Dedicated staff

Quality, client-specific claims handling

Reserve setting and maintenance of loss information

Development and compliance with Litigation Management Guidelines

Reporting of claims to state licensing and regulatory agencies

Reporting payments to the National Practitioners Data Bank, Boards of Medicine, Departments of Insurance, and Medicare/Medicaid

Typically, the handling and processing of professional liability claims is handled by the individual Gateway personnel assigned to a client, with support available from all of Gateway's staff. This method of service is designed to provide a client with a main contact, someone well-versed in the client's needs and wishes, making it easy for the client to receive assistance without having to decide which Gateway team member to call for specific situations.

Review and Investigation: When notification of a claim or potential claim is provided to Gateway by the client, we review the claim and advise the client as to what, if any, further steps should be taken. When investigation is required, Gateway investigates the nature of the incident, including interviewing appropriate personnel by phone or face-to face, reviewing records and other related documents, and other fact-finding as required. Throughout the investigation process, there is ongoing communication between Gateway and the client.

Negotiations: If a claim is made prior to the initiation of suit, the Gateway representative assigned to the client will be responsible for conducting negotiations in all non-litigated matters. Any such negotiations will, of course, be in consultation with the client and will be based on perceived liability and alleged damages. No settlements will be agreed to without the express consent of the client.

Reserve Setting: Whenever a claim is made, Gateway will establish a preliminary reserve based upon an initial evaluation of the negligence of the parties involved, the extent of the injury to the claimant, the defense posture of the client, and the claim venue. A summary of the claim and reserve information is reflected on the client's loss run maintained by Gateway. Thereafter, reserves may be adjusted, either up or down, based upon claim developments. Reserve changes are also reflected on the loss run.

C
ompliance with Litigation Management Guidelines: When suit is initiated and reported to Gateway, the matter is assigned to the defense counsel identified by the client. Gateway's assigned claims personnel actively participate in the management of the legal defense of the matter, including consulting with defense counsel as to the processing of the claim and assuring compliance with Litigation Management Guidelines developed by Gateway for the client's program.

The Guidelines will be designed to govern the processing of claims and assure that all participants in the process are aware of applicable standards and expectations.

Reporting to Appropriate Entities: If a state in which a claim is filed requires reporting to a licensing or regulatory agency, Gateway does this reporting on behalf of the client. Additionally, Gateway personnel are available to notify any applicable excess carrier should the value or type of a claim warrant. The Gateway staff is also available to serve as a client's liaison with the state agency or excess carrier should the need arise. Additionally, Gateway will prepare all reports of payments on behalf of individual health care providers for submission to the National Practitioner Databank, the appropriate State Board of Medicine, the appropriate State Department of Insurance, and/or pursuant to Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007.

Flexible Services: Because we find that client needs may differ, we are flexible in the provision of our services. We will, of course, comply with all the specific requirements established, with specific emphasis on aggressively investigating and managing events and claims.



GATEWAY RISK SERVICES, LLC
1946 Menold Drive · Allison Park, PA 15101 · Phone (412) 318-2888 · Fax (412) 367-4990
www.gatewayriskservices.com

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1946 Menold Drive
Allison Park, PA 15101
Phone: (412) 318-2888
Fax: (412) 367-4990