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
Claims Handling
Change Hats With Someone And Free Your Mind To Make Your Claims Operation Better
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.
Commentary – Expect Gulf Oil Slick Claims To Be Extensive And Impact Multiple Lines Of Business
We still do not truly understand the entire impact from a claims perspective of the tragedy that has unfolded as a result of the Deepwater Horizon rig accident in the Gulf of Mexico. Losses are being estimated in the $30-$40 billion range with only a fraction of that number covered by insurance. What has recently been reported, however, is an increase in premiums for offshore energy coverages. What is next? No one really knows. The Claims SPOT comments on the some of the issues facing the industry.
The Claims Writing Workshop: Write How You Speak! Just Leave Out The Color Commentary
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. “
How Do You Effectively Manage A TPA? Speak Up And Be Active!
Become The Squeaky Wheel To Actively Manage TPA Outcomes As claim practitioners, most of us are … How Do You Effectively Manage A TPA? Speak Up And Be Active!Read more
The 5 Essential Components of Defense Attorney Reports That Can Improve Claims Costs and Outcomes
Why are Attorney Evaluation Reports sometimes so light? I was recently conducting an audit of claim files and had the opportunity to review a significant number of Attorney Evaluation reports from a variety of law firms. Like many other things in life, some were better than others. What seemed to be most glaringly consistent was the inability of counsel to truly provide an assessment of exposure and what the case is worth. Every counsel evaluation report should contain 5 basic components that I outline and attorneys should be required to provide their actual valuable opinion. [More…]
Considering Forming a Captive? Maximize Your Claims Benefits In 3 Steps
The Benefits Of Forming A Captive Are Great – IF – You Set It Up And … Considering Forming a Captive? Maximize Your Claims Benefits In 3 StepsRead more
7 Considerations When Drafting Claims Guidelines
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.
Improve bottom-line outcomes on claims by thinking outside-the-box!
Claim handling is just as much an art as it is a science. Synthesizing facts and … Improve bottom-line outcomes on claims by thinking outside-the-box!Read more
Warning – Medicare Secondary Payer (MSP): Government sends strong message and goes after non-compliance
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.