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CLAIMS PANEL Tuesday, October 20 8:30 am -10:30 am

CLAIMS PANEL Tuesday, October 20 8:30 am -10:30 am. JOHN BURROWS. Dewitt Companies Ltd LLC. KIRRA FLOYD. Total Military Management. Claims on the Rise?. What we found:. Percent of claims vs overall shipments has stayed consistent

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CLAIMS PANEL Tuesday, October 20 8:30 am -10:30 am

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  1. CLAIMS PANEL • Tuesday, October 20 • 8:30 am -10:30 am

  2. JOHN BURROWS • Dewitt Companies Ltd LLC

  3. KIRRA FLOYD • Total Military Management

  4. Claims on the Rise? What we found: • Percent of claims vs overall shipments has stayed consistent • Industry standard is 20-30% of shipments with the higher counts during the peak seasons • Claimed amounts have risen over the past 2-3 years What caused this? • Military counseling service members to change the claimed amounts to the cost of replacement instead of their estimated cost of repair • Driver shortages have also affected claims • Freight shipments have twice as many claimed items and the highest average paid amount

  5. Mold What to look out for: • Improper Guidance by PPSOs/QCs to “wipe down” the mold – this conceals it from the agent, or the agent assumes that professional mitigation was done when it was not • Drivers picking up shipments where mold is visible can be prevented • Don’t pick it up even as a “favor”, the customer will still claim • Shipments being picked up with mold to avoid suspension • NTS shipments with some viable mold—no opening of cartons • Extra Pick-Ups with Mold

  6. Billing for Accessorials Mold guidelines • Mold guidelines outline a process for submitting mitigation invoices when the TSP is not liable for the damage • Most are denied • Mitigation is covered, Replacement is not • No common sense rule in the guidelines- even if shipment in care of TSP for 2-5 days, the accessorial invoices may still be denied if not documented as exception • Working with the MCO and PPSO from the beginning makes a big difference • Pre-approval needs to be submitted to the PPSO via DPS prior to submitting for billing

  7. 75 Day Notification Be Aware of Misguidance • Misguidance being given by the PPSOs/QCs/TMO- as long as the member files some items within 75 days they can claim any other item they find within 9 months • This is not true • All loss and damage must be submitted in writing to the carrier/TSP representative within 75 days of delivery • Agencies should ensure drivers/reps know the timelines • 75 days for notification • 9 months to file with TSP for Full Replacement Value(FRV) • 9 months- 2 years to file with TSP for depreciated coverage

  8. 75 Day Notification-Untimely Before Denying for Untimely? • Decentralized claims offices sometimes get it wrong and may incorrectly advise a TSP to consider a claim timely. It is important to review these carefully, and challenge when applicable. • DPS Claims filed on GMT time – and must be converted to determine timeliness • When denying, the appropriate MCO should be notified in addition to the member • Members should be directed to the MCO to determine if they qualify for an extension

  9. Repair Estimates Not Conforming to Requirements • Work with third party vendors to ensure compliance to repair estimate rules • All repairable items should list a repair cost, even if the damage is not transit related • Estimates can indicate that the cost is for not transit related damage • MCOs can still pay a member for damage that the TSP is not liable for • If TSP inspection does not include repair costs for all items the service member must pay for a second estimate out of pocket, MCO cannot pay this fee upfront for the member

  10. New Claims Rules being Drafted New Claims Rules for Property Damage • Claims Liability Business Rules do not currently have a section for damage to Real Property, but services are drafting them • TSP is ultimately responsible for property damage • Agents responsible for damage to real property either at origin or destination should address the damage as soon as possible • Repairs should be completed • If agent disputes the Real Property Damage they should notify the TSP • TSPs should review the dispute and proceed with repair or contact the appropriate MCO for further review

  11. Loss of Value as Final Offer You can make an offer • BUT it cannot be marked as final in DPS unless it is for repair or replacement • Marking an item as a final offer prevents the claimant from submitting counteroffer • If member rebuts, TSP should negotiate on the loss of value or salvage, but should not refer the member to the MCO unless the final offer is repair or replacement • “Horse Trading” is an acceptable means of negotiation, where member and TSP agree on a lump sum dollar amount for the overall claim

  12. Negotiation After MCO Transfer TSP and MCO Communication is important • Some members transfer items to the MCO before submitting rebuttal/counteroffer with TSP • Before completing negotiations with the member, check DPS to verify status of item • MUST advise MCO to avoid duplication of payment • TSP will be responsible for payment on Demand if they settle with the member after the transfer • Member must contact help desk to have item and or claim status revised back to “demand pending” prior to making final offer/payment

  13. Denials What the services are seeing • TSPs paying low dollar items and denying high dollar items for the MCOs to handle • Inherent Vice or Defect Exclusion (section 1.3.1.2.) • MCOs feel that TSPs are using this denial for items damaged in transit • Recommend- have support for denial for inherent vice, from qualified repair firm or manufacturer • 75 Day Notification overrides the presumption of correctness of inventory • -Do not deny for the sole reason that the item was not noted damaged or missing on the 1850

  14. Signed Releases Improper Conditions for releases, including release of Government liability • Signed releases or verbiage on settlement checks should not be used • TSPs cannot require claimants to sign a release of liability unless all liability is accepted • Partial settlement release should specify that it is for the settled/agreed upon items only • The claimant retains the right to transfer any disputed portion of the claim to the MCO for further review and consideration

  15. Communication is Key Explaining the Process up front is crucial • “Peak Season” should not be an excuse for ignoring calls and emails, even if there is no new update, respond • TSPmust “review claim” in DPS • Claim acknowledgement must be sent to the member • Level of communication with claimant depends on the claimant themselves, as each of them have very different expectations • MCOs advised that they are seeing delays in communication up to 2-4 weeks, unacceptable • Do not wait until day 59 to contact member about their claim as it will cause claim to go past 60 days, and also have a negative impact on the member’s claim experience

  16. Daniel Martinez • SDDC

  17. DP3 Update International Association of Movers Conference October 2015 Claims Panel

  18. Claims Score • Why? • GAO-03-367, BPWGs, Feedback • Will make program rankings more objective • Will improve claims process for Service Members and engaged TSPs

  19. Alternate Claims Score Metrics • SDDC study on Revised Claims Score metrics • Better aligned metrics with business rules • Removes member influence on TSP score • Eliminates confusion between CSS and a claims survey • Considers total number of shipments • Thoughts?

  20. Claims Score Plan • Working Group to streamline metrics, placeholder SCR 7413 • Objective measure • Can comprise a % of the Best Value Score • Requirement target 4thqtr FY16 • Implementation TBD • Thoughts?

  21. Boris Populoh • Senior Vice President, Willis Relocation Risk Group

  22. Willis Relocation Risk Group • Global Willis Group • Third Largest Insurance Broker in World • HQ in London and New York • $3.75 Billion in Revenue • 17,000 Associates in 120+ Countries • Merging with Towers Watson • Merged // 39,000 Associates // $8.25 Billion(+) in Revenue • Willis Relocation Risk Group • Domiciled in Washington DC/London UK • Focus on Mobility Risk • Arrange Coverage on approx. 30K Shipments Annually • 5% Military // 25%GSA // 70% Commercial • Settle approx. 7,000 Claims Annually • Focus Today on Commercial Claim

  23. Commercial HHG Claims: Data vs. Information 0101010101010101 01010101010101 010101010101 01010101010 010101010 First Things First: DATA Data is Not the Same as Information! COMPUTERS NEED DATA HUMANS NEED INFORMATION DATA IS A BULDING BLOCK INFORMATION GIVES CONTEXT Us the RIGHT Data to Answer the RIGHT Question Data Evolves / Information Changes SNAPSHOT a PROCESS a INFORMATION

  24. X Commercial HHG Claims: Data vs. Information Building Block: DATA - is the Foundation- the First Link in a Lager Chain of Understanding- Integrity is Key WISOM KNOWLEDGE INFORMATION DATA

  25. Commercial HHG Claims: Data vs. Information HHG CLAIMS ARE: - Inevitable- A Hassle- Result of Internal Service Failures- Someone Else’s Fault / Responsibility- Something For the Insurance Folks to Deal With- Bad Luck- Expensive (Direct or Indirect Costs)- Shippers Last Memory of The Move- Customer Service Opportunity- Learning and Improvement Experience- Risk Management Tool- Dependent on Circumstances- What You Make of Them- Response is Driven by Organizational Culture

  26. Commercial HHG Claims: Data vs. Information HHG CLAIMS ARE: THIS IS OUR NEW HHG INSURANCE CLAIM FILING PROCESS ANY QUESTIONS? - Inevitable- A Hassle- Result of Internal Service Failures- Someone Else’s Fault / Responsibility- Something For the Insurance Folks to Deal With- Bad Luck- Expensive (Direct or Indirect Costs)- Shippers Last Memory of The Move- Customer Service Opportunity- Learning and Improvement Experience- Risk Management Tool- Dependent on Circumstances- What You Make of Them- Response is Driven by Organizational Culture

  27. Commercial HHG Claims: Data vs. Information

  28. Commercial HHG Claims: Data vs. Information IDENTIFY YOUR INDIVIDUAL RISK PROFILE: What Factors Impact Your Organizations Claims Risk Profile • ORIGIN COUNTRIES/CITIES • LOSS RATIO • DESTINATION COUNTRIES/CITIES • LOSS FREQUENCY • SHIPMENT VALUES • TOTAL CLAIMS PAID and RESERVED • CONVEYANCE BREAKDOWN • ADJUSTING PRACTICES • CUSTOMER MAKE UP • ESTIMATED LOSS vs. TOTAL PAID • SHIPPER EXPECTATIONS/BEHAVIOR • SUBROGATION AGREEMENTS • PRE MOVE SHIPPER COUNCELING • ORIGIN AGENT • POST LOSS CLAIMANT COUNCELING • DESTINATION AGENT • DEDUCTIBLE / RISK RETENTION LEVELS • SIPMENT VALUATION METHODOLOGIES PROGRAM COST INFLUENCERS

  29. Commercial HHG Claims: Data vs. Information

  30. Commercial HHG Claims: Data vs. Information

  31. CLAIMS WILL CONTINUE TO HAPPEN! DEVELOP A PROCESS AND CULTURE TO LEARN FROM THEM

  32. Commercial HHG Claims: Data vs. Information - END -THANK YOU Reference Sources:- Willis resilience Magazine // Future of Risk Analysis // April 2015 // Issue 06- Business 2 Community // What is the Difference Between Data and Information? // August 6, 2015

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