Poll: Weak Data = Poor Claims Management

NU Online News Service, July 1, 9:31 a .m. EDT?Poor data and a lack of medical knowledge are the biggest reasons for incorrect injury claim payments by insurers according to a new study.[@@]

Insurance Services Office said in a customer poll it found 46 percent of U.S. insurance organizations identify a lack of historical databases as a major cause of poor claims management.

Jersey City-based ISO noted that in an earlier poll this year 78 percent of insurance organizations said reducing the rising cost of claims handling is their single most important goal this year.

The poll asked insurance organizations to identify the most likely reason for paying injury claims incorrectly. Of the five options, just under half (46 percent) identified lack of historical databases as a major cause.

Twenty percent of the firms cited lack of medical knowledge as the second most probable reason. Sixteen percent said inadequate negotiation skills, while 13 percent cited claims adjusters’ inexperience.

“Empowering claims handlers with more information about similar claims and injuries is the most important step insurers can take to achieve accurate claims assessments,” said Lee Fogle, ISO vice president of Claims Services.

ISO is a provider of products and services that help measure, manage and reduce risk. ISO provides data, analytics and decision-support solutions to professionals in many fields, including insurance, finance, real estate, health services, government and human resources.