Have a happy and safe 4th of July 2022!
Claims management refers to the way an insurance company or third party administrator settles claims made by insured parties for incurred losses that are covered by an insurance policy or contract. Insurance companies need to exercise extreme caution when assessing losses. They do this to avoid overpaying the claimant. On the contrary, claims management companies that make claims on behalf of policyholders do their best to improve claim outcomes.
If you are looking to increase your success in making a claim against an insurer, here are some important things you need to do:
Appreciate the importance of professional claims management services.
The professional assistance of capable risk claims management provider like Action Claim Service can be an invaluable help to your organization. This is the reason why you should be able to identify this need early on. Many organizations consider it as an added expense but in reality, claims management professionals can take a major load off your employees. It allows your staff to focus on their main duties and makes them more productive in the process.
Effectively use claims data.
Claims carry a lot of data. With the help of the right technology like artificial intelligence, a competent loss assessor will be able to:
- Identify claims with high potential for fraud
- Determine claims that require additional medical processes to ascertain that the present treatment is in accordance with best practices
- Detect claims with high potential for litigation.
- See claims with potential to do well with the aid of a competent risk claims adjuster
Implement a structured task recording system.
By systematically recording everything within the claim file, all the parties involved in the claims process will know what happened and who made it happen. Things that need to be recorded include medical diagnoses, adjuster notes, settlement authority, etc.
Stick to the 24-hour rule in responding to claims.
All companies should act on claims as soon as possible. Claims that are left to lag on for days or weeks, can become more costly. A delay in response time can also be understood by workers’ compensation claimants as a lack of concern on your part.
Implement a solid return-to-work program.
The longer a sick or injured employee stays out of work, the greater the costs will be. Add to it the worker’s lost productivity and see why a clear and firm return-to-work policy is necessary.
Consider your service providers a part of your risk management team.
Your service providers include lawyers, medical professionals, contractors, auto repair shops, third party administrators and medical case managers. They contribute to the overall safety and well being of your workers.You must consider them as members of your risk management team. Get to know each of them personally and let them be aware of what you expect from them performance wise. Also let them know of their accountability towards you as their customer and partner.
Use medical dashboards to their fullest potential.
A medical dashboard is a tool for healthcare analytics. It can contain everything you might want to know in order to assess the success potentials of your claim.
Seek the assistance of an experienced risk claims management specialist to get the best possible remuneration from losses you don’t expect. Entrust your property loss, workers’ compensation and other insurance claims to experts. Call Action Claim Service today at (888) 691-1095.
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