It’s not uncommon to see job postings for insurance adjusters include desired skills such as fast worker or excellent multitasker. With so many boxes to check on any given claim, most adjusters believe they need to complete three tasks at once to stay on track. However, this approach often leads to time-consuming errors that can delay the claim. If adjusters take a single-task approach, they can usually complete their claims faster with fewer mistakes.
What is Singletasking?
Instead of trying to perform several tasks at once, adjusters tend to be more effective if they focus all their efforts on completing one task before starting another. Avoiding distractions is vital as it allows adjusters to seamlessly flow from one step to the next without losing track of where they were in the claims process or forgetting to complete a different task because they began a new one halfway through.
How to Speed Up the Claim Cycle
The following are several ways adjusters can remove distractions for flawless claims workflow:
- Turn off all devices that require active listening—no television, no radio, no podcasts or audiobooks, etc. While some tasks may be tedious, active listening distracts adjusters’ attention, which can lead to errors.
- Set office hours and stick to them. Otherwise, adjusters should turn off their phones and allow messages to go to voicemail. Stopping to answer the phone every 10-15 minutes can derail progress on a claim.
- Do not check emails. Emails are notorious for consuming the workday. Adjusters often start with good intentions—checking for updates and the like—but a five-minute once-over can turn into upward of an hour of clearing out spam or replying to emails out of habit rather than to advance any claims. Set specific times of day for checking emails to avoid the temptation.
- Perform work in batches. When following up on claims, stack them in a pile and work through them from top to bottom. Do not take calls or listen to other voicemails at that time. This creates confusion and can result in accidentally overlooking a claim. The same is true for emails or writing estimates.
- Put up “Do Not Disturb” signs. This is especially vital when traveling for claims. Housekeeping for hotels coming and going can disrupt workflow, as can well-intentioned friendly coworkers dropping by to chat before heading out to their next claim.
Closing claims faster and with fewer errors improves an insurer’s bottom line while boosting customer satisfaction. To learn more about improving claims processing and management, contact the experts at Actec.
Improving 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.
Insurance customer service representatives have to familiarize themselves with the entire claim cycle from first notice of loss to claims resolution. However, knowing the ins and outs of the industry doesn’t mean an agent will automatically do well at his or her job. Insurance representatives need to possess a number of soft skills to succeed. Some of the more desirable soft skills include:
- Internal communication and teamwork. Representatives need to be able to communicate effectively with internal staff as well including coworkers and management. This allows them to express needs or challenges that are preventing customers from receiving the best possible care. In addition, good communication skills means being a good listener as well to fully understand the customers’ needs. Similarly, teamwork is vital for successful customer service. When representatives work together, they can find creative solutions for common problems as well as develop strategies that play to each other’s strengths.
- Conflict resolution. Customers approach insurance representatives with a multitude of problems. Many situations require creative solutions so insurance representatives need to be able to think outside of the box to solve their issues. If representatives are unable to provide a workable solution, they need to let the customer know they will reach out to management and get back to them.
- Efficient empathy. Customers calling in with a problem aren’t looking to hear similar stories. Trying to associate with customers by sharing a personal related anecdote is unnecessary and takes up valuable time. Representatives should be empathetic, but a simple “I know how you feel” will suffice.
- Remaining calm. Customers usually call their insurance provider when they need to make a claim. This means they are likely upset and will require delicate handling. Representatives need to remember the customer isn’t angry with them personally. Staying positive and optimistic can help the customer calm down and bring about a better experience for both parties.
No amount of skill can overcome a limited claims management system. If your claims processing is slow or irritating customers, Actec can help. Contact us to learn how we can help transform your claims handling processes.
Insurance agents influence claims during every step of the claim cycle. This gives them the unique opportunity to ensure the customer is experiencing the best service possible during a challenging period in their life. When a customer calls to report a claim, they are likely stressed and in need of compassion. The following are several ways insurance agents can help customers navigate the claims process:
- Follow up throughout the entire claim. Even if there is no new information, customers want to hear about the progress of their claim. Many customers feel uncomfortable or like they’re being pushy if they call to ask for an update. They appreciate when insurance agents keep them in the loop, which improves customer loyalty and the claims experience.
- Be a point of contact. Insurance claims pass through several hands during the claims process. More than one adjuster may be involved, the claim may go through multiple insurance providers depending on the situation, and scheduling damage assessment on top of all of that can make a customer’s head spin. Let the customer know they can always reach out to you to find out where they are in the claim and what the next step to take is.
- Make sure they understand their coverage. Just because a customer purchased his or her insurance policy doesn’t mean he or she understands everything about it. Customers may have known the minutia of their policies when they first bought them, but they’re likely to forget over time. Insurance agents should explain their customers’ coverage in general terms until they have all the facts about the claim.
- Listen to complaints. It is near impossible to complete a claim without some sort of snag or delay. More often than not, frustrated clients just want a sympathetic ear and an apology. Most complaints don’t require more than that and can boost customer retention.
- Encourage prompt action. Claim delays are one of the biggest sources of frustration for customers. However, they are often the cause of the delay themselves. Pointing this out to them won’t earn any favors, but insurance adjusters can encourage them to respond to requests for documents as fast as possible. This can help keep the claim on track and improve their overall experience.
Most customers want and need someone to hold their hand through the claims process. Insurance agents who provide guidance and compassion can enhance the claims process, improve customer satisfaction, and boost customer retention. To learn more about improving the claims process, contact the experts at Actec.
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 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.
Claims denial is part of any insurance revenue cycle, particularly when it comes to healthcare. While it is unrealistic to assume claim denials will drop to 0%, there are ways to prevent it from happening. According to the American Medical Association (AMA), denial rates ranged from 0.54% to 2.64% for major private payers and up to 5% for Medicare. Rates are down across the board from 2012, but there is still room for improvement.
The cost of claims denials has prompted some providers to focus on avoiding denials in the first place. The process involves:
- Putting an automated procedure in place
- Identifying and evaluating reasons for denials
- Enhancing front-end processes for the revenue management cycle
- Handling denials using an expedient method
The vast majority of denials are avoidable. By identifying the most prevalent reasons for denials, providers can improve their processes to reduce these issues. Some of the most common causes for denial include:
- Payer does not cover services
- Claim submitted outside of time limit
- Duplicate claim submission
- Relevant information missing
Rather than waiting for a rejection notice, providers can take an active role in claims denial management. By reducing inefficiencies that cause or promote common errors, providers can save money by avoiding denials. The best way to achieve this is with a custom in-house solution to address your specific claims process. Contact Actec to learn more.
First 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.
Claim 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.
There 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.
Claim management is a critical issue for most insurance companies. There are two major categories of tasks involved in the claim management process – claim intake and claim handling. Claim handling usually gets a lot of focus, due to its complex and often-drawn-out nature. But claim intake is an equally important part of the process, and warrants special consideration for a variety of reasons. The most significant reason is that poor or unsuccessful claim intake can result in one or both of the following major consequences: inaccurate case information that will lead to failures in the claim management process and customer dissatisfaction that can lead to loss of business.
Most people and companies are often unaware that when they first contact their insurance provider to report theft, loss or damage that they are actually contacting a first notice of loss (FNOL) call center. Call centers can be highly professional and serve a wide variety of insurance and other claims-related businesses. But beware – not all call centers are created equal. Yours should offer 24/7/365 operation to ensure convenience for clients and timely claim transmission for your organization. First notice of loss operations are sometimes staffed internally, but more frequently these days, the operations are outsourced to a specialist. As with most round-the-clock operations, staffing, training and accurate claims intake are challenging for any organization.
There are different types of vendors which offer solutions for FNOL – some offer software, others offer a comprehensive call center based on a proprietary application, and still others customize their call center operation to accommodate any platform. These are platform agnostic vendors who claim to work with insurance companies’ existing platforms. While there are a variety of solutions available, some will serve your organization more effectively than others. To learn more, contact us.