Insurance claims manager Essay

Insurance claims manager Essay

Understanding Insurance Coverage

– Introduction Insurance is a very important part of modern life and business. In this paper I will discuss the basic concepts of insurance, claims-made and occurrence liability policies, factors for selecting an insurance company and policies, and the difference between workers compensation and liability insurance. What is insurance. Insurance is a two-way legal agreement between the insurer and the customer. The customer, which may be an individual, business, or other entity, agrees to pay the premiums as required, in exchange for monetary protection from the insurer for any possible substantial loss….  

Insurance Companies: Allstate

– Introduction Allstate must consider a loss control strategy because of the unforeseen impact that can affect their bottom line. Understanding the most common and costly claim payouts such as wind, burglary, fire, water, and physical damage can direct Allstate toward a more streamline approach in addressing some controllable claims, which will reduce payouts and increase profits (Allstate.com, 2011). This assignment will further provide alternatives that can be used as a strategy so that Allstate can achieve additional growth that compliments their strategic vision of reinventing protection and retirement for consumers….  

Corona Data Analysis (CDA)

– Introduction: This case is about Corona Data Analysis (CDA) which processes claims for health insurance. CDA has about 90 employees out of which 75% work in the operations side of the business which is also the side of the business we were hired to consult upon. We were hired by the quality manager, Gordon Yu, who was hired by the CEO, Julieanna Sugumar. Gordon Yu has asked us to analyze the defects per unit, DPU, defects per million units , DPMO, and K-sigma quality levels. He has given us important access to the processing data and the number of errors that were made in 5 different categories including name, ss#, address, claim code, and claim date fields….  

Pricing Market Strategy: Pharmaceutical Benefit Manager

– Suppose that you are a pharmaceutical benefit manager. First, briefly assess various pricing strategies that could be used to charge employers for prescription drugs. The first PBMs were created by managed care organizations in the 1980s to apply managed care principles, such as provider networks and patient co-pays, to the drug benefit portion of health care plans. Through rapid growth in the 1990s, PBMs “emerged as the national standard for the administration of prescription drug insurance in the United States.” The three largest PBMs manage drug benefits for over 200 million Americans 95% of Americans with prescription drug coverage….  

R.F. Insurance

– R.F. Insurance is a commercial insurance company based on the east coast. In 1984, a group of graduate students were given a project to asses job design, career development, and job motivation in a particular district office of R.F. Insurance. The findings of this group despite the limited number of respondents permitted to take the student’s survey are more or else what can be expected given the circumstances surrounding employment at R.F. Insurance. The district office operates under the control of the district office manager who is essentially in charge of a sales team, claim adjusters, several office clerks, and one loss prevention engineer….