Claims Administration Services

SPARTA’s Claim Department evaluates and approves the selection of third-party claim administrators (TPA) who provide claim handling on an unbundled basis pursuant to a contract with SPARTA. A due diligence process assesses the organizational capabilities of proposed providers with the objective of selecting claim handling expertise oriented to long term management. This process involves the compilation of information on company management, technical and operational competencies and financial strength.

Organizational
Compliance with entity and adjuster licensing requirements:

• Insurance coverages of $5 million per occurrence for E&O and $1 million for Fidelity SAS-70 compliance
• Audited financial statements for the most recent two years and interim financial statements

Operational

• Claim system functionality and on-line access by SPARTA
• Data interface capabilities to meet SPARTA’s data layout
• Inception to date values reported monthly
• Risk attaching, program-based reporting capabilities
• Loss escrow accounting, 1099 reporting, Escheat, OFAC

Technical
Claim-handling procedures from intake, confirmation and investigation through to resolution, including management, supervision and oversight, case loads, subrogation, cost containment and litigation.