Claims Audit & File Reviews
SERVICES
Claims Audit & File Reviews
Claims Consulting Partners provides expert P&C Claims Auditing and File Reviews across most lines of business, delivered either remotely or onsite.
A claims audit or file review is conducted to identify operational strengths and weaknesses across key best-practice claims categories. Results are evaluated against internal claims handling guidelines and industry standards to drive measurable improvement in claim quality, financial performance, and operational consistency.
Our structured audit methodologies deliver objective analysis, actionable insights, and practical recommendations designed to improve overall claims outcomes.
What We Evaluate
Our Claims Audit & File Reviews provide a clear and objective assessment of claims performance across multiple lines of business and are tailored to each client’s needs.
- Best Practice Claim Reviews
- Litigation Claim Reviews
- Claims Leakage Reviews
- Case Reserve Reviews
- TPA Claim Reviews
- Forensic review of adverse jury verdicts
- Reinsurance Loss Portfolio Transfer (LPT) Reviews
- Reinsurance Adverse Development Cover (ADC) Reviews
- Large loss or catastrophe claim reviews
Audit Categories & Evaluation Areas
Our claims audit and file review services are tailored to each client’s specific requirements and typically focus on the key best-practice categories that drive claims performance and operational consistency.
- Coverage
- Contacts
- Investigation
- Analysis and evaluation
- Financial management
- Reserve management
- Litigation management
- Disposition and resolution
- Medical and disability management
- Recovery and contribution
- Vendor management
- Compliance
- Reporting and documentation
- Estimating practices
- Diary management and claim control
- Supervision
Our Approach
Our audit methodology utilizes a flexible combination of leading industry tools and proprietary platforms, including web-based audit systems that enable secure, efficient remote audits and collaboration.
Our platform is fully customizable to each client’s needs, including best-practice categories, scoring methodology, leakage measurement, and detailed reporting.
We use a transparent, numeric scoring system that evaluates each claim file across major categories and subcategories, generating both individual file scores and overall performance metrics. This approach provides clear, consistent measurement and supports meaningful comparisons.
Our final reports deliver detailed analysis, supporting exhibits, and practical, results-driven recommendations designed to improve claim quality, financial performance, and operational consistency.
Interested in Claims Audit & File Reviews?
Contact us to learn how our audit and file review services can provide objective insight and actionable recommendations to improve your claims performance.