Filed Under:Claims, Education & Training

An Ounce of Prevention…

Western medicine has long been criticized as reductionist for what some perceive as egregious oversights in preventative or holistic care. As Americans, we find ourselves in a precarious situation. With the proliferation of health information online, we are bombarded with an array of diagnoses and prognoses, as well as screenings and procedures that we may or may not need at some point.

However, our insurance policies often cover only a portion of these screenings or, in many cases, none of the bill at all. This can present us with an unfair decision: to opt for fiscal health in favor of wellness. This year’s campaign trail and ongoing reform mandated by the PPACA, which is already enshrouded in confusion and controversy, will serve to ignite underlying healthcare debates already at the forefront of our collective consciousness. It will also, I predict, lead to the oversharing of some very personal information, with health ailments woven into the fabric of ordinary water-cooler conversations.

When facing a daily deluge of conflicting priorities, we may primarily focus energy on damage control, rather than positioning ourselves—and the policyholders whom we serve—for optimal outcomes. That’s because by the time unsatisfactory customer service numbers arrive and retention declines, the bottom line has already been impacted.

So what is your claims organization doing to prevent a disgruntled claimant or policyholder from infecting the already dismal perception the public has of our field? What about that other sources of profit seepage, namely mishandling claims? John Postava of Simsol Software discusses common miscalculations in property losses, along with training and other preventative measures, beginning on page 26. He also enumerates why technology is only as good as those who adeptly employ it. How are you diagnosing and treating counterproductive processes and ways of thinking?  More importantly for the Baby Boomers among us, have you scheduled your colonoscopy?

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