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.
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.

Examples of Claims Management in a sentence

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

  • Waivers may be obtained from Safety and Health Claims Management, Loss Prevention and Risk Management, P.

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

  • We are regulated by the Claims Management Regulator in respect of regulated claims management activities.

  • Any referral to the Claims Management Ombudsman must be made within 6 months of receipt of our final response.

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

  • The Prudential Appeals Review Unit and Claims Management Team members are made up of individuals not involved in the initial benefit determination.

  • The plans also contain non-insurance Travel Assistance Services provided by C&F Services through Active Claims Management (2018) Inc., operating as Active Care Management.

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

  • The Claim decision will be made by a member of the Prudential Claims Management Team.


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.
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 proofmeaning 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.
Claims Management shall have the meaning set forth in the Recitals.
Claims Management means Third Party Claims Management, Inc., a Connecticut corporation and its successors and assigns.
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.

Related to Claims Management

  • Case management means a coordinated set of activities conducted for individual patient management of serious, complicated, protracted or other health conditions.

  • 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 means the systematic control of all records from creation or receipt through processing, distribution, maintenance and retrieval, to their ultimate disposition.

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

  • Claims Administration means the processing of claims made under the Shared Policies, including the reporting of claims to the insurance carriers, management and defense of claims and providing for appropriate releases upon settlement of claims.

  • 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 the preparation for and the carrying out of all emergency functions to mitigate, prepare for, respond to and recover from emergencies and disasters, and to aid victims suffering from injury or damage caused by all hazards, whether natural or human-made, and to provide support for search and rescue operations for persons or property in distress pursuant to the provisions of chapter 38.52 RCW.

  • Project Management Plan or “PMP” means a document prepared for the purposes ofdefining how the project is executed, monitored, and controlled.

  • 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.

  • 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.

  • Preschooler means a child age two through four years old.

  • 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.

  • Pest Management Plan and “PMP” means the Recipient’s plan dated March 9, 2010, which: (i) addresses the concerns relating to the Project risks associated with potential increases in the use of pesticides for agricultural production, intensification and diversification and controlling disease vector populations arising from irrigation schemes; (ii) sets forth mitigation and monitoring measures to be taken during Project implementation and operation to eliminate adverse environmental and social impacts, offset them, or reduce them to acceptable levels; (iii) recommends institutional measures to strengthen national capacities to implement the mitigation and monitoring measures; and

  • Virginia Stormwater Management Program authority or "VSMP authority" means an authority approved by the Board after September 13, 2011, to operate a Virginia Stormwater Management Program or, until such approval is given, the Department. An authority may include a locality; state entity, including the Department; federal entity; or, for linear projects subject to annual standards and specifications in accordance with subsection B of § 10.1-603.5, electric, natural gas, and telephone utility companies, interstate and intrastate natural gas pipeline companies, railroad companies, or authorities created pursuant to § 15.2-5102.

  • 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:

  • 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.