Ensuring Successful Claims Triaging

Posted on

July 19th, 2017


absence management video image borderInsurance claims, much like hospital patients, require proper triaging. For example, an emergency room will tend to an individual with a bleeding head wound before they treat the patient complaining of a persistent stomachache. Unfortunately, claims do not always follow appropriate triaging upon first notice of loss (FNOL). Inefficient systems and limited data are often the cause of misrouted claims and delays. This aggravates customers and can result in increased costs as well as lost business.
As claims continue to increase in number, insurance providers need to be able to triage their claims to achieve swift resolution. Below are several elements that can help insurers prioritize claims to improve customer satisfaction.

  • Fraud detection. Agents can waste several hours or even days on a claim only to find out that it is an insurance scam. Investing in automated systems that can red flag claims that may be fraudulent saves time and money. It allows agents to focus on resolving genuine claims rather than chasing down details to determine the validity of every claim that crosses their desk.
  • Accurate data. Without accurate information, insurers cannot hope to triage claims with any efficiency. When a customer initiates FNOL, they are likely upset and may not be able to provide all of the necessary information. Insurers should invest in FNOL solutions that can pull data from other resources to build up an otherwise thin claim. For example, if a customer only has the other party’s name and license plate number, the insurer should be able to obtain the other necessary information. Performing this legwork for the client goes a long way toward customer satisfaction. Investing in an automated system to perform this task will also save time for the insurer.
  • Automating claims. Automation allows insurance providers to fast track claims management. This means they can resolve more claims in less time, thus saving money and improving customer satisfaction. Investing in a system that combines fraud detection with data analytics is key to achieving these goals.

Actec understands that finding FNOL solutions that work can be a difficult task. That is why we provide custom FNOL intake solutions as well as a full cycle claims management system. To learn more about FNOL and claims management, contact us.