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Reimbursement Activities
- The number of applications received;
- The status of the claims;
- The current processing time for claims;
- Details regarding reimbursements paid to claimants; and
- The number of appeals under the program to date.
Applications Received and Processed
During the reporting period, ITVERP received 55 new applications for reimbursement. The applications reflect terrorist attacks dating from June 14, 1985, to January 4, 2009. Exhibit 5 illustrates the number of applications received during each ITVERP reporting period since the start of the program in 2006.
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Status of Claims
As claims reach certain phases in the application process, OVC assigns them one of several statuses. Frequently, applicants initiate the application process but do not supply complete information. Applicants have 120 days from the time ITVERP receives their initial application to provide the necessary information or their claim will become inactive. Once a complete application is submitted, the claim becomes active. Active claims may be in process for several weeks while eligibility and expenses are verified, additional information is requested, the incident related to the application is pending designation, and so forth. A claim is considered partially paid or paid after a claimant receives payment. A claim that does not meet the eligibility requirements is denied.
At the end of the reporting period, there were 57 active claims—41 claims in process, 14 claims pending NSD designation, and 6 paid claims, 2 partially paid claims, and 7 denied claims. No claims were designated inactive/unresponsive during the reporting period. Exhibit 6 presents the status of all ITVERP claims that had action taken during the reporting period, including claims that were submitted during a prior reporting period.
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Processing Time
Processing ITVERP claims requires verification of claimant eligibility and that the expenses submitted are processed in compliance with the ITVERP regulations. Denied claims typically require less time to process than those that are found to be eligible for reimbursement because the factors that make the claim ineligible (e.g., claimant does not meet eligibility requirements) are identified in the initial steps of the claims process.
Exhibit 7 shows the average length of time required (in calendar days) to process the six paid claims and the seven denied claims processed during the reporting period. Exhibit 8 shows the average length of time required (in calendar days) to complete each step in the application process for claims that were in process during this reporting period. Each step in the application process occurs concurrently.
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Types of Reimbursement Requests
Potential claimants who have incurred multiple expenses as a result of their victimization may apply for reimbursement in more than one expense category. ITVERP case managers work closely with claimants and potential claimants to assess and fully identify their needs to ensure they receive the maximum reimbursement allowable. Exhibit 9 shows the number of reimbursements requested, by category, by claimants during the reporting period; many claimants applied for reimbursement under multiple expense categories.
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Reimbursements Paid
During the reporting period, OVC paid out seven requests for reimbursement to six claimants, totaling $51,873.1 One claimant received payment as part of both an interim emergency claim and a supplemental claim.
Appeals
Under ITVERP regulations, claimants may file an appeal within 30 days of receipt of a final determination of their claim. During this reporting period, no claimant filed an appeal.
Future Liability
In process claims represent an estimate of ITVERP’s future liability. If all in process claims are paid at the amounts requested, ITVERP’s future liability is $823,320.2 Exhibit 10 shows ITVERP’s estimated future liability by type of reimbursement.
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1 In some cases, claimants do not receive the amount they have requested. In this reporting period, one claimant received a reimbursement for medical expenses that was less than what was requested, due to lower than expected out-of-pocket expenses verified by the health coverage provider. Another claimant received more than originally requested after the out-of-pocket expenses were verified with the health care provider and health insurance. Two partially paid claims have some expenses still pending verification and represent the remaining differences in amount requested versus paid.
2 This figure does not include the remaining expenses for two ITVERP claims that have been partially paid.