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2005 Annual Report

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Schedule N - Crawford’s Annual Report to March 31, 2005

On March 9, 2000, the Courts appointed Crawford Adjusters Canada Incorporated/ Expertises Crawford Canada Incorporée/The Garden City Group Canada to act as the Administrator of the 1986-1990 Hepatitis C Class Action Settlement. The administration of this complex class action settlement celebrated its fifth anniversary on March 9, 2005.

The duties of the Administrator include:

  • Developing and implementing systems for receiving, processing, evaluating and making decisions on claims;

  • Supplying claim forms;

  • Assisting claimants and their families in the completion of claim forms;

  • Making necessary inquiries (including consulting medical personnel) to determine the validity of any claim including requiring any claimant to undergo a medical examination;

  • Initiating or expediting completion of tracebacks where such procedures are necessary;

  • Receiving and responding to enquiries and correspondence about claims;

  • Receiving monies from the Trust Fund and forwarding compensation to approved claimants in accordance with the Settlement Agreement;

  • Reporting on operations to the Joint Committee and the Courts .

In Year Five, the Centre continued to process “residual claims” and “new claims”, and continued to process a significant number of supplemental claims for out-of-pocket expenses, uninsured treatment and medication, loss of income/services/support, costs of care, and HCV drug therapy. The Centre also processed all requests for disease level re-assessment.

The Centre processed all loss of income/ loss of support claims already paid and issued payments based on the 70% restriction that was removed and the limit of $75,000, which was increased to $300,000.

In preparation for the full-scale sufficiency review of the Trust Fund undertaken by the Joint Committee, the Centre prepared and submitted significant amount of data, which entailed a significant amount of work.

Some important year to date milestones include the following:

  • Prepared and issued an Annual Financial Statement to all paid Class Members.

  • Provided all requested data necessary for medical modeling and fund sufficiency purposes.

  • Processed all Claimant requests for a disease-level reassessment.

  • Continued our research with respect to HCV associated medical conditions and medications for the purpose of updating the “HCV Medication List”.

  • Processed claims with evidence of non-prescription drug use as per Court Approved Protocol.

  • Updated the www.hepc8690.ca Web site on a regular basis.

  • Updated and revamped the renewal forms for Loss of Income/Support/Services.

  • Developed and programmed new reports within the customized software application known as CLASS to improve the efficiency of our processes.

  • Reported weekly to the Joint Committee.

  • Met on a quarterly basis with the Joint Committee.

Since the inception of this project, the Centre has…

  • Scanned over 722,000 pages of claims-related documents.

  • Handled over 131,000 telephone calls via the 1-800 telephone assistance line.

Operational Highlights

Key Claims Evaluation Statistics as of March 31, 2005

Total Funds Disbursed to Date

$426,903,035.71

 

Claims Received to Date

12,687

 

Claims Reviewed to Date

12,670

 

Incomplete Submissions to Date

992

8%

Claims Approved to Date

9,883

78%

Claims Denied to Date

1,795

14%

Traceback Search Requests to Date

4,104

 

Traceback Results Pending to Date

94

 

Not all of the claims received in Year Five 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 increased volume of work. At the end of Year Two, the Claims Centre operated with a total of forty full-time and part-time staff. At the end of Year Three, the Centre had a total of twenty-eight full-time and part-time employees. In Year Four, the Centre had a total of twenty-one full-time employees, which represents a 48% decrease in staffing levels since Year Two. In Year 5, the Centre operated with the equivalent of eighteen (18.3) full-time employees.

Customer service is important to the Claims Centre. In Year Five, the average wait time for callers was eighteen (18) seconds. All “new claims” were scanned and first reviewed within 72 hours of receipt. Our service results are meeting or exceeding acceptable standards.

Year 6 Outlook

Year Six will once again be a busy year for the Centre. The year should involve a combination of processing “residual claims” and “new claims”. The number of requests for disease level re-assessments and supplemental claims is expected to increase.

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