Streamlined Quality Management

Adjusters are human, and even the most experienced claim professionals can occasionally overlook something during an inspection or make a mistake when coding an item on an estimate. RENFROE believes in proactive quality management, which is why every single claim our adjusters handle for clients is reviewed for errors. But what about claims handled by your staff adjusters? We are happy to offer these same quality management services as a standalone offering to carriers of all sizes.

Streamlined Quality Management

Adjusters are human, and even the most experienced claim professionals can occasionally overlook something during an inspection or make a mistake when coding an item on an estimate. RENFROE believes in proactive quality management, which is why every single claim our adjusters handle for clients is reviewed for errors. But what about claims handled by your staff adjusters? We are happy to offer these same quality management services as a standalone offering to carriers of all sizes.

The Cost of Claim Errors

Less experienced adjusters often misinterpret or misunderstand policy language and extent of coverage, and adjusters or inspectors with insufficient training far too often scope losses incorrectly due to inaccurate measurement techniques. Many claims simply lack sufficient information about the loss from the claimant.

These errors can quickly compound, causing claims to be underscoped, overestimated, and, ultimately, underpaid or overpaid. The cost of such oversights can range from reinspections, to grossly overpaid settlements, to expensive lawsuits.

Quality Assurance and File Review

When carriers use our QA and File Review solution, our file reviewers — all veteran adjusters — review the submitted scope of loss for mistakes and oversights stemming from the inspection.

Additionally, policyholder statements, first notice of loss forms, and policy documents are reviewed to ensure applicability and verify coverage.

Once the review is complete, a report of findings is returned to the adjuster and their manager along with recommended or required actions for remediation.

Interested in an automated solution? Check out ClaimSentinel™, our AI-powered claims QA platform.

Quality Assurance and File Review

When carriers use our QA and File Review solution, our file reviewers — all veteran adjusters — review the submitted scope of loss for mistakes and oversights stemming from the inspection.

Additionally, policyholder statements, first notice of loss forms, and policy documents are reviewed to ensure applicability and verify coverage.

Once the review is complete, a report of findings is returned to the adjuster and their manager along with recommended or required actions for remediation.

Interested in an automated solution? Check out ClaimSentinel™, our AI-powered claims QA platform.

Ensure You Pay What You Owe With AccuGuard™ Estimate Review and Audit

Underpaid claims put carriers at risk for costly reinspections or even litigation, while consistently overpaid claims can quickly impact a carrier’s bottom line. Perhaps even worse, patterns of underpaid claims -- even unintentionally -- can expose carriers to regulatory or civil action. Carriers that use RENFROE’s AccuGuard for estimate review or internal auditing can mitigate these risks and significantly reduce claim overhead.

Estimate Review

As part of your claim workflow, estimates are submitted to us individually or in small batches as they are completed. The estimates are reviewed by veteran licensed adjusters with significant estimating experience and a trained eye for common mistakes and oversights. Once the review is complete, the reviewer will return the estimate to the adjuster along with a detailed report of findings and recommendations, if needed.

Estimate Audit

We highly recommend that all carriers periodically audit their estimates and claim settlements, and we can assist you in doing so with AccuGuard. With an AccuGuard audit, you submit large batches of closed claims to RENFROE. A skilled audit team of highly experienced adjusters will review each estimate for accuracy and compliance. Once the audit is complete, the carrier will receive a comprehensive report of findings, an assessment of risk, and, if applicable, recommendations for remediation.

Ensure You Pay What You Owe With AccuGuard™ Estimate Review and Audit

Underpaid claims put carriers at risk for costly reinspections or even litigation, while consistently overpaid claims can quickly impact a carrier’s bottom line. Perhaps even worse, patterns of underpaid claims -- even unintentionally -- can expose carriers to regulatory or civil action. Carriers that use RENFROE’s AccuGuard for estimate review or internal auditing can mitigate these risks and significantly reduce claim overhead.

Estimate Review

As part of your claim workflow, estimates are submitted to us individually or in small batches as they are completed. The estimates are reviewed by veteran licensed adjusters with significant estimating experience and a trained eye for common mistakes and oversights. Once the review is complete, the reviewer will return the estimate to the adjuster along with a detailed report of findings and recommendations, if needed.

Estimate Audit

We highly recommend that all carriers periodically audit their estimates and claim settlements, and we can assist you in doing so with AccuGuard. With an AccuGuard audit, you submit large batches of closed claims to RENFROE. A skilled audit team of highly experienced adjusters will review each estimate for accuracy and compliance. Once the audit is complete, the carrier will receive a comprehensive report of findings, an assessment of risk, and, if applicable, recommendations for remediation.

Ready to Talk About Your Quality Management Needs?

We know that in a competitive industry with ever-increasing costs, quality has implications that extend beyond policyholder satisfaction. If you're looking for an efficient way to outsource your quality management needs, provide you're information below and someone will be in touch to help you determine the best solution.

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