Independent Adjusting Services

Full-Service Claims Administration
We handle your claim from inception to a successful conclusion and claim payment; all, of course, with the utmost Integrity, Experience and Results. Johns Eastern can operate as your home office, providing all levels of management, along with field and supervisory services.

Limited Services
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.

E&S TPA Services

The Excess & Surplus lines TPA office provides third party administrative services to E&S domestic carriers and for Certain Interested Underwriters at Lloyd’s. TPA programs administered include commercial and residential property, commercial general liability, contractor and artisans liability, liquor liability and motor truck cargo. E&S TPA losses are handled across the continental United States. Loss run reports and bordereaux are provided monthly and can be modified to meet our clients’ specific needs to ensure we provide a value-added service.

TPA Services: Workers’ Compensation

This unit is a completely integrated division designed to provide superior service and reduce your program’s overall costs. Johns Eastern will customize your program to meet your organization’s specific, evolving needs.

Experienced adjusters, working with registered nurses, cost containment personnel, national PPOs, our EPO, and a pharmacy benefits manager, provide an environment for excellent claims management and significant cost savings. Early intervention, thorough claims investigation, experienced medical management and negotiated savings are all hallmarks of the Johns Eastern program.

TPA Services: Property & Casualty Claims

Johns Eastern provides TPA services for all property and casualty lines beyond workers’ compensation. These services include:

• Managing Property & Casualty Programs for Lloyd’s of London
• Managing Property & Casualty Programs for Self-Insured Corporations and Governmental Entities
• Managing Property & Casualty Programs for Insurance Companies, Program Administrators and Managing General Agents

We provide all necessary services, including:

• Claims Management
• Field Investigation
• Data Collection and Reporting
• Reporting to Regulatory Entities
• Medicare Reporting

Catastrophe Services

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 respond to those losses.

Our job is to settle claims with Integrity, Experience, and Results, all while allowing you to maintain your normal level of services. As claims come into our call center, files are set up and appointments are made as soon as possible.

Catastrophe services include windstorm, hail, flood, riot, residential|commercial|condominium, and agricultural.

Medical Management Services

Our approach to medical management focuses on finding the best medical treatments to facilitate positive patient outcomes and improve the injured worker’s quality of life. We advocate timely, outcome-based medical care contingent on personalized treatment programs with a focus on stay at work objectives. Our telephonic case managers are registered nurses who proactively focus on reducing costs through efficient medical management of each claim.

Cost Containment | Bill Review

Our Bill Review team examines all medical bills for potential savings. Bills are reviewed and reduced to State Fee Schedule (if applicable), Usual & Customary,and Preferred Provider Organization (PPO) discounts. Bills are also reviewed 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.

All Lines Aggregate (ALA) Services

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. Johns Eastern has designed special computer programs to properly manage ALA arrangements, which sets us apart from most TPAs.

Risk Management Information Services (RMIS)

Our state-of-the-art claims system, AIM 3.0, facilitates the Adjusting, Investigation, and Management of your claims on the Internet. This gives 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.

Our RMIS products and services include:

• AIM 3.0 – Our fully integrated claims management system
• Ad Hoc query and reporting tool
• iFROI – Workers’ Compensation First Report of Injury or Illness through the Internet
• Web Assignments – Submission of new liability or property cases
• Periodic Reporting – Daily, weekly, monthly, quarterly and annually
• Custom Reports – Customized to your specifications
• Data Conversions – For new clients and other data exchanges
• Paperless System – Images available online for clients
• State EDI Reporting – Claims EDI and Medical EDI reporting
• Mandatory Insurer Reporting – Electronic filing of Medicare Secondary Payer claims

Excess Insurance Placements

Johns Eastern’s subsidiary, JECO Excess Agency, specializes in placing excess insurance on self-funded workers’ compensation programs.

 

Service Brochures

Click on each brochure below to see the full-size version.