Insurance claims management is varied by every agency I walk into. I have seen everything from someone hand drawing out what happened in the claim (on every single claim) to agencies that just give the person the claims number and move on. While both of these insurance processes are extremes we all need to get very clear, claims are the only time your client uses our product. For this reason alone we need to identify the best insurance claims management strategy.
Here are some common insurance claims process challenges we see:
- Agencies don’t have a consistent process so every team member handles claims differently
- Agencies don’t have a plan to check carrier websites so they are only aware when it downloads or when a client calls in
- Clients with claims are encouraged to call the carrier without a warm transfer or guidance
- Claims aren’t followed up on to ensure a great experience
- Agencies don’t fully embrace that claims are a word of mouth experience – everyone in that clients circle is asking them how they are doing you can win or lose in these moments
For these reasons we need to outline what a rockstar agency does to encourage the best experience for insurance claims management.
Does Your Agency Need a Claims Specialist?
Some of our agencies have a claims specialist and others opt to have their team manage claims. Here is the reality. I think we all wish we didn’t have enough claims to need a whole specialist! However, as the agency grows having the right person on claims can be a huge benefit to your clients and agency. While we can’t say here is the best time to hire a claims specialist, we can say it takes the right person to handle claims. It’s not a job for everyone.
A claims specialist will take all inbound claims as well as contact clients who called the carrier. They update the notes, coach and guide the client and are deeply involved in your large and complex claims. For commercial they are in tune with commercial lines to clear out and close claims that may impact renewal. In addition they also read the policies and work the claims adjusters to make your client whole. The right person is empathetic, detailed, organized and proficient in reading policy language. They have to have a backbone to work with adjuster and a soft touch to deal with a distraught client. Patience is a great skill for this team member to have.
Insurance Claims Management Process
If you’re looking for a great claims management process it all starts with answering some key questions. In our Insurance Claims Process Pack we walk you through making key decisions on your process before outlining the entire process. Let’s review the top decisions you need to make:
- Will your agency reach out to clients who directly file with the carrier?
- Do you use claims download? Are all the carriers downloading?
- Where will you document claims in your management system (some systems have a claims area)
- What activity code (label, action code etc.) will you use in your system to track claims?
- What do you want your follow up process to entail?
- Do you want to send a survey after a clam to gather feedback?
- How will you distribute the survey (text, email, mail?) Hint, we have a sample survey in our Insurance Claims Process Pack
- Will you ask the satisfied clients for an online review?
Many times in claims we dive into the details we want to be upfront and clear that claims represent an opportunity for growth.
Overview Of Insurance Claims Process
Now that your agency is ready to create your claims process we will walk you through the ideal steps to consider. We want the insured to be at the absolute center of the process. Your client doesn’t have claims every day so we want to make sure their experience is tailored to them. Claims can be very emotional, overwhelming and provide uncertainty. Have you ever been displaced from your home due to a claim? I have – it plays with your emotions and people aren’t at their absolute best. We need to be here and be their insurance hero.
Step 1: Insurance Claim Occurs
When the insured has a claim everything from a chipped windshield to a fatality at a worksite no one is happy. Claims are upsetting for many people. For this reason we need to meet people where they are and provide ultimate kindness even if the person is upset.
Client Contacts The Carrier Directly
Some clients will contact their carrier directly, in particular if it’s an evening or weekend. Most insureds don’t want to wait. Also, if your client doesn’t remember you the carrier is their direct link to reporting the claim. For this reason we recommend that there is an insurance agency process that goes to carrier websites and checks the claims so you know who is impacted and you can follow your process to reach out and follow up on the claim. Here is what this may look like:
- Daily a team member or virtual assistant review the carrier download list and or goes to the carrier website to pull claims
- You need to identify the carriers you need to proactively go to their website and pull
Client Contacts The Agency
Now, we have had clients call the agency when their house is on fire – please call 911 first. When a client calls into their agency this is a drop everything moment – no one should go to voicemail. In times of peril you want to speak with a person. To ensure the calls get routed correctly you want to consider the following:
- Who should claims go to?
- If the point person is not available who should be back up?
- Are claims allowed to go to voicemail? (Hint we say no!)
Step 2: Connect With the Insured
Your insurance claims management process needs to include either an outbound call or an inbound catch. Either way we need to remember that the insured has had probably a pretty horrible day. Now is the time to increase your empathy, slow down your pace and listen and educate your client. When you connect with the insured you don’t want to treat them like a transaction or policy. You need to treat them like a person. Here is a rough outline on how to handle the claim interaction:
- Ask if they are ok?
- Identify if there is any property damage?
- Make sure they are in a safe location.
- Confirm best contact information
- Ask if they have contacted the policy or authorities?
- If possible have them take pictures
There is one more very important step other than this. Document your management system. We stress this in our Insurance Claims Process Pack. No one, and I mean no one wants to repeat themselves. In addition, they will most likely have to repeat themselves to the claims adjuster. The less they have to repeat themselves the better the experience and process. In addition, claims can either be simple or very complex. The more documentation the stronger we will be.
Step 3: Work With The Carrier
Note this is only for clients who call you.
Every carrier will have variances on how they recommend claims are reported. Some want you to submit them, others want you to have the client call the carrier. Either way this is YOUR client you need to make sure there is a warm hand off. In the event a client’s teenager is in a car accident sitting on hold waiting for a claims adjuster can be infuriating. We recommend that you follow your carriers guidelines but if you are going to transfer the client to the carrier you warm transfer and make sure there is a connection. Set the client’s expectations and ensure you do the next step – which is follow up and follow through.
Step 4: Follow Up and Follow Through
Once the carrier has the claim our job is far from over. Many carriers may be short staffed; you need to ensure your client gets connected to the claims adjuster. Remember, if the experience is not on point even if it is not your fault the client still pulls you into the dysfunction. You need to separate the agency from the carrier and show you are working for them. Here are the follow ups you want to invest your time in:
- Has your client been in touch with their claims adjuster?
- If auto with rental car reimbursement – is the rental car all set?
- Is there a confirmed claim plan?
- Longer claims check in monthly to ensure its on track.
- Confirm the claims is closed
- Send a feedback survey
Sample Insurance Claims Scripts
While I am personally not a huge fan of scripts I see the value in setting them up so team members have some guidelines on how to handle challenging situations. Here are some of the scripts we provide agencies when handling claims:
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- Before we start with the claim filing, I’d like to start with the most important question of all… Are you okay?
- Are you in a position to talk right now? Are you in a safe place? Have you had a few minutes just to breathe?
- I am so glad that you called us. As your insurance professional, I would like to help you get your claim process started and taken care of from start to finish efficiently. This means the carrier will need to take an incident report from you. I would hate for you to have to repeat yourself twice. We can help you start that process, but first, please give a brief overview of what happened so we can get you to the right place.
- Small Claim:
- Ok, thank you for the detailed explanation. I am so glad you are okay. I’m looking at your file, and it appears your deductible is $XXX. Based on what you describe, what do you think the cost to repair would be? As you probably know, when you file claims with your carrier, this can and most likely will affect your rate at renewal. I’d hate to see you log a claim if the difference was minimal, and then you would have a claim on your insurance record. Do you understand?
- Large Claim:
- Ok, Thank you for sharing with me. I know this is a lot right now, so let me walk you through the process quickly. First of all, I will connect you with the carrier, and they will take your incident report. Do not worry, I will stay on the line with you to ensure you are connected, and I will make an introduction to make it more comfortable for you. From there, they will take your statement, ask for pictures, or list anything lost or broken, and you will be assigned an adjuster. I’ll call back the next day to check in with you to ensure everything is moving along. I will hold you briefly to get the carrier’s claim team on the line. Is that okay?
- Email Script
- As a loyal client of ____ Agency, I wanted to check in with you to see if you had heard from your claims adjuster at ____ Carrier. I can only imagine what you are feeling right now. I know that filing claims can be stressful. If you need anything, please call us. We are here to help you during your claim. Do not hesitate to contact us so we can assist you. 4
- Email Script for Survey-
- Thank you for being a loyal client of the ____ Agency. We are proud to be your agent. We understand that you had a loss recently, and we desire that you have a pleasant experience working with our agency, even on your worst days. Below you will find the link to a Claims Satisfaction survey. We know your time is valuable, so we made the survey short and sweet. Thank you for taking the time for our survey.
- Script for Proactive call to customer-
- Hello ______ (Customer name), My name is ______ _____ from the _____ Agency. It has come to my attention that a claim has been filed on your ____ policy. First and foremost, I hope that everyone is okay. (Pause and wait for a response). Secondly, I wanted to see if you have heard from the adjuster yet. If you have not, please let me know when you have. We want to help you to expedite your claim and give you the best experience possible, even in this tough time.
Conclusion
In conclusion, insurance claims management is one of the most critical aspects of an independent agency’s client experience. It’s the moment when clients truly engage with their insurance product, often during challenging and emotional times. By establishing a clear and consistent claims process, agencies can enhance client satisfaction, build trust, and ultimately drive loyalty. Whether your agency utilizes a dedicated claims specialist or equips the entire team with a structured approach, ensuring follow-up, empathy, and proactive communication will set your agency apart. Claims are not just transactions; they are opportunities to demonstrate the value of your agency and create lasting positive impressions. By adopting a strong claims management strategy, your agency can turn a stressful situation into an opportunity for growth and improved client relationships.
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