Achieving Effective Claims Payments | Insurance Thought Leadership (2024)

Digital solutions can make the high-stakes claims experience seamless, but industry data indicates a chasm between customer preferences and reality.

Insurance exists to mitigate the fallout from some of life’s most disruptive events. As such, claims are one of the most critical touchpoints for insurance companies. In moments of distress, it’s often easier for claimants to have a memorably negative experience with their insurance provider than a positive one, and waiting for a claims check in the mail or contending with complicated technology only exacerbates customer frustration.

Flexibility and accessibility are increasingly crucial when it comes to effective claim payments. Digital solutions have the power to make this high-stakes experience seamless for both insurers and policyholders, but industry data indicates a chasm between customer preferences and reality. Recent research conducted by InvoiceCloud, in partnership with Datos Insights, finds that while both claimants and insurers stand to benefit from a paperless shift, there are still stumbling blocks along the path that our industry must work to remove.

See also: Digital Underwriting Now a No-Brainer

Paper still reigns supreme

Most claims payments are still paid via check, even though this process is slower, less transparent, less secure and more expensive to manage than digital disbursem*nt. Not to mention that this manual method ignores policyholder preferences.

Seventy-three percent of those surveyed in InvoiceCloud’s State of Online Paymentsreport prefer to receive claims payments electronically. Not only does this streamline the payment experience, but electronic disbursem*nt also reduces the time and cost associated with printing and mailing paper checks, alleviating employee workloads. Paper claims are slower and less transparent, putting urgently anticipated payments at the mercy of everything from postal service disruptions to lengthy wait times for manual lienholder endorsem*nts. The rates of fraud when it comes to paper checks are also twice that of any other payment method, with JPMorgan Chasereporting that $1.3 billion was lost to check fraud in 2022.

Moving away from paper checks improves the claims experience for all involved. Yet, despite clear benefits to customers and insurers, most claims payments are still made via check.

This lag in the insurance industry is a disservice to claimants. Customers should be offered self-service resources long before they need them, so they can navigate the process for setting up paperless payment disbursem*nt on their own timeline, not during times of loss. The switch will also reduce stress and workloads for agents and the insurer’s customer service team.

The challenge of multiparty and lienholder disbursem*nts

A seamless transition to digital claim payments is even more important for multiparty and lienholder disbursem*nts. Outbound payments split between two or more recipients are one of the most significant challenges facing the insurance industry, especially when it comes to facilitating the paperless transition.

Fortunately, there are solutions that address this challenge head on. When the payment process is digitized, claimants, lienholders, vendors and partners can receive payments effortlessly in whichever way they choose.

When claimants receive traditional multiparty checks, they can face a host of issues. They may have to track down other claimants themselves or find a bank that can endorse this specific kind of check – and if there isn’t a local branch that can, the claimant may have to send the check to a larger bank, opening themselves up to theft or mail delays.

Modern solutions simplify this process with digitization. Following the claim, digital solutions will send payment to all the correct parties via their preferred payment method (direct deposit, check, gift card, etc.). This streamlined, digital process gets money to claimants faster, reduces the opportunity for fraud and saves time for everyone involved.

All of this is rapidly becoming the new normal. Carriers are beginning to appreciate the importance of claims interactions and are adopting tech to improve the touchpoint – keeping themselves competitive in the process. Customerswantto engage digitally. To keep policyholders satisfied and safeguard retention, it’s critical that insurers implement solutions that offer what customers want: digital options like real-time payments, mobile wallets and more. This is an easy way for companies to fulfill their commitment as an insurance provider and make their policyholders whole. At the same time, digitization helps insurers preserve costs, reduce calls to their office and get vendors paid quickly.

See also: The Need for 'Digital Fluency' in Insurance

An eye toward the claimant

Stressful and frustrating experiences while attempting to access disbursem*nts, either individually or as part of a multiparty claim, damage policyholder satisfaction. This, in turn, threatens retention. What’s more, the lack of paperless disbursem*nt options could affect an insurance company’s ability to attract new policyholders, perpetuating a vicious cycle.

High customer churn can also add stress for already overwhelmed employees in an industry facing a workforce shortage. When the severity and frequency of claims increase, they impair insurers’ ability to retain talent, leading to smaller teams with more work. Switching to digital outbound payments delivers claimants their ideal payment experience and thus improves their satisfaction. At the same time, it improves expense ratios. These solutions can also make it easier to meet security compliance requirements.

The gap between customer preferences and the current outbound payments market represents a significant opportunity for insurance innovation. Luckily, next-generation solutions are available in the market to bridge this gap. Facilitating a transition to paperless disbursem*nts creates a positive experience for policyholders, which is especially crucial in an industry with so few customer interactions. While it’s true that most people hope not to use their insurance policies, providing flexible digital options can go a long way toward improving the experience of those who do.

Achieving Effective Claims Payments | Insurance Thought Leadership (2024)

FAQs

Achieving Effective Claims Payments | Insurance Thought Leadership? ›

Flexibility and accessibility are increasingly crucial when it comes to effective claim payments. Digital solutions have the power to make this high-stakes experience seamless for both insurers and policyholders, but industry data indicates a chasm between customer preferences and reality.

How to improve claims process? ›

First, analyze the claim to understand why it isn't moving forward. Then, focus on ensuring that each claim has a clear path forward by developing training materials, providing individual training, and setting up new standard operation procedures (SOPs) and policies.

What is efficient claims management? ›

As a crucial component of the insurance value chain, claims management enables the proper handling and processing of claims efficiently and promptly. A set of well-designed claims management processes ensures that organizations can quickly address and resolve claims fairly and with optimal levels of customer service.

What is strategic claims management? ›

Strategic Claims Management (996) is intended for Claims specialists with several years' experience who are looking to develop their career through the route: Section Head; Departmental Claims Manager; Company Claims Manager and anyone who interacts with the claims function.

What are the 5 steps to file a claim? ›

Your insurance claim, step-by-step
  1. Connect with your broker. Your broker is your primary contact when it comes to your insurance policy – they should understand your situation and how to proceed. ...
  2. Claim investigation begins. ...
  3. Your policy is reviewed. ...
  4. Damage evaluation is conducted. ...
  5. Payment is arranged.

What is the first key to successful claims processing? ›

Patient Registration. It all begins with the initial patient check-in and collection of personal and insurance details. Accurate and complete information is a claims processing best practice. Registration information includes demographics, name, policy type, policy number, and group number.

What are the 4 phases of the claim process? ›

The insurance claim life cycle has four phases: adjudication, submission, payment, and processing. It can be difficult to remember what needs to happen at each phase of the insurance claims process.

What is effective claims management? ›

Claims Management Services include:

Manage the claims reporting process to ensure comprehensive claim data is submitted, resulting in favorable results for the client. Work with adjusters to ensure timely response and prompt claim resolution. Review reserves for appropriateness based on the type and severity of the ...

What is the claims ratio KPI? ›

The Claims Ratio KPI measures the number of claims in a period and divides that by the earned premium for the same period. It's important to note that insurance is the business of managing risks and, to do that well, the insurer needs a thorough understanding of the incurred claims ratio.

How to manage insurance claims? ›

The Steps of an Effective Claims Management Process
  1. ​Plan Ahead. ...
  2. Gather the Necessary Evidence. ...
  3. Identify Relevant Insurance Coverage. ...
  4. Reach Out to Your Insurance Broker. ...
  5. Cooperate With Your Insurance Adjuster. ...
  6. Keep in Touch With Stakeholders. ...
  7. Consider Expert Consultation to Strengthen Your Claim. ...
  8. Increased Productivity.

What is claims workflow? ›

What is A Claims Processing Workflow? The medical claim processing workflow is the set of steps that medical staff and insurance companies must take to ensure accurate and timely reimbursem*nt to the patient.

What are the objectives of claims management? ›

Effective claims management ensures that policyholders receive the compensation they are entitled to, fostering customer satisfaction and loyalty. It serves as the bridge between policyholders' needs and insurers' responsibilities.

What are claims analytics in insurance? ›

Claims analytics involves using data mining and data analysis to discover trends in your claims data that wouldn't be obvious on an individual level.

What is a claim checklist? ›

It functions as a to-do list, giving you an overview of the tasks required for each claim, along with labels, the due date, the assigned person and the action required.

What 4 things do you need to write a strong claim? ›

What Is a Main Claim Statement:
  • A claim must be arguable but stated as a fact. It must be debatable with inquiry and evidence; it is not a personal opinion or feeling.
  • A claim defines your writing's goals, direction, and scope.
  • A good claim is specific and asserts a focused argument.
Mar 13, 2018

What are 3 important things to do when you file a claim? ›

Here are some important steps to take in order to file your insurance claim.
  • Step 1: Call the Police if Necessary. ...
  • Step 2: Document Everything and Exchange Information. ...
  • Step 3: Contact Your Insurance Company. ...
  • Step 4: Filing Your Insurance Claim.

How can I make my claim process faster? ›

1. Contact Your Insurer Immediately. The sooner you contact your insurer to file a claim, the easier it will be for your adjuster to make the necessary inquiries to get your claim moving along. Call your insurance company as soon as possible – ideally from the scene of the accident, if you can do so safely.

What are the three things that make strong claim? ›

To be strong and effective, a claim should be debatable, focused, and specific.

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