Separating Content Claims Handling from Adjusting
By Andy Williams, Founder, e-djuster
(Published in Without Prejudice, reprinted with permission)
Are there piles of unfinished content claims on your desk?
How long have they been there? Weeks? Months? And what causes the delays? What if there
was a way to speed up the whole process?
At e-djuster these issues have been thoroughly researched
over the seven years since founding the Company. Our focus has been on Content Claims,
since so many apparently difficult problems arise from seemingly simple requirements. Big
challenges arise, for example, from the need to have a list of lost or damaged items from
the policyholder, an accurate assessment of what needs to be replaced, and valid replacement prices.
To avoid adding to adjuster workloads, we found it
necessary to do an end-to-end examination of the content claims life cycle, develop a
complete list of problems to solve, and outline integrated new processes. It was
imperative that the new processes achieve two goals – assist the policyholder, and
make the adjuster’s life easier when dealing with content claims.
Industry Trends
Insurance industry trends are demanding. Higher levels of
customer service, improved efficiency in claims handling, and the use of new technologies
are desperately needed. As the consumer society has evolved, content claims have become
more complex and time consuming. The demand for providing a greater selection of goods and
services to suit the needs of the policyholder has become more challenging. People are
less interested in replacing with the same items due to the many new choices now
available. A “new standard system” for content claims handling needs to be implemented, one
that promotes a positive insurer image and options to assist with the settlement process.
Re-examining the Content Claims Process
Our examination found several areas with serious issues and potential for improvement:
Customer Service
At a time of loss, policyholders are devastated and need
support and guidance through the claim process. The documentation of damaged items is a
daunting task for a person at a time of crisis. Personal service from contents specialists
can provide the comfort to the policyholder. People providing this support need training
and tools. The goal is to have support people available with knowledge of item assessment
and quantification, accessing price information efficiently, and working with the adjuster
and other contractors to provide service to the policyholder at a time when it is needed most.
Rapid Response
Providing trained people on-site for a detailed analysis of
contents needs to be done rapidly, usually within 2-3 days. This avoids problems with item shipping,
transporting and storage expenses, as well as loss of memory as to the accurate details of the loss.
Quantification
Traditional processes that focus on providing the
policyholder with schedule of loss forms give control of the claim details and the claim
financial obligations to the policyholder. Especially in a large loss, the quantification
process must involve a detailed on-site room-by-room cataloguing of each individual
destroyed item. This process is time-consuming – but it is critical in establishing
control of the claim and preventing claim leakage. The policyholder is not equipped with
the knowledge and tools to do this alone.
Research and Pricing
The research and pricing of all items need to be
effectively handled and based on like kind and quality. Custom software tools are needed,
with content claims functionality to allow efficient and accurate research, pricing and
management through the claim life cycle.
Timely Claims Settlement
Contents quantification issues often cause claim settlement
delays. When adjusters have difficulties getting the necessary item details and
valuations, it is difficult to assess fair and accurate cash values. This usually leads to
inflation of claim settlements, as well as other problems tending to add cost.
Separating Content Claims from Adjusting
With workloads having doubled in the past 10 years,
today’s adjusters fulfill a critical role as claims managers. They no longer have
time to spend on contents quantification, thorough research, or shopping for the most accurate price.
Our recommendation: Separate the contents handling from the
adjusting, allowing the adjuster more time to serve the policyholder as a representative
of the insurance company. Separately addressing the issue of content claims handling,
similarly to the way the industry uses contractors for structural damage, tends to allow
today’s insurance adjusters to better focus on the key “roles of adjusting”.
Adjusters can thus manage all parties involved in the
claims process and spend the necessary time needed in reaching fair and accurate claim
settlements in a timely manner. Fundamentally, we have discovered that the separation of
the two not only raises insurer image and reputation, it improves efficiency, promotes
lower claim settlement costs and enables greater adjuster productivity.
Re-engineering the Process
Development of reliable new process solutions has taken
several years. By conducting intensive field-testing, we have been able to fully
understand the core issues related to handling all types and sizes of content claims.
Rather than developing technology-only tools that may or
may not fit the needs of a particular insurer, we chose to re-engineer the overall
process. Professional and impartial assessment and pricing of each individual item is
provided to protect against padded and inflated claim listings, and put control of the
claim back in the hands of the adjuster. This support needs to be available on site or
over the telephone, depending on the adjuster’s view of claim severity.
Within this system, the common express claims can be
processed in 48 hours, while large and total loss claims are usually processed within six
weeks. Thus, insurance companies free cash reserves up, and legal fees are reduced.
Detailed content claim reporting provides the adjuster with
settlement options that are no longer fully dependent on the cumbersome process of
replacing items. This results in a significant reduction in indemnity dollars being paid
out, and lower overall claim handling costs.
Summary
Re-evaluating the contents claim life cycle and clarifying
the current requirements led to definition of a new system. It provides a new step-by-step
process, defines the training requirements, and provides the technology tools –
delivering a set of “best practices” for content claims handling, with broad
applicability. The process benefits everyone involved in the claims process including
adjusters, industry contractors, outside vendors, claims examiners and claims management.
So let’s start clearing all those contents files off your desk!
For more information about e-djuster and their content
claims services, please call 1-866-779-5950 or visit on-line at
www.e-djuster.com.
