What are the KPIs for improving insurance claims processing efficiency?

Improve the way you capture your FNOLs and receipt of documents to measure timing to process claims from FNOL to settlement or denial.

Implementing technologies like automation, machine learning, and robotic process automation (RPA) to automate repetitive tasks, reduce errors, and speed up processing can reduce time to close

STPs or straight through processing flows. Identifying opportunities of automation in your claim system, can reduce the claim processing time. For example, building rules related to automated fraud detection, robust payment mechanisms are some examples where automation processes can be built in the system. This will help to reduce the overall claim processing time

Claims Processing Time: Measure the time it takes to process a claim from submission to resolution. First-Time Resolution Rate: Track the percentage of claims that are resolved without the need for rework or additional processing. Customer Satisfaction: Gauge customer satisfaction through surveys or feedback to ensure a positive claims experience. Accuracy of Claims Handling: Assess the accuracy of claims processing to minimize errors and reduce the need for reevaluation.

Auditing claims supporting information and post settlement review sampling can help improve the accuracy rates and reduce inconsistences in adjustments

I'd say regular auditing of claims data and cleaning it, can lead to removing errors or inconsistencies. Ensuring that validation checks are implemented to maintain accuracy and completeness of information. These are some ways you can enhance the claims accuracy rate.

The P&C Space is reactive. Whether it is reacting to weather, fraud, litigation, it reacts. When risks are written, especially high TIV (Total Insured Value) the industry doesn't truly know the risk. Therefore it doesn't have a baseline to measure against post loss. This creates a lot of ambiguity and leakage. Creating that baseline is key to reducing claims leakage rate. Curious about this? Let's chat.

Average hold time to report a claim FNOL to inspection Estimate submission to File Review File Review to disposition At the end of the day, the KPI of all KPI’ is NPS. What’s yours?

Ongoing staff training is critical to ensure vigilance against errors and fraud. Clear customer communication minimizes overpayments. Monitoring claim performance and fostering staff accountability enhance overall efficiency. Collaboration with stakeholders aligns processes and addresses systemic issues. These are some of the methods that can help reduce the leakage rate.

I agree - The Customer Satisfaction Score (CSAT) is a valuable metric reflecting the perceived quality of your claims service. By understanding that it's derived from customer ratings based on their experience and expectations, you gain insight into their satisfaction and loyalty. Soliciting and acting on customer feedback completes the loop. Actively seeking input shows a commitment to improvement, and addressing concerns or suggestions can positively impact satisfaction. In essence, a well-managed claims service, coupled with transparent communication, flexibility, and responsiveness to feedback, contributes to an elevated customer satisfaction score and strengthens your overall relationship with policyholders.

Cycle time is always a focus. However, I see the best results when I coach the skill of decision making, which has proven to be the best root cause approach to claims management. There is a compounding effect to the results you see when you empower your claims team. If you pull a report that says an adjuster has a poor cycle time and you coach to the metric by focusing on speed, this could lead to a decrease in accuracy and customer satisfaction. Instead of simply focusing on how fast claims are closed, use cycle time as a signal to identify areas where adjusters might need help with decision-making. By coaching them to improve these skills, you'll see a positive impact on cycle time, accuracy, and customer satisfaction.

Here are few more critical KPIs: #Claims Touchpoints: Monitor the number of times a claim is touched or processed by different individuals or departments. Reducing unnecessary touchpoints can streamline the process and minimize delays. # Customer Retention Rates Post-Claim: Assess how well the claims process impacts customer retention. A positive correlation indicates that efficient claims handling contributes to customer loyalty.

Sometimes, it might be helpful or useful if you can tailor-made the claims process according to products features or reportable amounts. Then you can have a prior standardized faster track of claim settlement or handling in place. Your claim receptionists will have clear guidance to follow. In most circumstances, it costs time because of double-checking done by the front staff.