Insurance Basics: Understanding Claim Management Solutions

Insurance Basics: Understanding Claim Management Solutions

By Mainak Biswas December 14, 2015 - 2,208 views

There is a lot more awareness about insurance these days than ever before. With marketing and social media strategies helping insurance companies, we see an increasing number of people buying policies for everything they possibly can. While it is a good sign for insurance companies, a lot of people also claim insurance these days when things go wrong. It is difficult for financial institutions to review every insurance claim manually.

Reviewing these claims alone costs a lot of money and resources. Insurance officials admit that they spend more money on processing claims than they would actually do on marketing or getting people to buy policies. At the end of the day, insurance companies want people to buy policies and not actually have to pay insurers money when they file claims.

One of the ways insurance companies can ensure that both customers and the companies are happy is to use automation software programs. Claims management solutions help insurance companies to do precisely that. They help in running operations so that customer service is improved and errors are minimized, leading to customer satisfaction and also reduction of time resources.

Insurance companies can also ensure that legal formalities and payment handling are done automatically, all of which previously required expensive legal and clerical staff support. With all this in mind, it only makes sense to go ahead with claims management solutions full on.

In this article, let us take a look at what a typical claims management solution does.

What does a claims management solution actually do?

A good claims management solution offers adjudication support all through the timeline of a claim. This applies to both personal and commercial claims. Whether it is about the first notice of loss or reducing the payments made to claimants, these automation solutions increase customer satisfaction and boost revenues.

A good claims management solution helps insurance companies to setup claims and then process first notice of loss. Next, it helps the company to investigate these claims and engage in adjudication and subrogation. Along the way, these solutions provide important analytics which help in understanding the severity of the claims made and also detect frauds, if any.

Further, it also helps in certain consulting operations including benchmarking, lean transformation. Last but not the least, a claims management solution is a software program, which means, you receive the best IT support you possibly can for your insurance company. All this helps to streamline the claims processing system and ensures enhanced customer support and satisfaction.

How claims management solutions help you enhance customer relationship

Claims management solutions also provide data correction and call center services. These are important points of contact that help customers and your staff to reach a sort of agreement. When a customer makes a claim, it needs to be entered in an orderly manner before being processed. Manual entry of claims can lead to inadvertent errors and mistakes.

Automating this process helps in increasing transparency and ensuring that you don’t fall victim to fraudulent claims nor will the customer miss out on genuine payments that you should be making to them. All in all, these sorts of solutions accelerate claims processing and builds a healthy attitude towards insurance companies in the market.

It should be well noted that most of the time customers even choose not to make claims because the process of doing so is so convoluted. When making insurance claims are automated, it helps the customer to enter data himself or herself, without your staff having to do so. In case of disasters or emergencies, your customer will appreciate this speedy processing of claims.

Cloud based solutions only help you to take it all a step further

Claim management software solutions are cloud based and ensure that all data is stored on cloud servers. This means, all the data related to insurance policies are encrypted and there is no chance of this data being accessed by unsavory individuals. It also helps to know that all this can be stored for a relatively lower cost than you probably would if you still used legacy systems.

Moreover, the reports, the metrics and the analytics help you to understand wider insurance trends that will help you to make policies with respect to claims processing. Claims analytics provide valuable data and reports with respect to what is really happening and that is something that you as an insurance company cannot take for granted.

After all, it is known that more than 80% of an insurance company’s costs go towards claims and claims processing, even if they are not paid back to the customer. Automating this expensive but repetitive task ensures clarity, transparency and also a more contemporary approach towards solving problems.

What the future holds for insurance companies with respect to automation

Insurance companies will likely see an increased number of claims being made in the near future, simply because of the sheer number of people who buy insurance policies these days. This means, companies will need to be wary of fraudulent claims and also ensure that they don’t end up paying more than what they legally are required to.

Next, companies will have to be wary about storing encrypted data and this should be done only on a trusted cloud server. All this data should be processed and analyzed by trusted claims management software programs so that malicious entities do not get hold of your customer’s valuable data.

A good claims management system will ensure that all data is processed effectively and safely and that everything happens quickly. It also ensures that you have access to good customer care and that your company always has access to top-notch IT solutions in the form of claims management solutions.

Last but not the least, insurance companies should start moving away from legacy systems and programs and opt for cloud-based technologies that will help them to automate their regular tasks and focus on what is really important. After all, it is important to maintain a balance between understanding why people are claiming insurance and then processing those claims in a fair and transparent manner.

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