TNRMT Claims Management Process
Insurance coverage is perhaps the only commodity that we ever purchase and hope we never need to use. However when you must report a claim, you need confidence in the ability of the individual managing your claim. While most insurance companies have a claims staff who process large numbers and differing type of claims, the TNRMT employs in-house claim professionals who are dedicated to the specific needs of Tennessee public entity claims.
The TNRMT adjuster follows a standard process for each incident that is reported. The TNRMT adjuster will acknowledge receipt of the reported incident by phone and begin the investigative process contacting all involved parties to verify the details of the incident and determine the financial exposure to the Trust. Prompt, accurate reporting of every claim is essential to our continued success. Industry studies have demonstrated that a timely response by the adjuster, in most instances, can aid in mitigating the cost of the claim by removing anger and frustration of the injured party.
After obtaining all relevant facts, our adjusters attempt resolution of the claim based upon their extensive expertise. Our adjusters take into account not only the financial impact that the claim may have, but also what the final disposition may have on established policies of the member with regard to future claims.
If the adjuster is unable to resolve a claim, and a lawsuit is filed, the case is then assigned to an attorney from the TNRMT defense network. We only utilize attorneys that have extensive experience in public entity claims. In addition, those attorneys are very familiar with the TNRMT defense strategy. The adjuster does not abandon the claim to the attorney, but rather remains involved to assure the most satisfactory result for the Trust and its member.
The Trust operates under a deductible program. While most claim payments come from the TNRMT Loss Fund, please refrain from making any commitment regarding payment or denial of a claim. The Trust has purchased reinsurance from third party reinsurers, and those reinsurers require certain investigation and reporting from the TNRMT. Failure to observe these requirements could result in a coverage declination leaving the TNRMT or its member responsible for damages for violating the reinsurance contract. Therefore, decisions regarding disposition of claims must be left to the well-trained professionals of the TNRMT staff.