Services · Flagship engagement

Complex Claim Reset

A claim has stalled, become expensive, carries conflicting information, or no longer has a clear way forward.

What we do

We read the file independently, work out what is holding the claim up, then set a short list of priority actions with named owners and review dates.

A small number of claims usually account for most of the cost and most of the management time. They are rarely stuck for one reason. A reset separates what has already happened from what can still be changed, so effort goes where it makes a difference.

What you receive

  • A clear history of what has happened
  • The issues holding the claim back, across medical, workplace, personal and process factors
  • Costs and risks the employer can still influence
  • A review of how the insurer and providers are performing
  • A prioritised 90-day action plan
  • Named responsibilities and review dates
  • A working session with your leadership team

How engagements work

How we work with you

01

Understand where things stand

We read the file, the medical certificates and the workplace situation so everyone is working from the same facts.

02

Work out what is holding things up

We separate what has already been decided from what you can still change.

03

Agree the priority actions, owners and dates

A short list of actions, each with a named owner and a date it will be checked.

04

Ongoing support, if needed

Some employers run the plan themselves. Others keep us involved through the review points. That support is quoted separately.

Capabilities behind this engagement

Each engagement draws on the detailed capability areas below.

Talk through where this claim or process currently sits.

Other ways to engage us