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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The challenges that businesses face don’t simply disappear when they cease to be industry buzzwords. For example, articles about the move toward a “paperless office” have, for the most part, been replaced by those covering topics such as AI, robotic process automation, or the use of data from drones, wearables, and the internet of things (IoT). This comes as no surprise. New technology warrants coverage and generates more clicks.
Yet the reality is that many businesses are very much still dealing with paper—desktops, drawers, and box upon boxes upon boxes of paper. Even with the switch from paper to electronic documents, organizations still face bottlenecks in processes related to the handling of critical risk, safety, claims, and policy-related files.
The move from a legacy system to a cloud-based RMIS can help alleviate the burden of managing these paper documents. And while there are many reasons for digitizing paper documents, the real benefits for an organization lie in the potential for breaking free from the constraints and limitations of processes created around paper.
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A 2016 analysis published in BMJ revealed that medical error is the third-leading cause of death in the United States. This includes process errors, planning errors, and failures to act. Martin Makary, a health policy expert at Johns Hopkins and an author of the analysis, explains that the “complex medical system” in the U.S. “sometimes lacks transparency that results in the wide variation in quality of medical care that is the endemic problem in safety.” Makary also notes that “safety nets are missing and standardization is lacking.”
At the heart of this standardization problem lies outdated technology and confusing systems. Many healthcare providers continue to use lagging systems that don’t efficiently collect or analyze data. Furthermore, a mix of legacy and new systems makes for potential conflicts that add to the confusion and fortify workplace silos. Without the sharing of information, organizations fail to see big-picture strategies and solutions that could help prevent medical errors and increase patient safety.
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Another Groundhog Day has come and gone. Or has it?
In the movie Groundhog Day, weatherman Phil Connors (played by Bill Murray) is forced to relive the same day, over and over again, no matter how he tries to change the outcome. The Environmental, Health and Safety Newsletter recently compared the latest release of the Census of Fatal Occupational Injuries with previous years and observed a similar phenomenon.
The article notes, “The latest census is remarkably consistent with the previous reports. People continue to die in numbers, proportions and circumstances much as they did the year before, and the year before that and the year before that. There are a lot of Groundhog Days in how we’re getting killed on the job.” Even worse is the fact that these factors are no secret. “The same hazards keep killing workers,” the article continues. “What’s most likely to kill someone is not a trick question. It’s an open-book exam.”
If something as critical as lowering workplace deaths can get trapped in an endless cycle of no progress, it shows just how immovable some of these challenges can be. Lack of desire or effort isn’t always to blame.
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We all want reassurance that the work we do matters—that we’re contributing in a way that matters. Author, consultant, and speaker Norman Marks, in a blog post titled Internal audit needs to perform in a way that matters to the board and top management, puts forth a series of questions that prompt those guiding internal audit to consider whether their efforts actually support leadership’s ability to set and achieve organizational objectives.
“Internal audit can help leaders with assurance that their people, systems, and processes are able to deliver the desired results – and advice and insight on how to improve them further,” Marks writes. “But do we?”
Contributing greater value to the board and top management by serving as a knowledgeable and respected advisor may require a shift in thinking about the role that internal audit plays within the organization. It is also likely to necessitate a change in audit planning and practices. Audits themselves must be seen as a critical component of a more holistic and continuous approach to identifying and analyzing risk, evaluating the effectiveness of controls, and proactively addressing areas of weakness.
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Standing atop Mount Everest is an extraordinarily rare feat. Since the first reported ascent in 1953, only 5,000 people have reached the mountain’s 29,029-foot peak. Over the same span of time, nearly 300 have died attempting to do so. And while making it to the top of Everest is tough, having the fortitude to turn back when the summit is within reach can be even more difficult.
The costs of climbing Everest are significant. In addition to spending roughly $100,000 for a single attempt, the time climbers put into planning and training for the venture is typically measured in years. Given these investments of time, energy, and money, many climbers not surprisingly push on in the face of extreme weather, oxygen depletion, and increasingly bleak odds. Unfortunately, the drive to make the investment “pay off” costs some their lives.
In a season 1 episode of the podcast Choiceology with Dan Heath, Michael Roberto of the Harvard Business School refers to this phenomenon as a sunk cost trap. In a sunk cost trap, Roberto explains that the human mind obscures rational thought because of emotional attachments already ‘sunk’ into achieving a goal. We all experience sunk cost traps in our daily lives: holding on too long to a bad investment, staying in a bad relationship, or refusing to walk out of a bad movie on your first night out in months.
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