Reduce Claims Mis-assignment and Reassignment in FNOL
- Rick Tucker
- Sep 20, 2024
- 2 min read
Case Study # 1 from the recently published eBook
Our Story:
It was another busy day at the claims processing center for a major Midwest insurance carrier. Claim files were piling up, and adjusters were scrambling to investigate and resolve each case as quickly as possible. However, one glaring issue had management's attention – the alarmingly high rate of re-assignments for complex claims. On average, each case was being passed around between four different adjusters before reaching a resolution.
Determined to get to the root of this inefficiency, the carrier's leadership decided to take a deep-dive into their recorded first notice of loss (FNOL) calls. By transposing these initial claims recordings into their Celonis process mining platform, they could analyze the data for patterns and potential issues in their procedures.
What they uncovered was eye-opening. Their analysis revealed that the Northeast region's call center representatives were consistently failing to ask critical questions about the medical conditions of drivers and passengers involved in accidents. This lapse in information gathering was leading to incomplete claims files that required multiple re-assignments and requests for additional details.
Armed with this newfound insight, the carrier swiftly implemented revised call scripts and comprehensive training programs. Call center staff in the northeast were retrained on the importance of thoroughly documenting all relevant medical information during that crucial first notice of loss. With these improved processes in place, the carrier was able to drastically reduce the number of re-assignments for complex claims, streamlining their operations and providing better service to their customers.
In addition, they were able to use process intelligence to monitor and control the desired actions, and react in real-time to address non-compliance work steps as they happen in the claims process.
How Process Intelligence Helped
Discovered which types of claims are getting mis-assigned
Identify root causes such as missing information (questions not asked) in FNOL
Understand just how dramatic re-assignment impacts customer satisfaction (due to asking for the same information at each step in the process)
Key Claims Statistics
The cost of new scripts and training was less than $50,000.
Reassignments average dropped to 2.1, saving $1,240,000 in rework
Check out the table of contents for the rest of the claims stories
Our eBook Partner
Celonis is your gateway to Process Intelligence
About Celonis
Since 2011, Celonis has helped thousands of the world’s largest and most esteemed companies yield immediate cash impact, radically improve customer experience, and reduce
carbon emissions.
Its Process Intelligence platform uses industry-leading process mining technology and AI to present companies with a living digital twin of their end-to-end processes. For the first time, everyone in an organization has a common language for how the business runs, visibility into where value is hiding, and the ability to capture it.
Celonis is headquartered in Munich, Germany and New York City, USA with more than 20
offices worldwide.
Reducing claim re-assignments after FNOL is crucial. Imagine navigating a tricky slope in Snow Rider ; you wouldn't want to keep restarting, right? Similarly, asking the right questions upfront avoids costly re-routing of claims. A recent case study highlights how better FNOL data gathering significantly cut down on re-assignments, boosting efficiency and customer satisfaction. Clear communication at the start is key to a smooth ride.
When it comes to getting Assignment help USA, this is one of the most important aspects that many people forget to take into account. To get the best possible results from the assignment, the central concept that underlies it needs to be original and in line with the student’s characteristics. Therefore, the representative will ensure that you receive an accurate assessment of your way of thinking to ensure that you will be able to effectively meet the project requirements.
This article provides a really insightful take on reducing claim mis-assignment during the FNOL process. It’s clear that streamlining the initial steps can save both time and resources for insurance providers. I recently had a similar experience while researching workflow optimization in other industries, like montreal hair salons, where efficiency and correct task delegation are crucial to customer satisfaction. Just like in insurance, small mistakes in task assignment can snowball into bigger issues. It’s impressive how technology and structured protocols are helping solve such challenges. Looking forward to more posts like this that dive into operational improvements.
Math homework help provides students with the support they need to tackle challenging problems and build confidence in their mathematical abilities. Whether it's algebra, geometry, calculus, or statistics, expert assistance can simplify complex concepts and offer step-by-step solutions that enhance understanding.
FNOL sürecinde yanlış atanan veya tekrar atanan taleplerin sayısını azaltmanın ne kadar önemli olduğunu kendi deneyimlerimden biliyorum. Ziyaret Et seçeneğini kullanarak bu konuda sunulan çözümü daha yakından inceledim ve gerçekten etkileyici buldum. Doğru yönlendirme sayesinde hem müşteri memnuniyeti artıyor hem de operasyonel verimlilik ciddi şekilde gelişiyor. Taleplerin baştan doğru kişiye ulaşması, süreci hem hızlandırıyor hem de maliyetleri azaltıyor. Özellikle sigorta sektöründe bu tür dijital çözümler her geçen gün daha fazla önem kazanıyor. Bu yaklaşımı uygulamak isteyen firmalar için kesinlikle dikkate değer bir yöntem olduğunu düşünüyorum.