If you have any doubt about your automation system’s ability to improve your agency’s claims-handling activities, read this document. Sharon Cunningham illustrates the timesaving advantages to storing resources in an automated system, and how this can improve every aspect of data processing.
Consider these two scenarios, each describing a different path that agency staffs might follow in processing a claim:
1> A claims representative gets a call from a client. He writes down the claim information and tells the client he’ll review the claim and call back. Then he looks for the file in the file drawers, the CSR’s desk, and the producer’s office before finding it. After reviewing the file, he determines that the policy covers the claim, and enters the information in the agency management system to produce an ACORD loss notice. Because this is a specialty coverage, there’s no need for information pre-fills from the system into the loss notice. (The claims rep knows that even standard policy information in the agency management system might be outdated).
After completing the form, the claims rep prints three copies. He puts one in the claims file, gives the second to the producer (who doesn’t use the computer system), and faxes the third to the carrier. The rep calls the client to tell him the claim is covered and marks his desk calendar for follow-up. The client later e-mails more information, which the rep prints, copies, and stores in the open claims file. He places subsequent documents, digital photos and correspondence in this file. When the claims check arrives, the rep pulls the file and notifies the producer by phone. He writes a letter to the client from scratch, stores it on his hard drive, prints a hard copy, copies it for the file, and signs it. Finally, the rep enters the claim in a claims-tracking spreadsheet, prints it, and makes copies for management.
2> A claims rep receives a call from a client. The rep goes into a computer file and verifies coverage while the client is on the phone. He pulls up an ACORD loss notice form, which pre-fills most of the information. There’s no need to double-check this input because the agency uses transactional filing, and the Commercial Lines manager regularly audits electronic files for accuracy. The rep then instructs the client about the next steps and asks them to e-mail additional information.
The rep adds the client’s comments to the system, which produces an automatic follow-up. After sending an e-mail reminder for the producer to check the claim in the electronic file, the rep faxes the loss notice to the carrier directly from the system (which has preloaded fax numbers for each carrier). When he receives the client’s e-mail, he attaches it to the client file. As he receives subsequent documents, he scans them into a separate drive and references them to the customer file. When the rep receives the claims check, he customizes a letter from templates stored on a shared drive, prints a hard copy, and mails it to the customer with the check. A copy of the letter goes to the client file automatically. Finally, he runs a weekly claims report from the system and e-mails it to management.
These scenarios illustrate two far different ways of working. In the first, the process is manual. The agency’s computer system is more a typewriter than an electronic file, and the paper file provides the main source of client information. The rest of the agency can’t access information stored on the claims rep’s hard drive. Although the computer system provides faxing capability, an automatic follow-up system, word processing, and e-mail integration, the rep doesn’t use them. He produces claims reports manually because he can’t access the system’s management reports. This procedure is inefficient and makes it difficult for others to work on the file when the rep’s out of the office.
The second scenario shows how today’s automation systems can support efficient transaction processing. All information is in an electronic file, either in the agency management system or in an imaging system. The agency management system integrates word processing, spreadsheets, and e-mail files. These tools improve information access, simplify forms completion, and help keep management reports current and accurate.
Using electronic files also improves customer service. Because the claims rep doesn’t have to leave his desk to find files, make photocopies, or fax documents, he can take more customer calls. With information at his fingertips, he doesn’t have to call clients and carriers repeatedly. If someone else needs to work at his desk, that person can find documentation, do follow-up, and assure clients that their transactions will be processed.
Today’s consumers want immediate service, expect to complete transactions over the phone, and expect processors to have information on hand to answer their questions. Agency staff working with a comprehensive database can provide real-time customer service.
Most agency employees are knowledgeable, capable people who could provide more service and advice if freed from some paper processing duties. Automation gives them more time to spend with customers so they can review their insurance and advise them about better coverages, higher limits, or increased deductibles. With an accurate, complete database, a CSR can determine if the customer has used the services of the Life or Employee Benefits department or has been asked about an Umbrella policy. The CSR can also see whether the customer is receiving the agency’s newsletter or has recently received a mailer about agency programs.
Implementing electronic processing takes time and effort. Improved customer service, better retention of business, and additional sales make it well worth the effort.