Claims Management definition

Claims Management means the process of identifying, controlling and resolving demands by individuals or public entities to recover losses from any Member of the Association. Disposing of such demands for payment requires skills in insurance law, adjusting/investigation, loss control engineering and general business. Claims management is the function of supervising legal, adjusting, investigation and engineering services to resolve such demands.
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Claims Management means handling matters related to customers or third parties bringing a claim against a Party or claims by a Party against customers or third parties, including investigations, litigation support, and settlements.
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Claims Management means the entirety of the functions which are necessary for or incidental to the receipt, assessment, determination, payment, administration, review, finalisation and recording of a Claim.
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Examples of Claims Management in a sentence

  • The reporting requirement will be documented in the Claims Management System.

  • Under a Claims Management Agreement entered into by the Company, AICF manages and resolves claims and pays payable liabilities on behalf of the Company.

  • Claims Management in DPS enables the customer to work directly with the TSP to obtain settlement for any loss, destruction, or damage to their belongings while the goods were in the possession of the TSP.

  • Provide an overview of the Claims Management Program that your organization would use.

  • As part of this Electronic Claims Management (ECM) function, the Contractor shall also provide on-line and phone-based capabilities to obtain Claims processing status information.

  • Claims Management To reduce the risk exposure of the Syndicate, HMA has put in place strict claim review policies to assess all new and ongoing claims.

  • The County hired a third-party administrator, Sedgwick Claims Management Service, Inc., to review and monitor all claims on behalf of the County.

  • Provide an overview of the Claims Management Plan that your organization would use.

  • I understand and agree to let the University of Illinois Claims Management office adjudicate the claim and will abide by their findings.

  • The Trustee will follow the processes set out in its Claims Management and Assessment Policy in relation to insured benefit claims.


More Definitions of Claims Management

Claims Management or "Claims Management Services" shall mean the process by which claims for payment are paid to Network Providers (but not non-Network Providers or non-Participating Providers) for Home Health Services provided to Network Members, including emergency and urgent services as defined by the Health Care Financing Administration, and records that are to be maintained of claims and payments for such services. Network shall provide Claims Management Services in accordance with Company standards, subject to Network's ability to cure pursuant to section 6.F hereof. Network represents, warrants and agrees that at all times its provision of Claims Management services meet or exceed (i) all Company standards, policies and procedures; (ii) all applicable state and federal statutes and regulations, including but not limited to, Medicare statues and regulations and all fiduciary obligations under ERISA; and (iii) the standards of any applicable accrediting organization, including, but not limited to, NCQA. In the event that Company or an accrediting organization's standards or any state or federal statutory or regulatory provisions are materially changed or revised, Network agrees, without limiting the Parties' rights and obligations pursuant to section 6.G hereof, to comply with or implement, as applicable, and to the reasonable good faith satisfaction of Company, any such change or revision within the earlier of sixty (60) calendar days of receiving notice of such change or within such time frame as may be required by the accrediting organization or applicable law or regulation. Company agrees to promptly notify Network of any and all such changes, whether through written communication or through the Operating Committee.
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Claims Management. To the extent different from Operational Accounting, Prudential Management and Underwriting Management, any System or Control and/or Mediation Activity in order to identify, account for, audit or otherwise analyse or verify, reserve against, settle, indemnify for or otherwise pay, or receive, any incurred or potential Flood Risk, including by way of any claim on any Inwards Reinsurance, Retrocession and/or ART Contract, including by reference to any event or circumstance which constitutes, gives, has given or may give rise to any Flood Risk in whole or in part, as further particularised in SOR section 5.4
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Claims Management shall have the meaning set forth in the Recitals.
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Claims Management means the effective coordination of all activities associated with the just and economic resolution of an injured Worker’s Claim and includes activities associated with determining liability, providing Benefits and processing the Claim.
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Claims Management means if you can’t prevent an injury, you can at least contain the financial damage. The employer has the onerous “burden of proof” meaning if you don’t have paper, you don’t have a leg to stand on. To avoid getting caught in a whirlwind of stories and injury causes that can change on a dime leaving you without support always address the following:1) Accident Investigation – Your way to guard the truth. Never forget the devil is in the details.2) Light Duty – Your only way to stay in control no matter how difficult it may be. Remember, the system makes the rules and has both the ability and the desire to enforce them whether you agree or not. In the end, don’t bepenny wise and pound foolish. Be smart and not predictably reactionary.3) Injured Worker Contact - Your way to learn of and report to your carrier unusual events, oddities of timing or observations that contradict the employee’s injury condition whether at work or if they are seen around the local area.
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Claims Management means Third Party Claims Management, Inc., a Connecticut corporation and its successors and assigns.
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Related to Claims Management

  • Case management means a care management plan developed for a Member whose diagnosis requires timely coordination. All benefits, including travel and lodging, are limited to Covered Services that are Medically Necessary and set forth in the EOC. KFHPWA may review a Member's medical records for the purpose of verifying delivery and coverage of services and items. Based on a prospective, concurrent or retrospective review, KFHPWA may deny coverage if, in its determination, such services are not Medically Necessary. Such determination shall be based on established clinical criteria and may require Preauthorization.

  • Procurement Management means the Director of Lee County’s Procurement Management Department or designee.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Records management Administration of official government records (record linking/association, record storage/archival, document classification, document retirement, digital rights management).

  • Project Management The individuals appointed by each Party cf. clause 4.1 in the Agreement.

  • Claims Administration means the processing and payment of claims received from Settlement Class Members by the Claims Administrator.

  • PJM Management means the officers, executives, supervisors and employee managers of PJM.

  • Floodplain Management means the operation of an overall program of corrective and preventive measures for reducing flood damage, including but not limited to emergency preparedness plans, flood control works and floodplain management regulations.

  • Medical assessment means an assessment of a patient’s medical condition secured by our Assistance Company working in conjunction with the Medical Evacuation Provider’s medical director and in collaboration with the attending physician. The Assistance Company in collaboration with the Medical Evacuation Provider, will utilize the assessment to determine at its sole discretion whether a Plan Holder is fit to fly; the most appropriate means to provide medical evacuation; the medical personnel who will be accompanying the patient on the transport; and to confirm the medical facility closest to one’s home can meet their medical needs. If the patient’s medical facility of choice is unable to provide the high level of medical care required by the patient, arrangements will be made to transport the patient to the appropriate medical facility closest to their home, or closest to patient's preferred medical facility in the US when possible.

  • Emergency management means lessening the effects of, preparations for, operations during, and recovery from natural, technological or human-caused disasters. These actions are broad in scope and include, but are not limited to: disaster plans, mitigation, preparedness, response, warning, emergency operations, training, exercising, research, rehabilitation, and recovery activities.

  • Project Management Plan means the portion of the Project Development Plan providing the information requested in Section 4.2 of Exhibit B to the ITP.

  • City’s Manager means a manager who at the relevant time carries such designation from the City under, or in accordance with, ARTICLE 5;

  • Project Management Report means each report prepared in accordance with Section 4.02 of this Agreement;

  • Stormwater management means the programs to maintain quality and quantity of stormwater runoff to pre-development levels.

  • Mines Manager means the Mining Engineer so designated for Jhamarkotra Rock Phosphate Mines of Rajasthan State Mines and Minerals Limited.

  • Construction management at-risk means a project delivery method in which the District awards separate contracts, one for architectural and engineering services to design an infrastructure facility and the second to a construction manager at-risk for both construction of the infrastructure facility according to the design and construction management services.

  • disaster management means a continuous and integrated process of planning, organising, coordinating and implementing measures which are necessary or expedient for—

  • Storm water management plan means a comprehensive plan designed to reduce the discharge of pollutants from storm water after the site has under gone final stabilization following completion of the construction activity.

  • Change Management means the add-on module to the Programs that enables engineers to define network changes through one or more configuration templates. Those network changes can be applied to multiple devices and executed/rolled back automatically. The Change Management module enables engineers to verify the impact of the changes across the network to help ensure a safer change process.

  • Management means an activity inclusive of control and performed on a daily basis, by any person who is a principal executive officer of the company, by whatever name that person may be designated, and whether or not that person is a director.

  • Quality management means coordinated activities to direct and control an organization with regard to quality;

  • Virginia Stormwater Management Program authority or "VSMP authority" means an authority approved by the State Board after September 13, 2011, to operate a Virginia Stormwater Management Program.

  • Stormwater management plan means the set of drawings and other documents that comprise all the information and specifications for the programs, drainage systems, structures, BMPs, concepts and techniques intended to maintain or restore quality and quantity of stormwater runoff to pre-development levels.

  • trade in services means the supply of a service: (i) from the Area of a Party into the Area of the other Party (“cross-border supply mode”); (ii) in the Area of a Party to the service consumer of the other Party (“consumption abroad mode”); (iii) by a service supplier of a Party, through commercial presence in the Area of the other Party (“commercial presence mode”); and (iv) by a service supplier of a Party, through presence of natural persons of that Party in the Area of the other Party (“presence of natural persons mode”); and

  • Case management services means planned referral, linkage, monitoring and support, and advocacy provided in partnership with a consumer to assist that consumer with self sufficiency and community tenure and take place in the individual’s home, in the community, or in the facility, in accordance with a service plan developed with and approved by the consumer and qualified staff.

  • Virginia Stormwater Management Program or “VSMP” means a program approved by the State Board after September 13, 2011, that has been established by a locality to manage the quality and quantity of runoff resulting from land-disturbing activities and shall include such items as local ordinances, rules, permit requirements, annual standards and specifications, policies and guidelines, technical materials, and requirements for plan review, inspection, enforcement, where authorized in this article, and evaluation consistent with the requirements of this article and associated regulations.