Skip to content

Category Archives: SPOT on Ops

  1. 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, Uncategorized.

    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
  2. 5 Must Haves To Consider When Implementing a New Claims System June 21, 2011

    Posted in Claims Technology, SPOT on Ops.

    Implementing a new claims system can be fraught with issues and concerns. It is important to understand the people aspect both before and after a system is put into place. At the end of the day the system must support people and those people should be involved in the process way before you go live. This week we learn 5 suggestions to assist in the implementing a claims system learned from Paul Tuhy, Global Head of Claims for XL Insurance who recently spoke about technology at the most recent Americas Claims Event in New Orleans.

    No comments
  3. Claim Reviews Empower Better Decisions By Putting Critical Information In Hand March 30, 2011

    Posted in Best Practices, Claims Auditing, Compliance, Due Diligence, SPOT on Ops.

    Insurance is as much about having the right information at the right time as anything. Whether it’s an underwriting choice to price a risk correctly or a claim decision as to when to a play a claim, having the best data available can make or break an organization. Despite this fact, many organizations fail to take advantage of tools and rights available to them prior to making critical business decisions. Claim reviews are empowering tools to help make better decisions. Staying ahead of the competition and managing risk is a key component of any any successful organization. The claims review allow decision makers to have the most available data to make better decisions. In this weeks post we discuss 8 reason when they should be done and speak to going beyond the claim files to fully understand the substance behind the numbers.

    No comments
  4. 5 Business Basics Every Claims Person Should Live By February 14, 2011

    Posted in Customer Service, SPOT on Ops.

    Ideas from successful business can be adopted in claims very easily if one takes the time to look. As we all know, claims folks have little time to look and that is where I hope the Claims SPOT can help. Sometimes claims organizations get so involved in the day-to-day that they have little time do the basics. However, concentrating on doing the write thing from a business perspective is the best way to succeed in claims. Expanding on Donna Flagg’s recent article Five Things They Don’t Teach You In Business School, we explore how those five things apply in the claims world. It’s common sense time in our most recent post.

    5 comments
  5. Claims And A Half Plate Of Vegetables – Teachings From The New Dietary Guidelines February 3, 2011

    Posted in Best Practices, SPOT on Issues, SPOT on Ops.

    Recently the government changed the way the public should look at nutrition through simplified messages like “eat less.” Simplicity and looking at the obvious in an easy to understand way is a tool that would go a long way to helping the claims professionals be better at what they do. Being understandable and actionable can only be a good thing in claims. In our latest post, we discuss how trying to use visual cues when handling a claim or looking at the claims process can benefit today’s professionals. We are a visual society – time to shift some of those visual cues to claims.

    2 comments
  6. 5 Ways To Use Defense Counsel To Lower Claims Expenses And Get Better Results January 5, 2011

    Posted in Best Practices, Litigation Management, SPOT on Issues, SPOT on Ops.

    The management of litigation is both an art and a science. The issue that every company must face is how to best spend dollars on defense costs to minimize the amount paid in indemnity. In addressing this, lots of questions come to mind. Does the size of the claim matter when deciding how much to spend on defense costs? Does a higher rate buy a better defense? Do flat rates buy a better defense for certain claims? What is the effect of a looming trial date on the claimant’s view of case value? And of course every company is different and has its own philosophy.

    Defense Counsel should be a help, not a hindrance, to producing improved results and helping to lower indemnity payouts. Focusing on these 5 issues will go a long way to achieving better results.

    Read the latest from our newest contributor, James Pattillo, Partner in the Birmingham, Alabama law firm of Norman, Wood, Kendrick & Turner.

    5 comments
  7. Looking Back On 2010 And Forward To 2011 In The World Of Claims December 31, 2010

    Posted in Best Practices, Claims Technology, Commentary, My SPOT, SPOT on Issues, SPOT on Ops.

    The year began with continued economic concerns, a poor job market and no recovery in sight. It has come to a close with a booming stock market, improved job numbers and a better outlook for 2011. Looking back on the year in claims and looking ahead to the future of claims is always a fun exercise this time of year so here we go! The Claims SPOT adds to the debate about the past and the future.

    Thanks for reading and have a happy and healthy holiday season and New Year!

    2 comments
  8. Getting Creative And Reducing Claim Costs Without Sacrificing Quality – Part II December 22, 2010

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

    Last month, Suzanne Ganier discussed the building blocks needed to reduce claim and litigation costs, while still maintaining a strong focus on quality. Those building blocks included:

    * collecting current data about your claims and litigation
    * evaluating the claim and litigation work itself
    * settling on a carrier claim and litigation handling philosophy

    In her follow up, Suzanne discusses how these building blocks create a foundation on which to build new processes and procedures that will reduce your claim and litigation costs, and maybe even decrease you volume as well. I refer this building process as looking at What I Have, What I Want, and What I See.

    3 comments
  9. Here We Go Again! CMS Postpones Deadline For P&C Mandatory Reporting Until January 1, 2012 December 14, 2010

    Posted in Medicare Secondary Payer, SPOT on Ops.

    For the second time the government has postponed the mandatory reporting requirements for carriers. The complex nature of reporting and several unanswered questions surrounding implementation and enforcement seems to have prompted the change. The costs associated to comply as well as the risk for improper or failure to comply has resulted in a new insurance product to protect those entities from liability due breakdowns in the reporting procedures. Learn more in the latest from the Claims SPOT.

    No comments
  10. Time to Get Creative – Reducing Claim Costs without Sacrificing Quality (or your sanity) November 22, 2010

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

    In an environment of increased pressure to reduce costs and close claims, bright ideas can help to reduce legal costs while still ensuring great service. In this article, litigation expert Suzanne Ganier speaks about the importance of understanding what you know and what you don’t, analyzing the strengths and weaknesses of those involved in the litigation process, and aligning those analyses with your organization’s philosophies. The result can be a litigation management process that reduces overall claim costs and preserves your sanity.

    No comments
  11. There Is No Such Thing As A Pro Forma Signature On A Document – If You Sign It You Own It October 6, 2010

    Posted in Best Practices, Compliance, SPOT on Issues, SPOT on Ops.

    Doing things for the sake of doing things can have significant adverse consequences for an organization. It is important to realize that one day you may have to answer for every action you take on a claim file. The concept of how doing a pro forma task can come back to bite you is being highlighted as a yet another fallout of the mortgage crisis. Tens of thousands of foreclosures are being halted because of a process in place where an individual just signed hundreds of documents without ensuring the information contained on the documents were correct.

    Clearly, doing something for the sake of doing something can really have negative consequences for the organization. In our latest post we offer questions to ask when signing documents. Controls are important, however, if they are not adding value they should be reviewed.

    1 comment
  12. What are your towing and transport processes costing you? September 14, 2010

    Posted in Best Practices, Claims Technology, Customer Service, SPOT on Costs, SPOT on Issues.

    Claims organizations have long recognize the power of vendor networks. Direct Repair Programs are an easy example. New technology and new providers allow those same benefits to be applied to vehicle transport management, where a primary goal is to reduce vehicle storage costs. In fact vehicle storage costs can be a major component when evaluating the overall costs of non-drivable vehicles. This article highlights what to look for in evaluating your current process and how you can hone in with almost pin-point accuracy on this previously less-managed area of cost expenditure.

    1 comment
  13. 3 Ways To Help Defense Counsel Help You Make Claims Management More Efficient September 3, 2010

    Posted in Best Practices, Litigation Management, SPOT on Ops.

    We all talk about collaboration with counsel as a means to get better results at a lower costs. But getting what you want is not so easy. How about trying to get what you truly need to get your job done. In our latest post, we discuss three suggestions for helping counsel help you get better results. No attorney is going to say that they don’t want to make a claims professional’s job easier, so help them to help you. Start by telling them what you do, ask for what you want, and then make sure they do it. Take a look at the latest – from the Claims SPOT.

    No comments
  14. Quick SPOT: 6 Security Tips To Keep Portable Technology Safe For Claims August 27, 2010

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

    If you are like me you keep everything on your laptop and cell phone. Numbers, corporate information, claims data, and even some of the dreaded non-private personal information of others. Claims data is filled with information that if lost or stolen could be detrimental to both the company and the individual. Many companies today issue corporate cell phones and blackberry devices as well as laptop computes in place of desktops. It’s a modern world and we are all expected to be connected. Partial work at home arrangements also mean this information is traveling from location to location which can increase the risk that things may be lost or stolen.

    Take a look at these suggestions to help keep your claim information safe and secure in the latest post from the Claims SPOT.

    1 comment
  15. Why Can’t We All Get Along? Making The Agent A Partner In The Claims Process July 27, 2010

    Posted in Customer Service, SPOT on Issues, SPOT on Ops.

    Creating a strategic advantage through improved agent carrier relations

    The relationship between claim adjusters and agents can be an adversarial one. Each side often finds itself correcting issues created by the other side. Agents may set the wrong coverage expectation for a customer, leaving the adjuster to deliver the bad news. Adjusters may get overloaded and not return phone calls in a timely manner, resulting in a complaint to the agent’s office. In the worst case scenario, adjusters and agents may badmouth each other to customers, putting customers in the middle. Clearly, agencies have a role to play in the claim process. Enabling agents and their staff to perform their role efficiently with empathy and professionalism can benefit customers, agents, and the claims department. Read more this week from Melissa Loew.

    2 comments
  16. Increasing Claims Satisfaction Doesn’t Mean Increasing Staff July 21, 2010

    Posted in Customer Service, SPOT on Ops.

    Is it possible to increase claim satisfaction and decrease cost at the same time? Many claim representatives say no. Some view that satisfaction is driven by the ratio of adjusters to claims – having more people to handle claims means higher satisfaction, although also higher loss adjustment expense. Some believe that higher settlement amounts result in higher satisfaction and higher loss costs.

    As the Claims SPOT welcomes new contributing author, Melissa Loew, see how customer satisfaction can be addressed in tight staffing markets.

    5 comments
  17. Encounters of the Best Kind Can Create The Strongest Claims Organizations July 20, 2010

    Posted in Best Practices, Customer Service, SPOT on Issues, SPOT on Ops.

    Companies cannot define their core “brand” through brute marketing and advertising. Rather, customers define what that brand is in their individual interactions with the company. Those interactions can either be transactions or encounters. Encounters make the relationship stronger while transactions result in a worse relationship or one that stays the same. This is no different in the claims professional’s world. How can claims professionals create encounters, and avoid transactions, in their interactions with their customers?

    No comments
  18. 5 Questions To Ask Property Adjusters Before Making That Partnership July 9, 2010

    Posted in Due Diligence, SPOT on Ops.

    Selecting the right partner for your property adjustment needs can be absolutely crucial to meeting stake-holder needs across the claims process. Making the wrong decision up-front can create countless problems down the road.

    At a high level, claims executives might look for synergy, good philosophical fit, and a proven track record. But what about day-to-day operational considerations? What should be included in your detailed market evaluations, your informational meetings with potential vendors, or even your RFI and RFP for property adjustment services?

    Learn how to not not shortchange the process by not asking the right questions in Taylor Smith’s posting of 5 questions to ask property adjusters before making the partnership.

    1 comment
  19. “What’s The Point” Claims Process And How To Avoid Them July 6, 2010

    Posted in My SPOT, SPOT on Ops.

    Being able to truly focus on what’s important is a path to success. Claims organizations are notorious for multiple process and procedures. Many of these procedures are truly necessary and are required to maintain controls, prevent fraud or comply with a multitude of regulations facing the insurance industry. Nonetheless, doing something for the sake of doing it is no way to be an efficient organization. Today we speak about asking “what’s the point” before proceeding with new projects or exploring existing process.

    No comments
  20. 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.

    2 comments
  21. 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.

    No comments
  22. 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.

    No comments
  23. 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.

    No comments
  24. 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.

    1 comment
  25. 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