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Insurance Claims Management with New Software Programs

The Role of Insurance Companies in Capital Markets
The insurance industry is a vital part of financial markets. Companies promote risk mitigation by offering individuals and organizations various types of insurance products. These products fall under two basic categories: life (temporary/permanent life insurance, annuities, retirement funds, money back policies, etc.); and non-life/general (property and casualty insurance, liability insurance, third party insurance, credit insurance, health insurance, etc.).

Proceeds from insurance products are converted to long-term investments on behalf and for the benefit of stakeholders, particularly insurance policyholders. These investments can be in the form of corporate stocks, government bonds, and other financial instruments that later earn a projected profit either upon a policyholder’s death or at a specified period of time for the insured and his/her beneficiaries. Thus, aside from national and global economies, the insurance industry is essential to personal well-being as well.

Insurance Claims Management: Challenges and Good Practices of Client Service
Unlike life insurance, general assurance protects people and businesses from economic losses caused by natural disasters and human-made injuries, as well as related legal liabilities. In both cases, however, insurers are aware that it is imperative for them to satisfy policyholders with company services. With this context, some companies have developed software programs designed to assist client insurance providers in their claims management needs, such as producing timely and high-quality reports.

R. Qaiser’s “Claims Management in General Insurance – Issues & Concerns” (n.d.) specifies underwriting and claims settlement as an insurance firm’s key functions. The article notes that the latter “can be used as a marketing tool” and helps retain customers. It also states how necessary it is for insurance companies to “manage” the nitty-gritty aspects of claims processing that includes determining the “Average time being taken for the settlement of a claim and the claim settlement ratio and how it compares with other operators in the market.” Moreover, “a corporate claims management philosophy” should be adopted to inspire insurance claims personnel in serving clients efficiently, including providing them with compensatory approaches, if applicable.

In 2004, the Organization for Economic Cooperation and Development (OECD) adopted a set of guidelines for good practice for insurance claim management. The OECD Insurance Committee defined these guidelines that serve as a benchmark for insurance companies in its member countries, including the United States (US). Such measure is aimed to improve the industry’s public image, to sustain its marketability, and to reduce losses. Adequate information and assistance to policyholders, good claim filing methods, and expeditious claim settlement were among the cited standards.

Providing Efficient Insurance Claims Service with New Software Programs
To help maintain a client base and achieve efficient claims management set by OECD, many companies have started developing software programs for insurance companies and professionals. With committed personnel and reliable IT (information technology) facilities that ensure confidentiality of data and are compatible with mobile communication gadgets like iPhone™, some reputed companies have developed software tools that can document and help analyze critical insurance narratives, financial, and statistical information. Let us take a look at some of them.

• Claims Management Software programs generally cater to Insurance and Risk Claims Departments, Third Party Claims Administrators, and Risk Managers, especially those involved in legal cases. They feature an advanced search mechanism that easily finds one or more needed files, information, and transaction records for general insurance claims on Property, Casualty, Workers Compensation, Liability, Commercial/Business, Auto/Motor/Vehicle, Public Entity, and Excess Coverage. They can produce reports that can be exported to spreadsheets, Microsoft Office applications, and ASCII text files.

• Some software programs track financial information relevant to construction defect litigation procedures. Data including payments, insurer shares, and other expenditures, are stored in a virtual repository that can be accessed anytime and anywhere by vendors, lawyers, adjusters/appraisers, and claims handlers.

• Some software programs equip insurance claims professionals with activity documentation, organized notes, and database references. They also provide billing techniques that instantly monitor time-bound tasks. These include work periods and communication with clients through phone calls, faxes, and mails, among others.