GCMC is a complete (or "turn key") claims management solution for small to midsize businesses with self insured retentions from $25,000 to $500,000 per claim. We handle personal injury and general liability claims for small to midsize companies ($20-500 million in sales). We usually handle all claims covered under most "CGL" (Commercial General Liability) policies. We typically exclude workers compensation claims, health insurance claims and other related non third party liability claims. Unlike most TPA's (known as Third Party Administrators) we handle and track claims from their very inception to final resolution either at the claims or litigation level. There is no "handing" off the claim once it goes into suit. We handle the claim for its entire life no matter where the claim is located. That continuity is what sets us apart from all the other TPA's, in addition to our specialization in sports and recreation product liability claims. Our goal is to close cases as quickly as possible, not to "push paper around" like most TPA's. We can do that because we understand your underlying business, we understand these claims and we understand what it takes to resolve claims quickly. We are not insurer focused or created by and for insurers. We are focused on the insured, their business and their specialized claim needs. We want what you want. If you are looking for a comprehensive solution to your claims management problems, give us a call first. Or have your broker contact us directly. You will be glad you did.
What are Third Party Administrators "TPA's"?
This term is now commonly used in "CGL" (commercial general liability) policies or so called "casualty" business. In these instances the liability policies are written with a large (usually in excess of $50,000) "SIR" (self insured retention) that operates somewhat like a deductible, but rather than being paid at the end of a claim (when a loss payment is made to a claimant) the money is paid up front by the insured for costs, expenses, attorney fees etc. as the claim moves forward. If there is a settlement or verdict within the SIR then that is also paid by the insured up to the limit of the SIR, before the insurer steps in and pays its portion. The Third Party Administrator acts like a claims adjuster for the insurance company and sometimes works in conjunction with the inside insurance company claims adjuster or an outside claims investigator as well as the defense counsel. The defense counsel in some situations is selected by the TPA. The point is that the larger the SIR the more responsibility the TPA (third party administrator) has over the control of the way the claim is handled and ultimately resolved. Some self insured retentions are in the millions of dollars and the TPA's are large multinational non-insurance entities that handle all the claims. In some cases the insured sets up an entire department within their company (and staffs it with claim savvy people) to act as the TPA as opposed to hiring a commercial TPA company.
What do you need to know about a Certificate of Insurance?
There are a number of questions you should be asking yourself about that certificate of insurance that you worked so hard to get from your supplier. Now that you have it:
What does it mean in terms of coverage for your business?
What is "evidence of insurance" vs "additional insured"?
Do you still need your own policy?
If so what type and at what rate?
What is a rate and how can I properly compare one rate with another?
What good is the certificate if you obtain your own policy?
What are the terms of the policy(ies) listed on the certificate?
How can I find out?
What do you know, or need to know, about the insurer?
Who else has the same certificate on this policy?
What rights do you have and not have under the policy?
What is a vendors endorsement and what does it have to do with your certificate?
Where can you get one, and why do you need to?
What is the deductible or SIR of the policy mentioned in this certificate?
Is the policy claims made or occurrence based?
What does that mean and why do you need to know?
What are the limits of the policy vs. the limits on the certificate?
If you don't have answers to these questions and your broker or agent did not explain them to you then you need our service before you move forward relying on that certificate you are holding. Never pay thousands of dollars for insurance without understanding exactly what you are buying, what you need, what you don't and what you can expect.
Example of a Certificate of Insurance:
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What are self insured retentions "SIR's"?
A self-insured retention (sometimes abbreviated as "SIR") is a potential loss assumed by an organization--that is, not insured. The SIR differs from a deductible because the insured performs all the functions normally undertaken by an insurance company for losses within the SIR, including claims adjusting and audits, funding and paying claims, and complying with applicable state and federal laws and regulations.
A deductible on the other hand is the amount of an insured loss for which the insured is financially responsible before an insurance policy provides coverage.
from Rupp's Insurance & Risk Management Glossary. 2002, NILS Publishing. All rights reserved.
