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Tag Archives: Best Practices

  1. Why Extending More Claims Authority Means Extending More Responsibility September 10, 2010

    Posted in Best Practices, SPOT on Issues.

    Extending additional authority to a number of claim handlers can have a dramatic affect on the department’s total incurred. Make sure claim handlers understand the impact, both good and bad, to the company. Deciding when, and how much authority to extend will always depend on the line of business, and experience of the claims professional. Giving more authority also means extending more responsibility to the junior claims professional to make greater financial decisions for the company.

    In today’s post we discuss the authority-responsibility correlation and the importance of ensuring claims authority is extended only when responsibilities associated with that authority are understood.

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  2. 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.

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  3. 3 Suggestions To Beat The Summer Slow Down In Claims (If You Do Slow Down) August 3, 2010

    Posted in Best Practices, SPOT on Issues.

    It’s summer time and the living is easy!

    Take advantage of the summer slow down and make changes, clean things up and improve your operation. In the latest post from the Claims SPOT see three suggestions for ways to use your summer effectively. One for the manager, one for the claims handler and one for the claims executive, suggestions to use the slow down to improve your operation. Take a look and suggest others – we would love to hear from you.

    2 comments
  4. 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
  5. 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?

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  6. In Claims Don’t Let The Process “Thing” Get In The Way Of Doing The “Right” Thing July 19, 2010

    Posted in Best Practices, SPOT on Issues.

    Making a check in the process won’t ensure the matter is done right. I have written, and am a big proponent of, the importance of good process as a way to ensure good results. Putting a proper process in place is a road-map to help move claims to a prompt fair resolution. Nonetheless, doing and focusing on the process without making sure the outcome is sound is doing things right without doing the right thing. It’s so easy in claims to focus on the process and not use the process as a means to the end

    2 comments
  7. 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.

    2 comments
  8. 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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  9. 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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  10. 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.

    Like what you read? Pass it along to a friend and suggest they subscribe.

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  11. 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.

    2 comments
  12. 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. “

    1 comment
  13. 3 Settlement Techniques That Will Help Move A Case To Resolution May 25, 2010

    Posted in Negotiation, SPOT on Issues.

    As a claims professional, you know you have cases that will ultimately settle, and can settle, but for some reason or another you just can’t get there. Recently I came across a great blog dedicated to providing different ideas and solutions surrounding the settlement process. Settlement Perspectives, written by John DeGroote, provides insights and “thoughts on how to resolve disputes and get your deal done.”

    In today’s post I comment on three techniques suggested by John – Managing Expectations, Decision Trees and Offers of Judgment – and show how more out-of the-box approaches can be a useful way to move a case to resolution and settle claims faster and cheaper.

    4 comments
  14. How Do You Effectively Manage A TPA? Speak Up And Be Active! May 20, 2010

    Posted in Best Practices.

    Tweet Become The Squeaky Wheel To Actively Manage TPA Outcomes As claim practitioners, most of us are familiar with what to look for when we shop for a third-party claim administrator (“TPA”).  One recent discussion on this blog cited such elements as claims systems, data reporting capabilities, and quality control (6 Essential Elements When To […]

    3 comments
  15. 2 Chores that should not be neglected to become a stronger claims organization May 18, 2010

    Posted in Best Practices, Claims Auditing.

    Lets face it – no one really likes to do mundane things. Nonetheless, it’s those very chores that have to be done regularly to ensure a strong organization. Like cutting grass, the longer you let it go the worse it is for your grass, and the harder it will be to fix the mess that has been created. There are certainly enough chores that need to be done in the world of claims that no one likes to do. You know what they are – those things that you would prefer to not have to get to. They can include writing notes on files, keeping a diary and paying bills. But as any good claims handler knows, if you fail to do those tasks regularly not only won’t your grass grow, but you will have quite a clean-up.

    Two chores that can really help claim departments grow nice healthy grass are in the areas of training and managerial assessments. Learn a few chores that have to be done but will help grow your organization.

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  16. 6 Essential Elements To Explore When Choosing A Third Party Administrator April 27, 2010

    Posted in Due Diligence, SPOT on Ops.

    A Third Party Administrator (TPA) is often the best way to handle claims for an organization. Many self-insured and captives choose to outsource their claims instead of creating their own internal operation. Whether to get expertise in a particular areas, or not wanting to invest in the infrastructure to build a claims department, using a TPA can be a smart business decision. So what make a good TPA and what should you look for? In order to find out you must conduct a comprehensive due diligence of the TPA you are about to hire. This is especially the case when that TPA will be holding and managing your claim dollars. Besides understanding the financial strength and capabilities of the TPA, it is also important to know whether they will be able to meet your data needs, provide consistent claims handling, and work to lower costs where they can.

    In this weeks post I address 6 essential elements, and questions, that should be explored as part of any due diligence when selecting a TPA

    4 comments
  17. Considering Forming a Captive? Maximize Your Claims Benefits In 3 Steps March 10, 2010

    Posted in SPOT on Ops.

    Tweet The Benefits Of Forming A Captive Are Great – IF – You Set It Up And Manage It Correctly The use of captives as an alternative means for managing risk is growing rapidly  (read a nice overview of captives at the Captive Counsel Law Group). Changes in laws, increasing tax benefits and control over […]

    1 comment
  18. 7 Considerations When Drafting Claims Guidelines March 1, 2010

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

    Claims departments employ professionals that want to do a good job for policy holders as well as the company, and claims guidelines should help foster those goals. Before drafting guidelines there are a few things that should be considered and we, along with our fellow blogger Phil Loree, suggest 7 things a company should consider when drafting claims guidelines.

    5 comments
  19. Absence of procedures to notify reinsurance is a basis for bad faith February 17, 2010

    Posted in Bad Faith, Best Practices, SPOT on Issues.

    Tweet Recently I was discussing bad faith and notice procedures with attorney Phil Loree Jr., an expert on reinsurance and arbitration issues and author of the the Loree Reinsurance and Arbitration Forum blog.  I thought this was a timely conversation as it reinforced the concepts regarding procedures and the potential risks when they are not […]

    6 comments
  20. Improve bottom-line outcomes on claims by thinking outside-the-box! February 9, 2010

    Posted in Best Practices, SPOT on Issues.

    Tweet Claim handling is just as much an art as it is a science. Synthesizing facts and investigating losses requires, not only following process and procedures, but also the ability to look at new ways of solving established problems. Following best practices is of course an effective way to achieve consistently good claims results. Regardless, […]

    1 comment