Home case study The evidence needed to prove insurance fraud is often well hidden, which makes uncovering that crucial ‘silver bullet’ very satisfying.  A substantial water damage claim was identified as suspicious by one of our adjusters durin…

The decision to deploy clinical resources on a claim can be crucial to the outcome of the claim. This decision is frequently made when the claim hits a specific dollar threshold or when the examiner determines a referral is needed. However, assigning…

The U.S. Supreme Court accepted the case, New Prime Inc. v. Oliveira,for review to resolve disagreements among courts across the country regarding the exclusion in Section 1 of the Federal Arbitration Act (FAA) of “contracts of employment of seamen, …

Sedgwick has many achievements to be proud of as we begin 2019, including celebrating 50 years in business. Leveraging our proven experience working with the world’s leading organizations, we continue to adapt our offerings to help manage the wide ar…

As we wrap up the holiday season, “Season’s Greetings” feels more like “Season’s Grievings” for some seniors. The holidays tend to bring back memories of good times, happier times when life was “good.” But sometimes what’s underlying a change in mood…

At Sedgwick, taking care of people is at the heart of everything we do. Millions of people and organizations around the world count on us each year to take care of their needs. Clean water is a necessity for everyone and life without it can seem unim…

Well, it’s that time of year again.  As per the CDC, flu activity usually peaks between December and February, although activity can last as late as May. As we know, the flu is a contagious respiratory illness caused by influenza viruses that in…

In today’s information age, data is everywhere. We’re inundated with it. But gathering data is just one piece of a much larger puzzle. Data isn’t very useful if nothing is done with it. It’s the analysis that leads to using data effectively to make b…

To those unfamiliar with the process, calculating claims’ settlements may appear to be a mysterious and complicated endeavor. However, when done right, the process can and should be transparent, fair and beneficial to all parties. Risk managers play…

Disasters are unfortunately becoming commonplace news stories. Many people are dealing with tragic losses in the wake of both man-made and natural disasters. The recent fires that have ravaged California are now among the most devastating in U.S. his…

That magic moment . . . no, we aren’t launching a new dating site.  What we’re talking about is that specific point in time when a claim could and should have been settled and for some reason, often one beyond the control of the examiner, it was…

When I started my career as a young claims adjuster at an insurance company, my managers showed me the secret handshake and explained the position’s responsibilities. They then told me that to settle claims, we would negotiate to an agreed level of i…

In a disaster, emergency evacuation for long-term care facilities saves lives, not money. Evacuation expense reimbursement coverage may help when there is no question about whether to stay or go. The projected paths of the two most recent hurricanes…

When you think of industries with rising claims, cavity wall insulation (CWI) is probably not one of your top choices. However, we are seeing clients that have received thousands of claims from new ‘specialists’ against CWI contractors for negligent …

What do we discuss with our colleagues and peers at meetings, conferences and around the proverbial water cooler? What are the topics we read about in trade publications or LinkedIn posts?  What causes risk managers and those who develop claims’…