Tech Helps Speed Claims Without Sacrificing Service

In today's competitive environment, personalized service is often sacrificed at the expense of performing faster and accomplishing tasks more quickly. That's not the way it has to be.

Back in the 1960s, it was common practice for claims operations to have adjusters who routinely met with customers face-to-face and documented everything they did on paper. Handling claims by telephone was the exception.

Telephone or “in-office” adjusters and customer service representatives became commonplace in claims operations in the 1970s. In the next decade, facsimiles became popular as a means of transmitting written documentation, unlike voice communications, which had to be separately documented.

In the 1990s, e-mail and the Internet, as well as document imaging, dramatically started to change the way claims operations communicated with customers and vendors.

Today, business is frequently done through the Internet, using a multitude of electronic claims tools. Loss reports are now received electronically or through call centers for large areas, allowing operations to become centralized.

Claims are often handled in paperless environments, and claims management systems speed up processing in a variety of ways. Claims adjusters handle more claims, faster, and with less direct contact with customers, claimants and vendors.

While the rush to handle claims faster and more efficiently has been driven by consumers demanding speed at an affordable cost, surveys show that customer satisfaction increases significantly with personal contact that is both friendly and informative.

As costs for everything rise, consumers expect more for their money. In insurance claims, this means quick, quality personal service. The challenge is to do it all.

With today's electronic claims tools, the best claims operations can be centralized and simplified while increasing efficiency and accuracy.

Loss reporting, for example, can be centralized and interfaced with policy management systems, providing claims professionals with quick access to coverage information and verification. Contact management eliminates duplicate entries and provides information instantly across claims.

Similarly, vendor management insures that accurate information is continually available for payments and accounting purposes, while document management systems eliminate paper and assist with workflow. Combining these efficiencies with claims professionals who possess customer service skills provides speedy service delivered with a “personal touch,” which enhances customer satisfaction.

A well-developed Web-based claims management system can, and should, easily integrate with critical policy, document and accounting management systems. It will provide easy access to claim information, activity notes, reserves, payment and recovery transactions, subrogation, and litigation management.

Calendaring and action-item management, as well as automated correspondence programs, further help claims pros manage their time and priorities.

Such systems also provide configurable business rules to perform, for example, automatic limit checking, avoiding overpayment and ensuring management reviews.

Today's exemplary claims pro possesses customer service skills, provides speedy service (delivered with a “personal touch”) and takes advantage of these electronic tools to increase customer satisfaction.

Claims pros must remember their primary function is to provide the service their customer expects from the insurance policy, and must empathize with the client–someone who has just experienced an unfortunate life event. Whether it is an auto accident, home burglary or work-related injury, the customer feels victimized and is likely to be anxious and upset.

In the many cases where consumers are required to buy insurance, their expectations regarding service are often amplified–and any misstep by the claims professional is cause for the anxiety to become stronger and potentially turn into anger. Claims pros who stay positive, really listen to the client's concerns and follow through on their commitments most often receive high praise in customer surveys.

When a claims pro merely explains the next step or process without directly responding to client concerns, they are telling the customer they don't matter. When a claims pro tells a customer they'll do something by a certain time, then don't follow through, they become the focus of the customer's frustration.

On the other hand, when the claims pro–who is the “face” of the company at that point–is caring, helpful and efficient in the customer's time of need, the claimant's experience is enhanced.

Making full use of available claims tools enables claims pros to provide customers with more personalized service and attention. Since not all claims management systems are created equal, the claims pro who learns everything about the systems available, uses every function to their advantage and develops shortcuts where appropriate, increases efficiency and allows time to provide personal attention to clients.

A simple example is the claims operation with a Web-based system that provides the user with the option to use keyboard commands, instead of a mouse. This provides the claims pro with excellent keyboard skills to quickly tab to enter data on a screen, rather than reach for the mouse, click on the next data field, then return to the keyboard. Seconds saved hundreds of times an hour add up quickly.

Workflow analysis is also important to both a successful claims operation and the claims pros in it. On the operational level, claims management must evaluate not only how things are done, but why they are done that way, then develop workflows that are simple and make sense.

Good document imaging and Web-based claims management systems enhance the process by automating steps. Configurable business rules are key to tailoring workflows to the needs of the claims operation. Done properly, these enable the claims pro to function quickly and efficiently with the least amount of error and duplicative effort.

For the individual claims pro, a workflow analysis should identify who does what in the claims operation, along with the when, how and why questions. They should identify the specific talents and skills of team members and coordinate work routines, methods and processes for the most efficient outcome.

When a customer makes a request, the claims pro must know how to respond and get it done. The end result is not only a top-notch, efficient claims operation, but one that features claims pros who know how to keep the customer satisfied.