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Claims Management

•  Case reviews with comparative benchmarking

•  Provide expert third-party litigation resources

•  Develop claims procedure manuals for clients

•  Provide customized claim management education seminars

Highly Experienced Claim Personnel

American Excess Insurance Exchange, RRG (AEIX) membership is comprised of sophisticated, not-for-profit healthcare systems with capable, highly qualified claims managers handling their portfolio of pending claims within a self-insured retention (SIR).

Claims Resolution Caucus 

The American Excess Insurance Exchange (AEIX) hosted the annual Claims Resolution Caucus (CRC) at the Mountain Shadows in Phoenix, AZ on January 7th – 9th, 2019. This professional skills development program was designed for the lead claim managers, lead defense attorneys, brokers and reinsurance partners who represent the AEIX member hospitals in coverage, limit capacity and healthcare professional liability disputes. The CRC course focused on advanced settlement negotiation strategies based upon the model developed at the Straus Institute for Dispute Resolution at Pepperdine University School of Law – the #1 ranked dispute resolution program in the nation according to U.S. News & World Report. Over 70 attendees from around the U.S. participated in the excellent educational session. For more information please contact Mollie O’Brien at mollie_obrien@premierinc.com.

AEIX Claims Scorecard Benchmarking

To help ensure consistent claims management practices across the RRG, members participate in a comprehensive review process conducted by professionals from AEIX, utilizing a proprietary claims scorecard tool. The scorecard, developed jointly by AEIX members and staff, analyzes 31 claims metrics and ensures that all members maintain high reliability processes in the critical areas of communications, reserving, financial documentation, claims controls and technical management. The AEIX Subscriber’s Advisory Committee receives a summary scorecard report annually to discover any poor scores and to help the consulting team develop action plans to improve performance. These plans may include on site consultation engagements by consulting staff to build out processes and provide education. To share best practices and enhance capabilities, AEIX provides in-depth discussions of each audit category during governance meetings.

Results from the scorecard process demonstrate that all AEIX systems are meeting or exceeding expectations and have been improving steadily over the past five years.

Claim Management 

Adverse claim developments at the hospital level can financially drain a healthcare system of capital not easily replaced in today’s competitive environment. In the face of rising costs of defense and higher losses paid nationally, hospitals cannot overlook the importance of evaluating their claims performance to ensure they are efficiently achieving the best possible outcomes. To assist you, AEIX employs attorneys and healthcare professionals with significant experience in managing professional liability (medical malpractice) claims.

The AEIX professional team provides a wide variety of services:
  • Claim management of excess exposures above members’ SIR, as well as providing assistance and advice on cases within members’ SIRs.
  • Claim department audits measuring capabilities across five important technical and financial competencies, providing metrics which may be benchmarked against peer hospitals.
  • Full management of claims and lawsuits from investigation of incidents to mediation, settlement, trial, and post-trial activities.
  • Consulting in the development of claim management systems and protocols for healthcare entities.
  • Providing education seminars and newsletters to help drive member performance improvement and adoption of best claims and litigation practices.