Claims Process Improvement
Improving Claims Management Efficiency & Claimant / Member Experience
FOR LIFE INSURANCE COMPANIES • INDUSTRY MEMBER SUPER FUNDS
Insurers, super fund trustee offices and administrators have been among our main consulting clients for over 6 years, since the emphasis on the industry’s 'claims experience' first emerged in earnest. These days there is much work going on in the areas of claims process improvement and the claimant or member experience at the front end; The Risk Store has been one of the regular providers in this space.
We call on our many years of background both in the actual claims management arena and in process analysis and consulting which we have offered since 2006, via C-MAP and various client-tailored versions of C-MAP.
Our 'unique proposition’ is the skill of reversing the lens; establishing through file and departmental analysis what the claimant or member ‘sees and feels’ from their side, looking in to the provider, be it the insurer or a fund entity. The usual methodology is by on-site, randomised, detailed examination of (i) actual claim files, end-to-end; and (ii) the critical ‘departmental’ processes, philosophies and procedures that feed and dictate the action on those claims.
Whereas C-MAP is designed to feed findings only - leaving management to apply their resources to solutions - our client-directed consulting work is usually required to deliver - or project manage the delivery of - solutions to the improvements deemed warranted or desirable. So, as such, this work can range from redrafting client (and other third party) communication template libraries through to: workshopping with teams to reach new procedural outcomes; contributing to training as an additional resource; redrafting guidelines and procedure manuals; mediating between funds and insurers on process improvement; and drafting more member-friendly website content. Our work has also encompassed reviewing/updating Insurance Management Frameworks and other ‘compliance’ documentation.
11 questions with Sue Laing article, founder of claims management consultants, The Risk Store
"Sue came to us by referral from another client and has been working with us a few days a week over three years. Sue's breadth of insurance knowledge and capacity for analysis and fresh thinking has been invaluable to First State and over that time she has assisted us with change programmes in Claims and with many process improvements. The most notable has been the development of a claims tracking system within our SharePoint platform, for which Sue worked closely with the claims team and IT. The result is a simple but robust 'view' of all claims, centralised, universally accessible and providing a one-stop basis for our management reporting. Sue's claims expertise has also been a welcome 'back-up' resource for us, especially with death claim disputes. We enjoy Sue's dedication, lateral thinking and cooperative spirit."
Sarina Aarons | Head of Insurance, First State Super
"Sue contributed her wealth of experience and knowledge to our claims project. She was always helpful, forthright and proactive with sharing information she already had from previous work with REST. She always had our members at the forefront of her mind (member first) which fitted in well with our whole ethos we are developing at REST."
Mathew Simons | Insurance Vendor Manager, REST Industry Super
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Call Pete Wincott on 0416 009 403 or Sue Laing on 0412 265 822