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Claim Services
Claim TPA Approval Process
All Claim TPAs must be approved by SPARTA to be authorized to handle claims on SPARTA's behalf. The Claim TPA approval process begins with the Claim TPA Due Diligence Questionnaire, a compilation of information designed to perform an initial assessment of the TPA's background, management, competency, capabilities, and financial position.
The TPA Due Diligence process includes a thorough assessment and minimum requirements in the following areas
- Compliance with entity and adjuster regulatory licensing requirements
- E&O and Fidelity insurance coverage standards
- E&O limit of $5 million per occurrence
- Fidelity limit of $1 million coverage for entity and each employee
- Recent SAS-70 report
- Financial Viability review based upon audited financials for past two fiscal years and interim financial statements
- Proven data interface capabilities
- Meet SPARTA's data layout
- Inception to date values provided to SPARTA monthly
- Reporting on a program/policy risk-attaching basis
- Accounting procedures
- Loss Escrow accounting
- 1099 reporting
- Escheat
- OFAC
- Claim Operating procedures
- Claim intake
- Coverage confirmation
- Reserving and payment
- Supervisory
- Caseloads
- Subrogation
- Cost containment
- Litigation management
- Claim system functionality
- Online access to provider claim system
- SPARTA's Master Services Agreement
In order to apply for TPA Approval, please contact:
Susan Putterman, EVP and Chief Claims Officer
SPARTA Insurance
CityPlace II, 185 Asylum Street
Hartford, CT 06103
Telephone: 860.275.6500
Direct Line: 860.275.6507
Fax: 860.275.6501
