Studies show that insurers are now spending majority of their dollars on managing and keeping adjusters trained on the most updated claims management practices. Optimal outcomes and containing costs has always been top priority, with customer satisfaction ratings not far behind. Claim handling techniques can vary between seasoned adjusters and newer claim professionals who may be more accustomed to automated software systems. The term best practices is widely used but there really are no wrong or right answers just common practices. However, adjusters should always have these 4 steps included into their claims management workflow process.
1.Working outside of the box. No claim is the same as the next. Approaching each claim with a fresh mind set will be important in reducing indemnity payments and expenses. Claim adjusters who have the ability to research innovative ways to manage a claim file puts them ahead of any curve balls that may be thrown into the claim.
2.Know the importance of the pre-claim and post-claim processing details. Executing every stage in the claims management process is important to make the best decision possible. For an optimal outcome due diligence is necessary in all stages. Cooperation and collaboration of not only the adjuster but also the employee, customer, and employer will be the defining factor in adhering to the best practices for claims management.
3.Assess any leaks in your information management workflow. Regularly assessing your normal work flow process highlights any inefficiency that may be causing a breakdown in your claims management system. One common problem is the piles of documents that come in for each claim. Standardizing a process where all documents are appropriately filed and entered improves the claim handling process tremendously. A properly documented file is concise and gives a complete overview and easy understanding of the information.
4.Timely Investigation. The earlier a claim is investigated the easier it is in gathering all necessary information needed to move a claim forward quickly. Immediate questions should already be in place by claim professionals following the first notice of loss submission. How did the injury occur? Is it an unusual occurrence?
The pressures to effectively manage claims for adjusters have always been very high. The most reliable methods for optimal claims management are constant attentiveness, caution, and consistently reviewing daily practices. Success is never guaranteed, however, your goal should always be to ensure coordinated practices are in place to lower future claim management costs.