Lanzko Insights/The Claims SPOT

SPOT on Ops

3 Essential Report Types That Insurance Executives Should Use To Analyze Their Claims
ByMarc Lanzkowsky February 23, 2010February 25, 2010

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.

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Medicare Secondary Payer | SPOT on Issues | SPOT on Ops

Important Update: Medicare Secondary Payer changes production date to January 1, 2011
ByMarc Lanzkowsky February 18, 2010June 1, 2010

The Centers for Medicare/Medicaid Services (CMS) have announced the following: CMS advises all NGHP RREs that the date for first production NGHP Input Files is changed from April 1, 2010 to January 1, 2011, effective immediately. Read the complete announcement at the CMS website in “What’s New.” This is clearly a welcome change and one…

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Bad Faith | Best Practices | SPOT on Issues

Absence of procedures to notify reinsurance is a basis for bad faith
ByMarc Lanzkowsky February 17, 2010October 26, 2010

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 in…

Read More Absence of procedures to notify reinsurance is a basis for bad faith
Best Practices | Compliance | SPOT on Issues | SPOT on Ops

5 Claims issues cited for non-compliance on market conduct exams & 3 tools to avoid them
ByMarc Lanzkowsky February 15, 2010September 13, 2010

Insurance Market Conduct examinations are a regular part of the insurance business. Besides the stress of the exam itself, being cited for violations can result in costly fines. Regardless, many citations can be avoided. Every year, insurance compliance solutions provider Walters Kluwer releases its annual study of top ten reasons insurance companies are found to…

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SPOT on Ops

Blizzard Warning in the East! Can your claims department keep running if the office closes?
ByMarc Lanzkowsky February 10, 2010February 15, 2010

The East Coast snow storm is a great reminder to be prepared for disasters and other reasons why your office would have to close. Do you have the plans in place to manage the next event? Does your claims system give you the ability to manage claims remotely? Can you manage claims remotely for an extended period of time?

Read More Blizzard Warning in the East! Can your claims department keep running if the office closes?
Best Practices | SPOT on Issues

Improve bottom-line outcomes on claims by thinking outside-the-box!
ByMarc Lanzkowsky February 9, 2010March 15, 2012

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, the…

Read More Improve bottom-line outcomes on claims by thinking outside-the-box!
Medical Malpractice | SPOT on Issues

Med Mal Update: Reasons for decrease in frequency and recent Illinois court decision to strike down damage caps
ByMarc Lanzkowsky February 5, 2010July 26, 2010

In response to my post, medical malpractice report shows increased severity despite lower frequency, I received a number of LinkedIn comments that I felt offered an interesting perspective on this topic. I have included some of that discussion below. Additionally below, I review the news that the Illinois Supreme Court has struck down that state’s…

Read More Med Mal Update: Reasons for decrease in frequency and recent Illinois court decision to strike down damage caps
Medicare Secondary Payer | SPOT on Ops

Warning – Medicare Secondary Payer (MSP): Government sends strong message and goes after non-compliance
ByMarc Lanzkowsky February 3, 2010March 21, 2010

If you are an insurance company or self-insured, and make payments on liability or workers’ compensation claims, be aware that the Federal Government has filed a lawsuit signaling their intent to be aggressive in seeking reimbursement. As reported in Business Insurance, this “case breaks new ground because CMS simultaneously named insurers, settlement beneficiaries and plaintiffs attorneys all in one lawsuit.” This case should alert all that if you make a payment on an injury claim, and fail to let the Government know about money they should be collecting, they will come after you.

Read More Warning – Medicare Secondary Payer (MSP): Government sends strong message and goes after non-compliance
Best Practices | Commentary | SPOT on Ops

Failing to properly document files can be costly – It cost one insurance agency $5.83 Million
ByMarc Lanzkowsky February 1, 2010February 9, 2010

Files should speak for themselves. A recent California decision is yet another example of what can happen if you don’t document your files and maintain procedures. In this case – it cost $5.83 million.

Read More Failing to properly document files can be costly – It cost one insurance agency $5.83 Million
Customer Service | SPOT on Ops

Better claim reports can help improve producer/carrier communications (take our poll)
ByMarc Lanzkowsky January 29, 2010July 22, 2010

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.

Read More Better claim reports can help improve producer/carrier communications (take our poll)