Customers and insurers both want rapid resolution for claims. However, insurers have to balance risk and fraud with customer satisfaction, which can result in some delays. The longer a claim sits unresolved, the angrier the customer will become. To help resolve claims without increasing risk, insurers need to put a well-organized claims process in place. Some ways to achieve this include:
- Keep claims loads manageable. When claims adjusters take on too many claims at once, they are likely to drop the ball on at least one (if not more) of them. Forming claims into sets or groups based on necessary resources can help expedite the process while keeping the workload practical.
- Identify the bottleneck. There are a number of reasons why claims don’t reach settlement. These include disagreements over what insurance will compensate, requests for medical treatment, and overlooked simple requests. These issues can halt a claim so identifying and addressing them can help get it back on track.
- Triage claims. The number of unsettled claims can spiral out of control if adjusters don’t manage resolutions appropriately. Adjusters should first focus on claims that are ready for settlement. After that, the next most appropriate claims to settle are the oldest in order to regain those customers’ satisfaction. New claims with complex intricacies should also garner rapid attention as well so that the details don’t get lost over time. Adjusters should avoid working on claims where the claimant is uninterested in settling in favor of the above types of claims. They can always return to those claims after resolving ones that are more straightforward.
- Pinpoint ways to improve going forward. Some claims remain unresolved for long periods due to inefficiencies in the claims process. When working claims, try to identify the reasons for this and implement new practices to prevent them in the future. For example, if numerous delays are the result of unanswered medical requests, consider adding a step to check for these requests at regular intervals to make sure no one misses them.
Improving claims processing from first notice of loss to settlement helps improve customer satisfaction and close more claims. If your claims handling processes are causing customer retention issues, Actec can help. Contact us to learn more about our Full-Cycle Claim and Incident Reporting Solutions.