3 Ways to Improve Claim Intake with Enhanced Call Center Customer Service Practices

Posted on

July 23rd, 2018


shutterstock_138016598 - CopyWhen customers call their insurance provider to make a claim or discuss an existing claim, the experience isn’t always smooth. After wending their way through a phone tree, customers often just want to speak to a knowledgeable person about their claim. Many of these interactions flow through a call center, which represents a prime opportunity to improve customer retention. The following are several ways to boost customers’ experiences with insurance claim call centers.

  1. Give representatives the tools and training they need. Customer service representatives (CSRs) need to feel confident that they can help any customer that calls. The best way to do this is a blend of quick thinking and expertise with systems and tools of the trade. Skimping on training or forcing representatives to work with outdated tools will yield average results at best, which isn’t a great start for improving customer satisfaction or retention rates.
  2. Foster a positive working environment. Unhappy customers need fast resolutions to keep them from searching for new providers. However, representatives often take the brunt of customers’ anger. Insurers need to make sure they’re taking care of their people as well as their customers. Keeping CSRs in good spirits is vital to processing claims without complaints or delays. Some ideas to boost the office mood include providing snacks in the cafeteria free of charge, raffling off free movie tickets, recognizing performance-based achievements, etc.
  3. Focus on soft skills. Most customers are hesitant to contact call centers because they don’t want to interact with a robotic CSR. Soft skills such as communication, adaptability, conflict resolution, and more are all vital to successful claims resolution. Call simulations or listening to recorded calls can help CSRs learn how to handle angry or upset customers without losing their cool or coming across as unfeeling.

Many insurers focus on closing cases as fast as possible, and they can sometimes lose sight of the customers on the other side of the claims. By investing in a quality claim reporting solution, insurers can spend less time on redundancies and focus their efforts on customer satisfaction, retention, and claims resolution instead. To learn more about claim reporting and outsourcing, contact the experts at Actec.

How to Improve Claims Management Workflow in 3 Simple Steps

Posted on

June 5th, 2018


shutterstock_251707783 smThere are only so many hours in a day, but clients don’t care about their insurer’s workflow problems. They want answers to their questions, rapid resolutions for their claims, and quick payouts for settlements. While insurance companies can’t make the day any longer, they can optimize their existing procedures to improve efficiency. The following are several ways to improve the claims management workflow.

Consolidate and Share Data

Insurers that rely solely on spreadsheets limit their service abilities. When insurance agents and adjusters need to access information about a claim, a massive excel spreadsheet is not the most efficient method. Storing data on several databases also makes it difficult to find all of the relevant information, which slows down the claims resolution process. By storing all data in one location and granting access to all relevant employees, insurers can speed up the claims management cycle.

Prepare for Emergencies

Many businesses operate well enough until they are hit with an emergency. They don’t have the ability to take on the additional work, so their day-to-day tasks sit on the sidelines until they can resolve the problem. This creates a looming disaster, as the sheer volume of backlogged work will swiftly overwhelm employees. If insurance companies consolidate their data as suggested above, adjusters and agents can access the information they need much faster, which better enables them to handle emergency situations.

Look for Trends

When data is easier to access and view, insurers can identify trends much faster. For example, an insurance company may notice certain natural disasters provoke more fraudulent claims than others do. They can then look at those false claims and search for commonalities to red flag similar claims going forward. This can save hours of time otherwise spent working on a case that may or may not be duplicitous.
Resolving bottlenecks in the claims management process doesn’t always have to be complicated. Sometimes, it’s as simple as revamping an existing system to make it work better. If your claims management process is causing headaches, contact the experts at Actec to learn how we can help.

Successful Claims Management with Superior FNOL Data

Posted on

December 4th, 2017


shutterstock_306793247 - CopyClaims intake specialists cannot optimize the claim intake process without the right information. Missing analytics and failing to use the right tools can result in delays, unnecessary expenses, and frustrations for both the agent and the customer. Harnessing the power of quality data at the onset of a claim is vital to successful claims management. For example, insurers can gain insights from claims data to sort and prioritize claims to ensure they reach the right adjusters.

Gather Data at FNOL

The best time to collect information about a claim is when a customer initiates First Notice of Loss (FNOL). Insurance agents should ask for information about the loss, any injuries or damages that occurred, and encourage customers to collect as many photos of the incident as they can. Mobile apps often allow customers to upload photos, which can be a great help to adjusters.

Funneling Claims

Collecting all the relevant data at the outset of the claim can help insurance companies filter the claim through the right channels. For example, data collected about injuries during FNOL can help adjusters triage the claim. The severity of an injury can determine the route a claim takes. If an insurance agent has to transfer the claim to an injury team later down the line, it may require the new agent to redo work on the claim. This wastes time and money as well as reduces customer satisfaction. Proper data collection can help avoid this issue and get the claim to the correct adjuster from the start.
While early information gathering is key, insurance companies need a full-cycle claim solution for effective claims management. Actec’s claims management solutions include complete FNOL activity tracking to support the claims process. To learn more about using FNOL data for effective claims management, contact us today.

Documentation Secrets for Successful Claims Management

Posted on

November 1st, 2017


shutterstock_138016598 - CopyProper 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.

Is Your Claims Management System up to Par?

Posted on

October 18th, 2017


shutterstock_306793247 - CopyInsurance 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.

Reducing Expenses

The longer it takes an insurance company to settle a claim, the more it costs the insurer. This is because of increased administrative costs. One way to mitigate this is to automate some of the claims management process. For example, investigating a claim by hand without automation takes much longer and is prone to errors. Resolving errors draws out the amount of time it takes to close a claim. Automation can also detect incidents of frauds. Long processing periods, errors, and fraud all eat into a company’s profits, so it behooves insurers to invest in some automation technology.

Identifying and Handling Fraudulent Claims

When an insurance company pays out for a fraudulent claim, the cost does not stop with them. The customer also takes on the burden of this unnecessary expense as premiums often increase to account for the added expenditure. Claims management software can help detect fraud and trigger an investigation well before the insurer settles the claim.

Closing Claims in a Timely Manner

The amount of time it takes to settle a claim has a direct correlation to the customer’s overall satisfaction. Swift claim resolution also gives companies a competitive advantage over those who take longer to settle claims. Expediting the claims process also saves time and money as well as boosts customer satisfaction.
The best way for insurers to address costs, fraud, and claims processing time is with an efficient claims processing system. This is why Actec offers full-cycle claim and incident reporting solutions. Contact us today to learn more about managing risk and settling claims while improving customer satisfaction.

Using Metrics Data to Improve the Claims Process

Posted on

October 10th, 2016


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.

Top 6 Features of a Workflow Management System

Posted on

July 6th, 2015


Workflow management systems are quickly becoming an integral part of the internal infrastructure of a work team. Workflow systems are used to setup, execute and monitor the documents and tasks of a business process. Workflow can refer to the progressive sequence of work objectives and activities, or a complex set of processes that take place concurrently. Work flow activities have a direct impact on the rules, routines and roles of the work group.
Workflow systems provide First Notice of Loss (FNOL) service providers with the opportunity to define and control the various activities that are needed to efficiently and successfully execute claim and incident reporting systems. In addition, quality workflow systems allow FNOL providers the opportunity to measure and analyze the workflow process so that continuous improvements can be made.
Here are the top 6 features of a workflow management system to consider when researching your application.

  1. Process design tool. A process design tool enables the administrator to define what activities need to be done, by whom and by when. It may also designate specialized tools and/or equipment that might be needed and any budgetary constraints that should be considered.
  2. Test process capability. A quality workflow system will include the ability to test or pilot a version of a workflow to see how it works before it goes into use. This gives users the chance to fine tune and work out the bugs of a process before it is finalized.
  3. Cloud-based application. As work teams become more mobile, the ability for team members to access workflows from home or anywhere on the go is an essential feature for today’s applications.
  4. Document and media integration. There are many different applications in use across various operating systems in today’s workplace. It is important that your workflow management system have the capability to share and integrate various types of documents created in different formats such as forms, documents, spreadsheets, videos, audio files and more.
  5. Email notifications. It is very important that team members are able to be notified of new tasks and service-level agreement (SLA) violations.
  6. Customized reports. It is essential that evaluation feedback loop is completed at the end of each process to ensure the process and participation flows as planned or adjustments are made. A quality workflow system will enable administrators the opportunity to set up reports that indicate how well the process was executed and enables fine-tuning.

A workflow management tool is an opportunity for FNOL providers to improve both the underlying business process as well as the organizational structure of the work team. Workflow management systems that are designed and implemented using best practices will unify team members with diverse skills into a cohesive, high-functioning work unit.

Five Musts For a Better Claims Management System

Posted on

April 10th, 2015


Claims reporting can happen whether something minor, like a fender bender, or something catastrophic, like a house fire, occurs. We’ve outlined some of the basic steps to go through when filing a claim.
I.            Assignment of claim:
After the claim is received, a professional will be assigned based on the type of claim it is.
II.            First contact:
Claim professionals will contact the victim to gather facts, assess the total loss, and evaluate coverage. They’ll then run through everything with the victim and identify ways to protect the property from further damage.
III.            Valuation and estimation:
A claim professional will check and document the damages to determine whether the loss is covered by the policy. Photos are sometimes taken, and if needed, witnesses are interviewed — after which the claim can be evaluated.
IV.            Declaration:
After reaching a resolution, the customer is either compensated for the loss or they’re denied payment because of lack of coverage.
V.            Shutdown the claim:
Once the claim is resolved under the terms of the policy, it is closed. However, it can be re-opened for investigation if any additional expenses are discovered.
To learn more about how Actec can assist your business in claims management, click here.

9 Tips for Better Claims Management

Posted on

March 26th, 2015


The best claims management techniques will control costs, and improve a company’s employee retention. Mentioned below are 9 tips to do exactly that:

  1. Understand the people and responsibilities of all participants involved.
  2. Ensure that all individuals understand their roles and responsibilities.
  3. Document all injuries, whether they are major, or minor.
  4. Report everything without leaving out any detail.
  5. Train staff on filing claims, and encourage employees to take the appropriate steps.
  6. Work-related, and non-work-related claims must be treated equally.
  7. Do not be biased with employees, and ensure equal treatment of all claimants.
  8. Document, document, document everything.
  9. Cultivate your relationships with the claimants, even after settlements.

Companies should encourage their employees to be honest with the management. At the same time managers need to be respectful and patient with the concerned parties. To know more about Actec and how we can assist your business’ claim management procedures, click here.

FNOL: The Backbone of Claims Handling

Posted on

February 25th, 2015


FNOL is the backbone for claims handling, outlining fundamental strategies to organize and improve tracking methodology. Though it speaks to the fundamentals, FNOL can be very complex.

The process of claims handling can cause anxiety for internal and external customers alike. They need care and compassion on your part. Yet it’s crucial that you ask the right questions to collect appropriately detailed information. These details must then be uploaded into a claims management system in a timely manner.

One mistake can prove costly to both your bottom line and your reputation.

It’s vital to have staff and employees trained in claim handling. They need to be equipped with the know-how of the situation. All the while being able to comfort the customer and carry out his/her job.

A capable FNOL specialist should provide:

  • An extraordinary representative who is well informed about the process
  • A representative who is always ready to talk to a customer
  • A representative who can provide instant care for critical situations

Contact us to find out even more about Actec and our services.