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September 14, 2016

Finding Efficiencies in Claims Process

Summary:

Getting an entire company to revamp its claims process is difficult, but individual pros can do three things that customers will relish.

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Whether for individuals or businesses, the #claims handling process is often the most confusing and frustrating part of having insurance. According to J.D. Power, 2015 was one of the worst years for customer satisfaction in claims handling as overall satisfaction decreased five points during the year. Even our community members acknowledged that claims handling can be frustrating, with 37% of respondents to a recent survey listing “more efficient claims resolution” as an enhancement that customers would like to see in 2016.

While the claims process may be the aspect of insurance that non-industry folks know the least about, it’s actually one of the most important for customer retention. That same J.D. Power study found that only 14% of displeased claimants say they “definitely will” renew their policy and only 7% say they “definitely will” recommend their current insurer. Conversely, 81% of highly satisfied claimants plan to renew their policy, and 81% will recommend their insurer. Clearly, a positive experience with the claims process goes a long way toward keeping customers despite what is becoming a more competitive environment, seemingly by the day.

See also: Bad-Faith Claims: 4 Ways to Avoid Them  

For most claims pros, getting an entire company to revamp its claims process by implementing new technology may be difficult. However, there are improvements that individuals can make for customers. Here are three tips:

1. Openly communicate with claimants early and often

When customers call an insurance company about a claim, chances are that they are doing so during a time of distress either for themselves or their business. It’s critical for claims professionals to be open and honest with the claimant from the first point of contact. Letting them know up-front the steps of the insurance claims process, what is needed from them and the timeframe for receiving their insurance settlement can help ease fears before they arise.

Additionally, claims professionals should update claimants on the status of their claim and provide a timeline of what they should expect along the way. This way, misunderstandings about expectations and confusion about why the whole process is taking so long can be reduced or eliminated altogether.

2. Get to know the claimant on a personal level

A large part of the practice of opening up communication avenues with claimants is not only providing information but also being empathetic to what they may be going through. Today, the difference among insurers and the amount and types of coverage they provide is smaller than it’s ever been. The biggest differentiator among insurers is often the lengths they go to understand the individual’s unique situation and to provide a personalized experience. Do you know what claimant Sarah needs and the amount of care she’s looking for versus claimant John, who may have submitted a similar claim but wants a totally different result and interaction with his claims pro?

Even the smallest things, like knowing whether someone has a pet or knowing they have children, go a long way toward reinforcing the notion that you are aware of their needs and doing everything you can to take care of them. Doing this not only differentiates you as a claims professional, but also the insurance company you work for as one willing to go that extra mile.

3. Organize and prioritize

Few people outside the industry are aware of the vast amount of critical checks and balances and documentation necessary to get a claim processed. Unlike other jobs, in which having “your own organized chaos” works to an extent, claims handling requires diligent organization and prioritization to ensure a claim is processed accurately and on time.

Developing guidelines and checklists for processing each claim, including having a status document or claims system to know where in the process each claim is at any given time, will make the entire process much smoother and more efficient for both the insurance company and the claimant. In addition, being familiar with policy coverages and provisions, staying current on new technologies to help you organize your tasks better and completing work on a designated timetable will streamline the process and help you provide professional and specialized service to your customers.

See also: Power of ‘Claims Advocacy’  

Finding efficiencies in the claims handling process is less about improving life for the insurer than about showing the claimant that the insurer truly does care about making sure the process is smooth, as efficient as possible and fair to all parties.

Interested in other claims handling tips? Find out about our Associate in Claims and Associate in Claims Management designation programs.

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About the Author

Susan Crowe, MBA, CPCU, ARM, ARe, AIC, API, is a director of content development at The Institutes. She is also a member of the Philadelphia CPCU Society Chapter and of the Reinsurance Interest Group committee.

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