Newsletter

2023 Liability Third-Party Claims Administrator (TPA) Audit

On an annual basis, and to ensure the highest level of liability claims administration, the California JPIA conducts an independent audit of our liability third-party administrator (TPA). For the past 11 years, the Authority has engaged Independent Consulting and Risk Management Services (ICRMS) to evaluate the proficiency of our liability claims handlers and our overall liability program.

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ICRMS President Mark Nestor has extensive experience with more than 30 years in the development, daily management, and operation of liability and workers’ compensation programs. Mark has been responsible for developing and managing six public entity pools with annual premiums of more than 100M. While Mark’s skilled claims evaluators are reviewing liability claim files, Mark meets with the TPA Claim Director, key TPA staff, and the Authority’s Claims and Insurance Director to put his finger on the pulse of the program’s health and where areas of improvement could lie. After the week-long audit, ICRMS provides a detailed analysis of the TPA’s claims-handling proficiency and recommendations for program improvements, which are tracked from year to year.

Regarding the claim file portion of the audit, a thorough analysis is done on coverage evaluation, investigation, damages evaluation, litigation management, resolution, documentation, supervision, reporting, and reserving. In addition, each file handler is scored, and their cumulative scores are then tracked on a yearly “roll up” to track their historical performance. We are pleased to report that the Authority’s liability TPA, Carl Warren & Company, posted an overall score of 98 percent for 2023. Carl Warren has consistently scored in the high 90s for the past decade. ICRMS continues to complement the municipal claims handling proficiency exhibited by Carl Warren & Company. Carl Warren & Company has been our trusted partner since the inception of the California JPIA, and we are pleased that they are performing at a very high level.  We invite members to share their feedback regarding our liability claims administration efforts at any time by contacting our Claims and Insurance Director, Paul Zeglovitch.

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