From Bottlenecks to Breakthroughs: A New Claims Processing Workflow

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December 19th, 2024

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Insurance companies frequently grapple with operational bottlenecks in claims reporting, leading to increased costs, delays, and compromised client satisfaction. Streamlining insurance processing system —by tackling issues such as restricted service hours, lengthy claim cycles, and inadequate staffing—can enhance efficiency and deliver better client outcomes (a win for any business).


Challenges in claims reporting often arise from limited operating hours, leading to slower claims processing and extended cycles that drive up costs and reduce customer confidence. Prolonged claims are not just costly; they can lead to legal entanglements, further straining resources. Staffing shortages exacerbate these challenges, resulting in inefficiencies that hinder customer satisfaction.


Strategies to squash operational bottlenecks


While it may seem challenging to stay on top of your operations, here are some strategies to reduce bottlenecks and create a smoother customer service experience:


Be available: Offering 24/7 claims intake allows for real-time responses, reducing delays and building customer trust. Immediate access prevents backlogs and minimizes frustrations caused by slow service. For example, consider a policyholder involved in a car accident late at night. With round-the-clock intake, they can report the incident immediately, initiating the claims process and securing a timely response. Suppose they had to wait until regular business hours. In that case, they might face increased stress, delays in vehicle repairs, and even out-of-pocket costs, all of which could erode trust and satisfaction and can ultimately lead to attorney involvement.


Communicate clearly: Accuracy and clear communication are essential in the claims process. Slowdowns increase claim costs, and while adjusters may receive incentives for closing cases quickly, rushing without precision can lead to mistakes and delays. Setting clear expectations with claimants reduces unnecessary follow-up calls—a significant issue, as roughly 25% of contact center calls are inquiries.


Streamline with tech: Emerging technologies are changing how claims are managed. Take Bland.ai, for example—it uses conversational AI to handle full or partial claim intake with a smooth, efficient process, even supporting multiple languages. While still maturing, this tool promises to elevate contact center operations with faster, more responsive service. Similarly, Symtrain.AI is transforming agent training, boosting efficiency by 30% compared to traditional methods. These tools free up agents to tackle the cases that require more care and emotional intelligence.


The idea of implementing these solutions while managing other responsibilities, such as daily operations, responding to customer inquiries, coordinating with vendors, and handling unexpected issues that demand your attention, may seem daunting—and that’s because it is! The good news is that at Actec, we take care of all of this for you. Actec can provide various options to improve operational efficiencies and cost savings, whether you need around-the-clock service or just after hours. If you’re curious about what partnering with an FNOL service provider could look like, visit our website or contact Paul Neleman at pneleman@actec.com or 770-916-6847.

How to Improve Productivity in the Workplace Through Absence Management

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December 12th, 2024

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Employee absences are more than just a line item in today’s workplace—they’re an overlooked gateway to improving workplace productivity and engagement. Most businesses meet only the basic requirements for absence reporting, logging federal, state, and local mandates while offering additional sick leave. But what happens to this data? Often, very little. Absences are simply seen as a “cost of doing business.”


Now, consider a different perspective. Imagine if every type of absence—whether tardiness, sick leave, family medical leave, disability, or workers’ compensation—formed a cohesive story, revealing trends that can reshape workflows and strengthen the bottom line. With a comprehensive absence reporting system, businesses not only gain clarity on where productivity might be slipping but signal to employees that their presence and well-being matter.


The cost of absenteeism


Managing employee absences presents unique challenges, particularly when each type of absence—from sick days to family leave—follows a different process. Employees often find themselves uncertain about whom to inform: their manager, HR, or a specific contact within HR. This confusion not only disrupts workflows but also increases the risk of costly misclassifications—like mistaking FMLA leave for a regular sick day—leaving businesses vulnerable to compliance issues and potential legal complications.


Our absence reporting system has enabled several companies to pinpoint critical gaps that might otherwise go unnoticed. One of our partner companies, for example, identified a sharp increase in absences when a local HR position went unfilled. Recognizing the impact, they adjusted their hiring strategy to make these positions a priority, using temporary HR staffing in the interim to maintain continuity.

As a result, their absence trends stabilized, demonstrating the value of proactive HR support. Employees at this organization can report an absence through our app or by calling our contact center, where each interaction is documented through recorded calls. These records offer added security, providing a safeguard against potential litigation and making sure employees’ voices are heard and respected in a consistent, compliant framework.


Clarity builds trust


For employees, a simplified absence reporting system reduces confusion and enhances satisfaction by creating a reliable way to communicate their needs. When employees have a clear, dependable method for reporting absences, they know they’re seen as individuals whose needs and well-being are acknowledged. This level of transparency sends a powerful message: the organization not only values productivity but also the health and balance of its workforce. A streamlined system also promotes fairness by standardizing how absences are reported and managed. It eliminates the guesswork of who to contact or what steps to take, ensuring that each employee is treated consistently regardless of their role or situation.


Reducing overtime costs, ensuring compliance, and enhancing productivity are the pillars of an effective employee absence management strategy. Every time an employee misses work, the typical response is to cover the gap with overtime, which, though costly, is also less efficient. Most of us have experienced the strain of working double shifts, and we know firsthand how fatigue can diminish output. By tracking absence patterns—such as the high rates on predictable days like the Monday after the Super Bowl or the opening of hunting season—businesses can proactively adjust staffing and operational plans to prevent unnecessary overtime and maintain steady productivity.


According to Paul Neleman, Vice President at Actec, companies typically see a 5-to-1 ROI on their absence reporting program, highlighting the measurable impact of strategic absence management. If you’re looking for expert guidance on absence solutions, contact Paul Neleman at Actec to explore how we can support your organization’s productivity goals.

24/7 Claim Reporting: Meeting Customer Expectations in the Digital Age

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December 5th, 2024

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In today’s digital world, customers expect 24/7 service, especially during critical moments like filing an insurance claim. Just as people now rely on round-the-clock access for ordering food through apps like DoorDash, managing finances via mobile banking, or tracking deliveries with real-time updates, they also expect their insurance provider to be available whenever they need support. With select tools and an unwavering commitment to continuous availability, we’re redefining the first notice of loss (FNOL) process to be faster, smarter, and always accessible from any device, improving the customer experience in insurance claims processing.


What 24/7 FNOL means for modern insurers


First Notice of Loss (FNOL) is the initial report a policyholder files when an incident occurs, and it can happen at any time—day or night. This moment sets the stage for the claims journey and influences how satisfied customers will be with their experience. Delays in response or intake due to limited availability can impact customer trust and satisfaction. By outsourcing FNOL to us, insurers benefit from our 24/7 availability, leveraging select capabilities to handle routine tasks, speed up response times, and make it easy for policyholders to report incidents immediately, no matter when they occur.


Cost-effective, 24/7 FNOL solutions


Errors during intake can lead to costly delays and dissatisfied customers, but staffing an in-house team to provide 24/7 service can be expensive. By outsourcing FNOL to us, insurers avoid the high costs of hiring, training, and maintaining a round-the-clock, in house support team. Instead of investing in complex systems or additional personnel to cover late-night or holiday shifts, insurers benefit from our dedicated team and proprietary FNOL technology.


For example, insurers often face sudden surges in claims volume during peak claim periods, such as natural disasters or high-traffic seasons. With our scalable infrastructure, we’re able to seamlessly handle these fluctuations without requiring insurers to scramble for temporary hires or overtime staffing—both of which add significant expense. Our efficient processes reduce errors and streamline intake, helping insurers avoid the financial burden of costly rework and customer dissatisfaction.

 

A customer-centered, always-accessible approach


Policyholders expect transparent, responsive service from their insurance providers at any hour. We prioritize communication throughout the intake process, ensuring that customers feel heard and reassured from the moment they file a claim. By confirming receipt immediately and providing timely updates, we keep customers informed and build confidence in their insurance provider’s commitment to their needs.


Customization is key to our philosophy. Our FNOL intake solution allows us to prioritize customer requirements above all else, without the constraints typical of software or ASP vendors. This flexibility means we can implement customizations quickly, adapting workflows on demand rather than following a rigid schedule. For example, during a catastrophic event, we developed a fully custom, browser-based solution to intake claims for an oil company, allowing for rapid response. Our Account Managers can set up, adjust, or remove client-specific questions and scripts within minutes, ensuring the intake process aligns with each insurer’s unique needs.


The outcome? Satisfied policyholders who feel supported and valued, even in stressful situations.


Balancing 24/7 technology with empathy


While technology is essential for delivering 24/7 service, it’s empathy that makes the experience memorable. Many claims involve personal losses, and customers need more than efficiency—they need understanding and support. Our FNOL process manages data collection and verification, freeing our team to focus on delivering the compassionate care that helps customers feel truly supported, even in the middle of the night.


If you are having trouble keeping up with insurance claims or staffing teams overnight, we would love to help you. Tell us what is keeping you up at night!

Empathy Meets Automation in the Future of FNOL

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November 21st, 2024

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The insurance industry has seen some major changes, largely driven by the adoption of artificial intelligence (AI) in the First Notice of Loss (FNOL) process. Traditionally, claim intake has been a labor-intensive, error-prone, and time-consuming task. Lengthy phone calls and extensive paperwork have long frustrated customers while inflating operational costs for insurers.

In the past, certain technological tools were introduced that, while user-friendly, did little to improve the actual handling and processing of claim intake. Over the last decade, text and chat functions have emerged as useful alternatives, particularly for younger generations who prefer not to phone in a claim. However, the challenge has always been the sheer volume of information required—often around 50 to 70 questions—making text and chat somewhat cumbersome for handling typical claims.

Today, as the insurance sector continues to seek ways to improve efficiency and enhance customer satisfaction, AI is offering solutions that go beyond just user convenience. It streamlines and automates FNOL processes, making them faster, more accurate, and more consistent—a win for everyone.


AI tools that are making an impact in the FNOL process


A rising AI tool in the insurance industry is Bland.ai, a conversational AI platform designed to automate much of the claims process, whether fully or partially. With Bland.ai, insurers can automate claim intake, handling everything from gathering and verifying data to answering standard queries—even processing claims in multiple languages. This automation shortens the time it takes to file a claim, reduces human error, and creates a more consistent claimant experience.

Symtrain.AI improves agent performance by utilizing AI-driven simulations that replicate real-life scenarios agents might encounter during claim handling. The platform uses these simulations to train agents in a controlled, realistic environment, allowing them to practice handling different types of claims, from straightforward tasks to emotionally sensitive situations.

The AI behind Symtrain.AI analyzes agent responses and provides feedback on areas for improvement, leading to more effective training sessions. The platform can also adapt to each agent’s skill level, focusing on areas where they need the most practice. This targeted training, combined with the consistency and immediacy of AI feedback, leads to a 30% improvement in performance.

Touchpointone.com is another AI solution that provides a comprehensive quality assurance platform that enables insurers to monitor and evaluate the accuracy and efficiency of claims handling throughout the entire process. By leveraging AI and analytics, it reviews claims interactions, including phone calls, emails, and digital communications, to ensure that key details are captured correctly and compliance standards are met.

The platform allows supervisors and QA teams to set performance benchmarks, track agent performance, and identify potential issues or areas for improvement. For example, if there are discrepancies in the claim intake process or errors in data entry, Touchpointone.com can flag those issues early, enabling quick corrective action.

The necessity of a hybrid-ai model


However, even with these technological advancements, AI cannot fully replace the empathy often required in claim intake. Customers who have experienced a traumatic event—be it a home loss, workplace injury, or vehicle collision—seek more than efficiency. They want to feel understood and supported. In fact, studies show that over 70% of claims are still processed by phone, indicating a clear preference for speaking with a live agent who can offer sympathy and emotional support.

While automated FNOL processing undoubtedly improves efficiency, the most successful systems leverage a hybrid approach, where AI works in concert with human agents. For example, Bland.ai can handle the initial intake, processing routine data and straightforward claims. But when a claim becomes more complex or emotionally charged, the system can seamlessly transfer the case to a human agent who can provide the compassion and understanding that technology cannot replicate.

Looking ahead, AI in FNOL is expected to evolve further, becoming even more personalized and capable of handling increasingly complex claims scenarios. Emerging technologies like machine learning and natural language processing (NLP) will enhance AI-driven tools, enabling them to adapt to specific industries and offer more sophisticated solutions. With multilingual support and integration with other advanced technologies, AI will continue to grow as a critical asset in the global insurance market.

Are you curious what next steps you can take to streamline your FNOL process, fill out our quick intake form and we will reach out to you soon.

Is Your FNOL Process Costing You? Here’s How to Fix It

Posted on

November 14th, 2024

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In today’s world, every second counts—especially in insurance. When policyholders experience something unexpected, like an auto accident or a storm-damaged home, their first call is to their insurance provider. For insurance companies, claims directors, and third-party administrators, this is the moment of truth. The FNOL claims process is where trust is built or broken.
Collecting information is only part of the equation—what truly matters is delivering prompt assistance and reassurance to customers when they need it most. However, insurers often face significant challenges during after-hours or late-night periods. Even though claim volumes may be lower at these times, the need for supervisors, IT support, and additional resources remains, driving up operational costs. In industries like healthcare, manufacturing, and beyond, ensuring a smooth FNOL process can be the key to retaining employee loyalty and staying competitive.
Accuracy and speed are the twin pillars of an effective FNOL claims process. Adjusters rely on accurate information collected during that first point of contact to process the claim correctly. When details are unclear or incomplete, adjusters are forced to seek clarification, which not only frustrates the insured but also reflects poorly on the insurer. Equally important is the speed at which this information is relayed to adjusters. The faster an insurer can adjudicate a claim, the quicker they can close it—leading to a satisfied customer who appreciates the prompt resolution.
On the other hand, delays in processing insurance claims often result in elongated claims cycles, which increase the likelihood of legal involvement. Once attorneys become part of the process, the cost of the claim can skyrocket. By engaging claimants quickly and providing them with reassurance that their insurance company is managing everything efficiently, insurers can significantly reduce the overall claims cycle time and avoid unnecessary complications.

How Actec’s FNOL Services Optimize Efficiency and Reduce Costs for Insurers

Actec’s FNOL services are specifically designed to streamline the FNOL claim process, ensuringthat insurers receive the accurate, timely information needed to make quick decisions. One of the key benefits our services bring to the table is reducing the amount of time FNOL claims handlers spend gathering incomplete claim details. In fact, up to 50% of lost dollars come from incomplete claims—something we minimize by ensuring comprehensive data collection from the outset. This enables adjusters to focus on processing insurance claims efficiently, rather than having to chase down missing information.
Additionally, our 24/7 reporting capabilities significantly improve cycle times, a critical factor in maintaining customer satisfaction in insurance. With 30% of lost dollars attributed to elongated claims cycles, around-the-clock reporting helps keep claims moving forward, reducing delays and preventing cost escalation. In catastrophic situations, we excel at early identification and proper notification, which accelerates mitigation and reduces the financial impact on insurers. Finally, our commitment to accurate, complete call recordings ensures that every interaction in the FNOL claim process is well-documented. Incomplete recordings can lead to poor outcomes, but our thorough approach enhances overall customer satisfaction in insurance, while ensuring errors are minimized and claims are processed as smoothly as possible. By optimizing every step of the FNOL claim process, we help insurers save time, reduce costs, and improve the customer experience.
Want to make your claims process smoother and keep your customers happy? We’re here to help you every step of the way. Fill out an intake form today, and let’s get started.