Policies, Procedures and Service Standards

Case Loads - Claims adjusters typically maintain a caseload of between 125 and 150 files.

Claims file documentation requirements - The computer claim file contains documentation of all adjuster activity through adjuster notes, reserve calculation worksheets, forms and correspondence, medical bills and records of the event and claim. Documentation is required for each file activity.

Investigation and communication - Upon receipt of a claim the adjuster is required to make a three point contact with the insured, claimant, and medical provider within 24 hours of notification of the claim. An investigation of the claim is conducted and documented.