Is Your Claims Process Ready For Autonomous Vehicles?

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March 7th, 2017

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greenhouse gas truckThe 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:

  • Targets of claims and lawsuits
  • How adjusters allocate liability
  • An increase in product liability claims

With incidents involving traditionally operated vehicles, most claims and lawsuits target one or more drivers. By removing drivers from the equation, individuals will turn to the car and technology manufacturers. Technology may be insusceptible to distractions and alcohol, but it can wear down over time. Experts expect many autonomous vehicle lawsuits to focus on the potential for fatigued software to malfunction.
Meanwhile, insurers will need to consider how they will assign liability after a customer makes a claim. Another liability headache adjusters should expect is dealing with shared ownership of a vehicle. Autonomous vehicles come with a hefty price tag, so more than one individual may own and operate the vehicle. This adds an additional layer of complexity to allocating liability.

Expect More Product Liability Claims

Specialists are predicting a rise in product liability claims for one significant reason: money. Car manufacturers and software development companies have much deeper pockets than one individual does. This makes them a lucrative target. Engineers responsible for crash avoidance algorithms could also find themselves liable or pulled into lawsuits.
While autonomous vehicles pose certain difficulties for insurers, experts agree the technology will reduce accidents. Insurers may need fewer dedicated auto adjusters as a result, but they will need a proportionate increase in product liability adjusters. Regardless, insurance companies need to examine their current claims management process. To learn more about custom claims management solutions, contact the experts at Actec.

FNOL and Technology: Human Element Still Required

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February 23rd, 2017

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shutterstock_138016598 - CopyAs more cars integrate some sort of smart technology, auto insurance agents find themselves wondering if they will soon be out of a job. While OEMs can report accidents and get the first notice of loss (FNOL) process rolling, agents can rest easy. Customer, particularly younger customers, still want a human element involved in their claims process. This is great news for insurance agents as Generation Y made up the largest portion of auto insurance claimants for 2016 at 40%—this is a 7% increase from 2015.
While their customer satisfaction levels are the lowest of all the generations making claims, their perception is improving. Generation Y also has significant influence over the auto insurance industry. Because of this, many insurance providers are taking steps to address this generation’s wants and needs.
While Generation Y values smartphone apps and text alerts, they appreciate human interaction more. For example, a Generation Y claimant is more likely to use a mobile app for FNOL purposes than other age groups. However, they will want to talk to an actual agent about next steps and how their claim is progressing.

The Shifting Role of Insurance & Claims Agents

Successful insurance agents will adapt to new technology to meet their clients’ needs. Learn how customers are using technology and be ready to fill in the gaps. In addition, when a customer calls they have much higher satisfaction levels when they remain on the line with that agent. Their satisfaction drops if the original agent transfers them to a call center and it takes an even greater hit if the agent tells the customer to contact the call center himself or herself.
Customer satisfaction affects customer loyalty. Agents cannot afford to neglect client’s concerns or rely too much on technology to do the heavy lifting of a claim. To learn more about improving your business’s approach to FNOL or overall claims process, contact the experts at Actec.

Claims Management: Tips for Detecting Fraud

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February 9th, 2017

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claim fraud car on fireSome 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.

Unusual Coverage

The age of the customer’s insurance policy can be a telling sign. If the policy is less than a month old or is about to expire, this can call for some additional inquiries on the agent’s part. Another example of an unusual coverage circumstance is if the insured took out an excessive amount of coverage for the age and model of vehicle. An over-insured vehicle can be an indicator of fraud.

Vehicles Burned Beyond Recognition

If a vehicle is a smoldering shell, it warrants further investigation. Many believe setting a vehicle on fire will cover their tracks, but the source of the fire often survives. Other red flags for burnt vehicles include:

  • The vehicle was found empty in an abandoned location
  • Excessive amount of paper was found in the fire remains (i.e. potential insight into how the vehicle was set on fire)
  • The insured was recently fired or is in a financial bind

Phantom Hit-And-Run Incidents

Customers often invent this type of false claim to cover up their own carelessness. If a customer damaged their vehicle by sideswiping a light pole, their rates will likely increase if they file the claim. However, if they say an unidentified vehicle forced them off the road to avoid a car accident, they may be able to avoid a rate increase. While the rules differ from provider to provider, several insurance companies do not increase rates for not-at-fault or uninsured motorist claims. If the customer cannot provide solid details about the other vehicle, the claim may be worth further investigation.
The issue with these fraudulent claims is they increase rates across the board for all motorists. Insurance companies have to pay out a certain amount of money depending on the individual’s insurance plan. The more customers that file false claims, the more funds insurance companies must allocate to them without cause. To learn more about reducing fraud through claims management, contact Actec.

New California State Claim Reporting Requirements Beginning January 1, 2017

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January 16th, 2017

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shutterstock_250505056 - CopyThe 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.
Common types of workers’ compensation claims include:

  • First Aid Claims, described by the California Labor Code as those involving a single treatment and subsequent observation of a minor injury. This might include antiseptics, bandaging and non-prescription medication.
  • Incident Only Claims are actually not claims at all, but rather documentation of an incident that does not result in any treatment or disability.
  • Indemnity Claims involve exposure to indemnity benefits (temporary or permanent disability).
  • Medical Only Claims involve treatment which exceeds the definition of first aid but does not involve any indemnity exposure. A medical only claim can cover a maximum of 3 days of lost time.

Common practice has been for employers to handle first aid in-house, without documentation. This can save time and have a positive effect on experience mods (and therefore insurance premiums). This change in policy suggests that the State of California now considers these hazards relevant to the overall safety conditions of a workplace. To learn more about how these changes could affect your organization, contact us.
 

Tips to Improve Your Mobile Insurance Strategy

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December 13th, 2016

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phoneThe insurance industry is sometimes slow to adapt to new technologies. However, as of 2015, almost 70% of adults in the United States own a smartphone. This is almost twice the number of adults who owned a smartphone in 2011. With smartphone ownership skyrocketing, insurance companies cannot afford to overlook mobile applications.

Mobile Benefits Everyone

Mobile capabilities cease to be an option but a necessity as more millennials come of age. The millennial generation may be driving the need for mobile apps, but rising customer expectations across the board are pushing for it too. Going mobile can benefit insurance companies as well. For example, offering mobile solutions for First Notice of Loss (FNOL) can give an insurance company a competitive edge. A mobile app can also provide recommendations for vetted service providers. This will help ease the customer’s stress. Improving the customer’s experience during a time of crisis goes a long way toward retention.

Be Forward-Thinking

It is not enough to adapt to customers’ wants after they happen. If your competition had a mobile app before you, you are already behind the curve. While insurance companies cannot predict accidents, they can detect them as they are happening. An example is using sensors in the home. These sensors can detect plumbing problems. The sensor will then notify the insurance company, who can then contact homeowners about the issue. This can help prevent catastrophic water damage, especially if the homeowner is out of town.
Making these necessary changes can be daunting, but there is no need to take on these tasks alone. Contact Actec to learn more about custom solutions to improve your claims process.

Technology a Critical Component in FNOL Solutions

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October 24th, 2016

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shutterstock_229854826 1920x750First notice of loss plays a critical role in many organizations. The manner in which data is reported, transmitted, managed, stored, organized, and used will dramatically impact the efficacy of an FNOL operation and everything it touches. Whether in use by an insurance carrier, an airline, or other FNOL-dependent organizations, success has been redefined by the widespread implementation of technological advancement. What kinds of technology play such an important role?
Electronic Data Interchange – FROI, SROI and medical bills can be carefully reviewed before submission to avoid delays. This can improve customer service while decreasing costs and reducing error.
Adaptable, Cloud-Accessible Database Functionality – Keep data in the form most conducive to its users with unique, cloud-accessible implementations of data intake, organization, and management.
Multifold Communication – Leveraging modern communication tools like social media and texting to communicate reduces lag time in reporting and management while increasing customer and employee satisfaction.
High Fidelity VoIP – Increase bandwidth, record communications for further analysis, and decrease costs with internet-based telecommunications.
To learn more about first notice of loss and technology-based implementations, read our blog posts or contact us.

Using Metrics Data to Improve the Claims Process

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October 10th, 2016

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shutterstock_251707783 smIntegrating your claims process with technology can provide a number of benefits. Your company can reap most of these benefits through the collection and analysis of data. Simply having the data is not enough, though. Claims management should use the data to improve operations, discover trends, and forecast future claims.

Data to Improve Operations

Metrics can locate areas that need improvement within your claims process. They can also show you where your claims process is performing at its best. You can leverage this information to implement practices that improve the areas where you are weakest. Relevant data include:

  • Open and close rates
  • Closing ratios
  • Age of claim (time it takes from receipt to move it forward in the claims process)
  • Workloads of employees

Data to Discover Trends

Discovering trends can help your company manage incoming claims. It allows you to take a more aggressive approach to managing certain types of claims based on trend data. It can also allow your company to make changes to reduce the frequency of certain types of claims.

Data for Predictive Modeling

Knowing trends is great, but predicting the outcome is better. While predictive models will never remove the needs for a claims expert, it can help assist and expedite the claims process. For example. Predictive tools can alert the claims representative of a potential fraudulent claim.
Data collection can help you streamline your claims process. To learn more about claims management and custom claims solutions, contact us.

FNOL: Is Your Claims Process Hurting Customer Retention?

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September 6th, 2016

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shutterstock_174875483When a customer first contacts their insurer, this is the best chance to have a lasting and positive influence on their experience. However, if the notice of loss process is not efficient or requires a lot of leg work on the customer’s part, they will likely have a long-term negative association with their insurer. Once the customer initiates the process, other factors begin to affect their overall perception as well. Communication with employees, ease of understanding the claims process, and how fast the insurer handles their claim all contribute to the customer’s final opinion.
Ineffective claims processes are often the root of customer dissatisfaction. Traditional claims processes segment the claims manually which can lead to delays. Another element that slows down the claims process is high employee turnover rates. This reduces work quality and further interrupts the process.
A major way to improve customer satisfaction is to meet their technological expectations. Many customers want a digitized claims process that is clear and progresses without their continued input. While dated systems can hinder this, there are ways to improve the customer’s experience.
To improve the FNOL process, insurers can:

  • Automate the initial claims process by going digital. Automating segmentation can reduce the amount of effort required for both the customer and the insurer.
  • Engage in proper staff management and forecasting. If an insurer knows what time of year is busiest, they can fill labor gaps without overtaxing their permanent workforce. This will reduce turnover and training time as well as increase work quality.

By focusing on meeting the customers’ needs and expectations during their time of crisis, insurers can improve customer satisfaction and retention. To learn more about claim management, contact us.

5 Steps to Improving Your Claim Intake Procedures

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August 25th, 2016

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shutterstock_138016598 - CopyClaim intake strategies are as varied as the business landscape of the United States. Different organizations require different approaches, starting with an in-depth analysis of status and objectives. Deriving claim intake procedures from your unique needs ensures development of a custom workflow that fits. It’s critical to use your business rules to ensure accuracy, minimize call times, and reduce follow-up calls.

  • Develop a best practices workflow for thorough and logically organized reporting
  • Make claim reporting available through many media: telephone, e-mail, fax, website, even social media
  • Implement a contact tracking module, to improve forms management and dissemination capabilities
  • Rapid response to critical incidents including clear escalation procedures
  • Ensure correct routing of claims with coverage verification and claim office assignment

While all of these capabilities can be developed in-house, it’s often more efficient and effective to outsource them to a professional claim intake center. To learn more about claim management, custom intake solutions, and outsourcing, contact us.

5 Key Terms in First Notice of Loss Operations

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August 17th, 2016

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shutterstock_306793247 - CopyThere several important terms when discussing first notice – some may seem esoteric, others mundane. But understanding their full meaning and method of execution can dramatically improve business operations for organizations of all shapes and sizes. A positive FNOL interaction is key to successful business operations – from client relationship management to risk reduction.
1. First Notice of Loss (FNOL) – The initial report of a claim or incident resulting in loss of an insured product. A crucial element of insurance coverage. This discipline and its various constituents is now dependent upon a vast array of technologies, from data management and communications software to social media awareness and forensics.
2. Claim Intake – The initial interaction between claimant and professionally trained personnel – a critical step in the FNOL process.
3. First Report of Injury – The initial report of a claim or incident resulting in injury to an employee. A employer practice required by law.
4. Claim Handling/Claim Management – The conveyance of an insurance-related claim through a system of communication and investigation to ascertain the appropriate compensation. The more adept and timely the claim management, the less shrink for insurers and the higher satisfaction for clients.
5. Incident Reporting – A system of documentation for FNOL in which specific details must be thoroughly recorded to ensure proper claim management. Well-trained personnel and a modern, sophisticated incident reporting medium significantly reduce costs due to slow resolution, shrink, and other organizational issues.
There are other components of FNOL, but familiarity with these 5 key terms will illuminate much of our industry and its purpose. To learn more, contact us.