Improving the claims process and management

Efficient and effective claims management systems are critical to any business, as insurance claims have a wide range of complexity – from simple claims that are handled in days to complex liability claims that take years to complete.

Companies are now trying to reduce turnaround time with innovative ways to improve the claims process and enhance the customer experience. Claims handling can be seen as a very complicated process. From receiving to paying, there are several detailed workflow processes that need to be attended to in order to have a smooth transition. With the right understanding and improved methodologies, appointees can turn it into a process to improve operational performance and workflow productivity.

Let’s dive a little deeper into the process with an overview of the key moments in each claim.

First Notice of Loss (FNOL) is customer driven and is the first step in improving your customer’s experience. Streamline this critical internal process with the ability to enter the claim by the claimant, HR, attorney, and/or broker with established system business rules that follow the reporting process. The end result is a dynamic workflow for the first loss notification.

Acceptance, evaluation and approval are at the heart of the claims management process. For insurance companies, the question is not only to provide the best customer experience with fair settlements, but also to micro-manage the details behind the scenes. Implementing customer-driven business rules ensures a stimulated workflow process.

Other challenges that arise during the process are leveraging the data. Claims adjusters look for integrated results and specific or customized reports that an outdated system may not be able to provide. The ability to generate basic reports is a normal feature in claims processing software. Take the next step to transform it by maximizing your reports and implementing advanced ad hoc reporting. Enhanced reporting helps managers adapt to new market demands to retrieve information and output results to provide better understanding for decision making.

Claims payout allocations are the most important expense for insurance companies and also have one of the largest impacts on insurance underwriting. The insurance company’s claims process must be not only effective but also efficient. By closely observing the end-to-end process, you can build a high-level workflow – from receiving to paying – that can be evaluated for improvements. The result is manageable costs, high-quality customer service, operational efficiency and streamlined internal processes.