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Tag Archives: Best Practices

  1. 3 Types Of Claims Metrics Every Department Should Be Looking At February 12, 2016

    Posted in Claims Technology, SPOT on Ops.

    Good news! – claims departments are now flooded with great data.

    Seems like great news doesn’t it. It is great news, or can be, if you’re using the data to help improve the operations, lower cost or predict the future. However, many firms aren’t using the data they have to provide valuable information for the operation. With the advent of more modern claim technology there has been a push to input more and more information about claims.

    1 comment
  2. 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
  3. Part 3 on Leadership: Challenges and Assistance in Leading Change March 25, 2014

    Posted in Strategic Planning.

    In Leadership: The Change Process In Claims Requires A Different Approach, I put forth the position that changing a claims organization needs a new brand of leadership skill that does not usually exist in the traditional claims organization. In Part 2 on Leadership: Developing a Strategic Transformation Team, I addressed how to break from existing management process to achieve effective strategic results. In the final installment, I discuss how challenges around leading change make it beneficial to bring in strategic support to help achieve the desired success.

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  4. 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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  5. 3 Things Good Claims Professionals Won’t Do January 24, 2013

    Posted in Best Practices.

    I have audited a lot of claim files over the years and one consistently good claims professionals manage their claim files following best practices. And when looking at these files there are certain patterns that develop. Good claims professionals don’t fail to document, assume things they don’t know and always stick to the basics. Our latest post gives three examples of things NOT to do to become a good claims professional.

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  6. How Would Albert Einstein Approach Claims January 3, 2013

    Posted in Best Practices, SPOT on Ops.

    Who knew Albert Einstein was a claims professional? OK maybe he did more important things in this world but some of his most memorable quotes could certainly apply to a claims organization. “Nothing happens until someone does something” as he has been quoted so make it happen and readt our latest post.

    2 comments
  7. 4 Areas Of Concern From The Latest Insurance Executive Conference December 12, 2012

    Posted in Commentary, Strategic Planning.

    Recently insurance leaders came together at the 23rd Executive Conference looking at “Driving Growth in the Life and Property-Casualty Insurance Markets.” Throughout the conference 4 themes seemed to permeate: Data and technology, regulatory environment, climate change and social media. It would seem these issues will with the market for a while. Take a look at our brief overview of the conference.

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  8. 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
  9. The 5 Core Leadership Traits Of A Well Managed Claim File October 8, 2012

    Posted in Best Practices.

    Leadership is a topic that we tend to think about as it relates to an individual leading a group. In claims we are always faced with leaders that manage us and help, hopefully, to get the best out of us. But leadership does not mean that you have to have a group of people that follow. There are 5 core traits a good leaders show. In our latest post we connect those five traits to 5 traits a good claims file, when handled well, will show.

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  10. 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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  11. Insanity: Claim’s Departments Can’t Expect Different Results Without Changing Their Organizations May 9, 2012

    Posted in Commentary, My SPOT.

    Maybe I care too much about our industry or am just frustrated by the lack of attention to quality claims handling, but this is annoying. Why should claims make up half of the most frequent market conduct issues for the Property & Casualty industry as listed by Wolters Kluwer for the 5th straight year? As part of their review they track and analyze the results from state market conduct examinations. As with their prior studies, claims issues continue to dominate the list of state concerns. In my latest post I analyze the last 5 years of the Wolters study and find an upsetting trend – nothing is changing. This is a challenge to claims organizations to improve! Check it out.

    7 comments
  12. 2 Problems To Prevent Before They Get Out Of Control: The Lily Pads Revisited December 7, 2011

    Posted in Best Practices.

    Waiting to the last minute can be a costly venture. In out latest post we tell the story of the farmer who waited to clear those innocent lily pads from his pond. He kept going on to what he thought were more important things. Unfortunately he waited to long and the lily pads took over the pond and cost him a lot more to clear. We all have lily pads we don’t want to clear from our desks. It’s time to look for them and clear them off before they strangle the life out of your pond….I know a little poetic but read on and you will get the idea.

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  13. 2 Company Types And Their Approach To Claim Audits: The Have To’s And The Wants To’s  November 9, 2011

    Posted in Best Practices, Claims Auditing.

    Companies can choose to audit because they have to or choose to audit because they want to. Companies that want to audit are destined to provide better customer service, happier employees, and improved results. Our latest post asks the question: Which company are you?

    1 comment
  14. 100 Posts And Counting September 6, 2011

    Posted in Commentary, My SPOT.

    100 articles and counting. In today’s post we stop to reflect on our latest accomplishment and provide some context as to our last 100 articles. Thanks for the continued support and we look forward to writing the next 100.

    1 comment
  15. 6 Ways To Conquer Procrastination – A Primer For The Claims Professional August 17, 2011

    Posted in Best Practices, SPOT on Issues.

    Continuing with more insight from the Business Insider War Room, our most recent post deals with ways to fight procrastination. One of the hardest things to do sometimes is avoid distractions and focus on the work. Claims can be exceptionally exciting but at times can be rather repetitive. Working to deal with those times of procrastination in a positive way will help you become a better claims person. Take a look at these ideas and let us hear from you about others.

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  16. 7 Steps To Effective Problem Solving For Every Claims Professional August 2, 2011

    Posted in Best Practices, SPOT on Issues.

    Let’s face it solving problems in claims is a core reality to what we do. From the second a claim hits your desk until the minute it leaves it there are a series of problems that need to be solved. Should this claim even be accepted? Was there any liability? What experts should I hire? How much is it worth? What are my next steps? At every turn there is another problem that needs to be solved. As you probably have experienced, some people are very good problem solvers and others are not. In claims, however, there is no escaping the need to solve a variety of issues on a daily basis. Don’t fret if you don’t consider yourself a good problem solver as it turns out there is help for you. In our latest post we discuss 7 effective step to problem solving.

    1 comment
  17. “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
  18. Continuing Education Is The Path To An Improved Claims Operation April 19, 2011

    Posted in Best Practices, SPOT on Issues.

    We at the Claims SPOT are committed to promoting continuing education within our industry. As part of that commitment we have teamed with the Americas Claims Event as a media sponsor to promote the conference. Expanding claims knowledge is a critical part of any successful operation and at the ACE Conference you will learn new trends from the best and the brightest in the industry.

    1 comment
  19. 5 Things To Avoid When Negotiating In Business and Claims March 2, 2011

    Posted in Negotiation, SPOT on Issues.

    Let’s face it, claims is as much about negotiating as anything. It is a significant part of our jobs as claims professionals, yet little real time is spent honing those skills. In coming across an article on 5 things you should never say while negotiating, we comment on how these techniques can be used in claims negotiations. Take a look, and tell us your techniques.

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  20. 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
  21. 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
  22. Claims And The Investigative Journalist And Learning From All The President’s Men November 9, 2010

    Posted in Best Practices, SPOT on Issues.

    Investigating a claim is like being an investigative journalist. Using the story of Bob Woodward and Carl Bernstein and All the President’s Men, see how there is a relationship between investigative reporting and claims. In today’s post we also remind claim professionals how technology has truly made certain aspects of claims bette. Regardless, it is important not to forget what is most important in claims – the knowledge and skill of the claims professional’s ability to analyze fact and come to a reasoned and supported conclusion.

    1 comment
  23. 3 Perspectives On The Use Of Social Media In The Claims Investigation Process October 25, 2010

    Posted in Best Practices, SPOT on Issues.

    Social medial sites like LinkedIn, Foresquare and Facebook are becoming a regular common experience in today’s world. With increased use is information that regular people put online that is available for review and scrutiny. In today’s post we discuss the use of these sites in the investigation of claims from the perspectives of attorneys, claims professionals and investigators. Summarizing a recent discussion on the Insurance Professionals group of linkedIn, it provides and interesting perspective on how these sites are very much being used in the claims process today.

    2 comments
  24. Do The Hard Things First And Embrace The Challenges: A Conversation With Chartis (AIG) Chief Claims Officer Rick Woollams October 13, 2010

    Posted in Rick Woollams (Chartis Chief Claims Officer), The Inside SPOT.

    On July 28, 2010, The Claims SPOT had the pleasure to sit down with Rick Woollams for our “The Inside SPOT” series of industry leaders. We hope to present more interviews where we explore how these leaders began their careers and how they see the industry today.

    Rick Wollams is in charge of one of the largest claims organizations in the world. What was most interesting about our discussion was how he began his insurance career as a front line liability claims handler and worked his way up the ranks. At his heart he is a claims person through and through and clearly cares about the profession and the people that work for him.

    Do the hard things first and embrace the challenges is a wonderful message from Rick Wollams so please read more and enjoy the interview.

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  25. 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