Filed Under:Claims, Education & Training

Collaborating in Claims

A Conversation About Technology and Training

Even for insurers that have attained high levels of efficiency, claims management and processing remains a complex, difficult endeavor. Each claim requires the involvement of different professionals, many of them in varied locations, and many with widely varying degrees of technological sophistication. At many insurers, there are deep pockets of expertise within the claims workforce, but finding and accessing that expertise may not always be easy.

At first glance, the claims workplace might seem to be fertile ground for the application of collaboration technology. However, a number of obstacles stand in the way for insurers seeking to improve communication and increase efficiency in claims management. First and foremost is the state of the systems supporting claims professionals. Although insurers do not like to admit it, some claims management operations are still in the “green screen” era, using outmoded technology to obtain, organize, analyze, and process claims information. Even companies that present a modern face to the public─touting the latest mobile applications, for example, or using social media to initiate conversations with potential customers─may rely on decades-old systems to handle and document claims. Such systems are often stitched together in ways that discourage communication, let alone true collaboration.

In claims management and processing, however, insurers do not have the luxury of waiting for “the next big thing.” A flood of claims arrives every day. Each claim presents the insurer with the opportunity both to minimize losses and to please the customer through speed and superior handling. The question for insurers is not, “What is the perfect system?” but rather, “How can we make the best of what we have, or of what we can afford right now?”

The stakes are quite high, not only in terms of cost savings but also for customer satisfaction. It is generally accepted that customer’s loyalty depends upon his or her most recent claims experience with a given carrier. Since collaboration can improve both the speed and the precision of claims processing, it can make a significant contribution to enhancing the customer experience as well.

Collaborative tools have their most immediate impact in key areas including first notice of loss (FNOL); incoming call routing; remote review of management files; damage reviews; and customer communications. Collaboration can also improve the customer experience. During a FNOL call, for example, if a call center agent discovers that an adjuster’s assistance is required, then advanced call center technology enables an immediate transfer to the appropriate person. Before transferring the call, a conversation via instant messaging or an audio conversation with screen sharing allows the call center agent to fully brief the claims adjuster on the case, making it unnecessary for the customer to repeat any information he or she already provided. Depending on the type of loss a customer reports, software prompts the call center agent to ensure that the customer provides all needed information– for example details about the police reports. In turn, this exchange enables the call center agent to relay important information to the customer (such as preferred repair shops) while facilitating one-click access to experts when assistance is required.

Collaboration also enables claims adjusters to obtain immediate input from managers (as necessary) during a call. Adjusters can quickly find an available claims executive, review the case with and secure approval, even if that executive is physically located in a different office, or perhaps even in a different country.

Implementing Collaboration Technology

Given the benefits derived from collaboration, however, it is important to start somewhere. We find that there are three logical entry points for implementation of collaboration technology:

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