Customers never think about insurance until they need it. When it comes time to file a claim, consumers want the process to be fast, streamlined, and accessible. By modernizing your FNOL processing you will be able to improve the customer experience.
Customize the Claims Process
Companies need to customize the claims process with software solutions, electronic delivery, and online communications tailored to their business model and the needs of their clients. Customers demand solutions that meet or exceed their expectations while conforming to their logistical challenges..
Synchronize Processing
FNOL is only one step in a complicated processing chain. Each step of the process may be handled by different departments, but claims processing needs to be synchronized so that the experience is seamless for customers.
Uncomplicated Processing
Customers need assistance when they’ve been the victim of theft, automotive collision, and a host of other unfortunate events. The last thing they need to worry about is navigating a complicated claims process. Updating your process with data management, cloud and CRM systems will help your company make claim intake and the FNOL process easier for your customers. This includes mobile compatibility, social media responsiveness, metrics and analysis to better understand your claim intake needs, and more.
State Requirements
Your customers consider you the authority regarding state policies and requirements. Your representatives need to have the answers for customers as well as understand company obligations. Talking customers through the process and letting them know your organization will handle state requirements will put their mind at ease.
Simplifying the Process for the Company
When you are working to enhance the customer experience you also need to find ways to make it easier for your company to manage claims. Sometimes outsourcing FNOL solutions can allow your company to focus on other aspects of managing claims. For more information about absence reporting, first notice of loss, and 24/7 claims reporting, contact the experts at Actec.
Tag: claims handling
Claims Management: Tips for Detecting Fraud
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.
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.
Using Metrics Data to Improve the Claims Process
Integrating 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 Strategies: Efficient Data Entry Strategy For Claim Management
Claim management is a critical element of a First Notice of Loss (FNOL) system. The efficiency of data entry, quality assurance and information systems help companies save money and adhere to policy requirements. One of the first aspects of claim management is an efficient data entry strategy.
What Is Entered Matters
When call center operators assist consumers with a FNOL report, the information entered during that contact will set the tone for the rest of the claim process. If the operator is able to capture vital information quickly and enter it into the system, the company will be able to continue the next stages of the process efficiently. If, however, the operator fails to answer the right questions, obtain all of the necessary information or properly document the conversation then extra steps will be needed to complete the process.
Software Isn’t the Only Concern
The right software is an important element of claim management. The ability to create customized fields so that operators can ask the right questions will help make the intake process fast and efficient. Organizing the screens so that operators spend less time moving through pages and more time entering information is also important. But operator training and company policies are also vital.
Operator Training
Good customer service skills and empathy are important traits for call center operators who handle first notice of loss contacts. They need to be able to collect information from people who are distraught and may not be thinking straight at the time. The ability to help a person relax and remember details will help the operator obtain a complete report on the situation.
Company Policies
How companies teach operators to enter information into the system will help employees to be thorough and fast while still creating legible notes for quality assurance and claim processing. Medical codes, insurance codes and a company shorthand will help create a consistency to data entry that will increase efficiency.
The data entry strategy for claims management needs to be comprehensive, detailed and enhanced by the latest technology. Efficiency in claim management improves the customer experience and is a better return on investment for businesses. Outsourcing this aspect of the business can help increase efficiency and ROI. For more information about FNOL and 24/7 claim reporting, contact us.
Claims Process Outsourcing – Business Performance Efficiency
Today’s business organizations are faced with multiple challenges across a multitude of business functions and processes. Business challenges requiring high degrees of specialization, such as first notice of loss insurance claims processing, need to be highly customized to meet the needs of each unique organization and industry.
Optimizing processes such as improving the customer experience, dealing with a growing need for data, driving more business, better connectivity and integration can help all companies. To accomplish this, many organizations leverage an outsourcing model.
Business outsourcing isn’t new. As a matter of fact, it’s widely used – and accepted – by many organizations, of many sizes. Today business success is measured by outcomes and KPIs which help drive business growth, innovation and customer satisfaction. Whether the function is staffed internally, or outsourced to a specialty firm, is determined by efficiency and success metrics.
For example, absence claim reporting processes that are outsourced are typically more efficient and less expensive and, because of the dramatic shift toward internet-based work tools, the economy of scale of an existing, staffed 24/7 call center, and the existing systems and knowledge available from the outsource organization. Outsourced claims reporting services can assist companies in accelerating claims process optimization, ensuring fewer claims related issues, mitigating lost claims and wasted time.
Increasingly efficient processes are a huge advantage for companies, especially larger organization. Specialty outsource business process providers can dramatically improve the efficiency, and bottomline, of a company. And that is what a true business partner is all about. For more information about absence management solutions, first notice of loss (FNOL) and 24/7 claims reporting, contact the experts at Actec.
How to Handle Claims Effectively
Many insurance companies do not have an effective claims management system,
oftentimes leading to a loss of accounts. There are four key elements that need to be included in an effective and efficient claims handling policy. These elements should be included in a productive claims management evaluation process.
Element #1: Written Agreement with Carrier and Intermediary (Broker)
It is vitally important that you maintain an excellent working relationship with your insurance carrier and broker (or third administrator – TPA.) The basis of this relationship includes a written agreement on roles, responsibilities, key performance indicators (KPIs) and communication protocol.
Element #2: Written Internal Protocols
A well-defined, written internal process for claim reporting, tracking and oversight of the claims management methods that employees are expected to follow is essential.
Element #3: Specific Metrics
Metrics and data tracking are powerful tools when assessing the effectiveness of claims management. Specific metrics need to be developed and tracking protocols implemented. Examples of helpful metrics include:
- What is the basis for reserves?
- What trends are affecting claims?
- What challenges are claims managers facing and why do these challenges exist?
- Are the certain claimants that present problems? What issues are claim managers having with these claimants?
Element #4: Support from Upper-Level Management
In order for claims management systems to be effective throughout the company, all levels of management within the company need to be involved and committed to the process. A system for regularly measuring the frequency, type and severity of claims needs to be implemented; periodic claims need to be reviewed, referenced and follow-up systems noted.
If implemented systematically, these four key elements of effective claim management will significantly reduce your TCor by reducing both claim frequency and severity and reducing handling time.
An Effective 24/7 Claims Reporting System Is Essential
Many individuals require an effective after-hours claims service. Today, most insurance businesses have 24-hour toll free lines for their clients to call up in times of trouble.
With Actec, you get the benefit of our professional staff that is trained to support a customer through a claim. We can also help with reporting the claim to your insurance company and will work with the customer and the company to ensure that the customer is satisfied with how their claim is handled.
Claims are not time specific and can happen around the clock; all the more reason to have a 24/7 claims reporting system available. Although loss is something people have no control over, when a customer calls in to report a loss, we can take control of the situation.
A lot of businesses today are outsourcing FNOL systems, to allow their own staff to focus more on their respective tasks. When you join hands with Actec, you benefit from having a representative present at all times to take a call and provide instant care.
To know more about Actec and our services, contact us.