2002 Annual Report
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Operational Highlights
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Key Claims Evaluation Statistics as of March 31, 2002
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Total Funds Disbursed to Date
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$209,624,348.83
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Average Payment per Primarily-Infected Person (PIP) Claim
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$61,975
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Claims Received to Date
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8,175
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Claims Reviewed to Date
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8,160
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99%
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Incomplete Submissions to Date
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1,876
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23%
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Claims Approved to Date
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5,367
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66%
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Claims Denied to Date
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917
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11%
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Traceback Search Requests to Date
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3,112
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Traceback Results Pending to Date
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439
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14%
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Total approved payments to date are $218,627,467.66. The large majority of difficult claims that were received but not completed in the course of Year One were finalized in the course of Year Two.
Not all of the claims received in Year Two could be fully evaluated by year-end mostly due to incomplete submissions. Incomplete submissions mean that additional proof, tests results or documentation are needed before we can diligently make a final decision. In all cases where the submission was incomplete, we advised the Claimants in writing of what exactly was missing. Should the file remain inactive for more than sixty days as of the date said letter was sent, we attempt to follow-up with the Claimant by telephone.
The Centre saw peak staffing in Year Two due to the fact that the volume of work increased. Our work volume included Year One “residual claims” and “new claims”. At year-end, the Claims Centre operated with a total of forty full-time and part-time staff. Various key functions were assigned to individual employees, which allowed the staff in the Centre to work more efficiently and provide a higher level of service to Claimants.
While we kept very busy processing both “new claims” coupled with claims by Approved Claimants for supplemental compensation, we also undertook several special projects in the hopes of “pushing along” incomplete claims. These projects focused primarily on the following claims:
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Claims where the Traceback related documentation had never been submitted by the Claimant;
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Claims where the file was inactive for a period of sixty days or more;
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Claims where individuals had registered with the Claims Centre but never returned a completed Initial Claim Forms Package to the Centre.
Overall, these projects involved a few thousand letters and telephone calls over the course of several months.
Customer service is important to the Claims Centre. With the exception of the fall of 2001, the average wait time for callers was consistently forty (40) seconds. All “new claims” were scanned and first reviewed within 72 hours of receipt. Our service results are meeting acceptable standards.
Year Three Outlook
Year Three will once again be a busy year. The year should involve a combination of processing “residual claims” and “new claims”. Processing work relating to Requests for Review and supplemental claims is also expected to increase. We also expect an increase in requests for disease level re-assessments. Based on statistics compiled to date, we expect that our volume of work will decreased by roughly 20%. As a result of this finding, we will reduce our claims processing resources by 20% before the end of Year Three.
Crawford & Company
Garden City Group Canada (GCGC) is an operating division of Crawford Adjusters Canada Inc. (CACI). CACI is the largest claims administration company in Canada. Services provided include claims and risk management, loss adjustment, healthcare management, class action administration and risk information services.
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