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Category Archives: SPOT on Issues

  1. 3 Claims Department Musts That Will Let The CEO Sleep Soundly March 23, 2015

    Posted in Best Practices, SPOT on Issues.

    There are many elements to a well run claims department. As with many areas of business it comes down to people, process and technology. Good people will drive the success of any department and working with defined efficient processes, as well as technology tools that support the organization, are basic core requirements to any well run department. Specifically what people, processes and technology make up a good claims department is a subject for another day. Regardless every claims department should be using metrics, performing audits and have a business continuity plan in place as a minimum. Take our survey too and let’s see what companies are doing on these three.

    1 comment
  2. 4 Keys to Managing a Successful Outsourced Claims Operation October 30, 2013

    Posted in Best Practices, Compliance, Due Diligence, SPOT on Issues.

    All things being equal there are many fine TPAs in the market that will provide wonderful service to your insureds in a cost effective and comprehensive manner. Initially you think you have chosen a good one. However, as time goes on you realize you are not exactly getting what you expected from your TPA. So what happened?

    It matters little what your reasons for outsourcing were. Bottom line is if you didn’t take certain steps to properly select and manage a TPA you are likely to end up with problems. The partnership you form with your TPA will be fruitful if you take key steps to select and manage them in a way designed to foster long term success.

    Learn how in our latest post!

    No comments
  3. Kindergarten Management: Getting Back to the Basics June 10, 2013

    Posted in Best Practices.

    Everything we know in life started back in kindergarten. Kindergarten is where we learned to socialize in groups, lived by rules, played well with others, managed time, took turns asking questions and listened to authority. Success and creativity were rewarded and failures became further learning experiences. The more I thought about this recently the more I realized that kindergarten is a perfect example of a well-functioning organization and management.

    We can lean a lot by going back to kindergarten. Bear with me take a look how this would apply in a claims department.

    No comments
  4. 3 Things Good Claims Professionals Won’t Do January 24, 2013

    Posted in Best Practices.

    I have audited a lot of claim files over the years and one consistently good claims professionals manage their claim files following best practices. And when looking at these files there are certain patterns that develop. Good claims professionals don’t fail to document, assume things they don’t know and always stick to the basics. Our latest post gives three examples of things NOT to do to become a good claims professional.

    No comments
  5. How Would Albert Einstein Approach Claims January 3, 2013

    Posted in Best Practices, SPOT on Ops.

    Who knew Albert Einstein was a claims professional? OK maybe he did more important things in this world but some of his most memorable quotes could certainly apply to a claims organization. “Nothing happens until someone does something” as he has been quoted so make it happen and readt our latest post.

    2 comments
  6. 3 Ideas To Prepare For The Completely Unexpected: The “Sandy Contingency” November 28, 2012

    Posted in SPOT on Issues, SPOT on Ops.

    Preparing for the unexpected is always the core of any disaster recovery plan. Regardless, the Sandy “Super Storm” created a series of events that few truly every contemplated. It was a scenario that strained many businesses and exposed a number of weaknesses in disaster recovery planning. Unlike prior events, Sandy left a wide are in surrounding a major metropolitan city without power, fuel and public transportation for long periods of time. It’s time to rethink plans that don’t take into account a Sandy Contingency. Tell us what type of planning you have done too and share those ideas with others looking to learn from this tragedy.

    1 comment
  7. The 5 Core Leadership Traits Of A Well Managed Claim File October 8, 2012

    Posted in Best Practices.

    Leadership is a topic that we tend to think about as it relates to an individual leading a group. In claims we are always faced with leaders that manage us and help, hopefully, to get the best out of us. But leadership does not mean that you have to have a group of people that follow. There are 5 core traits a good leaders show. In our latest post we connect those five traits to 5 traits a good claims file, when handled well, will show.

    No comments
  8. Claims Predictive Modeling: Using The Numbers To Improve Operations And A Change Worth Exploring August 22, 2012

    Posted in Claims Technology, SPOT on Issues.

    Claims Predictive Modeling (CPM) is one of the big buzz words in the industry. After a few decades of improving claims technology systems and creating vast databases of claims information, CPM is an attempt to use that information more effectively. In our latest post we discuss CPM and what it means to make changes to adopt this new metric.

    1 comment
  9. A Claims Tale Of Three Little Managers And Their Review Programs June 20, 2012

    Posted in Best Practices, Claims Auditing, Compliance, SPOT on Issues.

    We have all head the story of the 3 little pigs but have you heard of the 3 claims managers? The Manager of Straw, the Manager of Sticks and the Manager of Bricks are all motivated to do the right thing but they go about it in very different ways. One had no program in place to review their operation, one had a basic process in place and one used a detailed program to review claims. Read on this story and see how problems occur and are managed differently.

    No comments
  10. 2 Preventative Steps To Help Avoid Claims Crisis Before They Become Emergencies June 11, 2012

    Posted in Best Practices, Commentary.

    Seth Godin in his wonderful blog recently wrote about Emergency room doctors in organizations. These are the people that are really good at and are rewarded for stopping bleeding. Seth is questioning where all the strategic thinking to prevent those emergencies in the first place? In claims we tend to hire and support that emergency room doctor mindset. Despite this, we can avoid becoming emergency rooms and be more proactive strategic organizations. In our latest post we explore possible solutions to be less reactive.

    2 comments
  11. What Would Steve Jobs Do In A Claims Organization? March 15, 2012

    Posted in Best Practices, Claims Technology, SPOT on Ops.

    So what would Steve Jobs say about our claims industry? Well, having heard about his reputation I think I will leave what he would say out of this post. Regardless, I think Mr. Jobs would see an industry with tremendous opportunities to innovate and improve the way they deliver and manage claims services. In our most recent post, we explore a claims world in as it may be in the world of a master of product design and marketing.

    No comments
  12. Negotiation Strategy: Going to the Balcony February 13, 2012

    Posted in Mediation & Settlement, Negotiation, SPOT on Legal.

    Sometimes taking a break from the heat of negotiations is a good way to jump start the process. In our latest post from contributor Nancy Hudgins, The Claims SPOT explores ways to cool those emotions in a heated claims negotiation. Take a look and tell us how you would react?

    No comments
  13. Getting More in Your Negotiations January 24, 2012

    Posted in Book Review, Mediation & Settlement, Negotiation, SPOT on Legal.

    Take a look at Contributor, Nancy Hudgins review of the Stuart Diamond book on negotiation. We can always use ideas on how to improve negotiations and these look like some good ones.

    2 comments
  14. Why Don’t Claims Organizations Track Claims Through The Process The Way UPS Tracks A Package? December 28, 2011

    Posted in Bad Faith, Best Practices, Claims Technology, Commentary, SPOT on Costs, SPOT on Ops.

    Today as a customer you can track your packages from the moment they leave the store to the second they arrive at your door. During that time you can see where they are in the process. Truly amazing. Why can’t claims organizations do the same thing? How much better would a claim be if we could track it through the system in the same way UPS can track a package. Something to think about when reading the latest from theClaimsSPOT.

    2 comments
  15. 2 Problems To Prevent Before They Get Out Of Control: The Lily Pads Revisited December 7, 2011

    Posted in Best Practices.

    Waiting to the last minute can be a costly venture. In out latest post we tell the story of the farmer who waited to clear those innocent lily pads from his pond. He kept going on to what he thought were more important things. Unfortunately he waited to long and the lily pads took over the pond and cost him a lot more to clear. We all have lily pads we don’t want to clear from our desks. It’s time to look for them and clear them off before they strangle the life out of your pond….I know a little poetic but read on and you will get the idea.

    No comments
  16. Want To Really Save Money In Mediation? Here’s The Secret: Practice Your Negotiations November 17, 2011

    Posted in Mediation & Settlement, Negotiation, SPOT on Issues.

    Like most things in life, the more you practice the better you will get at it. Try and practice negotiations wherever you are and you will become a better claims negotiator. Take a look at our latest post from Nancy Hudgins on the art of practicing your negotiations.

    No comments
  17. 2 Company Types And Their Approach To Claim Audits: The Have To’s And The Wants To’s  November 9, 2011

    Posted in Best Practices, Claims Auditing.

    Companies can choose to audit because they have to or choose to audit because they want to. Companies that want to audit are destined to provide better customer service, happier employees, and improved results. Our latest post asks the question: Which company are you?

    1 comment
  18. Don’t Go Into Mediation Cold: Settlement Requires A Game Plan October 3, 2011

    Posted in Mediation & Settlement, SPOT on Issues.

    Like football, a good play book will make executing the game plan better. That is if you have a game plan. In her latest post by contributor Nancy Hudgins, she discusses the importance of having a Settlement Game Plan. Most counsel do not spend a significant amount of time preparing for mediation and settlement. With a game plan discussed in advance, you will improve your chances of settlement.

    No comments
  19. 2 Approaches To Early Resolution And Cost Savings For Litigation Guidelines September 19, 2011

    Posted in Mediation & Settlement, Negotiation, SPOT on Costs.

    We welcome Nancy Hudgins as a contributing author to the Claims SPOT. Nancy is is a national mediator based in San Francisco and will be writing on resolving claims. In her first post, she points to two methods to early resolution and ways they can cut litigation cost.

    5 comments
  20. 6 Ways To Conquer Procrastination – A Primer For The Claims Professional August 17, 2011

    Posted in Best Practices, SPOT on Issues.

    Continuing with more insight from the Business Insider War Room, our most recent post deals with ways to fight procrastination. One of the hardest things to do sometimes is avoid distractions and focus on the work. Claims can be exceptionally exciting but at times can be rather repetitive. Working to deal with those times of procrastination in a positive way will help you become a better claims person. Take a look at these ideas and let us hear from you about others.

    No comments
  21. 7 Steps To Effective Problem Solving For Every Claims Professional August 2, 2011

    Posted in Best Practices, SPOT on Issues.

    Let’s face it solving problems in claims is a core reality to what we do. From the second a claim hits your desk until the minute it leaves it there are a series of problems that need to be solved. Should this claim even be accepted? Was there any liability? What experts should I hire? How much is it worth? What are my next steps? At every turn there is another problem that needs to be solved. As you probably have experienced, some people are very good problem solvers and others are not. In claims, however, there is no escaping the need to solve a variety of issues on a daily basis. Don’t fret if you don’t consider yourself a good problem solver as it turns out there is help for you. In our latest post we discuss 7 effective step to problem solving.

    1 comment
  22. “Summer’s Here And I’m For That” With 2 Ideas To Improve Your Claims Operations July 11, 2011

    Posted in Best Practices, SPOT on Issues.

    It’s another summer and it can be a slow time for many. Don’t waste the opportunity of a slow time period to improve your operation. In our latest post, we suggest 2 ways to make your claims organization better. First we write about developing a better claim review process and create a value added claims auditing process that goes beyond crossing the “T”. Second, conduct a worklow audit and you will find hours of wasted time for those working even the most basic tools such as Excel or Outlook.

    1 comment
  23. Shakespeare & Claims: Looking Inward June 6, 2011

    Posted in Claims Auditing, Commentary.

    Cassius said in Julius Caesar, “The fault, dear Brutus, is not in our stars — but in ourselves…” This was a frequent theme of Shakespeare’s, who put it another way in All’s Well That Ends Well, when Helena says: “Our remedies oft in ourselves do lie, which we ascribe to Heaven.” In claims and the insurance world we are quick to blame everyone when things don’t go well. In our latest post we discuss the importance of self review and reflection as a means to improved performance.

    2 comments
  24. 3 Ways to Make Your Claim Notes Better May 11, 2011

    Posted in Best Practices, SPOT on Issues.

    Recently I have been spending a lot of time auditing claim files. It’s really a great exercise to review files, and an important part of well-run claims organization. One thing that continues to amaze me is the number of files that have poor documentation. Writing good claim file notes are an important part of handling a claim file. Claim notes record the history of what is going on in addition to the reasoning behind claims decisions. Good claim notes tell a story.

    In our latest post we discuss three suggestions to make claim notes better.

    4 comments
  25. Continuing Education Is The Path To An Improved Claims Operation April 19, 2011

    Posted in Best Practices, SPOT on Issues.

    We at the Claims SPOT are committed to promoting continuing education within our industry. As part of that commitment we have teamed with the Americas Claims Event as a media sponsor to promote the conference. Expanding claims knowledge is a critical part of any successful operation and at the ACE Conference you will learn new trends from the best and the brightest in the industry.

    1 comment