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The Stop Loss Claims Department of Majestic offers the experience and knowledge required to provide the highest quality service, with 90% of all claim submissions being processed within 10 business days. We are a full-service MGU, which allows all claims to be handled in-house. Case management, if needed, can be established and large claims monitored for possible early intervention through The Majestic Edge and Compass Solutions.
At the time of sale we offer the client the option of purchasing Simultaneous Reimbursement for Specific claims and monthly Accommodation for Aggregate claims.
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Stop Loss Claim Procedures
Written notice must be given to Majestic once a catastrophic claim, such as a transplant, premature birth, motor vehicle accident, etc., has been identified; or within 60 days of the payment date once the claim has exceeded the Specific deductible. Our claim forms are designed after the Self Insurance Institute of America, Inc. (SIIA) standard:
*We will accept the TPA's or Broker's standard form if it contains all the necessary information.
Typically, an Aggregate claim is finalized within 45 days of receipt of all required documentation. If an on-site audit is needed, we will work closely with the TPA or ASO to schedule and complete the audit as quickly as possible. If we anticipate completion will be delayed more than 45 days due to the Aggregate audit process, partial reimbursement will be considered.
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Claims Contact Information
All claim submissions and/or questions should be directed to:
Claims Manager
Majestic Underwriters LLC
550 Stephenson, Suite 407
Troy, MI 48083
Phone (800) 428-8460, Ext. 244
Fax (248) 577-6472
Email claims@majesticuw.com
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