Third Party Administration (TPA)

LoCA provides customized, client-driven third party claims administration services for self-insured groups, individual public and private entities, and insurance companies.

Third Party Administration – Workers’ Compensation 

We provide “unbundled” third party claims administration services customized to the needs of our clients.  LoCA’s guiding mission, core values and business model drive our highly experienced and motivated claims professionals to recognize the alignment between the client’s interests and our own. That way both parties are pulling in the same direction with common expectations.

Our workers’ compensation client base includes school boards, municipalities, construction companies and chemical plant service companies.

Transparent Service Relationships 

Typical TPAs generate more revenue from payments for ancillary services than they charge to actually administer the claim. This creates a tremendous potential for a conflict of interest but, unfortunately, this type of business model is common in today’s TPA market and it puts self-insured entities at risk.

To ensure our client partnerships are mutually beneficial, we don’t enter into profit-sharing agreements with, or have an ownership stake, any of the companies that provide ancillary services related to our clients’ claims. While others in the industry believe that disclosure of these relationships is sufficient to avoid the appearance of a conflict, we’re convinced that it’s best to avoid these potential conflicts altogether.

Vendor Management for Cost Containment and Quality Control

LoCA maintains a carefully screened list of approved vendors selected strictly on their ability to provide the highest level of service and their proven dedication to our clients’ best interests.   We review vendor invoices to ensure that they use accepted billing practices and that they accurately represent the services provided. We only refer vendors who are legitimately competing for business rather than those who offer to profit-share. We put our clients’ interests first.

Medical Case Management and Vocation Rehabilitation Services

LoCA adjustors assign medical case managers or vocational rehabilitation providers after carefully evaluating the case to ensure there will be a significant medical benefit for the injured employee. They have the skills and experience to keep cases moving forward to an appropriate medical resolution.

Integrating vocational services with medical case management can accelerate the return to work process, improve individual outcomes and prudently manage benefit expenditures. Our claims professionals work closely with and even monitor medical case managers and vocational rehabilitation service providers regarding their work on individual claims. LoCA only assigns medical case managers when claims are medically complex or if the current treatment plan is not moving the injured worker to pre-injury condition or to maximum medical improvement within an appropriate time frame.

Medical Bill Review 

After evaluating many potential partners, LoCA has chosen to work with the Novare Network to provide our clients with medical bill review, pre-certification authorization, and hospital bill auditing services.

Pharmacy Management Services 

LoCA partners with PMOA for pharmacy management services. Bills are automatically adjusted below state fee schedule and the service offers 30% to 50% savings with mandated generic prescription substitutions. Unlike most of our competitors who use PMOA or other pharmacy management programs, LoCA does not charge the client a percentage of the savings or send the bills through bill review.

Contact LoCA today for a detailed assessment of your current claims administration, cost management and loss control capabilities. Based on that assessment, we’ll provide you with a proposal for a customized claims management program that will put your interests in line with your claims administrator’s.

Third Party Administration – Property and Casualty  

We provide TPA services for the following property and casualty lines:

  • General Liability
  • Commercial Property
  • Auto Liability
  • Professional Liability
  • Educator Legal Liability
  • Police Liability
  • Product Liability
  • Employer Liability

We currently provide property and casualty TPA services to several statewide self-insured groups and many individual self-insured public and private entities.

Risk Management and Loss Control

LoCA offers comprehensive loss control services that complement our proactive claims administration coverage. The two should be integrated in order to promote employee safety while minimizing the cost of coverage. We’ll identify, assess, and prioritize the risks you face from legal liabilities, hazards, and accidents, and then prepare a comprehensive plan for how to best apply your resources to minimize, monitor and control the probabilities and impacts of these risks.

This comprehensive service begins with an assessment of your operations so we can determine the specific safety and health hazards and related regulatory compliance issues that put your people, your property and your reputation at risk. Based on that assessment, we’ll design a specific risk management program that meets your needs, time schedule, personnel requirements and budget.

Independent Adjusting Services

LoCA’s highly experienced team of field adjusters and claims staff provide daily adjusting services for the following lines:

  • Commercial General Liability
  • Personal and Commercial Automobile Liability
  • Workers’ Compensation
  • Professional Liability
  • Product Liability
  • Environmental Liability
  • Maritime Liability
  • Premises Liability
  • Residential Property
  • Commercial Property