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Tag Archives: Process

  1. 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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  2. 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.

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  3. “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
  4. Commentary: Claims Departments Are Facing A Crisis And Have To Learn To Encourage Innovation January 12, 2011

    Posted in Commentary, My SPOT.

    I’m fed up and I’m not going to take it any more. OK maybe that is an extreme statement but it is time for the industry to face facts. Talent is diminishing and the need to change the claims process is now. So we have heard this before, regardless, the “we have always done it that way mentality” is not helping. In our latest post I comment on the need for change in the industry.

    5 comments
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. Better claim reports can help improve producer/carrier communications (take our poll) January 29, 2010

    Posted in Customer Service, SPOT on Ops.

    Improved producer carrier relationships can be a competitive advantage to help increase profitability in tough economic times. According to the survey, a key differentiator for carriers to attract more business from their producers is in the areas of claims handling and technology. Most modern claims systems can create automated customized reports. Producers should be able to ask for specific reports and have them electronically scheduled for delivery. Better reporting will go a long way to improving relationships, and can only help increase profitability and enhance service to the policy holders.

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  11. 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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  12. A checklist of the 8 critical issues to be concerned about when self-managing claims January 25, 2010

    Posted in SPOT on Ops.

    You self-insure, but how well do you manage claims? Companies make decisions to self-insure their risks for a variety of reasons from financing to claims control. Regardless of the reason, when handling claims in-house it is important to manage those claims in an organized manner to protect company assets. Insurance and reinsurance companies use loss experience to determine what to charge for coverage as well as how much coverage is needed

    1 comment
  13. With old claims systems come old claims processes – You can’t change one without the other! January 21, 2010

    Posted in Claims Technology, SPOT on Costs.

    Tweet So you need a new claims system You know the darn thing doesn’t work or do what you want it to do so what’s next? You can’t just go out and buy a new system without understanding what your current process looks like. Over the years you have adopted your operation to your existing […]

    2 comments