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CLAIMS DOWNLOAD, WHAT IS THE BENEFIT TO AGENTS VS

Emerging Tools to Give Independent Agents & Brokers Better
 
Information on Claims
 
by
 
Donna J. Barr, Marsh, Inc.
 
This article discusses technology tools that are being introduced to permit independent agents and brokers to serve their clients more promptly and effectively in claims situations. Claims download, real-time claim inquiry, real-time filing of First Notice of Loss (FNOL), and real-time requests for loss runs all have great promise to make agency workflows more efficient. Most of these new capabilities have already been introduced by some carriers, but we need to see much broader usage. The agents will play the critical role in making this happen, but first they need to be convinced that these new technologies will materially improve their workflows. This article seeks to make that case.
 
One of the most exciting new opportunities is for the automatic downloading of new claims and claims status information into agency management systems. An ACORD standard has been put in place for claims download, and the vendors and carriers are beginning to move toward implementation. However, an agent might ask: “How exactly will claims download benefit me? I already have claim inquiry available via carrier websites or through my agency management system using real-time inquiry.” Or, the agent might say: “Why do I need download, when I already receive a real-time alert message into my agency management system or an e-mail that tells me there is a claim?”
 
Real-time claim inquiry has been a great enhancement for agents and will continue to be so for up-to-the-minute information. But, it is only beneficial if the agent knows the claim has taken place! Further, real-time claim inquiry does not populate the agency management system’s database, and so the agent must enter the claims information into his or her system. Alerts or e-mail notifications are also great “incremental” steps, but again, the agent has to enter the claim into the agency management system and update the information as the status of the claim changes.
 
The goal is for all of the latest features of technology to work hand-in-hand to make the claims process as streamlined as possible.
 
This year’s horrific hurricane season provides an instructive example as to how claims download can help agencies. If an agent has had no power and has had clients reporting claims directly to the carrier, how does he or she know what claims have been filed? Once the agency finds out about the claims, who is going to enter the hundreds or thousands of claims into its agency management system? Who is going to update the status on each of the claims, as it is paid or closed? The agency’s employees are already working overtime under terrific stress, and they want the needed claims information to be handy in their system. They want to spend their limited time assisting their clients regarding the claim and demonstrating the value added that their agency provides to its clients. The last thing these employees want to spend hours upon hours doing is entering all of this claims information into their system.
 
Claims download would allow for all of the claims to be automatically entered into the agency management system, updated as the status is changed, and closed when the carrier closes it. Claims download would save the typical agency hundreds of hours per year, as well as enable agency employees to provide better service to their clients should a claim occur.
 
The question, then, is how do claims download, real-time claims inquiries and e-mail or alert messages work most efficiently together? Consider the following workflow:
 
1) The claim is reported directly to the carrier by the client (FNOL reported by the agent is a different workflow and is addressed below.).
 
2) An alert or e-mail message is sent to the agency instantly notifying it of the loss.
 
3) Overnight, the claims are processed via a batch process into the agency management system.
 
4) A log is waiting for the agent in the morning, when he or she comes in to review what was attached (similar to policy download) and what went to suspense to be attached.
 
5) The claim is now in the agency management system and is ready to be serviced.
 
6) Claim inquiry can be used at this point to look at anything that has transpired during the current day, if necessary. An example would be that the adjuster had not been assigned when the claim was downloaded, and you need to get that information today.
 
7) Any updates to the claim will download each night (or at given intervals during the day, if the carrier and vendor provide this feature). Again, this download information will populate a log for review.
 
8) The agency is also now in the position to run reports from the agency management system to track losses.
 
Another very important technology for agencies is real-time FNOL claim reporting, where the agent can submit the claim to the carrier and instantly get back the claim number and adjuster for the claim. What a terrific service to be able to provide the client with this information on the spot! Even where the agent is using real-time FNOL, however, claims download still plays an important role, because it allows for the automatic updating of the status of the claim, including payments made, adjuster notes, and the closure of the file.
 
Requesting loss runs through the agency management system and receiving them back in real-time from the carrier is another significant improvement for agents, providing clients with immediate service and saving considerable time for the agent.
 
Whether we are talking about claims download or real-time claim inquiry, FNOL, or loss runs, agents will play the critical role in making these improved workflows a reality within our industry. Agents need to advocate for these improvements, and then “walk the walk” by implementing them within their agencies when they are introduced by particular carriers. High agency usage will be the dominant factor in convincing additional carriers to leave the sidelines and join the game by implementing these new capabilities.
 
As exciting as these new technologies are, the future will require the industry to take yet another step, and that is to permit the agency’s clients to access their claims information directly from the agency’s website. Claims download and real-time claims inquiry will provide the foundation for this enhanced consumer capability. Consider once again what this would mean to an agency devastated by a disaster, struggling to make or receive phone calls of any kind. What a godsend it would be if anxious clients could go to the agency’s website and learn that their claim has been received and is in processing, and receive the assigned adjuster’s contact information. This is the future, and agents, carriers, and vendors need to continue to work together to harness the exciting technologies that are available to us today to significantly improve the overall customer experience and to make our distribution system more efficient and responsive.
 
Donna Barr is an Assistant Vice President of Marsh USA, Inc., and Chair of the ACORD Claims Download Working Group. She is dedicated to improving the technologies and workflows available to independent agents and brokers, both internally and with their insurance carriers. She is deeply involved in ACT, AUGIE, ACORD, and ASCnet, her user group. Donna Barr can be reached at donna.j.barr@marsh.com. She prepared this article for the Agents Council for Technology (ACT) which is part of the Independent Insurance Agents & Brokers of America. For more information about ACT, contact Jeff Yates, ACT’s Executive Director, who can be reached at jeff.yates@iiaba.net. This article reflects the views of the author and should not be construed as an official statement by ACT.
 
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