With over 400 committed life and health professionals, we provide expert long-term care and disability claims management services for major insurance carriers. Our solutions are designed to align with each insurer’s unique objectives to ensure professional, timely, diligent and accurate policyholder service administration and claims management backed by systems that are flexible, customizable and scalable.
Additionally, we are an innovation leader with a proprietary long-term care and disability management platform that leverages fully integrated, real-time data. We have invested in well-designed security architecture and procedures and are highly experienced in data conversions and block takeovers. We have a deep product line knowledge and expansive risk management expertise.
Our strength comes from our people, training, quality control and assurance, and successful process improvement. We understand that no two claims are alike, and every policyholder deserves to be treated with dignity, respect, and care. We take a methodical, thoughtful approach to long-term care and disability claims management, focusing on thorough investigations and objective evaluations. This strategy helps us to achieve timely and accurate adjudication while delivering exceptional customer service.
At Davies, we keep policyholders at the forefront of our mind. We provide a wide range of diverse services for policyholders such as mail room and imaging, underwriting and new business, a call center, policy administration, handling of premium billing and collections, commission processing and payments, a significant knowledge base, and automation tools. It is our goal to make your operations more efficient saving you time and making your life easier.
The claims management process can be daunting, but we bring a wealth of experience and expert resources to the table. At Davies, we recognize that objectivity, accuracy, timeliness and professionalism are paramount. As a top priority we provide clear and frequent communication to all stakeholders and provide our clients with the digital tools required to actively participate in the appeal process. Because we strive for decision and financial accuracy, training our people and quality assurance are integral to how we operate. Finally, our platform provides broad automation of calculations, case load and task management, and accurate payments with multiple controls in place.
Our proprietary online platform supports all administrative services and reporting while providing real-time data. Having up to the minute information enables us to provide a prompt resolution to customer inquiries. Our highly qualified technical team has designed security architecture and implemented stringent data privacy procedures. Our platform delivers automated reporting that can be customized for the client’s preferred format. Additionally, our technology allows for third-party integration of workflow, imaging and telephony.
Our robust suite of actuarial services can be easily tailored to meets speciﬁc needs, from actuarial support for existing business, to helping assess the viability of a new product oﬀering. We can deliver on time-sensitive initiatives and more extensive block analyses – or anything in between. These services include end-to-end rate increase implementation, gross premium valuation and reserve adequacy monitoring, financial projection, financial reporting (management reports, statutory and tax reserves), experience studies, due diligence, and audit support.
We are equipped to provide expert litigation management and auditing services. Lead by a highly experienced in-house counsel, our team minimizes unnecessary claims litigation by applying proven dispute resolution techniques and being proactive to promote fair and cost-effective outcomes. Our legal team also provides annual training for all our claims and PHS personnel.
Our auditing team equally plays a vital role in the client experience. We conduct periodic systematic reviews of all claim segments and ensure compliance with regulations and client requirements. These auditing professionals also make recommendations to enhance the handling of specific claims and identify potential training needs. They are always open to discussing process evaluation and feedback.
With Davies, your business can count on our compliance services. Our experienced team handles fraud, SIU, and consumer complaint reporting. We also monitor changes in claims adjudication regulations and privacy requirements and evaluate the impact of regulatory changes and proposed regulatory changes. Additionally, we assist with new product filings supported by our experience with the interstate compact, annual state filings, and meeting OFAC compliance requirements.