Maintaining claims excellence is difficult. It requires vision, efficient and consistent processes, qualified personnel, and ongoing discipline to properly execute the plans. It is easy for claims leaders to let their guard down and assume that their program is operating as it should. In some cases claims programs have evolved to a mediocre status because leaders have shirked their responsibilities, either consciously or unconsciously, by failing to keep pace with the ever-changing claims industry and adapting their programs to “best in class.”

These claims programs may have evolved over the years without a comparison of their practices and procedures to leading industry standards. The programs may have continued without the benefit of additional products and services that exist today and that continue to evolve. It may have occurred because the organization has not kept pace with the industry’s ongoing updates and enhancements that are designed to improve outcomes.

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