to Minneapolis. The best person to talk to at Wells is Barbara Miller, Wells Fargo Bank, Risk Management Department, 6th & Marquette, Minneapolis, MN 55479, phone (612) 667-1427.

2. Sparkletts Water (and Alhambra Water), now doing business as Danone Waters of North America. These two very large bottled water companies were once owned by The McKesson Corporation and were significant Carl Warren clients prior to being sold. Our contact was with Kathy Polo – her office is at 3280 East Foothill Blvd, Pasadena, CA 91107 and her phone number is (800) 344-5456.

3. The ConAgra Corporation, One ConAgra Drive, Omaha, NE, 68102. ConAgra purchased one of our National Accounts (Beatrice Foods) and utilized our services for a number of years for their Beatrice subsidiary, until re-organization created a combined program. We still have a relationship with them, but it is now for asbestos claims only. The contact person at ConAgra is Dan Wenzl at (402) 595-4079.

10. Describe your company’s policies/procedures for providing training/certifications and/or licenses for your adjusters.


Quoting from our Employee Handbook:

“Carl Warren and Company recognizes that the skills and knowledge of its employees are critical to the success of the organization. The educational assistance program encourages personal development through formal education so that employees can maintain and improve job-related skills or enhance their ability to compete for reasonably attainable jobs within Carl Warren and Company.

Carl Warren and Company will provide consideration for educational assistance to eligible employees after one year of service within an eligible employment classification. To maintain eligibility employees must remain on the active payroll and be performing their job satisfactorily through completion of each course.”
Additionally, each office is responsible for regularly scheduled educational seminars for their employees. Most of these seminars are put on by defense attorneys working on our programs, as those lawyers are encouraged to do this in place of their more traditional marketing ventures. As to licensure, continuing education is a state-by-state situation. For states like Texas with ongoing education required for license renewal, we monitor and pay for all required training.
Our company also works with an outside vendor to provide computer training to all of our employees, specifically in the use of Microsoft products. We consider the ability to utilize our technology tools critical to our success.
11. Describe the criteria used to measure an adjuster’s performance. Provide a sample of processes and tools.
Each of our programs has different goals and each requires different methods of monitoring. Our normal procedure is to suggest a physical file audit twice a year, scoring each adjuster on issues like the ones listed below:

Adjuster Audit Factors





  1. Was documented contact made with the claimant within stated program goals? Y/N

  2. Was documented contact made with client employees within stated program goals? Y/N

  3. Were witnesses identified or ruled out during initial investigation? Y/N

  4. Was the liability investigation substantially completed within 30 days? Y/N

  5. Was the damages investigation completed in a timely manner? Y/N

  6. Were recorded statements taken from all injured claimants? Y/N

  7. Were appropriate statements taken from the insured’s Personnel? Y/N

  8. Were appropriate statements taken from any witnesses? Y/N

  9. Were appropriate photos and diagrams obtained? Y/N

  10. Were tender opportunities recognized, documented and appropriately pursued? Y/N

  11. Were documented, fact based reserves established on all claimants within the stated program goals? Y/N

  12. Was appropriate contact with the claimant maintained during the handling of the claim? Y/N

  13. Were reports to the file or client created in a timely manner? Y/N

  14. Do the adjuster notes clearly document all work done on the file? Y/N

  15. Were appropriate inspections made of all property damage over $1,000? Y/N

  16. Were damages properly documented and clearly evaluated? Y/N

  17. Was resolution actively pursued by the adjuster? Y/N

  18. Was appropriate settlement authority requested and documented? Y/N

  19. Were all negotiations clearly documented in the file? Y/N

  20. Were releases obtained on all settlements? Y/N


We believe that this scoring process, designed to be objective and client specific, should be shared with the adjusters and the client each time it is performed.

14. Does your company have an “800” Claim Reporting System? In addition, does your company have the ability to accept First Notice of Loss via fax and/or e-mail?


Yes, we have “800” numbers available to our clients for reporting claims, 24 hours a day. We also receive claims each day by fax and e-mail. Our e-Fax system converts each incoming fax to an e-mail document to facilitate distribution and retention.
15. Regardless how your company receives a First Notice of Loss, please state the hours of operation where claims can be reported to your company.
24/7, 365 days a year.
16. Does your system have the capability to produce and select historical claims data in queries from a “valued as” of date?
Yes.
17. Does your system produce triangles as a standard feature?
Our system can provide very basic loss triangles as a standard feature, though most of our clients utilize other resources to develop this information. Future versions of mycarlwarren will provide additional functionality in this area if there is sufficient interest.
18. Does your system produce graphics that are exportable to an Excel or other software package?
Yes.
19. Is your system Internet accessible? Describe any issues regarding firewalls, access, etc.
Our secure site is accessible to any authorized user who has any standard internet browser (Internet Explorer or Netscape Navigator) from any location with internet access. No other software is required.
20. Does your system have the capability to interface with other external vendors that may be providing other claims-related services to us?
Yes. We currently provide information directly to STARS, Corporate Systems, Risk Sciences and a number of other software vendors.
21. Please describe the pricing structure for access to your company’s RMIS.
Full access for up to 10 users is priced into the costs contained in this proposal.

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