ADJUDICATION

Most Third-Party Administration (TPA) firms provide some level of insurance claims management and handling services for Property, Casualty, and Workers’ Compensation. Other TPA firms may specialize in Automobile Liability with Medical Payments Coverage. It is rare to find a firm that encompasses a “one-source” solution for all claims management and handling needs. HGI is that “one- source” firm. Our claims service solutions are completely customized to your needs. Our services, such as Unemployment Claims Adjudication and Tax Appeals, are scalable, timely, and engineered to provide results that other TPA firms are unable to match.

 LWC – Unemployment Claims Adjudication (case study): 

As a result of the coronavirus global pandemic, the Louisiana Workforce Commission experienced unprecedented numbers of unemployment claims extending far beyond their regular capacity. Like many state unemployment offces across the country, LWC enlisted the services of HGI. Described by agency leadership as “a local, professional claims irm to expand our claims handling capabilities,” our team was initially assigned 7,114 claims and in less than 60 days we adjudicated over 62% of those claims. 

We provide Hearing Officers and Adjudication Officers to programs that require third-party expertise that effectively utilize the evidentiary process as governed by law or client process to hear claims challenging the decisions rendered whether denials of claims or requests for reconsideration.  

Our experience includes Parish and County Property Tax Appeals, Unemployment Claims, Disaster Benefit Claims, Lawsuit Settlement Claims, and Utilities Billing Appeals.  Our unique experience allows us to quickly secure the necessary hearing officers and support staff, call center equipment and staff, website and claim portal design, and notifications to claimants, appellants, and potential beneficiaries of programs who need to be contacted about the program, the claims process, notification of hearings or rescheduling, and ultimate notice of decision and next steps for appeal.  This can include tens or thousands of claims over short periods of time and hundreds of hearing officers as necessary.  

All programs include intense training of hearing officers and staff to ensure compliance with the needs and desires of the clients, including vetting all program staff applicants with e-verify, drug tests, and background checks.