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Tag Archives: Management

  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!

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  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.

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  4. Claim Files Are Evaluated Using A Form Of Root Cause Analysis So Why Not Do The Same When Evaluating The Department? March 5, 2013

    Posted in SPOT on Ops.

    Similar to a claim file analysis, operational problems require an assessment as to what happened, how it happened, how could it have been prevented, who was at fault, what’s it going to cost to fix the claim and are there any lessons learned. For example, let’s say payments are being delayed resulting in fines being assessed against the department. If one looks at the fines as a claim one would want to determine what caused the fine? how did it happen? and how can it be corrected? An analysis of the “claim” needs to take place prior to making any decisions. Why not use these smae claim evaluation techniques to understand the operation? In our latest post we give a suggestion for doing just that.

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  5. 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
  6. 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.

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  7. 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
  8. 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
  9. 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
  10. 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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  11. 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
  12. 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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  13. 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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  14. Is Your Caims Department Becoming A Bus Company? May 12, 2010

    Posted in Commentary.

    Claims departments can get into ruts and begin to act like bus companies. As Seth Godin, business author, recently wrote in his blog – “We all have a vision of the typical bus company, slowly moving people from place to place, going through the motions and showing a lot of fatigue.” In this weeks post, I point to some ways claims department can avoid the bus company mentality and figure ways to stay fresh and motivated.

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  15. Does Hiring More Staff Improve Claims? How To Know When The Time Is Right May 3, 2010

    Posted in SPOT on Ops.

    Deciding when to hire new staff is always a difficult question to answer. It’s even harder in a tough economy. In this week’s post I explore what to consider before hiring. Developing a staffing model and exploring internal metrics should be done before making a decision. But how do you create a staffing model? I suggest a few methods for developing a staffing model that makes sense. Before you bring on more staff review your staffing model, see if there any trends affecting file loads and take a quick look inward at your operation. Once these assessments are completed, you will be in a better position to know if hiring is the right decision.

    1 comment
  16. 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
  17. 3 Essential Report Types That Insurance Executives Should Use To Analyze Their Claims February 23, 2010

    Posted in SPOT on Ops.

    Today’s modern claims systems have a wealth of knowledge about every aspect of claims operations. With the right reports it should be easy to get a basic snapshot of how effective your claims are being managed, and how well your business is doing. With all that information where is one to start? What are the key metrics that should be reviewed by claims and business executives to better understand their operations? We give three specific report types that claims executives should review on a regular basis to get a valuable snapshot of their organization.

    1 comment
  18. 5 expense reduction opportunities insurance CEOs should not overlook January 27, 2010

    Posted in SPOT on Costs.

    Increased profits come from efficient claims operations: Take a look at that annual reports of the top performing insurance companies and you will see a similar message from their CEO’s. Expense management and efficiency is a principal driver of profitability.In a tight market do less with more without sacrificing quality and significantly customer service is the edge needed to be a top performer. The claims department is the perfect place to lower costs and improve the customer experience at the same time. Here are 5 key areas that should be looked at for cost savings.

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  19. Why use a consultant? The second set of eyes! January 20, 2010

    Posted in SPOT on Costs.

    Tweet Ever try and organize your own closet? It should be so easy to get the thing in order yet for some reason it’s very difficult. That is until you bring in a closet organizer to arrange everything in easy to manage sections. Sometimes the only way to truly accomplish a task is to have […]

    1 comment