Get East Coast Underwriters Third Party Claims Administrator Questionnaire And Application For Approval 2019-2025

Filling out the East Coast Underwriters Third Party Claims Administrator Questionnaire and Application for Approval is a crucial step for entities seeking approval as third-party claims administrators. This guide will provide you with a comprehensive and user-friendly approach to completing the form online, ensuring that you have all the needed information at your fingertips.

Follow the steps to complete the application smoothly.

1. Click 'Get Form' button to obtain the questionnaire and open it in your online document editor.
2. Begin by filling out Part I, which includes details about your entity, such as your company name, street address, city, state, and zip code. Ensure that the information is accurate to avoid delays in processing.
3. Provide the locations of sub-offices and their respective contact numbers in the designated fields.
4. Indicate if your firm is connected to any other organizations in the insurance or reinsurance sector by answering 'Yes' or 'No' and providing the necessary details if applicable.
5. List the principal officers and their titles. Include how long each has been with the organization.
6. Specify if you are a member of any professional societies, providing the name if applicable.
7. Fill in your bank reference information, including the bank name, contact person, title, and phone number.
8. Complete the questions about business development and any substantial organizational changes expected in the near future.
9. Proceed to Part II, where you will list any excess insurers that have allowed your firm to administer claims, including the percentage of in-force stop-loss policies.
10. Continue filling out questions regarding the administration processes and the security of your systems in Part III.
11. Address the claims administration section (Part IV) by detailing the number of staff, qualifications for claims examiners, and the systems used.
12. In Part V, outline your managed care services, the companies utilized for Medical Case Management, and your claims cost management processes.
13. Navigate to the final section (Part VI), where you will disclose any legal actions or complaints against your firm in the past three years.
14. Affirm the accuracy of the information provided and sign the certification section, ensuring all required documents are attached.
15. Once you have completed all sections, you may save changes, download the document, print it, or share the questionnaire as needed.

Complete your documents online today for a smooth and effective filing process.