Effective Claims Management
Effective claims management can reduce costs and maximize the effectiveness of your internal workers’ comp management program. Effective claims Management is all about finding the balance with communication. In business, this means filing an employee claim early, staying in regular contact with the employee and the insurance provider, and maintaining consistent communication between the two.
Claim Departments in insurance companies generally focus on “Claims Handling” which is the claims process with emphasis upon claim review, investigation, negotiation and settlement. This excludes emphasis upon the monitoring and lowering of claims costs. Settling insurance claims is just one aspect of the claims management process. The time it takes to process a claim involves several stages beginning with a filing a claim. The stages that follow determine if a claim has merit as well as how much the insurance company will pay. Monitoring costs throughout the claims management process determines how much of a customer’s premium rate goes toward paying for the insurance company’s administrative costs. Generally speaking, when settling a claim is delayed, it costs the insurance company more money. The higher the claims costs, the lower the profitability. Insurance customers expect a company to settle claims quickly and to their satisfaction. “Claims Management” includes both the aspects besides Customer Satisfaction and Customer Care contributing to retention of business and enhancing brand image and reputation of the company. This programme is then designed to deal with the subject in this new perspective to cover the entire gamut of Claims Management – ; its strategic role, cost-monitoring role, service aspect, dispute redressal and customer satisfaction.
Objectives
- Appreciate the difference between “Claims Handling” and “Claims Management”
- Understand intricacies of claims settlement;
- Importance of Quality Management in Claims Management;
- Claims estimating and reserving
- Detecting and managing fraudulent claims;
- Managing disputes that arise in claims;
- To handle claims related complaints towards ultimate satisfaction of customer