View from The Helm

Claim Management WTF (What's the Focus)?

Claim Management WTF (What's the Focus)?

I don’t always like to admit it (because it means I have less hair and longer teeth), but 2018 will be my 32nd year in this business. Many of you reading this can relate and I wonder if you’ll agree with this reflection: When the New Year comes around we often see a new focus in the claim management space.

The new focus is never anything really new though. It’s typically pulled from the archives. Those of us who harken back to slide rules and curly fax paper wonder which way and how far the pendulum is going to swing every year.

It’s interesting because when I review a claim today, I see the same general contract, the same basic plan provisions, and the same basic approach I saw 30-plus years ago. When I attend conferences, I listen to the same presentations, I have the same cocktail party conversations, and I hear the same frustrations expressed about the swinging pendulum or change of focus.

“Last year we focused on improving our acceptance rates at the initial liability. This year, we’re focused on turnaround time.”

“Last year we did settlements. This year we’re not allowed to do settlements.”

“Last year 80 active claims was the right number. This year it’s been bumped to 90.”

I won’t bore you with the litany of examples, but it could easily fill this page.

Why can’t we truly focus? Maybe it’s because in our search for the next best mousetrap, we’ve lost touch with our main objective. I think that objective is “To administer disability claims fairly and accurately.” If that’s a true statement then we need to refocus and stay focused ON THE CLAIMANT.

The claimant (we like to call them customers) is a constant. They were here when insurance was invented and they will be here when our job is being done by a robot. Don’t laugh. It’s coming sooner than you think but that’s a topic for another day.

If you focus on the claimant as a customer and you develop your claim philosophy accordingly, hire the right people and invest in their training, build workflows that enhance the ability to focus, and develop systems that facilitate efficiency, you shouldn’t need to reinvent the wheel every year.

Don’t get me wrong. I’m a big fan of continuous improvement. We can all do a better job than we’re doing right now. However, if you have to start over time and time again because the focus changes all the time, significant improvement is hard, if not impossible to pull off.

If you'd like to discuss, we're ready when you are.