Managing certificates of insurance (COIs) has always been a challenge. With increasing pressure on the budgets of state and local governments, dedicating the resources required to effectively manage this process can mean sacrificing time spent on other core functions. Relying on color-coded spreadsheets and a manual review process often leads to unsustainable procedures that fail to scale and adapt as an organization grows.
COI management is risk management
Although the process can be a time-draining administrative exercise, COI management is fundamental to managing risk transfer. The article Contractual Risk Transfer Issues: Reviewing Certificates of Insurance highlights the important role COIs play in risk management, noting, “Because many liability losses occur through the transfer of risk, it has become necessary for a Risk Control Consultant to assess the hazards and controls arising from contracts and agreements in a fashion similar to identifying other hazards, such as exposed wiring or missing guardrails.”
Most public entities are obligated to carefully monitor COI compliance in order to control unidentified risk transfer. Yet the administrative burden associated with endless cycles of hunting down updates and monitoring for expirations or deficiencies can easily exhaust any department. Given the mandate public entities have to stretch every resource to the furthest extent possible, the tension between the importance of an effective COI management process and the toll it takes on those managing it is difficult to resolve.
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Steve Schmutz is a successful entrepreneur with an extensive technical background and more than 20 years of experience in software design and implementation. He has founded and run two software companies, including Origami Compliance (formerly, ClaimWire, LLC), which integrates with any claims management system to provide automated workers’ compensation forms, compliance resources, and regulatory information.
Q: Why is the “build or buy” question important to consider?
A: The “build or buy” decision isn’t limited to software. It’s a question that has been around forever. Homeowners evaluate whether to pour their own patio or have a professional do it. Budding artists wonder if it would be best to create their own website or have a more experienced web designer do it. But when it comes to enterprise software, the stakes are much higher than many other situations. Making the wrong decision can cost millions of dollars and put your project years behind. We’re talking about the type of mistake that can, quite literally, take a company down.
Q: Where should an organization begin?
A: They should start by creating an exhaustive requirements list. Making the build-buy decision before knowing its requirements is like arriving at the airport before knowing where you’re going. The list should be as thorough as possible. Creating this is absolutely worth the effort. Doing so provides a true picture of the scope—breadth, depth, and length—of a project. Without an understanding of these details, it’s impossible to make an informed decision.
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An abundance of data accumulates in the claims management process. And while that data relays critical facts about each claim, that’s not the only insight it can provide. Data, no matter how seemingly unimportant, has the power to unleash valuable insight into your overall claims strategy. As the article Effective Data Discovery Can Be A Difference Maker For A Company’s Long-Term Success says, “Data that you may not even take into consideration can end up giving your company great insight after using proper analytics and data discovery techniques to make sense of it.” The failure to engage in data analytics means your organization may miss out on potentially rich data that sparks innovative strategy.
Benchmarking is one of the most powerful forms of data analytics. Used to measure competitor success and find areas for your organization to improve, benchmarking thrives on an abundance of data. With the right risk management information system (RMIS), you’ll not only be able to seamlessly collect troves of essential data, but also use benchmarking and other data analytics tools to extract meaning from it.
How does benchmarking make your data meaningful?
Data analytics can improve claim outcomes and, in some cases, help to prevent future claims by identifying trends and outliers that may otherwise go unnoticed. Benchmarking, specifically, involves comparing your data and performance against the industry’s best, which helps identify opportunities for improvement and establish long-term goals.
For example, risk managers, insurers, TPAs, and others who work with workers’ comp claims benefit from the annual Workers’ Compensation Benchmarking Study, conducted by Rising Medical Solutions. The study goes beyond merely reporting how claims payers are conducting business and outlines “how organizations turn the challenges identified in the prior studies into solutions and action.” The report’s mission is “to advance claims management in the industry by providing quantitative and qualitative research that identifies what high performing claims payers are doing differently than their peers.”
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Taking the time to evaluate your RMIS technology can play a part in ensuring your long-term risk management objectives are met. Equally important is an honest assessment of whether the RMIS support you’re receiving is meeting your expectations.
Your responses to the following questions may indicate that the relationship between you and your RMIS service team is in trouble.
#1 Has there been significant employee turnover?
For years, the users of prominent RMIS platforms have been forced to deal with service issues that stem, in part, from the departure of experienced RMIS support personnel. Rather than reaching a point of stabilization, M&A activity over the past year has been followed by rounds of layoffs, as well as account reassignment for the service team members who remain.
This turnover can leave you at a net deficit, as constant changes mean more work for you and your risk management team. As the article A Stranger is Calling: The impact of RMIS service team turnover points out, “a revolving door of service team personnel who need to be brought up to speed on the unique aspects of a RMIS and the risk management program it was put into place to support compounds the problem” of RMIS technology that may already be struggling to keep pace.
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Implementing an enterprise risk management (ERM) program can be a daunting, intimidating project. Trying to introduce new frameworks and controls across the organization, roll up risk reporting from the unit to enterprise level, and initiate discussions with the board that lead to action can be overwhelming. Using techniques proven to work with startups, however, can make the process far more manageable and increase the odds for success.
Startup incubators often promote a few common themes:
- Let customers/market dictate the product
- Scale it down – start small and go live fast
- Do the research and learn about the market
- Get feedback as quickly as possible
- Fail silently – incorporate lessons learned without dragging the whole effort down
These techniques suggest that the traditional high-profile, enterprise-wide rollout of a new ERM program may not always be the best way to launch. Instead, focusing on the smallest scale project—one with the potential to yield meaningful results—and relying on a customer-driven approach may be the key to creating a sustainable, effective ERM program.
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Technology can play a pivotal role in improving claims management by providing adjusters, claims managers, and other stakeholders with direct, centralized access to the pertinent claims information that they need to do their jobs. As Improving claims administration with an integrated solution points out, centralizing claims data in an integrated system “that combines workflow automation tools with all of the functionality needed for end-to-end claims adjusting can be transformative.” This is especially true when the system is used to streamline claims handling processes, increase adjuster productivity, and inform decisions that contribute to swift, cost-effective claim closure.
Improving incident reporting, controlling costs, and closing claims more quickly certainly count as claim management “wins.” Yet, as Christopher Mandel points out in Next-Level Claim Strategies, there is the potential to take claims management to an even higher level.
“Just when you thought risk managers understood and had explored all the opportunities around optimizing the claims management function, next-level opportunities emerge,” he writes at the outset of the article, which examines the shared goals, motivations, and hurdles that make up the “long minimized and largely untapped synergy between casualty claims (risk management) and the benefits world.”
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Risk managers looking to move on from spreadsheets or leave the limitations of a legacy system behind know what they want from a new RMIS. But they should also know there are certain things they’re entitled to. Given the size of the investment, as well as the fact that the system will support efforts to prevent losses, control costs, and inform decisions that impact an entire organization, there are—at a minimum—five critical elements that every risk manager should expect from their RMIS platform and service team.
#1 – A transparent, proven RMIS implementation process
RMIS implementations are complex endeavors. Promises of “quick” and “easy” should be taken with a grain of salt. As with IT projects of any size, the potential for unforeseen delays and changes in scope are not uncommon. You deserve to know where you stand throughout the implementation process. In addition to a detailed plan for delivery, the team you work with should also be experienced enough to anticipate and address potential problems, and have a track record of successfully responding to unforeseeable issues.
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Deciding to implement a RMIS system or make a RMIS switch comes with a range of emotions. There’s the excitement of knowing something better is on the horizon. There’s the nervous energy that comes with major change. There may even be dread over the daunting task ahead. After all, you know your current RMIS—warts and all—and a new one takes some time to get used to. But the payoff from getting a new system that’s adaptable to your organization’s specific needs can’t be overstated.
Don’t let the fear of implementation stop you from making a change that will reap benefits for years to come. With a straightforward plan in place that plays to your organization’s strengths, you can slay the implementation dragon—and even enjoy yourself along the way. Such was the case for non-profit professional association New Mexico Counties (NMC), which teamed up with Origami Risk to complete a highly successful implementation.
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A Risk & Insurance article recently stated that the souls of employees everywhere are saying, “Treat me like a human.” This applies to your claimants, as well. You’ve likely already considered many of the ways you can provide them better service, but you may have yet to tap into one of the keys to humanizing the claims process: automation.
The word is everywhere, as pervasive as the technology it’s infiltrating. Automation can bring to mind processes that are cold, robotic, and removed. So, considering software with automation functionalities may raise some hesitations. Will automation put distance between us and our clients? Will processes become mechanical and impersonal? How will this affect our service reputation and brand?
As the article Automation and AI: Miracle Tool or Hostile Takeover points out, automation “is neither the one answer nor a dangerous technology to be shunned. It’s another tool available to your organization, and every tool must be used effectively and for the right problem.”
Automation, when done properly, can bring more heart and soul into the work you do. Many manual processes consist of time-sucking drudgery. They leave you vulnerable to error and service headaches. They can become ingrained within your organization, forcing you to treat every claim or client the exact same way, despite variables, because deviating requires even more work. By using automation strategically, you’ll be able to deliver service to your claimants that’s more personal than ever. With a risk management information system (RMIS) that includes built-in automation, you can make humanizing the claims process a reality.
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Whether you’re an organization whose business is handling claims for others or one that administers its own claims, claimants are your customers. Viewing claimants through this lens will help focus your efforts on strengthening relationships and delivering better support. You also have the opportunity to go a step further and establish your reputation as truly customer-first. How? Through a straightforward branding exercise.
Before dismissing branding as something far removed from the claims world and better left to marketing and advertising executives, consider that every customer interaction further establishes an organization’s brand. Your reputation for customer service — however good or bad — is out there. You can continue with the status quo, or you can take control and push the narrative.
“Think about it,” says the Insurance Thought Leadership article 3.5 Ways to Deliver Happiness in Claims. “The claimant is going through your process during a time of grief, hardship and huge loss. Your process should not add to the stress. Your process should be easy. It should work to deliver a little happiness for them during this time. You want your beneficiaries to tell stories to their friends, family or other loved ones about how seamless your process was.”
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