Claims Handling Best Practices: Claims Reviews


Claims reviews are an effective loss control tool used as an integral part of your risk management program. Loss runs provide a great deal of valuable information, but they cannot provide the full picture of a loss or your overall open exposures. Claims reviews provide a dynamic information exchange that gives real-world context to your claims analytics.

Preferred Governmental Claims Services (PGCS) partners with Preferred to provide claims services. We welcome any opportunity to increase our knowledge about your entity and ways PGCS can help you reach your risk management goals. PGCS’ team of claims professionals focuses solely on Florida’s public entities. Our adjusters have specialized knowledge and experience with your area’s attorneys, providers and facilities who directly impact the value of your claims. PGCS works closely with local defense attorneys to understand the best litigation strategy. We leverage that knowledge to close your cases, both non-litigated and litigated, as efficiently as possible while meeting the goals of your risk management program.

The PGCS claims team will contact you to discuss which claims you would like to address in your claims review. The adjuster then prepares detailed written reports on each of the claims. The reports cover the facts, coverage, damages/injuries, financials and plan of action for resolving the claim. You get a holistic view of the entire claim at a certain point in time, presented by the claims professional who knows it best. The reports are provided to your team in advance of the review.

The actual claims review meeting provides a confidential forum to discuss the case with stakeholders. Your selected representatives meet with claims professionals, claims leadership, Trust administrators, your Preferred loss control representative and your agent. It’s the only occasion where your entire team gathers to focus solely on mitigation and resolution of your losses. It allows you to ask questions, exchange information about the losses and partner on developing a resolution strategy before you are requested to provide agreement on a proposed settlement or litigation strategy.

We want to make your experience as productive as possible. We are flexible as to scheduling. We can combine Liability and Workers Comp, or do each line of business separately, depending on your needs and availability. The emergence of widely used video conferencing technologies such as Microsoft Teams© allows virtual meetings that can accommodate more people in separate locations and use less of your entity’s valuable resources and the precious time of your staff.

Claims reviews provide an excellent opportunity for you to develop a rapport with both adjusters and claims leadership. Our team enjoys getting to know more about your member organization and building relationships with your staff. The increased knowledge helps us align our handling with your expectations to provide more positive outcomes for your entity.

If you would like to set a Claims Review, please contact your Loss Control representative or Cheryl Riley ([email protected] for Workers’ Comp or [email protected] for Liability.

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