Claims Advocacy for Senior Living Organizations
Senior living operators do not plan for a claim or lawsuit. Pro-active planning includes the development of special handling instructions to ensure that carrier adjustors communicate according to your expectations. Should a claim arise, our claims team interacts with your designated team and makes any reported claim a priority.
Typical support from our team examines questions like:
- Do we file now or wait?
- Do we have HIPAA compliant requests for release of information?
- Which policy and/or period will it affect?
- Are there coverage questions or do we need to seek coverage opinions?
- Are there third parties to whom a claim might be tendered, and from whom might indemnification and defense obligations exist?
- Do we need to notify our excess carrier?
- Is there more than one policy that might respond and provide coverage?
- Do we have lease agreement arbitration clauses to trigger and enforce?
- How do we respond to a reservation of rights letter?
- Do we have our MSP reporting issues covered and liens resolved in any settlements?
We commonly engage with insureds, adjusters and defense counsel in strategic discussions on how best to respond to a given situation including settlement discussions. We routinely engage with adjusters and defense counsel to ensure that the client is always aware of the status of their claims and why, including settlement proposals. We strategically and tactically manage claim exposures that potentially exceed coverage limits with defense counsel and carrier, i.e. settle within limits when a claim appears to have exposure beyond stated policy limits.