17 Storms Since January Didn’t Stop Our Adjusters
The Property team has been busy in 2015 with 17 declared catastrophes. According to Property Vice President, Tim Allen, the “CATs” have fallen into two types of events: winter storms and wind/hail storms. “There has literally been a new storm every week since late January. While it has been a challenge, the whole organization has come together as a team, putting in extra time, including weekends and we brought on a lot of extra help to make sure that our customers receive immediate attention.” The field adjusting team at National ConnectForce Claims (NCC) has been pivotal in helping ACM achieve industry-leading cycle times by ensuring field adjusters are dispatched immediately.
Go North! New Offices Opening Soon
Be on the lookout for new ACM locations in the Northwest and Northeast. To better meet the needs of our clients and their geographical needs, ACM’s Workers’ Compensation Program and Marquee Managed Care Solutions will open a new office location this summer in the Sacramento California area. Additionally, ACM’s Property Casualty Program will expand into New York by the end of 2015.
On the Road in 2015
Team members from American Claims Management will attend the following upcoming industry events:
- California Coalition on Workers’ Compensation, July 22-24 in Anaheim, CA
- NAPSLO Annual Convention, Sept. 8-11 in San Diego, CA
- Int’l. Association of Claims Professionals Annual Conf., Sept. 27-30 in Lost Pines, TX
- CA Workers’ Compensation & Risk Conf., Sept. 30 – Oct. 2 in Dana Point, CA
- Pacific Claims Executive Association Fall Conf., Oct. 8-10 in Portland, OR
- 12th Annual IRSF San Diego Charity Golf Tournament , Oct. 16 in San Diego, CA
- Target Markets Program Administrators Association, Oct. 26-28 in Scottsdale, AZ
- California Self Insured Group Annual Conf., Nov. 6 in Sacramento, CA
- National WC & Disability Conference Annual Conf., Nov. 11-13 in Las Vegas, NV
- Professional Liability Underwriting Society Annual Conf., Nov. 11 (location TBD)
More Than a Decade of Hope Supporting Rett Syndrome
ACM continues the tradition joining our insurance industry friends for another year of fundraising and fairways. The 12th Annual Rett Syndrome Charity Golf Classic is October 16, 2015 at Cottonwood Golf Club in San Diego.
The annual tournament began in 2004 after ACM’s Workers’ Compensation team members pooled their friends, families and community resources in the hope they could raise awareness for Rett Syndrome, a rare autism spectrum disorder that affects young girls. The disorder causes problems with muscle and coordination and leaves these children wheelchair bound with no ability to speak. They are able to experience a full range of emotions, are cognitively aware of their surroundings and are capable of learning and growing but they are essentially trapped in their bodies. We call them our silent angels.
During the years, the tournament has raised more than $700,000 for researching new treatments and a cure for Rett Syndrome. More than 400 participants return year-after-year to be a part of this community experience and enjoy the opportunity to meet families affected by the disorder and bring them hope.
Watching these girls grow each year drives us to continue our fundraising efforts. ACM feels blessed by the opportunity to raise money for Rett Syndrome and we hope to continue the tradition for years to come. Learn more about the annual golf tournament and Rett Syndrome.
Saving Our Client’s Money: Success Stories
Check out examples of how ACM and Investigative Solutions saved our clients money.
Hold On! Not So Fast!
This case involves a two vehicle collision in which the insured, who was operating their own insured vehicle, was hit by vehicle one which failed to yield while turning in front of the insured’s vehicle, causing the insured to strike vehicle one. The insured was seeking PIP benefits from her carrier policy.
Through our investigation, several policy misrepresentations were identified including failure to list proper vehicles and all drivers on the policy application. As such, a policy rescission was completed and a denial of the claim was sent to the insured and medical providers.
Projected client savings: $30,000
Lights! Camera! Gotcha!
An injured construction worker alleged a cumulative trauma injury to his knee and leg as a result of stacking bricks during a period of time, as well as an injury on an additional occasion to his back, hand, shoulder neck and chest. The claim also includes a psych add-on. Coverage periods apply in this claim with contribution as an issue as this is a cumulative trauma injury. This case was referred to Investigation Solutions’ Special Investigations Unit based on surveillance of the claimant working the same duties he performed prior to the injury.
The DQME reported that the claimant would be in need of significant future medical care; however ACM’s surveillance showed the claimant working construction and appeared to be fully recovered. A combined total of five hours surveillance video was obtained on seven separate days/times of the claimant engaging in heavy construction work.
It was then concluded the claimant showed no signs of disability and that “the degree of depression doesn’t correlate with his ability to perform heavy constriction labor.”
Based on SIU’s investigation and doctor’s review of all documents, the parties were able to go from 71 percent permanent disability of $121,297.50 with a $200,000 C&R demand down to $23,000 new money and all medical treatment for the second injury was deemed unreasonable and unnecessary. This finding is also providing great benefit to the lien negotiations.
Projected client savings: $150,000
ACM Welcomes New Clients in 2015
Constitutional Insurance Company • Faraday • Hiscox • McCormack – Baron • National Unity Insurance Company • Western National Group