Top 3 Insightful Trends for Successful Claims Management

Posted on

January 22nd, 2018

shutterstock_138016598 - Copy At the start of every New Year, insurers look for innovative ways to improve their business strategy. However, with a dizzying number of trends flooding the industry, it can be difficult for insurers to ascertain which trends will withstand the test of time and retain their value. Actec understands this predicament, and, as such, put together the following list of essential trends adopted by successful insurance firms.

The Human Touch

Artificial Intelligence (AI) and machine learning are here to stay, but that does not mean insurance providers never have to interact with their customers again. When a customer calls to file their first notice of loss (FNOL) after an accident, they want and need human kindness. While machines are fantastic at processing data, they lack the empathy and finesse required to manage FNOL.

Contextual Connectivity

Insurers need to increase how often they are in contact with their customers, but providers do not want to run the risk of irritating their clientele. While text messaging and email make communication easier than ever, an irritated customer is not an acceptable outcome. Insurers need to make their messages valuable to the customer. For example, a customer requesting information about homeowner’s insurance does not want a barrage of questions and quotes; they want good coverage to protect one of the biggest financial investments of their life. By understanding the context of the customer’s situation, insurance providers can adapt their conversations to help solve the customer’s problem rather than complicate it.

Perfecting Business Operations

Insurers that want to succeed need to make improving business operations a top priority. Accepting the existing state of affairs can lead to complacency, decreased customer satisfaction, and customer turnover. Part of the improvement process should include reexamining and revamping the claims management process. FNOL represents the single greatest opportunity insurers have to deliver superior customer service. If a customer is dissatisfied with their FNOL experience, it is almost impossible to win them over later in the claims management cycle. To learn more about improving your claims management system, contact the experts at Actec today.

How to Stop FMLA Abuse in its Tracks

Posted on

January 15th, 2018

Andrew

While most employers don’t begrudge their employees taking legitimate leave, problems arise when employees begin to abuse FMLA with intermittent absences. This type of fraud is difficult to tackle due to numerous and complex Department of Labor (DOL) regulations. Even so, businesses can take several steps to curtail intermittent FMLA leave abuse.

Understanding FMLA

Before addressing suspected leave abuse, employers must understand FMLA. The act allows eligible staff members to take 12 weeks of leave for medical reasons including to care for sick family members. FMLA also allows military caregivers to take up to 26 weeks of leave. Under FMLA, employees can take this leave without running the risk of losing their job. This includes repercussions, so employers cannot demote absent employees protected by FMLA.

Problems begin to occur when employees determine how they will take their leave, as FMLA does not make such stipulations. Employees can take their leave in one fell swoop or they can take it in intermittent blocks. If an employee opts for intermittent leave, they must provide their employers with 30 days’ notice. However, intermittent leave is not always foreseeable; in this instance, employees only need to provide notice as soon as is feasible. This last part is what allows for much of the existing FMLA abuse.

Strategies to Tackle FMLA Abuse by Employees

Employers who believe staff members are misusing FMLA have some options available to them. When an employer receives notice for the need for FMLA leave from their employees, they can request a doctor’s note certifying that intermittent leave is necessary. If the employee returns with a doctor’s note, and the employer still has suspicions, they can do the following:

Request a second medical opinion. If the second opinion differs from the first, employers can seek a third opinion to provide a majority rule.
Request that employees provide a re-certification every 30 days or when the minimum duration of the condition passes.
Require employees to submit a fitness-for-duty certification before allowing them to return to work with no restrictions. This helps reduce claims of relapse.
Require employees to provide status reports on a regular basis to stay abreast of their progress and recovery.

Some leave abuse is obvious, such as when an employee is only absent on Mondays or Fridays. If an employer has reason to doubt the employee’s stated reasons for needing leave, they can request a re-certification. While most FMLA leave requests are legitimate, employers cannot afford to overlook fraud. Taking proactive steps to mitigate leave abuse helps improve workplace morale and productivity. To learn more about managing employee absences and leave requests, contact the experts at Actec.

5 Simple Ways to Boost Employee Morale

Posted on

January 8th, 2018

Andrew

shutterstock_174875483 If you think there isn’t a direct correlation between employee morale and absenteeism, think again. Employees with low morale are also likely to lack motivation, have low job satisfaction, and call out more often. While managers and employers should search for the root cause of the morale issues, there are several easy ways improve the office mood.

Make birthdays a holiday. Most workplaces offer paid leave on government holidays. However, there are certain days no individual wants to work—his or her birthday being a common one. By letting staff take their birthday off (or the Friday before if it falls on a weekend), it signals to employees that their company cares about them. It also serves as a nice gift!
Offer flexible start times. Not everybody’s personal life is well suited to a specific start time. Employees with children may prefer a later start to allow them time to drop kids off at daycare or school. Staff attending college in the evening may prefer to start work earlier to allow more time to relax after work before heading off to class. By offering flexible start times, employees can achieve a better work-life balance.
Allow staff to listen to their own music. While managers may not relish the idea of employees wearing headphones at the office, it has proven benefits. Employees who listen to their own music while working are often happier and more productive. It can foster creativity as well.
Ease up on the dress code. Wearing a suit and tie does not make staff better able to perform their job. In fact, casual clothing tends to make employees feel more comfortable and relaxed. So long as employees are not meeting with clients, allowing them to dress down on Fridays is a simple way to boost their morale. It also can help prevent staff from mentally checking out in preparation for the weekend.
Call it quits early on Fridays. Even if staff members are in street clothes, they may be longing for the workday to end and the weekend to begin. If there are no pressing deadlines and employees are up to date on their work, consider closing the office an hour early on Fridays. If employees know they are getting out of work early, they will have more motivation to focus on the remainder of their day. It is also an easy way to make the entire office happy.

If your staff is struggling with low morale, you may start to notice attendance issues. Employees may start to call out more often, arrive to work late, or leave early. Once absenteeism creeps into the workplace, it can be hard to resolve. Actec can help your business track absences and implement measures to improve attendance. To learn more, contact us today.

How to Catch Fraud Before You Pay the Claim

Posted on

January 2nd, 2018

Andrew

Insurers catch most instances of fraud after they already paid for the claim. However, it is harder to get money back from a fraudulent claim than it is to prevent fraud in the first place. This was not always the case. With the rise of powerful analytics, insurers can use the data to make predictive models. These models can trigger an investigation into a claim if it contains markers of previous cases of fraud. This will allow insurers to stop fraud before paying the claim.

How Data Models Work

Data analytics are not new, but insurers had not been able to use them to their full potential until now. Statistical modeling and machine learning were not readily available in the past, but the technology has made significant strides in recent years. For example, an insurance agent could always survey claims data and try to draw conclusions. However, this method would prove too slow and too prone to error to be reliable.
With machine learning, the insurance agent presents the machine with sets of data (in this instance, true claims and fraudulent ones). The machine then learns over time how to develop insights into these sets of information. The machine can then use this knowledge and apply it to new claims. Through this method, the machine can interpret with reliable accuracy if a claim is high risk of being fraudulent.

Catching Fraud During FNOL

It is best to identify fraud during or right after first notice of loss (FNOL). This is because each step after FNOL is investigative or communicative. It is easier to look for fraud at the outset of the claim than to go back after the fact and try to find the relevant information.
Internal and external data are both relevant for fraud detection. Internal data, the information insurance agents collect, can provide common fraud statistics. However, external data is just as important for statistical modeling. This includes information such as regional demographics or weather conditions during the time of the loss. All of this data combined creates one premier set of data to use for predictive modeling.
Fraud is not the cost of doing business—at least not anymore. Fraud detection and prevention will always be a crucial element to claims management, but, with new technology, insurers can simplify and expedite the process. They can even identify fraud before they pay the claim. To learn more about claims management and fraud prevention, contact the experts at Actec.

Do You Know Which Absences Are Federally Protected?

Posted on

December 26th, 2017

Andrew

fmla Managing employee absenteeism is one of the greatest challenges facing employers. Employees miss work due to illness, vacations, and a variety of other factors, which is why most employers offer several types of paid and unpaid leave. However, a few absences for legitimate reasons are not employers’ main attendance concern. It is when employees begin to abuse their sick leave or paid time off that employers need to step in and address the issue. Even so, employers need to make sure they do not take disciplinary action against employees taking time off for reasons protected by federal and state law.

Family and Medical Leave Act (FMLA)

FMLA protects employees when they have to take leave due to major life events. However, the employee must provide written notice that he or she will be absent as well as provide proof that their absence qualifies under FMLA (e.g. a doctor’s note). Some examples of life situations covered by FMLA include:

Giving birth and caring for a child during the child’s first year of life
Adopting and caring for a child for the first year
Caring for a spouse, child, or parent with a serious health issue
Taking time off due to a serious health issue
Emergencies relating to a spouse, child, or parent due to the military

American with Disabilities Act (ADA)

Businesses that employ individuals with disabilities have to put accommodations in place to ensure that employee can do his or her job without undue hardship. If an employer neglects to implement reasonable accommodations, that employee may not be able complete his or her job properly, resulting in absences. Employers need to discover the root cause of the absences before taking disciplinary action as the absences may fall under the ADA.

Uniformed Services Employment and Reemployment Rights Act (USERRA)

This act protects military members’ jobs after returning from military service. Some periods of service are short, such as mandatory drill periods for individuals in the reserves. However, some service periods are months long and arise with little notice, such as when a reserve unit activates and deploys. In both of these instances, employers cannot take disciplinary action against the affected employee.

Title VII of the Civil Rights Act of 1964

This act protects employees from discrimination based on their race, sex, color, national origin, and religion. Similar to the ADA, employers should investigate employee absences to determine their cause before disciplining the employee. For example, the employee may be absent due to a religious holiday, which Title VII protects.
In addition to federal laws, many states have laws protecting a variety of absences as well. Some of the most common are workers’ compensation and jury duty laws. Managing absenteeism is a challenging job but investing in absence reporting technology can help. To learn more about how absence reporting programs can help employers improve employee attendance while remaining compliant with federal and state laws, contact Actec today.

How Powerful Telematics Technology is Changing FNOL

Posted on

December 18th, 2017

Andrew

Car driver The auto industry is no stranger to technology. Automotive technology has allowed for drastic improvements in driver safety as well as increased connectivity. With the rise of telematics, first notice of loss (FNOL) underwent a significant transformation.

Understanding Telematics

Telematics is more than just data. It is a connection between onboard computers and wireless technology. This connection allows the vehicle’s computers to share information with several platforms, improving safety and forever altering the FNOL landscape. One of the first major uses of in-vehicle telematics was with communications and security systems. If an individual was involved in an accident, the vehicle’s communication system could call for help on the driver’s behalf.
Another use for telematics was adjusting car insurance prices based on driver behavior. Insurance companies use a variety of factors to determine each individual’s insurance rate. However, with telematics, a driver could secure better rates by proving they do not speed, make hard brakes, and so on. Now, insurers can use telematics to establish FNOL as well.

Telematics and FNOL

Vehicles equipped with computers and sensors can do more than dial out for help in the event of an accident. Those sensors can pull details adjusters need to start the claims process such as where the accident occurred, how fast the vehicle was traveling at the time of the accident, what areas of the car were damaged, and more. This can allow the adjuster to begin working on estimates, expediting the claims process.
FNOL telematics allows insurance adjusters to resolve more claims in less time, which provides a boost to customer satisfaction. Happy customers are also more likely to recommend their insurer to friends and family, which can increase the customer base as well. To stay up to date with the latest FNOL technologies, contact the experts at Actec.

Improving Employee Attendance and Engagement

Posted on

December 11th, 2017

Andrew

shutterstock_174875483 A business cannot operate without its employees. When employees call out often or exhibit other attendance issues (i.e. arrive late, leave early, etc.), there is a problem within the company. Left unchecked, staff morale will start to decline and turnover rates will start to increase. There are plenty of businesses waiting to reel in skilled but dissatisfied workers from competing companies, so it behooves employers to ensure their workforce stays motivated.

Professional Development

No employee wants to remain stagnant in his or her position. Professional development opportunities not only expands employees’ skill sets, it also helps them improve their job performance and productivity. Consider cross-training employees in different departments or have them attend seminars.

Incentives

Some workweeks are hectic and every company experiences busy seasons. However, failing to recognize when employees go above and beyond will tank morale. Given enough time and neglect, employees will start to look for other job opportunities. One method to combat this is to provide small bonuses such as free movie tickets for every month of perfect attendance. Rewarding and incentivizing desired behaviors has two benefits. First, the employee experiences a boost in job satisfaction. Second, other employees will take notice and emulate the behaviors to achieve acknowledgment as well.

Flexibility

Millennials value flexibility in the workplace. As the percentage of millennials in the workforce is ever increasing, it behooves business owners to address their needs. Employers can incorporate flexibility in a number of ways:

Offer a once a week telecommute option where applicable
Allow employees to work from home when needed (i.e. when staying home with a sick child or if weather prevents them from reaching the office safely)
Allow flexible start and end times to help employees achieve a better work-life balance

Communicating with employees can provide invaluable insights as well. Employers may think they have a good read on their employees, but, without asking them, it is all speculation. Employers should also discuss attendance expectations with their staff to prevent any confusion.
Managing employee attendance is an important job and one employers should take seriously. Failing to monitor employee attendance can affect productivity and hurt a company’s bottom line. To learn more about absence management, contact the experts at Actec.

Successful Claims Management with Superior FNOL Data

Posted on

December 4th, 2017

Andrew

shutterstock_306793247 - Copy Claims intake specialists cannot optimize the claim intake process without the right information. Missing analytics and failing to use the right tools can result in delays, unnecessary expenses, and frustrations for both the agent and the customer. Harnessing the power of quality data at the onset of a claim is vital to successful claims management. For example, insurers can gain insights from claims data to sort and prioritize claims to ensure they reach the right adjusters.

Gather Data at FNOL

The best time to collect information about a claim is when a customer initiates First Notice of Loss (FNOL). Insurance agents should ask for information about the loss, any injuries or damages that occurred, and encourage customers to collect as many photos of the incident as they can. Mobile apps often allow customers to upload photos, which can be a great help to adjusters.

Funneling Claims

Collecting all the relevant data at the outset of the claim can help insurance companies filter the claim through the right channels. For example, data collected about injuries during FNOL can help adjusters triage the claim. The severity of an injury can determine the route a claim takes. If an insurance agent has to transfer the claim to an injury team later down the line, it may require the new agent to redo work on the claim. This wastes time and money as well as reduces customer satisfaction. Proper data collection can help avoid this issue and get the claim to the correct adjuster from the start.
While early information gathering is key, insurance companies need a full-cycle claim solution for effective claims management. Actec’s claims management solutions include complete FNOL activity tracking to support the claims process. To learn more about using FNOL data for effective claims management, contact us today.

The Truth About Employee Wellness Programs and Why They Fail

Posted on

November 28th, 2017

Andrew

fitness imag Employee wellness programs have taken the workplace by storm. Seventy-nine percent of large businesses and 44 percent of mid-sized businesses offer wellness programs. However, no employer can label his or her wellness program a success without measuring its value. While it is great to implement wellness programs, employers need to ensure they are effective to reap any benefits. However, over 60 percent of those that offer such programs fail to track the return on investment (ROI).
While few large-scale studies on the value of employee wellness program exist, some small ones do. A study by the Harvard Business Review found businesses with wellness programs saw a one to two percent increase in healthcare costs compared to the national average of seven percent. Ensuring the success of employee wellness programs is possible if businesses take the following approach.

Viable Wellness Programs Are Top Down

A wellness program will fail to thrive if management at the executive level does not engage. If CEOs host and participate in quarterly health screenings, it will show their employees that they are committed to improving the health of the organization as a whole. Other examples of nurturing long-term health are offering healthy meals at meetings and stocking the vending machines with nutritious snacks. If employers want to improve their employees’ health, it must be a long-term commitment. Holding one health fair per year while continuing to stock the break room with donuts sends a mixed message and will yield poor results.

Simplify Participation

If it is hard to engage or easy to miss the notice, employees will overlook wellness programs. An employer cannot send one reminder email or post one announcement and expect employees to take notice. Employees receive dozens of emails daily and are busier than ever. Employers can utilize several methods of communication (emails, text messages, etc.), but an online portal is the most likely method to succeed. Providing a single location for updates and screening results makes engagement easy for employees.

Seek Professional Support

Wellness Programs often fall under the purview of HR departments, but most HR employees are not equipped to manage the programs. Wellness programs can be complicated and time-consuming so it is best to invest in providers and vendors who are familiar with health screenings, health coaching, and so on. Wellness experts can schedule events, help employees with enrollment, manage communication efforts, and more.
Wellness programs are growing in popularity for obvious reasons: they increase employee engagement, improve morale, address budding employee health issues before they become a significant problem, and reduce absenteeism. Improving employee health has a direct correlation to improving their attendance. This in turn improves a company’s productivity and bottom line. To learn more about how employee wellness programs affect absence management, contact the experts at Actec.

Newer Technology Proving Unpopular for Claim Filing

Posted on

November 17th, 2017

Andrew

shutterstock_138016598 - Copy Technology is booming in several industries, the insurance sector included. However, while customers are more than happy to use mobile apps to buy insurance and review their policies, they hesitate to manage their claims this way. J.D. Power conducted a customer satisfaction study focusing on auto insurance and found only nine percent of customers provided first notice of loss (FNOL) via the internet or mobile app. Surprisingly, younger generations also prefer to provide FNOL by phone as a meager 12% reported their claim via digital means.
This would not be a major cause for concern if not for two facts:

Insurers have invested heavily in technology, and for good reason. The frequency, severity, and cost of claims are on the rise so they need to automate much of the claims process to help manage expenses.
Customer satisfaction with technological FNOL plummeted 16 points. This means that not only are insurers using technology more often, their customers are not happy about it.

However, not all is doom and gloom for insurance apps. Where insurance technology shines is with status updates. While only 16% of insured individuals use a mobile app to receive updates about their claim, their satisfaction is 33 points higher than those who do not. However, this trend skews toward Generation Y and Millennials. Pre-Boomers, for example, do not care for mobile updates. However, as younger generations begin to eclipse all other insured generations, their preferences will take center stage.

What Does This Mean for Insurance Providers?

Customers prefer the human touch when providing FNOL, but technology still has a place in the claims process. To ensure the greatest customer retention and growth, insurers need to tighten up their FNOL process. They also need to train agents on how to maximize customer satisfaction during the FNOL phase of the claim. From there, insurance companies can automate some of the claims processes without disappointing their customers. Actec can help insurers achieve these goals with our custom claim intake solutions. To learn more, contact us today.