Claims Handling

Claims Administration

Experience seamless end-to-end claims handling services, from initial report to final resolution. Choose from a range of services, including: First Notice of Loss (FNOL), Special Investigation Unit (SIU) and Subrogation; as well as related administrative, management and reporting services.

A quality claim organization closely monitors loss and expense costs while searching for alternative approaches to managing these costs. Pilgrim is the right choice to improve your organization’s claim handling process and service.

In depth: Claims Services brochure

PIP/No Fault Claim Services

Pilgrim aggressively manages your claims, mitigating damages and ultimately reducing claim payouts.

Your Pilgrim solution will create measurable cost containment and increased productivity throughout your organization. Depending on your business requirements, we can also develop medical bill review and cost containment services for your automobile programs.

By combining the latest medical industry data with an intuitive and flexible interface, we’ll streamline your workflows to improve efficiencies, increase productivity and identify potential fraud more quickly, strengthening your bottom line.

Learn more: PIP Claims Services brochure

Fraud Investigation (SIU)

Stop fraud in its tracks. Special Investigation Services is a dedicated fraud division with specialized expertise and resources focused on minimizing the adverse effects of fraud for our clients.

Our investigators average over 20 years’ experience in the insurance industry and the attorney general’s office. We investigate all potential fraud situations, providing a thorough investigation through to litigation support including depositions, interrogatories and examinations under oath. Our team will liaise with insurance fraud organizations, state fraud regulators and law enforcement agencies as well as provide fraud prevention training for your claims and underwriting staff.

In depth: Special Investigative Unit brochure

Subrogation

Insurance, reinsurance and large companies with self-insured retentions rely on Pilgrim’s subrogation services. Receive automatic diary, tasks based on complexity and statute of limitation dates by state with Pilgrim’s internal subrogation application.

Work with a talented pool of associates who have extensive insurance knowledge. Our team has an experienced collections mentality and the skills to aggressively pursue and resolve your subrogation claims. We focus on processing your reimbursements quickly and fairly, keeping you informed throughout the process. Your Pilgrim solution will also be results-driven: you’ll receive weekly evaluations through Quality Control measures and productivity assessments.

Learn more: Subrogation Recovery brochure

Audit

In any claims organization, a comprehensive audit process is necessary to reduce expense and loss dollars. Effective audits provide insight into the quality of work being produced, identify workflow or processing issues, and offer opportunities to improve claims service and increase customer satisfaction.

Get a more complete picture of your claim handling quality and leakage in your claim operation with Pilgrim’s audit process. Our highly skilled and experienced auditors will provide measurable insights into your workflows, staffing analysis, claim quality, and dollar leakage.

Learn more: Auditing Services brochure

Consulting

Stay competitive. Pilgrim’s business process outsourcing provides the expertise and perspective your business requires to create efficiency and reduce costs.

Our experienced insurance professionals understand the requirements affecting the insurance industry. We can provide your firm with consulting services to assist you with your regulatory compliance efforts. Our consulting team has the statistical expertise and the systems to accept your data, perform quality edits and prepare complete submissions for timely and accurate bureau reporting.

Pilgrim maintains industry-leading policy processing and claim management information systems. Deploy a cost-effective systems solution that includes systems management, printing, mailing, data entry and reporting. Our solution will be backed by a dedicated team who will strive to deliver excellent customer service year after year, helping your organization build upon its success.

As a business process outsourcer, we can provide complete, unbiased and confidential claim auditing. Our subrogation review process has been extremely successful in achieving recovery dollars for our clients.

For expertise in agency management (including managing challenging agents and providing agency audit services), and for assistance with your regulatory and compliance efforts, Pilgrim can help.

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Policyholders

  • (800) 721-8294

Agents

  • (617) 956-6000

Outsourcing Clients

  • (617) 956-6000