Author: Andrew

5 Things Insurers Need to Know About Avoiding Bad Faith

Posted on

August 19th, 2019

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No legitimate insurance adjuster sets out to commit misconduct that could constitute bad faith. However, the expenses associated with bad faith lawsuits and the upswing in legal action are strong indicators that insurers need to reconsider the economic implications of bad faith for their company. Knowing what constitutes bad faith and how to avoid it can save legal headaches and a significant amount of money.

Understanding Bad Faith

Every state has its own set of laws governing the minutia of bad faith lawsuits. However, the majority of states define bad faith as a combination of negligence and deliberate misconduct. Most states determine if negligence occurred using a simple and objective analysis to determine if the insurance provider behaved in a way that was unreasonable toward the customer.

The second element of bad faith is establishing whether the company behaved unreasonably on purpose. It’s important to note that negligence alone is not enough to establish bad faith. Accidents happen and employees can make mistakes unwittingly.

5 Practices that Can Result in Bad Faith Claims

The following are examples of behaviors that can result in bad faith lawsuits. Insurance providers need to take all possible steps to ensure these behaviors do not occur to avoid costly litigation:

  1. Delaying, disregarding, or denying payment without a reasonable basis for doing so
  2. Failing to reply within a reasonable time frame to a notice regarding a new covered claim
  3. Neglecting to perform a swift, unbiased, and realistic assessment of damages and rightful settlements to insured within a reasonable period, especially when liability is clear
  4. Attempting to offer a settlement far less than what a reasonable person would believe is acceptable or attempting to undercut a claim’s severity, forcing the insured to file a lawsuit
  5. Requiring the insured to provide a burdensome amount of documentation that their policy doesn’t require

Again, none of the above can constitute bath faith on their own basis without the insurer intentionally doing so. However, the behaviors are enough to initiate a lawsuit regardless, and it’s better to avoid going to court whenever possible.

Acting in good faith should be a guiding principle for all insurers and having a solid claims management system in place can help achieve that goal. Contact the experts at Actec to learn how we can simplify and improve your claims management processes.

Allergies or a Summer Cold? 5 Key Indicators to Know the Difference

Posted on

August 12th, 2019

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Many people associate the winter months with illnesses such as the common cold. However, people are just as easily susceptible to catching a cold in the summer months as well. Unfortunately, many of the symptoms of a cold mimic those of allergies. It can be difficult to tell the two apart, and, once a sick employee comes to work, much of the damage is done. Identifying key differences between the common cold and allergies is the first step to keeping the workplace healthy.

Is it Allergies or a Cold?

The following are some of the major differences between a cold and allergies:

  1. Colds have additional symptoms. While allergy sufferers will experience sneezing, runny noses, sore throat, and congestion, individuals with a cold will also have coughing and feel generally run down.
  2. Allergies last longer. If the individual has been sneezing for weeks on end, allergies are likely the source of the problem. While allergy symptoms can be as misery-inducing as cold symptoms, allergies last much longer. Colds typically last 1-2 weeks at most.
  3. Cold symptoms fluctuate. Allergy symptoms are usually persistent and constant. Colds, however, can shift in intensity with certain symptoms being worse from day to day and even hour to hour.
  4. Cold symptoms appear in stages. For allergy sufferers, their symptoms hit all at once whereas individuals coming down with a cold experience symptoms one at a time. On day one of onset, they may wake up with a sore throat while day two may present a runny nose.
  5. Nasal discharge is not the same. Allergy sufferers tend to have clear, thin nasal discharge whereas individuals with a cold may notice yellowish to greenish mucus that is thick in consistency. This is due to an increase in white blood cells, indicating the body is fighting off an illness.

Preventing the spread of germs in the workplace is vital to keeping it operational and productive. Encouraging employees to wash their hands often and to stay home when sick can help cut down on illness in the workplace. Healthy employees are happier, more productive, and less prone to absenteeism. Contact the experts at Actec to learn how we can help your business reduce absences.

Reducing the Likelihood of Employee Fraud

Posted on

August 6th, 2019

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shutterstock_174875483Despite proper planning and safeguards, workplace accidents can happen. Injured employees often file worker’s compensation claims to help them pay for medical expenses and lost wages while they recuperate. However, some unscrupulous employees abuse the system and it costs everyone money. Fraudulent claims increase insurance premiums for employers, the workload for the remaining employees, the time required to complete projects or provide services, and manufacturing costs due to production delays.

Minimize the Prevalence of Fraud

One-hundred percent prevention isn’t always possible. However, employers can take several steps to reduce instances of fraud. These include:

  1. Full screening before hiring. Employers should only consider complete job applications. Missing information can indicate laziness or a history to hide. Employers should also follow up on job references as well as ask their contacts if they know anything about the applicant’s job history. Taking these steps prior to providing a job offer can save employers a lot of time, money, and hassle.
  2. Creating and enforcing safety programs. Employers should hold onboard training as well as continued safety-training exercises throughout the year. Improving safety will reduce accidents and injuries. If employees aren’t getting hurt, they won’t file worker’s compensation claims—fraudulent or otherwise.
  3. Establishing a return-to-work plan. After an employee files a claim for a work-related injury, employers need to follow up on a regular basis. An employer who stays up to date with the employee’s recovery can establish realistic expectations and make the necessary modifications for the individual to return to work.
  4. Not tolerating fraud. Businesses can work with their insurance company to develop methods that best prevent, identify, and rectify incidents of fraud.

Companies can also invest in an absence management system that can flag questionable absences to help employers manage employee attendance. If your company is struggling with employee absenteeism, abuse of paid leave, or fraudulent worker’s compensation claims, Actec can help. Contact us to learn more about our absence reporting system.

How to Spot 4 Common Warning Signs of Absenteeism

Posted on

August 5th, 2019

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Absenteeism costs employers a significant amount of time and money; it also has a negative effect of productivity and overall office morale so it’s best to identify it and address it before it becomes a costly problem. Thankfully, many employees who abuse their paid leave show predictable patterns. This allows employers to pinpoint the behavior to take action.

Predictors that Point to Potential Absenteeism

The following are key indicators of employees who are likely to call out sick when they’re not or otherwise misuse their leave:

  1. Previous absence record. If a structure isn’t already in place, consider implementing an absence management system to keep track of all absences. It’s easy to forget who called out on what days and how many times when a business begins to grow. Having documentation can provide easy to digest data and identify absenteeism.
  2. Job characteristics. Employees who work jobs with repetitive tasks are more prone to absenteeism. Encourage managers to rotate employees through these tasks to maintain morale and interest in the work. Employees who feel engaged are much less prone to absenteeism.
  3. Work environment. No one wants to work in a stressful environment. Make sure managers know positive methods of communication. Making sure to spread load work so no one is overwhelmed can help keep stress levels at bay as well.
  4. Shift work. It’s not always possible to avoid night shifts or shift work. However, those employees are more prone to burnout and absenteeism. Building flexibility into leave policies for these individuals can help mitigate this issue.

Absenteeism is rarely a problem without a root cause. Identifying what the problem is early on can help employers address the issue and make changes if necessary to accommodate employees. For example, an employee who always arrives late may have a difficult childcare situation. Allowing that employee to shift his or her hours to the right can solve the issue.

Regardless, having a reliable absence management system in place is a must to identify questionable attendance. This allows employers to deal with attendance issues before they become a recurring problem. Contact the experts at Actec to learn more.

Claim Reporting and Claim Management: Streamlining the Process

Posted on

August 3rd, 2019

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shutterstock_138016598 - CopyImproving claims management efficiency is a multi-pronged effort. It isn’t enough to streamline processes or hire the best people. Insurers also need to upgrade their technology and enhance communication efforts. By making the necessary changes, efficient insurance providers can gain an edge on the competition. Clients value swift claims resolutions with few hiccups. By processing claims swiftly and accurately, insurers can improve customer satisfaction, increase revenue, and lower costs.

Start with the People

Insurance agents are the first people customers will interact with during a claim. Finding the best candidate relies on several factors. These include:

  • At the very least, employees should have stellar qualifications. Unqualified employees can cause delays and make expensive errors.
  • Employees need to have the right attitude to manage claims and interact with customers. When a customer calls in to report an incident or to get an update on an open claim, they are likely to be in an emotional state. Employees need to be able to interact with customers in a pleasant, calming, and professional way.

Implement Good Processes and Technology

Establishing a solid claims process can help eliminate redundancy and unnecessary steps. The following is an example of a good workflow:

  • Create the claim
  • Verify the claim
  • Request corrections if necessary; verify again
  • Provide an expert review
  • Based on the review, reject and close the claim or resolve the claim
  • If the claim is to go to resolution, seek final approval from superiors
  • Close the claim

Insurers that implement a solid claims management process can then focus on improving the technology side of the claim. They can automate certain processes to streamline the entire experience. Today’s customers expect a certain level of speed and care that outdated legacy systems cannot provide.

Communication Is Key

Many customers report dissatisfaction with their experience because the claim took much longer than expected to resolve. While insurance providers cannot speed up certain processes, they can manage customers’ expectations. By utilizing effective communication, insurance agents can keep customers abreast of where the claim is in the process and how long it will take to reach a resolution.
If your insurance company is struggling with inefficient claims processes, Actec can help. Our Full-Cycle Claim and Incident Reporting Solutions provide improvements to first notice of loss (FNOL) and claims management. To learn more, contact us today.

6 Common Mistakes Adjusters Make and How to Prevent Them

Posted on

July 22nd, 2019

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Mistakes happen, but they don’t have to happen often nor should they. Whether it’s a bad judgment call or a simple oversight, mistakes add up to much bigger issues down the line. The following are some of the most common errors that auditors encounter when reviewing claims:

  1. Failing to perform a thorough investigation. With multiple claims to juggle, it’s possible for a detail or two to slip through the cracks. However, missing important information such as the nature of the claim or the severity of injuries can lead to prolonged claims due to incongruous settlement offers. On the flip side, assuming injuries are extreme based on face value can result in overpayment as well.
  2. Failing to read medical reports. Not keeping up with medical reports can lead to poor control over medical treatments. Insurers may pay out for unnecessary treatments or erroneously withhold payments for medical care. Reading the medical reports thoroughly can help adjusters stay on top of those claims details.
  3. Failing to close claims in a timely manner. While some factors are out of adjusters’ hands, auditors have found many mistakes result from adjusters mismanaging their time. This prolongs claims and ultimately costs the insurer more money.
  4. Failing to keep proper documentation. Not only does this irritate customers, but it also costs time as well as money to re-confirm details multiple times. Taking detailed notes on all incoming documents/information expedites the claims process.
  5. Failing to maintain good contact with the claimant. Keeping the insured in the loop helps boost customer satisfaction, but it also helps keep insurers up to date on any new developments. Insured customers don’t always think to contact their insurer for every claim related event/situation after the initial incident.
  6. Failing to maintain claim continuity. Handing claims off from one adjuster to another without a specific reason (i.e. more appropriate field of expertise) can cause errors during the exchange and confusion for the customer.

For every mistake that occurs during a claim, the cost of the claim increases. Insurers can’t afford repeat mistakes, especially when the majority of them are easy to avoid. To that end, implementing a full-cycle claim management system can help dramatically. Contact the experts at Actec to learn more.

5 Methods to Keep Employees Engaged During the Summer

Posted on

July 15th, 2019

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With the arrival of warm summer weather and enticingly clear skies, employers may notice their staff’s attention wandering. With friends and families going on vacations all around them, it’s hard not to daydream, especially when they live vicariously through it on social media. Employers may notice employees calling out frequently on Fridays or Mondays to prolong their weekends or other disruptive absences.

The following are several ways that employers can encourage better engagement during the summer months before attendance becomes an issue:

  1. Allow for flexible schedules. Instead of dreading to see if employees call out on Friday, work with their desires. For example, allowing for summer schedules so employees can work longer hours Monday-Thursday in order to have Fridays off can be hugely appealing for many employees. Depending on the organization and industry, employers may be able to offer half-day Fridays through the summer months as a benefit.
  2. Encourage creativity. Dress down or casual Fridays are nothing new. However, employers can add a fun and creative twist to them by giving certain Fridays of every month a theme. For example, one month could be a tropical theme where employees dress in their favorite Hawaiian shirt. Employees could hold a vote on who has the best shirt for a chance to win a small prize such as a gift card. Letting employees express themselves through their clothing as well as offering them a chance to win a prize can be a powerful motivator.
  3. Hold outdoor meetings. Part of the appeal of calling in sick to work on a beautiful summer day is to enjoy the nice weather. If possible, try holding meetings outdoors so employees can take in some fresh air. Putting in picnic tables in a shaded spot can also allow employees to eat outdoors.
  4. Host a company picnic. Holding an annual event can be as simple as grilling out or as involved as ordering catering. Either way, companies should include games like corn hole or bat mitten as well as encourage employees to bring their families along, too.
  5. Set goals with rewards. Establishing tangible goals whether to increase marketing ROI, improving customer satisfaction, or even aiming for perfect attendance can go a long way toward improving engagement and productivity. This is especially true if there is a reward for achieving the goal. This can be as simple as a free lunch on the company’s dime or as large as an extra paid day of leave.

One last point worth noting, employers should encourage their employees to take vacations. While it may seem counterintuitive to actively suggest employees take off a week of work, it reenergizes and improves their overall wellbeing. Employees who go on annual vacations are much less likely to experience burnout and the associated attendance issues that follow.

If your workplace is struggling with absenteeism during the summer, Actec can help. Contact us to learn more about our absence management solutions.

Enhancing Claim Intake, Management, and Closing Efficiency

Posted on

July 8th, 2019

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Closing a claim is an insurance adjuster’s primary goal for any file that crosses his or her desk. The insurance industry expects no less, either. Insurers and policyholders alike want a claim assigned, investigated, and closed as fast as possible. When claims linger, customers grow frustrated and retention rates decline.

Owner vs. Employee Mentality

However, many adjusters seem to struggle with closing claims rapidly. One reason is that some adjusters have an employee mentality over an ownership mentality. There are several legitimate reasons that can stall a claim such as an insured client not providing information or an outside service such as an auto repair facility not communicating well. Adjusters with an employee mentality will wait for the information to come to them. Adjusters that take ownership of their claims will seek out that information for faster claims resolution.

Give up the Myth of Multitasking

A common trend on job applications is to include “excellent multitasking skills.” However, multitasking as an adjuster can lead to errors as well as bring workflow to a halt. For example, when adjusters try to gather data following first notice of loss (FNOL) for multiple claims at once, they run the risk of mixing up claims or recording incorrect information. This will require more time later on to undo the mistakes in order to close the claim.

Instead, adjusters should give single-tasking a try, which is focusing on bringing one task to completion before moving onto the next without distractions. This means:

  • Turning off message notifications on computers and on cellphones
  • Avoiding checking emails while working on a claim
  • Turning off podcasts, webinars, and anything else that requires the adjuster to be an active listener
  • Putting up Do Not Disturb signs around workspaces to ensure no interruptions

Making these two changes can do wonders for improving insurance adjusters’ workflow and time to resolution for claims. Of course, a vital aspect of ensuring that claims process in a timely manner is excellent FNOL intake. FNOL represents the single greatest opportunity to secure a customer’s satisfaction as well give the claim a favorable start. Contact the experts at Actec to learn how we can improve your claims process.

6 Ways to Improve Productivity in the Workplace

Posted on

July 1st, 2019

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The workday is a finite amount of time and employers want their staff to use every minute of it effectively. Even the most dedicated employees may struggle with maximizing their productivity. Most people can’t accurately track the passage of time when they’re focusing on a task. It’s all too common for checking emails to go from a fifteen minute task to a 90 minute task without the employee realizing it. The following are several methods to improve productivity in the workplace:

  1. Time tracking. Several apps allow employees to track their time spent on various tasks. Getting a gauge on how long individual jobs take can allow employees to plan their days better and see where their time is going.
  2. Take breaks. While stopping work to take a break may seem illogical, studies have shown otherwise. Employees who brute force their way through tasks steadily decline in their performance while those who take breaks can maintain their work quality.
  3. Turn off notifications. Many workplace computers have built in notifications to let employees know when they have a new voicemail, email, or inter-office message. The allure of these pop-up messages is almost impossible to resist and can derail productivity. Instead, employees should build in time to listen, read, and respond to these messages.
  4. Stop multitasking. Many job candidates like to list multitasking as a skill, but studies have found it can be a productivity killer. Trying to do multiple tasks at once may seem like a great way to complete more work on a faster timeline. However, the opposite tends to be true—they take more time and tend to be lower quality.
  5. Adhere to the two-minute rule. It’s easy to overlook tasks that won’t take up that much time in favor of more pressing, time-consuming tasks. However, those little tasks add up and can become overwhelming when an employee looks at their to-do list. Knocking out jobs that take two minutes or less straight away can whittle down employees’ task lists and increase their drive to keep crossing things off their agenda.
  6. Spruce up workspaces. It may seem silly, but research has shown that employees work better in aesthetically pleasing environments. Hanging art or bringing in potted plants can improve the appearance of the office. Employers can encourage their staff to personalize their workspaces as well to improve their overall mood, which has a direct effect on their productivity.

Poor productivity can be indicative of larger issues at play. Absenteeism, tardiness, leaving work early, or taking long breaks can all effect productivity across the office. When an employee has consistent attendance issues that go unchecked, it can breed contempt among other staff members. They may emulate the behavior as well if there are no repercussions.

If you suspect you have a latent absenteeism problem lurking among your staff, Actec can help. Contact us to learn more about our innovative absence reporting program and how it can help reduce attendance challenges and improve productivity.

Tips to Improve the Claims Process and Retain Customers

Posted on

June 13th, 2019

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smart devicesWhile gaining new customers is vital to an insurance company’s success, retaining existing customers is more so. This is because it costs significantly more money to acquire a new customer than it does to retain one. If an insurer is experiencing a high volume of customer turnover, they may need to examine their claims process. The claim cycle is a vital part of the customer’s experience. By streamlining how customers file claims, insurers can improve customer satisfaction and retention.

Meet Customer Communication Expectations

Today’s customers want technological solutions to their insurance needs. This means an insurance company should offer communications through several channels including a website, a mobile app, and traditional methods of communication (e-mail, print, etc.). To remain competitive, insurers need to upgrade their system to allow customers to complete a variety of tasks from their phones or tablets. Some examples include:

  • First notice of loss (FNOL)
  • Updating policy information
  • Requesting information about new or existing policies
  • Communicating about open claims

Customers want a variety of electronic communication options. Insurance companies that fail to meet these expectations will lose their customers to more technologically advanced competitors.

Prompt and Accurate Claims Processing

Customers dislike complicated or lengthy claims processes. Improving communications and minimizing the amount of back and forth required to close a claim go a long way toward improving customer satisfaction. For example, if an insurance agent provides the wrong information or requests information from the customer several times, that customer will be unhappy with his or her experience. If this occurs every time the customer tries to make a claim, they will eventually find a new insurance provider.
Implementing an effective claims processing system can help insurance companies address any issues with how they resolve claims. Actec’s Full-Cycle Claim and Incident Reporting Solutions allows insurers to customize their entire claims process including FNOL intake, managing client and customer-specific questions and scripts, and much more. To learn more about improving how your company manages claims, contact us today.