I have personally met with the insured, explained insurance policy, clarified coverages, inspected claimed damages, determined the subrogation possibilities, hand wrote the repair estimate, and issued payment drafts. Yet, I was told, the most important aspect of all claims handling was 'human relations.'
Training focused on customer service and the claims adjusters' association with people... in other words, the application of human behavior. If we understood human behavior, we gain insight on motivation and establish rapport with the insured, which in turn...helps in settling the claim.
Today, the customer service department contacts the insured and schedules the appointment for the appraiser. The claim is assigned to a desk adjuster, which in turn waits for the appraiser to submit the repair estimate. The appraiser, either an independent adjuster or direct repair contractor, meets with the insured and cannot discuss coverage issues or make a payment to the insured. The appraiser submits the repair estimate to the file examiner. The file examiner returns the repair estimate to the appraiser with the recommended revisions and upon approval, submits the final repair estimate to the insurance company.
In the meantime, a portion of the claim is assigned to the contents unit for review and processing. The desk adjuster reviews and approves the repair estimate and contacts the insured with information on what and how to get paid for the claim. A partial payment is usually made to the insured for the actual cash value of the claim.
Upon completion of the repairs, the remainder of the payment for the claim is issued. Upon final payment, the desk adjuster will transfer the claim to the subrogation department for review.
This process supposedly streamlines the claims workflow, improves underwriting profit, and promotes expense management. Today, training focuses on laptop navigation, property estimatics software, electronic claim files, claim management systems, consumer protection timelines, and strict policy interpretation.
What has happened to customer service?
Has our industry fallen so far that the only factors to claims handling are expense management and limiting indemnity?
The answer is "no". Even though it appears the only true 'constant' is 'change,' one element of claims handling will always be a 'constant'...Customer Service. Without true customer service, no claim will be final.
A customer service oriented adjuster can satisfactorily settle a claim with a not-so-perfect repair estimate, while a poor customer service oriented adjuster will not be able to settle or finalize a claim with perfect or accurate repair estimates.
Why is this?
While displaying consideration, building rapport, and obtaining the insured's confidence, a claim can almost always be settled with a positive result. Without these traits, a claim will remain open and ultimately cost the insurer more money, since time is money. You can't always measure the cost of a claim by the indemnity payment.
The feature story in a recent claims magazine highlighted 'poor, disjointed claim handling' as a blemish on an insurer's reputation...specifically 'poor service.' The reasons for poor service are diverse, but one of the main reasons seems to be that the insurers sometimes unwisely prioritize cost savings over customer service when making process and technology decisions. It goes on to mention that some insurers don't appreciate the human dimension of claims and its centrality to the mission of any insurance enterprise. Whatever the true intentions of the insurer, dissatisfied customers are likely to come to the conclusion that the insurer doesn't really care about the individual's experience and is thus more focused on receiving premiums than properly executing on claims. Customers who feel they have been betrayed are not likely to keep quiet about it.
With today's focus on claim modernization, how can the insurance industry blend customer service back into the mix? Fortunately, improving claims performance (modernization and customer service) is becoming a high priority for most insurers and independent adjusting firms (IA) servicing the insurers. Forward thinking firms are implementing modern web-based claim systems to support claims processes that offer both greater efficiency and more thorough, timely, and consistent claim service. IA firms now have the capability to communicate and connect directly with the insurer to seamlessly coordinate their administration and billing systems.
So, it is possible to have high technology and modernization as well as superior customer service. When we consider technology and processes with the customer in mind and with a goal of making them whole in a timely manner, then we can begin to see the real potential of modern technologies.
When responding to a customer in need, specifically in a catastrophe situation, insurers and IA firms can't just respond, but they must be thoroughly prepared. By organizing claims, administration, and invoicing, today's firms can better prepare policyholders in advance by notifying field adjusters that are standing by and being on site as early as possible. Most catastrophes (70%) are predictable, weather-related events that can be monitored and tracked.
When an insurer's claims system tracks potential catastrophic storms, the insurer has the capability to warn and advise policyholders that are in the storm track via email and social networking tools such as Twitter and Facebook to take shelter, turn off utilities, or remove pets from the house, thus exhibiting better customer service. One IA firm, mandates all roster applicants to complete and pass a four part Assessment Test, just to be considered a candidate for catastrophic deployment. The first of their four-part exam covers customer service. They state if the candidate does not pass the customer service portion of the Assessment, they are not allowed to take the remainder of the exam. Now that is a true focus on customer service.
By implementing today's technology with yesterday's focus on human relations, the insurance claims industry is turning the corner on improving and excelling in customer service. As stated, if there is a 'constant' in handling insurance claims, it's customer service.