01
Estimate review
Line-by-line review of field and desk estimates for scope, pricing, coverage application and documentation.
Independent Claim Review and Quality Assurance
Estimate review, reinspection, closed file audit, reserve accuracy review and adjuster and vendor performance review, delivered as standalone engagements with written findings. The firm does not need to have handled a file to review it.
Estimate reviewReinspectionClosed file auditReserve accuracyQA program design
Who we serve
- Carriers and MGAs
- TPAs
- Independent adjusting firms
- Self-insured entities and pools
- Reinsurers and auditors
Review led by an adjuster who ranked in the top 5 percent
A file review is only as good as the reviewer’s own field judgment. Reviews are directed by an Executive General Adjuster who held multi-line supervisory and special claims authority at Farmers Insurance and Zurich and was ranked in the top 5 percent for file quality, cycle time and customer service throughout his career.
Engagements range from a single disputed estimate to a sampled audit of a catastrophe book. Every finding is tied to the evidence in the file and to the client’s own guidelines, so the report holds up in an internal audit, a market conduct examination or a reinsurance review.
Credentials behind the work
DesignationExecutive General Adjuster
Experience25+ years P&C catastrophe
PerformanceTop 5%: quality, cycle time, service
NFIPRCBAP, commercial, HO, MH
LicenseTexas DHS, reciprocal
EstimatingXactimate, Cotality Estimate
Services
Claim review services
02
Reinspection
Field reinspection of sampled or disputed files, with photo documentation and a reconciled estimate.
03
Closed file audit
Sampled audits of closed files against the client’s guidelines, with scorecards by adjuster, vendor or event.
04
Reserve accuracy review
Review of reserve setting and movement on open files, with flags for under- and over-reserved claims.
05
Adjuster and vendor performance review
Quality, cycle time and leakage findings for individual adjusters, IA firms and repair or mitigation vendors.
06
QA program design
Design of a quality assurance program, sampling plan, scorecard and feedback loop for a claims operation.
How it works
How a review engagement runs
STEP 1
Scope
Agree on files, sample size, guidelines and deliverables.
STEP 2
Access
Work in the client’s systems under its security rules.
STEP 3
Review
Review and reinspect against the client’s standards.
STEP 4
Report
Written findings with evidence and prioritized recommendations.
STEP 5
Debrief
Walk the results with claims leadership.
Questions
Frequently asked questions
Q01
Does the firm have to handle the claim to review it?
No. Reviews are delivered as standalone engagements on files handled by any adjuster or vendor.
Q02
What does the deliverable look like?
A written findings report with the evidence attached, scorecards where useful, and prioritized recommendations a claims executive can act on.
Q03
Can reviews be done remotely?
Yes. Most estimate and file reviews are performed remotely in the client’s systems. Reinspections are performed in the field.
Q04
Can the review support litigation or appraisal?
Yes. Consulting reviews of disputed files are available to counsel before suit. Testifying engagements are handled through the expert witness practice.
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Related services and guides
Have a book of files to look at?
Send the file count, the event or program, and the question you need answered. You will get a proposed scope and sample plan.