Filed Under:Carrier Innovations, Technology Solutions

Intelligent Application of Automated Workflows

Managing Claims, Litigation Tasks

It is no surprise to find that, in most lines of business, claims managers are assuming heavier caseloads. With 250 or more open files to manage, mastering the multitude of timelines involved with litigated claims drains precious time.

The claims manager’s law firm and staff counsel partners provide critical support and expertise in shouldering the added burden. Even with this assistance, the claims organization is ultimately accountable for managing critical dates and growing legal expenses in an environment where carriers demand ever-increasing transparency and greater control over operational decisions. Often, technology is expected to offer answers. Of course, technology alone can only do so much. To answer all of the questions involved, one must examine the impact of applying technology to the litigation management process and what considerations must be met in order to reach a successful application.

The task management, calendaring, and information procurement involved with litigated claims necessitates the precise application of technology. Reaching key milestones, applying expertise at each point of decision, falls to the claims manager, his or her staff, and/or panel counsel partners. Project management is a necessary evil when dealing with an increasing caseload, but often one that is not a natural skill for claims managers or counsel.

Although many organizations still rely on email as their primary litigation management workflow tool, automated workflow technology can more efficiently track crucial tasks using the naturally occurring triggers in the claims management process. When a claim is moved to litigation, the process of assigning counsel can be triggered and timed to include notice to selected counsel and scheduled tasking of formal acceptance of the case after completion of a satisfactory conflicts check.

Acceptance can then trigger notice and creation of a task to complete an early assessment of the case, along with the proposal of a budget. A workflow engine may then be used to manage the status reporting process—both timing and content. In fact, the provision of the firms involved in the process should also be incorporated within the creation of tasks and timing that can be monitored by claims management. Therefore, when counsel is assigned a task to provide an early case assessment and budget, a truly helpful addition to the process should not simply place a task or reminder in someone’s inbox.

Eliminate ‘Busy Technology’
Moving beyond simply placing a task in an inbox, what is more beneficial is for a task notice to include the information being requested so that the process advances without the intervention of “busy technology.” If counsel is asked to provide assessment of a case, then the particulars of the request should be presented as part of that request, along with offering the ability to provide the response within the same package. In effect, the goal should be for counsel to receive a request that is transparent and can be prioritized by both counsel and claims, and further incorporates the requested information, as well as the capture of that information without requiring reference to separate forms or documents. Meanwhile, an automated workflow will track, monitor, and remind the parties of outstanding tasks. This process should carry through to all milestones and information required in the litigation cycle, and be flexible enough so that, as information on a case changes, automated workflow can help move the case project forward. If a trial date is set, then the completion of a pre-trial report ensues. If counsel proposes an increase in budget, then an updated assessment of the case necessarily must be offered.

The efficiencies of automated workflow are best realized when deployed in a truly shared environment. In the mainstream, this means leveraging secured cloud or Software as a Service (SaaS) technologies that are purpose-built to enjoin parties around matters for focused collaboration, regardless of geographic or organizational structure. Importantly, and unlike many portal offerings, administrative and security control should still rest with the primary consumer (the carrier). Litigation management workflows frequently involve collaboration across systems or, at a minimum, through a firewall. Panel counsel frequently has no direct access to the claims system, thus leaving the adjuster and counsel to manage workflow through email.

SaaS-managed and delivered workflow reduces adjuster workload and enhances the process through the sharing of information within a single system. Pushing that information automatically to the claims system and central file or document repositories can similarly be managed through integration, leaving the adjuster to focus on case strategy instead of data management. Deposition summaries, invoices, and emails, for example, may all be included in the case file through an automated push of data from the collaborative application to the carrier’s document system—again, without asking adjusters or administrators to “upload” and “download” material for the sake of improved collaboration

Benefits Overflow
Applied business intelligence (BI) tools should also offer added transparency and exception reporting to claims management. Such tools can serve to provide the aggregated trial docket for an adjuster, a supervisor or a region and also the contextual intelligence to assist in counsel selection. Upcoming trials and critical discovery deadlines, for example, can come into sharp focus for adjusters and their managers as these dates and milestones approach. Combining robust e-billing and case management tools, this data can be overlaid with severity, expense, and even projected outcome data so that limited resources may be used most effectively. After the closure of a case, counsel’s performance can be subjectively evaluated through scoring, which should be captured and used throughout the BI process to evaluate performance at an aggregated level.

Since workflow tasks and deadlines are captured throughout the process, including the information required in budgeting and assessment, performance may be measured on a three-dimensional level and include key indicators such as budgeting behavior, expense management, and total case cost (expense plus outcome). This highlights perhaps the most important part of an intelligently applied workflow and technology: the ability to aggregate, use, and deliver information once relegated to the adjuster’s desk, individual claim files or even the adjuster‘s inaccessible data warehouse. This information can now be used for the greater business benefits of the company.

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