5 Deadly Sins of Claims Management- Part 4 of 5

Mar 10, 2010

Welcome to Salt Associates

Since 2003, Salt has been performing disability claim audits and reviews, claim data analyses, claim operation reviews and consulting to disability insurance companies, third party administrators, disability reinsurers and large employers¹. We've seen the good, the bad and the ugly. Recognizing that no one is perfect and understanding the complexities of managing claim operations in this day and age, we continue to find elementary claim management techniques missing. We call them The Five Deadly Sins:

 

  1. Timeliness
  2. Use of the Telephone
  3. Use of Risk Management Tools
  4. Written Communications
  5. Something we call "Risk Management Critical Thinking"

 

1Based on over 80 claim audits and reviews in 31 different claim operations.

Written Communication

The letter: Many times it is the only communication a claimant receives.  Think about that for a minute. Like a telephone call, the letter is an opportunity to interact with a customer. So it better be good right?

This one letter is the face of the "dreaded" insurance company or third party administrator.  It arrives from some unknown place often several days after the claim has been filed and it is typically filled with instructions and forms and insurance contract jargon and acronyms.

For someone feeling pain and stress from an injury or accident, i.e. the customer, this one letter is their lifeline and one way to establish a relationship with them.

How difficult can it be?  You'd be surprised what we see.  Granted, it's not easy writing to a wide range of people on a wide range of topics.  Consider the numbers of letters, topics, templates, forms not to mention the variety and quality of letter writing production systems and methodologies.

However, at the end of the day, like the previous topics we've covered, there are some very basic elements that could be followed to ensure that you're getting the most out of every communication with a claimant.

Written communications should be:

  • Clear and concise
  • Use appropriate grammar and spelling
  • Include contract wording where appropriate
  • Used to document telephone calls and decisions
  • Done in a timely fashion

Through the course of our claim audit work, we very often find that written communications are:

  • Often Over Used - To the point where letters take the   place of the telephone
  • Written with poor grammar and spelling - At which point you lose credibility and portray a poor image of your company
  • Contract wording not included where appropriate - Although confusing to some claimants, this is a must
  • Too complicated - Too many words

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