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Tag Archives: Innovative Thinking

  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. Breaking Those Competing Commitments To Change January 23, 2015

    Posted in SPOT on Ops.

    In life change happens and people adapt. In business change happens and people react. Those who are resistant to change are usually easy to spot and equally as easy to manage and therefore rarely derail a change initiative. However, it is the person that generally supports change and outwardly appears to be working for the implementation of a new initiative that can sometimes harbor a “competing commitment” that can have a more deleterious impact on the success of a new initiative.

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  3. 15 Excuses For Not Changing And 5 Reasons To Change The Way We Make Change April 1, 2014

    Posted in Strategic Planning.

    Change is hard for everyone and how and when to change has been debated and discussed in companies since the first company was formed. What is never debated are some of the excuses used for not changing. People are generally resistant to change and despite the need to move forward people generally prefer to live with what they have. Taking a strategic approach to the issues around change itself shuold help to alleviate some of the resistence. In this post we look at changing the way we change.

    1 comment
  4. 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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  5. Part 2 on Leadership: Developing a Strategic Transformation Team March 17, 2014

    Posted in Strategic Planning.

    Breaking from the linear approach to management is the key to leading Strategic Transformation. A standard organization will have a head of claims and then a variety of department heads to manage each line of business. Depending on the company there may be additional senior managers to handle various operational aspects of the group, which may include support staff, call center, technology and data analytics. Under this method, projects get initiated and managed within the same linear organizational framework. The result of this approach is a development process built in a silo that limits input and understanding of possible interdependencies that may exist outside the framework. In this post we will explore further how a strategic transformation team is formed and can be effective.

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  6. Leadership: The Change Process In Claims Requires A Different Approach March 10, 2014

    Posted in Strategic Planning.

    Successful organizations are always changing and adopting to improve their operations, lower costs and increase efficiencies. Claims departments are no different and have been under pressure to transform their operations and live by the mantra of doing more with less. Good claims organizations continuously evolve and adapt to ensure they add value to the overall business. Regardless, changing to meet the challenges of the marketplace is often fraught with problems and difficulties. Many initiatives fail to get off the ground or fail in the implementation process. Change can be very successful and if managed and led correctly. To change effectively there must be a strategic approach and a change in how these initiatives are led.

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  7. Kindergarten Management: Getting Back to the Basics June 10, 2013

    Posted in Best Practices.

    Everything we know in life started back in kindergarten. Kindergarten is where we learned to socialize in groups, lived by rules, played well with others, managed time, took turns asking questions and listened to authority. Success and creativity were rewarded and failures became further learning experiences. The more I thought about this recently the more I realized that kindergarten is a perfect example of a well-functioning organization and management.

    We can lean a lot by going back to kindergarten. Bear with me take a look how this would apply in a claims department.

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  8. Claim Files Are Evaluated Using A Form Of Root Cause Analysis So Why Not Do The Same When Evaluating The Department? March 5, 2013

    Posted in SPOT on Ops.

    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.

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  9. 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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  10. 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
  11. Everybody Wants to Make Improvements In Claims But No One Actually Makes It Happen June 15, 2012

    Posted in Claims Technology, Commentary.

    There is so much that needs to be done in the world of claims. Operations need fixing, technology needs improving and a futures need to be defined. For some reason however, we are all really good at talking about it and not so good about doing anything about it. The industry needs to take action. Claims departments need to think creatively and “out-of-the-box” if we are going to attract new talent to the industry. This also means acting and not just talking about acting.

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  12. 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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  13. “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
  14. 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
  15. Time to Get Creative – Reducing Claim Costs without Sacrificing Quality (or your sanity) November 22, 2010

    Posted in Litigation Management, SPOT on Costs, SPOT on Ops.

    In an environment of increased pressure to reduce costs and close claims, bright ideas can help to reduce legal costs while still ensuring great service. In this article, litigation expert Suzanne Ganier speaks about the importance of understanding what you know and what you don’t, analyzing the strengths and weaknesses of those involved in the litigation process, and aligning those analyses with your organization’s philosophies. The result can be a litigation management process that reduces overall claim costs and preserves your sanity.

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  16. 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
  17. Promote Creative Thinking To Get The Most Out Of Your Claims Staff August 16, 2010

    Posted in Best Practices, SPOT on Issues.

    Good workers are sometimes all that claims departments look for and, given the nature of claims these days, it is not a bad thing. There is so much to do and so little time to do it and good workers, however you define them, are great to have. But how often are creative thinkers looked for? In a video lecture from, Sir Ken Robinson, he asks why don’t we get the best out of people? He argues that it’s because we’ve been educated to become good workers, rather than creative thinkers. Do you recognize that employee in your organization? How should we promote creative thinking in the claims world – read more in today’s post at the Claims SPOT.

    2 comments
  18. What Paul Revere Can Teach Claims Professionals About The Benefits Of Building A Strong Professional Network August 12, 2010

    Posted in Best Practices, SPOT on Issues.

    Is professional networking (so-called social networking) relevant for claims professionals? Does it make them more effective, help them to identify resources they need to do their job better, find the right attorney, be creative, identify emerging technologies, spark their imagination, and set industry trends? Or are they a waste of time, an invasion of privacy, or just not part of your world?

    To look at that, this article examines the effectiveness of Paul Revere and the analytical work done in several publications, including the Harvard Business Review, Tipping Point and Connected. It examines the potential of social and professional networks, what makes them successful and effective, and the applicability of technology platforms liked LinkedIn to the claims management profession.

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  19. 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
  20. Social Media And Claims Investigation: Do You Know About Foursquare? June 28, 2010

    Posted in Best Practices, SPOT on Issues.

    Undoubtedly, you’ve read plenty of articles or have been to numerous presentations regarding the use of social media to investigate claimants. At this point, the novelty of Facebook and MySpace has worn off. The same can be said about Twitter. Everyone knows at this point to take a look at those platforms when searching a claimant’s background. Enough said. However, seemingly with every new day comes a new social media application. One relatively new application that you should also take a look at during your claims investigation is Foursquare.

    Learn more from out latest contributor, Christian Stegmaier, JD and look for more articles from Christian in the weeks to come.

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  21. 6 Steps To Reduce Expenses For Medical Experts As Suggested By The Expert June 17, 2010

    Posted in Medical Malpractice, SPOT on Costs, SPOT on Issues.

    The traditional method for preparing an expert is to send them the entire record and let them review for possible issues. Dr. Philip Lanzkowsky, a medical expert providing opinions and testimony on cases for both plaintiff’s and the defense, raises some practical questions and provides a series of suggestions as to how those expert costs can be reduced.

    Read more in this interesting post of expense reduction of medical expert costs as suggested by the expert.

    2 comments
  22. Change Hats With Someone And Free Your Mind To Make Your Claims Operation Better June 9, 2010

    Posted in Best Practices, SPOT on Issues.

    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.

    2 comments
  23. Cutting Costs Without Overloading The Claims Handler – Part 2 Of The Series April 6, 2010

    Posted in SPOT on Costs.

    In part 2 of this series on cutting cost without overloading claim handlers I given an example of hiring a part-time employee to review legal bills. As noted, sometimes specific types of work, such as legal bill review, subrogation and anti-fraud, can best be handled by dedicated resources. Hiring a part-time employee that can focus on an area of claims is sometimes the best way to get results. Overworking claims handlers with additional tasks not part of their core job function – to evaluate and settle claims – can result in some aspect of their job suffering. Key cost cutting initiatives, such as Anti-Fraud and subrogation recovery, get put aside by the handler and never get the fullest attention needed to be successful. Take a look at the latest example of solutions that work.

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