Each Johns Eastern office is staffed with experienced
claims professionals who are available to you 24 hours a day, year-round.
We tailor our programs to your specifications, providing as little
or as much as you need. Whether we supervise a field office or set
up a system to view your medical bills, all services are supplied
with the speed and accuracy
for which we are known.
Following
is a list of the major services Johns Eastern provides:
•
Adjusting Services
• Field Investigations
• Catastrophe Services
• TPA Services – Workers’ Compensation
• TPA Services – Property and Casualty
Claims
• Cost Containment/Bill Review
• Risk Management Information Services
• Excess Insurance Placements
• All Lines Aggregate Services
A Johns Eastern professional can handle usual and
unusual claims including:
•
Workers Compensation
• Automobile, trucks and motorcycles
• General liability, professional and medical malpractice
• Property
• Commercial, residential, mobile homes, time element
• Marine wet and dry
• Commercial Losses
• Building, contents, business center
• Extra expense
• Condominium
• Agriculture Losses
• Crop losses due to fire, wind, hail, freeze
• Restoration coverage
• Extra expense
• Loss of revenues
• Packing houses and equipment
• Residential Losses
• Dwelling
• Personal property
• Loss of use
• Scheduled property and floaters
• Alternative Resolution Services
• Appraiser
• Umpire
• First-party policy provisions.
•
Full Service Claims Administration – We handle your claim
from inception to a successful conclusion and claim payment; all
of course, with the speed and accuracy for which we are known. We
can operate as your home office, providing all levels of management,
along with field and supervisory services.
• Limited Service – Johns Eastern handles portions of
your assignments, from taking statements, to performing activity
checks on injured parties, to property appraisals.
• Program Supervision – Our employees will set up a
regional office when you need field and supervisory services, whether
in Florida or the Mid-Atlantic states. Johns Eastern can provide
field personnel where we have staff; or we can supervise independent
adjusters in all other areas.
Back to Top
Since our company grew up in Hurricane Alley, we
understand the importance of handling catastrophic losses promptly
and reliably. When a major disaster strikes, rest assured that our
catastrophe specialists will swiftly handle those losses.
Our
job is to settle claims with speed and accuracy, all while allowing
you to maintain your normal level of services. As claims come into
our call center, files are set up and appointments made as soon
as possible.
Catastrophe
services include:
• Windstorm
• Hail
• Flood
• Riot
• Residential commercial/condominium
• Agricultural
Back to Top
Our nurses and adjusters work side-by-side with
one goal in mind: returning an injured or ill employee to work as
soon as possible. The result for your company is decreased workers’
compensation, indemnity and medical costs; and an increased bottom-line.
Together, our nurse-adjuster team uses the same system to manage
a handful of cases or a comprehensive claims program. We get involved
in a case within the first 24 hours and follow it through to its
completion.
A
nurse-adjuster team performs a three-point contact within those
first crucial hours – to the injured worker, medical provider,
and the client. This helps clarify information related to the claim
while letting the worker know that you, the employer, cares.
Johns
Eastern Company recognizes that clients have unique needs and want
different levels of participation. It is that flexibility that gives
us the ability to customize a program to meet your needs.
Along with a knowledgeable adjuster, our team consists
of:
• a Medical
Doctor, who becomes involved if there are disputed medical issues
• Director of Medical Management Services, who oversees the
unit
• a Claims Supervisor, who supervises the nurses’ day-to-day
activities
• a Nurse Case Manager, who handles a claims case load with
an adjuster
• Team Assistants, who provide assistance to the case managers
and adjusters in day-to-day activities.
Back to Top
Johns
Eastern provides TPA services for all property and casualty lines
beyond workers’ compensation. These services include:
• Managing Property & Casualty Programs
for Lloyds of London
• Managing Property & Casualty Programs for Self-Insured
Corporations and Governmental Entities
• Managing Property & Casualty Programs
for Insurance Companies
We provide all services necessary, including:
• Claims Management
• Field Investigation
• Data Collection and Reporting
• Reporting to Regulatory Entities,
as necessary
Back to Top
Our Bill Review team examines all medical care
provider invoices in search of savings. Bills are reviewed and reduced
to the present State Fee Schedule, Reasonable & Customary fees,
or Policy Standards. Preferred Provider Organization discounts are
applied. Bills are also studied for special discounts and to ensure
consistent standard billing practices. Finally, we track a history
of provider payments to determine if the duration of care or the
number of visits billed exceeds a reasonable level. This also prevents
duplicate payments for the same invoice or service.
Back to Top
Johns Eastern can control and reduce your overall
costs with solutions tailored to your needs. Our environment allows
Internet access to all claims, so you can check the status anytime.
We’re flexible enough to deliver data however you request
it.
Our state-of-the-art data system, AIM, facilitates the adjusting,
investigation, and management of your claims on the Internet. This
allows you, the adjusters, and supervisors immediate and real-time
access to all claims information. You can retrieve this data in
a secure environment and communicate quickly with the parties involved.
Here are
some of our RMIS products and services:
• iAIM – Internet version of our claims management AIM
system (Adjust, Investigate, Manage).
• Looking Glass – our ad-hoc query and reporting tool.
• iNOI – work comp first report of injury or illness
(online notice of injury) through the Internet.
• Web assignments – submission of new cases for our
adjusters.
• Periodic reporting – both on paper and via e-mail
– daily, weekly, monthly and quarterly.
• Custom reports – creating reports to your specifications.
• Data Conversions – for new clients and other data
exchanges.
Back to Top
Excess
Insurance Placements Johns Eastern Company’s subsidiary, JECO
Excess Agency, specializes in placing excess insurance on self-funded,
workers’ compensation programs.
Back to Top
ALA programs
are special programs designed for larger governmental entities and
corporations. They allow multiple lines, such as workers’
compensation, automobile liability, and general liability to be
combined into one policy under one aggregate. Specialized policy
provisions such as “clash” coverages help the client
control retention costs.
These programs are best handled by one TPA, because it is important
to have the data in one system. If the data is in multiple systems,
the client will probably lose some of the benefits that the ALA
program provides in cases that involve one occurrence, but multiple
coverages.
Johns Eastern has written special computer programs that properly
manage ALA arrangements. This is offered by very few other TPAs.
|
