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.
Claims Operations
3 Ideas To Prepare For The Completely Unexpected: The “Sandy Contingency”
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.
2 Preventative Steps To Help Avoid Claims Crisis Before They Become Emergencies
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.
Insanity: Claim’s Departments Can’t Expect Different Results Without Changing Their Organizations
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.
What Would Steve Jobs Do In A Claims Organization?
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.
There Is No Such Thing As A Pro Forma Signature On A Document – If You Sign It You Own It
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.
Increasing Claims Satisfaction Doesn’t Mean Increasing Staff
Is it possible to increase claim satisfaction and decrease cost at the same time? Many claim representatives say no. Some view that satisfaction is driven by the ratio of adjusters to claims – having more people to handle claims means higher satisfaction, although also higher loss adjustment expense. Some believe that higher settlement amounts result in higher satisfaction and higher loss costs.
As the Claims SPOT welcomes new contributing author, Melissa Loew, see how customer satisfaction can be addressed in tight staffing markets.
Is Your Caims Department Becoming A Bus Company?
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.
Does Hiring More Staff Improve Claims? How To Know When The Time Is Right
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.
6 Essential Elements To Explore When Choosing A Third Party Administrator
A Third Party Administrator (TPA) is often the best way to handle claims for an organization. Many self-insured and captives choose to outsource their claims instead of creating their own internal operation. Whether to get expertise in a particular areas, or not wanting to invest in the infrastructure to build a claims department, using a TPA can be a smart business decision. So what make a good TPA and what should you look for? In order to find out you must conduct a comprehensive due diligence of the TPA you are about to hire. This is especially the case when that TPA will be holding and managing your claim dollars. Besides understanding the financial strength and capabilities of the TPA, it is also important to know whether they will be able to meet your data needs, provide consistent claims handling, and work to lower costs where they can.
In this weeks post I address 6 essential elements, and questions, that should be explored as part of any due diligence when selecting a TPA