Welcome to 2015. We get a fresh slate to work smarter, possibly harder, and to continue to make a difference in the lives of all who come in contact with us. I'm not a big believer in New Year's resolutions, since they're usually broken as fast as they are made. However, I am a huge proponent of doing things to the best of my ability — doing just enough to get by never really flew in our family.
That same perspective applies to the business of insurance — serving policyholders to the best of our ability — being fair, ethical and providing the best service possible under the policy parameters.
How do we measure success or failure on a claim, as well as the performance of vendors, third-party administrators and others involved in the insurance claims process? Marilyn VanderLey outlines some very specific key performance indicators (KPIs) your company should be tracking on a regular basis. She lists the measures recommended for supplements, subrogation, cycle time estimatics and a host of other factors companies should be tracking on a regular basis.
Lee Haripko takes a look at provider network programs and the opportunities they provide insurers to maximize their resources and offer excellent service to policyholders. He identifies five "pillars" that can be used to assess and measure the effectiveness of a program and how to implement them.
Part of an insurer's responsibility may include defending an insured in a legal matter. Joseph Junfola examines the issues involved in an insurer's "duty to defend" such as is it possible to have a duty to indemnify but not a corresponding duty to defend? And, is the duty to indemnify without a corresponding duty to defend an anomaly, or at least a bit illogical?
Part of our focus this month involves a look at ethics and how they apply to claims management. Gary Jennings asks some hard questions and provides some guidelines to help claims professionals consistently render ethical service to their clients.
On a totally different topic, Rosalie Donlon reviews a recent court case concerning liability for a claim involving a tractor trailer delivery and a forklift operator. The trucking company was insured by two companies, so you can imagine how important it was to determine what happened, the sequence of events, and who was liable for the circumstances involved in the claim.
We hope all of the information in this issue will help to get your business off to a strong start and provide the information to make 2015 your best year yet.
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