Supervisors actively involved in reviewing the files of their direct reports can drive better outcomes and improve claims performance, according to a recently released report from Towers Watson. While 86% of the survey participants said they "empower their supervisors to make decisions and provide direction to their teams because it delivers the most value," the supervisors often fail to capitalize on that authority because they spend too little time reviewing their direct reports' files.
While supervisors said they budgeted 2 to 6 hours a day for supervisors to review files, in reality the majority (51%) were spending only 2 to 4 hours on this task, while 26% spent 4 to 6 hours, and 20% only 1 to 2 hours. The two key barriers to superior claims performance were identified as ineffective supervision (60%) and passive claim handling (77%).
The study identified a critical link between effective supervision and vital claim functions such as customer service and cost containment. Supervisors who review cases can provide valuable guidance on which cases will require less time and effort to resolve and which will require more time and attention. According to the study, "proactive supervision facilitates and encourages proactive claim handling (and best practice execution), and the two are inextricably linked."
"Greater focus on reviewing claim-handler files is necessary — three hours a day is insufficient to efficiently manage claims," said Frank Ramsay, Towers Watson's North American Claim Management practice lead. "Competing priorities prevent supervisors from spending enough time reviewing the files of their direct reports. This inhibits the claim operation's ability to deliver optimal claim outcomes and can have an adverse effect on insurers' profitability."
The biggest challenge for supervisors involved the high number of claims they are required to manage and the supervisor-to-handler ratio (49%). Using a more hands-on approach and triaging claims files to identify routine claims or others that could be handled more expediently could help improve outcomes. Other factors impacting supervisor effectiveness included a lack of understanding of claim indicators and metrics (37%), insufficient supervisor expertise (31%), a lack of claim leading indicators/metrics (29%) and slow or cumbersome claim systems (29%). Again, greater supervision could help identify some of these issues earlier on in the process and provide support to supervisors managing overly heavy caseloads.
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