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  1. The Importance Of The Pre Bind Claims Review In The Reinsurance Context June 29, 2010

    Posted in Claims Auditing, Due Diligence, SPOT on Ops.

    Reinsurance companies faced with a new submission often review loss runs and other financial data to determine the effectiveness of an account. However, numbers only tell half the story and in order to get a complete picture of a cedent’s submission, it is important to have an understanding of the claims department. What is the company’s reserve philosophy? What kind of systems do they have in place? How are claims staff measured? Conducting a comprehensive pre-bind review is an important step to help minimize the risk.

    In this post, the Claims SPOT explores the importance of the Pre-Bind review in the Reinsurance context.

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  2. Social Media And Claims Investigation: Do You Know About Foursquare? June 28, 2010

    Posted in Best Practices, SPOT on Issues.

    Undoubtedly, you’ve read plenty of articles or have been to numerous presentations regarding the use of social media to investigate claimants. At this point, the novelty of Facebook and MySpace has worn off. The same can be said about Twitter. Everyone knows at this point to take a look at those platforms when searching a claimant’s background. Enough said. However, seemingly with every new day comes a new social media application. One relatively new application that you should also take a look at during your claims investigation is Foursquare.

    Learn more from out latest contributor, Christian Stegmaier, JD and look for more articles from Christian in the weeks to come.

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  3. Allstate SVP of Claims Discusses The Customer And Claims At The ACE Conference June 24, 2010

    Posted in SPOT on Ops.

    An interesting keynote speech given by Allstate head of claims at America’s Claim Event in Las Vegas. Michael Roche discussed Allstate’s push to improve customer service through both improved technology and initiatives. We discuss a few interesting lessons learned that can be considered by claims operations to improve customer experiences.

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  4. You Can’t Wait Till The Last Minute To Improve You Operation – Planning Starts Now! June 22, 2010

    Posted in SPOT on Ops.

    In a a great analogy about the rapid growth of lily pads in a pond, we discuss the need to start strategic planning to solve problems before they become to hard to deal with. Like most industries, adopting and changing with the times can be a difficult proposition. It takes time to think of issues, come up with solutions and implement the changes. Insurance companies have added legal, compliance and regulatory concerns to say nothing of complex (sometimes outdated) information technology systems. Regardless, it’s not too late to address issues such as a social media or mobile strategy. We give two suggestions of recent trends that should be explored by claims organizations over then next few years.

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  5. 6 Steps To Reduce Expenses For Medical Experts As Suggested By The Expert June 17, 2010

    Posted in Medical Malpractice, SPOT on Costs, SPOT on Issues.

    The traditional method for preparing an expert is to send them the entire record and let them review for possible issues. Dr. Philip Lanzkowsky, a medical expert providing opinions and testimony on cases for both plaintiff’s and the defense, raises some practical questions and provides a series of suggestions as to how those expert costs can be reduced.

    Read more in this interesting post of expense reduction of medical expert costs as suggested by the expert.

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  6. How To Understand Capturing Lost Hotel Profits Due To The Gulf Oil Spill June 16, 2010

    Posted in SPOT on Issues.

    Knowing how to capture lost profits is critical when seeking reimbursement from the responsible party With uncertainty and concern surrounding the impact of the Gulf oil spill to the coastline from Florida to Texas, many companies are asking what needs to be done to quantify and document lost income for future claims.  Many businesses are […]

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  7. The Need For Claim Auditing In Catastrophe Loss Situations Such As The Gulf Tragedy June 15, 2010

    Posted in Best Practices, Claims Auditing, Rick Woollams (Chartis Chief Claims Officer), SPOT on Issues.

    The tragedy of the Deepwater Horizon and the aftermath seem to be a topic of constant conversation. From an insurance perspective there is a large amount of criticism being brought to bear on the claims process. The massive administrative organization that has been established to handle what are already tens of thousands of claims is an undertaking that could be fraught with problems. In today’s post from The Claims SPOT we discuss how auditing in the Catastrophe situation is an important part of the process to ensure claims are paid quickly and appropriately while at the same time preventing fraud.

    Take a look and join the conversation.

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  8. The Modern Claims File – 5 Considerations When Selecting A Records Retrieval Partner June 14, 2010

    Posted in Claims Technology, Litigation Management, SPOT on Costs, SPOT on Ops.

    The growth of national records retrieval partners, and the availability of sophisticated web-based record delivery platforms, means new options for claims executives looking to improve their operations. Turning over the routine tasks associated with retrieving records in the claims process to an expert company can mean more time available for what claims professionals, staff counsel and outside law firms do best — analyzing and resolving claims. It can also mean faster retrieval and lower case cycle times. And, depending upon how the records are presented, it can dramatically reduce the time required to index, sort and derive real analytical value from the records themselves. Five key ideas for what to consider in selecting a records retrieval partner are discussed.

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  9. Change Hats With Someone And Free Your Mind To Make Your Claims Operation Better June 9, 2010

    Posted in Best Practices, SPOT on Issues.

    Don’t limit what you can imagine by what you know – look to others to help improve your claims department.

    In Trading Places: A Smart Way to Change Your Mind, Harvard Business Review contributor, Bill Taylor discusses the “power of a whole new mindset about innovation.” The article goes into what happened when two CEO’s switched companies for a day and the learning that came from the new perspectives they had. The Claims SPOT discusses how having claims adjusters switch roles with different disciplines can be a new way to expand their skills. Having managers sit with other business divisions, such as underwriting or actuarial, can be a great way to get a better understanding of the entire insurance process outside of claims. And lastly, looking outside of claims and insurance altogether to change hats and free your mind to new ways to make your operation better.

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  10. The Legacy Claims System Facelift – 5 Issues To Consider When Looking At New Systems June 7, 2010

    Posted in Claims Technology, SPOT on Ops.

    While historically the replacement of a claims system could seem like a 18-month root canal, new technologies and new approaches have made it possible to significantly reduce implementation times. While this can make a decision to change systems more appealing, the evaluation of new claims systems still presents a myriad of options. Pages and pages of feature-sets offer tremendous advancement, but can seem confusing and even overwhelming.

    So with all these options available, what are some key items to consider as you look at the marketplace? Taylor Smith gives 5 items to consider when selecting a new claims system for you organization.

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  11. Commentary – Expect Gulf Oil Slick Claims To Be Extensive And Impact Multiple Lines Of Business June 5, 2010

    Posted in Commentary, My SPOT.

    We still do not truly understand the entire impact from a claims perspective of the tragedy that has unfolded as a result of the Deepwater Horizon rig accident in the Gulf of Mexico. Losses are being estimated in the $30-$40 billion range with only a fraction of that number covered by insurance. What has recently been reported, however, is an increase in premiums for offshore energy coverages. What is next? No one really knows. The Claims SPOT comments on the some of the issues facing the industry.

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  12. Medicare Secondary Payer Allows Direct Data Entry For Small Reporters Of Claims June 2, 2010

    Posted in Medicare Secondary Payer, SPOT on Ops.

    A new change to the Medicare Secondary Payer reporting will allow those entities with a small number of reports the ability to key in individual claims. This will alleviate the need to create, test and manage a data feed. While not without limitations, the news should help those smaller reporting entities that had been struggling with the onerous requirements. The method is limited to those reports that have less than 500 reportable events in a year. Read more about the changes in today’s post.

    1 comment
  13. The Claims Writing Workshop: Write How You Speak! Just Leave Out The Color Commentary June 1, 2010

    Posted in Claims Writing Workshop, SPOT on Issues.

    From our new contributor Dr. Gary Blake, we learn about writing and claims. Dr. Blake is a Port Washington, NY-based writing consultant who presents claims writing webinars and seminars throughout the United States. In his first post on The Claims SPOT, Dr. Blake discusses writing the way you speak without the color commentary. As he states, “write using the model of speech’s simplicity, directness, and warmth. Just don’t mirror speech’s unplanned distraction and tendency to ramble. “

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