"From Backlogged to Brilliant:
Transform Your Claims Operation in Ten Steps"
In the fast-paced world of claims, backlog is more than just an annoyance—it's a critical bottleneck slowing down operations and frustrating staff.
Imagine a world where you transform your claims workflow, tackle backlogs, and supercharge your claim unit’s productivity and morale.
This scenario isn’t a fantasy. It’s an achievable reality.
Whether you work remotely, at a TPA, within a claim department, or for a corporate self-insured unit, these ten strategies will reduce inefficiencies and drive your claim department to peak performance.
1. Detect and Deter "Drifters."
One key step towards optimizing productivity is minimizing the time adjusters spend away from their desks. If you notice excessive wandering, often pejoratively referred to as "Floaters," it might indicate too little work or poor time management. Encouraging adjusters to stay desk-bound unless necessary, without micromanaging their every move, is a balance that's vital for maintaining both efficiency and morale.
Recognize that periodic breaks to walk around or venture outside help knowledge workers stay productive and recharge mental batteries. (Apple's co-founder Steve Jobs was famous for his walking meetings. Jobs believed that walking boosted his creativity and problem-solving.) Monitoring "floaters" does NOT mean turning the claim department into an Orwellian Surveillance State.
2. Go Digital, Stay Productive.
Embrace digital transformation within your claims processing. By converting paper documents to digital files, adjusters don't need to leave their desks to retrieve information. Digital formats for company claim procedures, lists of approved vendors, and policy forms ensure that everything an adjuster needs is just a click away, dramatically reducing time wasted on physical document retrieval. Caveat: Recognize that there is still a need for and tremendous benefit from person-to-person real-time contact. Encourage eliminating much digital back-and-forth by picking up the phone, dialing someone, and asking, "Can we talk?"
3. Stationary Success: Equip to Empower.
Equip each adjuster's workstation with all necessary tools and information to minimize the need for physical movement. Provide printer access, digital document retrieval systems, and comprehensive online resources. Each workstation should be a self-sufficient hub that enables adjusters to handle most tasks without stepping away.
Again, recognize the legitimate need for periodic breaks. These are not necessarily signs of slackers but help mentally and physically recharge to optimize the cognitive effort needed for successful claim-handling.
4. Provide Immediate Information Access.
Make all relevant information readily available at adjusters' fingertips. Scan in policy forms, endorsements, and reference materials. Upload them to your office's Intranet or claim handling system. Similarly, digitize statutes of limitations, state-specific claim handling practice regulations, and details on coverage for punitive damages to streamline analyses and decision-making processes.
5. Communicate with a Button-Click.
Improve communication efficiency by organizing contact lists and setting up speed dial for frequently called numbers. Doing so saves time and keeps adjusters focused on core tasks without disruptive searches for addresses, emails, or phone numbers.
6. Enable Desk-Based Documentation Access.
Let adjusters manage documentation directly from their desks. Provide dedicated printers for each workstation and use paperless filing systems that adjusters can access electronically. Documents should be printable, email-able, and manageable from the desk, ensuring seamless and efficient communication with insureds and coordination with attorneys or doctors.
7. Use Time-Tracking Technologies.
Employ technology to keep digital tabs on backlogs. By electronically tracking each document and task, managers can easily identify bottlenecks and uneven work distribution. This enables proactive workload management and ensures no adjuster is overwhelmed or idle.
8. Monitor and Balance Workloads for Better Outcomes.
Review and balance the distribution of files among adjusters regularly. This prevents inefficiency and ensures that all team members are productively engaged, with manageable workloads that optimize their potential without leading to burnout.
This tip doesn't mean every adjuster must have identical workloads. Savvy managers customize workloads to claim representatives based on a blend of their experience, expertise, specialization, work habits, and key client relations.
9. Harness Tech to Tackle Tasks.
Invest in technology that automates repetitive tasks, improves accuracy, and enhances overall claim efficiency. This accelerates claim processes and causes claim representatives to focus on more complex claim-handling tasks. The advent of large language models and generative AI will create new risks and opportunities for optimizing claim operations while retaining the needed human element (a topic for a future column).
10. Continually Monitor for Ongoing Improvement.
Monitor and review your claims processing workflows. This helps identify existing inefficiencies and fosters a culture of continuous improvement and adaptation in the face of evolving industry standards and technologies.
By implementing these strategies, your claims operation can improve its efficiency and transform its workflow into a productivity and effectiveness model in the insurance industry.
Accelerate Toward Excellence
Embracing these strategies heralds a new era of claims management. By optimizing each step of your department’s workflow, you not only minimize backlogs but also unlock unprecedented levels of efficiency and customer service. Imagine a department where every claim is smooth sailing and files close swiftly! Claim representatives feel empowered to perform at their best.
The preceding picture isn't a mere vision—it's an attainable reality. Adopt these practices and watch your claim operation strive toward excellence. Leave inefficiency in the past and step into a future where your claim processes set a new standard for success!
Kevin Quinley, CPCU, AIC, ARM, is the Principal at Quinley Risk Associates LLC. He has 47 years of claims experience and serves as a nationwide expert in over 150 cases in state and federal courts. He helps clients improve outcomes through expert evaluation and testimony in high-stakes insurance claim disputes. Kevin has written over 770 articles and ten books on claims, litigation, and risk management.
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