BIIA has established best practices for claims management based as summarized below:

Coverage

• * Upon notification of the loss, coverage must be confirmed. 
• * Adjusters verify that the loss occurred within the coverage period, falls within the scope of the policy including any potential exclusions or conditions that may apply. 
• * Notifications must be sent to appropriate parties promptly upon recognition of potential claim issues.

Initial Contacts

• * Standard contact is required within one business day for the insured, claimant, and/or their authorized legal representative. 
• * Witnesses are contacted within one business day of identification. 
• * If contact is not possible with any part, the reason will be stated in a contact letter that
  will be sent to employer or injured employee.

Investigation

• * All files must be investigated promptly. Most investigations are completed within 30 days of receipt with exceptions for severity, complexity and legal reasons.
• * Investigations include coverage analysis and research, recorded statements of injured parties, witness statements, medical authorizations, verification of damages, estimates, appraisals, index reports scene photos and diagrams, expert reports and applicable legal references, as needed.
• * Plans of Action will be developed on each claim. 
• * Employers should contact claims supervisor to receive update on claims process.

Reserves

• * Reserves will reflect the best estimate of the probable exposure based on the damages, liability, known facts, recent verdict values and jurisdiction.
• * Reserve worksheets are required on all bodily injury files exceeding $5,000 total
  incurred.
• * Initial reserves must be set within seven days of receipt of the loss.
• * Final reserves should be set by 30 days. 
• * Analysis of reserves must be documented.
• * If reserve changes are required as result of investigation, a new reserve analysis should take place stating the reason for the change.

Action Plans

• * We provide a plan of action on every file.
• * The plan of action states the current status of the claim and what is needed to move the claim to resolution. 
• * The initial plan of action is completed within seven days. 
• * The plan of action is reviewed and adjusted as appropriate.

Subrogation

• * Subrogation potential is identified and reflected early in the investigation.
• * Subrogation potential are updated as merited by new information. 
• * If the claims handling agreement includes pursuit of subrogation, recovery is pursued immediately by putting the potentially responsible party on written notice as soon as they are identified.

Litigation Management

• * Our goal at BIIA is to resolve all claims in a fair and equitable manner without litigation. However, at times, situations require litigation to resolve claims based on legitimate irreconcilable disputes regarding liability, coverage or damages.
• * Upon receipt of a Summons and Complaint (Suit), contact is made immediately with the insured/client to determine the date of service and specifics regarding the litigated matter.
• * Suit files are assigned to defense counsel immediately via phone and confirmed by sending a transmittal letter and file material as expeditiously as possible. 
• * Defense counsel must provide an initial report and budget within 30 days of the receipt of Suit. Our adjusters work with counsel to develop the budget and litigation plan.
• * An interim report is required at a minimum of every 90 days. 
• * Pre‐trial reports are due from the defense counsel 45 days prior to a trial date.

Tempo

• Investigations are normally complete within 30 days of receipt with the exception of complex or legal matters.
• Until the investigation os completed, the adjuster will work the file frequently.
• Notes are entered as activity occurs to keep our files up‐to‐date.
• A normal diary interval is 30 to 45 days for our adjusters.

Disclaimer

• BIIA and its affiliates are committed to providing the best quality product and services possible. The contents of this document are provided for information purposes only and are subject to change without prior notice. The information contained in this document represents the current views of BIIA on the issues discussed as of the date of publication.