Earlier this year, ISO released a white paper entitled Good Communication Impacts More Than Just Claims (click here). This paper examined the various processes and tools utilized by many claims departments to help adjusters complete thorough and consistent claims investigations, and the important overall role this plays as part of claim handling.
Recently, the author attended a conference where many of these same issues were discussed, as part of the general conference sessions and as part of individual conversations with fellow attendees. As these issues will continue to surface, it may be a good time to revisit this area.
As such, the author has prepared the following general overview in follow up to his recent white paper analysis, with additional focus placed on other stakeholders that carriers typically work with as part of this process. The following also highlights how ISO’s portal technology can be used to improve current processes.
Building Effective Processes
Having a consistent and timely communication strategy is a critical first step toward ensuring that claimants receive superior service and that all parties (including the insurer) experience a fair outcome. An important building block to achieve this involves gathering key information as part of the investigative process.
Along these lines, some of the major items that adjusters should be addressing in a timely manner include:
- contacting the involved parties early;
- processing the claim accurately and efficiently;
- gathering eyewitness statements;
- completing other investigative steps consistently; and
- keeping all parties apprised of the claim’s status at all key stages.
Confronting the Challenges
While building effective processes is vital, it is equally important to recognize the challenges that can easily diminish the effectiveness of even the best programs.
For example, the author has witnessed time and again how the process can break down in wake of adjusters facing the pressure of 100% closure rate expectations or requirements. While a 100% closure rate is certainly an admirable goal for reducing the life cycle of claim; this goal can end up causing a reduction in the manual effort that is currently necessary to share the claim investigative details to all stakeholders. If technology is not used to compensate and streamline the process, the adjuster must make different decisions to keep up, which often includes providing more of a summary to the other stakeholders instead of providing a robust presentation of all necessary details.
Another area for consideration involves use of outside law firms. Frequently, outside law firms are employed to maximize a company’s recovery. The difference between a great subrogation firm, versus a less effective one, often rides on the level, and timeliness, of client communication. However, if that communication consists of requests for additional details, the life cycle is slowed down, recovery amounts can be reduced, and the expense for each file is increased. Both the firm and their client suffer.
Making it Work Better – ISO’s Portal Technology
So the questions become: How does a firm become great in this environment? How does the carrier become aware of poor communication? How can the carrier improve the situation?
The answer: ISO’s portal technology.
ISO’s state of the art portal technology is the ideal solution that both streamlines the adjuster’s investigative processes and reduces the manual effort required by the adjuster to effectively communicate the claim details to all internal and external stakeholders.
ISO’s portal offers several benefits, including:
- provides the right permissions and applicable security to all stakeholders so they can access the claim file and share details in real-time, without requiring redundant data entry, manual effort to summarize and send a claim file to each stakeholder, or requiring subsequent follow-up to exchange more information.
- helps front line adjusters quickly settle claims that should be settled, while also quickly and consistently identifying those claims that require further investigation and contain further subrogation opportunities. This helps limit longer claim cycle times to only those case which truly need additional investigation.
- allows pertinent claims facts to be captured while providing access to external sources that most adjusters use already as part of their investigation.
An important aspect of optimizing portal technology involves using it to help consistently evaluate a company’s share of claim costs. In this regard, it is estimated that approximately 20% of claims involving multiple drivers have fault not only assignable to the insured, but to the claimant as well.
Unfortunately, with little time and variable claim processes, companies often end up missing other parties who may be at fault. However, by using ISO’s portal technology an evaluation to address fault factors and parties can be produced literally in seconds. This not only reduces the adjuster’s effort to do this manually, but also encourages all adjusters to evaluate similar facts in a consistent manner.
Armed with this type of an evaluation, the adjuster can then determine who needs to see the claim file to aid in resolution, and he/she can simply set a diary for the party to pick it up at this point. Manual summaries that may have been missing pertinent information are no longer required to facilitate the communication.
Further, the ISO portal allows the subrogation firm to receive the diary, allows the firm attorney to login and view the claim details they have permission to view, including supporting documents, and allows the attorney to more timely and effectively communicate their opinion, recommendation, cost per action, and the file’s status without first having to request more information – all without typical delays in waiting to receive copy of the paper file, additional documents manually, or emails which then later must be attached to the file. All communications become part of the claim file using the portal.
In a nutshell, ISO’s portal places all this pertinent information at the fingertips of each user. If you have the right portal, configurations are available to have it reflect the processes of each insurance company. The outside firm can have this available so any recommendations and statuses are continually in line with their client’s processes.
In addition, such communication can also encourage better vendor management on each file. Often, outside firms are expected to predict and consult with their client on the perceived outcome of a file. If the adjuster has a vendor that is great at performing a particular service, but is perhaps not as strong as an expert witness, the firm can effectively communicate and influence what experts are recommended on a case by case basis.
With the right technology to support this type of “best of breed process,” missed recovery opportunities can be reduced and communication will become more timely and accurate. In addition, the same tools will be made available to each adjuster reducing the effort with current manual processes as well as promoting consistent claim investigations and evaluations.
To learn more about ISO can help you as part of this process, please contact the author at firstname.lastname@example.org.