Claims Advocacy

A True Advocate Capable of Settling Claims Disputes and Resolving Problems

    Claims Advocacy
    Aggressively engaged in the claims process
    The Capitol Group employs claims professionals with years of experience working for insurance companies, and who handle actual claims files. This knowledge enables them to navigate through any claims situation at an extremely high level. The end result – lower claims and costs, which means quicker resolutions for clients.

    Litigation Management
    Understanding attorney protocol
    We enhance the vital relationships between clients, lawyers, independent adjusters and other professionals who assist claims professionals in the investigation, adjudication and resolution of litigated claims.

    Selecting a Medical Clinic
    Understanding the employee's specific needs
    Industry leading companiesunderstand the importance of selecting an appropriate doctor and a specific examination. We offer comprehensive assistance in selecting the proper medical hospital or clinic and a preferred physician, according to an employee's needs, wishes and personal choice.

    Return-To-Work Programs / Modified Duty
    Safeguarding a speedy recovery
    Industry leading companiesoffer an effective return-to-work program that includes modified duty as part of their proactive cost containment. Our programs are efficient, timely, and appropriate. Professional help is immediately assembled upon notification of an injury, to ensure the employee has the best opportunity to recover and return to work.

    Fraud Detection Assistance
    Investigating and enforcing ethical measures
    The instances of insurance fraud are increasing at an alarming rate each year. This abuse impacts all areas of claims cost significantly. In response The Capitol Group can assist our clients with the warning signs to watch for. We also will coordinate with your carrier the referral to the Special Investigation Unit and follow up for appropriate action. A through investigation and tying down the facts can be a key in fraud investigation.

    Lawsuit and Tenders:
    The claims professionals and our legal team work in conjunction to determine possible risk transfer. When a lawsuit is received, they collaborate to determine that all the proper parties are on notice of a loss. If through review of the contracts it appears the loss can be tendered to another party, The Capitol Group’s team will assist with that process. 

    • Loss Control
    • Claims
    • M&A

    • Remains current on all outstanding items
    • Pays legitimate claims quickly
    • Challenges questionable claims
    • Sets reserves properly