PayerFusion leading the way in Claim Excellence with the ICA

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April 10th, 2012

PayerFusion Corporation has been accepted as member of the International Claims Association

International Claims Association. Leading the way in claims excellence.

PayerFusion is proud to announce that it has been inducted as a member of the prestigious International Claims Association.  This is one of several credentials that assure clients of a pervasive organizational knowledgebase fortified with quality and integrity throughout PayerFusion processes.

In joining the ICA, PayerFusion comes to stand alongside Blue Cross and Blue Shield Organizations nationwide as well as international companies that represent all areas of the globe with a commitment to the principles and standards of the organization.

The ICA is dedicated to the development of well-educated claims professionals. They are prepared and able to represent their industry's interests and serve the customer in the most efficient, cost-effective manner.

Ongoing ICA research, training, education and communications programs, ensure its members continue to be informed and at forefront of the insurance claims industry.

ICA's tradition of providing beneficial service to the industry has been guided by a well-established set of goals.

The purpose of the ICA is to:

  • Promote efficiency, effectiveness and high standards of performance in claim administration by member companies
  • Provide a forum for research, education and the exchange of ideas relating to various aspects of claim administration
  • Devise and effect measures for the benefit of policyholders and beneficiaries in matters relating to claims

By becoming a member of the ICA PayerFusion Corporation embraces, honors, and agrees the ICA Statement of Principles which is as follows.

The International Claim Association, in recognition of the need to continue public trust and confidence in the insurance industry, reaffirms the following principles:

  1. Any individual who has, or believes he has, a claim is entitled to courteous, fair and just treatment; and shall receive with reasonable promptness an acknowledgment of any communications with respect to his claim.
  2. Every claimant is entitled to prompt investigation of all facts, an objective evaluation and the fair and equitable settlement of his claim as soon as liability has become reasonably clear.
  3. Claimants are to be treated equally and without considerations other than those dictated by the provisions of their contracts.
  4. Claimants shall not be compelled to institute unnecessary litigation in order to recover amounts due, nor shall the failure to settle a claim under one policy or one portion of a policy be used to influence settlement under another policy or portion of a policy.
  5. Recognizing the obligation to pay promptly all just claims, there is an equal obligation to protect the insurance-buying public from increased costs due to fraudulent or non meritorious claims.
  6. Procedures and practices shall be established to prevent misrepresentation of pertinent facts or policy provisions, to avoid unfair advantage by reason of superior knowledge, and to maintain accurate insurance claim records as privileged and confidential.
  7. Reasonable standards shall be implemented to provide for adequate personnel, systems and procedures to effectively service claims. These standards shall be such as to eliminate unnecessary delays or requirements, over insistence on technicalities, and excessive appraisals or examinations. Claim personnel shall be encouraged and assisted in further developing their knowledge, expertise, and professionalism in the field of claim administration.

PayerFusion is a Six-Sigma, Total Quality Management Organization and pending ISO certification.