Proper documentation is crucial to closing insurance claims with a positive outcome. As the saying goes, “if it’s not documented, it doesn’t exist!” That’s why insurance adjusters need a full-cycle claims system to help them document all facts relating to liability, damages, coverage, and more. This information is especially helpful if a new insurance adjuster picks up the claim part way through processing.
Tips for Documenting Claims
Documenting claims is a delicate business. Claimants often experience anxiety or lack of focus when attempting to communicate, and notes that make sense to one adjuster may be confusing to another. Below are several suggestions for effective documentation.
- Provide regular training on documentation. The methods for documenting claims continue to improve as claims become more complicated. Training adjusters on the latest documentation procedures is key for quick and efficient claims resolution.
- Log everything. Whether it is a phone call, a face-to-face consultation, or an inspection, the adjuster should keep notes. It is impossible to remember the specifics of every claim so detailed notes are essential.
- Focus on the facts. It is easy to read into a client’s emotions, but this can result in biased documentation. For example, making a notation such as, “The client was distraught,” without the client saying so themselves is conjecture.
- Time-stamp and geotag all photographs and videos. Visual evidence is an excellent way to support written records. However, an adjuster needs to be able to prove when and where they took the photo or video. Recording the date, time, and location digitally crucial.
Maintaining accurate and up to date notes on a claim is an important element of the claims management process. Poor documentation can prolong a claim and affect customer satisfaction and retention. To learn more about effective claims management, contact the experts at Actec.
Insurance companies encounter a number of hurdles on their way to business success. Aside from the inherently competitive nature of the insurance field, companies must also remain compliant with strict regulations as well as meet growing customer expectations. An effective claims management process plays a significant role in a company’s relative success within the industry. In particular, a company’s claims management process needs to find ways to control costs, decrease incidents of fraud, and keep customers happy.
Insurance claims, much like hospital patients, require proper triaging. For example, an emergency room will tend to an individual with a bleeding head wound before they treat the patient complaining of a persistent stomachache. Unfortunately, claims do not always follow appropriate triaging upon first notice of loss (FNOL). Inefficient systems and limited data are often the cause of misrouted claims and delays. This aggravates customers and can result in increased costs as well as lost business.
Insurance companies have to balance several priorities while managing claims. They need to ensure the loss information is accurate, control costs, and keep customers happy. Thankfully, there are several new technologies designed to help insurance providers improve their performance.
Proactive claims handling is necessary for insurance providers to thrive. A company using a dated paper-based system cannot deliver the level of service customers now expect of their providers. The greatest opportunity insurance carriers have to ensure customer satisfaction is when the customer provides their first notice of loss (FNOL).
The number of automated processes within any given vehicle continues to grow as technology progresses. Fully autonomous vehicles are on the horizon and insurance companies need to prepare themselves for this reality. Autonomous vehicles will change claims management to a significant degree. Some examples of these changes include:
Some fraudulent insurance claims are obvious right away. For example, a customer may call to claim he or she was in a hit-and-run accident. They may describe the car as red, but pictures from the scene show blue paint transfer. While the agent managing the claim may never know the truth of what happened, a customer’s motive for filing a false claim is usually financial. If the customer recently lost their job or has excessive monthly car payments, that may be their incentive to offload the vehicle. Most claims do not involve fraud, but agents should make themselves aware of the following warning signs.
The State of California recently amended the California Workers’ Compensation Uniform Statistical Reporting Plan. As of January 1, 2017 it now requires insured employers to report first aid claims to their claims administrators. This does not apply to self-insured organizations that handle claims in-house.