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The right mindset on insurance claims
30 Jan 2020 (78 views)

Most claim officers, including those who have been in the industry for a few decades, carry the wrong mindset towards insurance claims. Whenever an accident or disaster occurs, they get depressed about the amount of claims that have to be paid. Their instinct is to look for a way to avoid paying the claim or to pass the burden back to the claimant or to another party. 

They look at every claim as a loss to the insurance company that they work for.

What is the correct mindset?

The purpose of insurance is to pay claims. If there are no losses, there is no need for insurance. It is only when losses arise that insurance can demonstrate its value to its customers. 

If you run a motor insurance business, you should expect to process 10% of all policies as claims in a year. If you insure 100,000 policies, you should expect to process 10,000 claims a year or 40 claims every day. The same ratio can apply to a health insurance portfolio.

You can expect about 5% of all the claims to be exceptionally large. When they arises, you should not be alarmed. It is in the normal course of business. 

Of course, it is your duty to make sure that the claims are not fraudulent and that the losses are not intentionally created for the purpose of cheating the company. 

If it is a genuine loss, and the claimant are decent people (and most of them are), the claims officer should have the mindset of helping the claimant to have a prompt and fair of the claim. It should be done without any hassle.

The claim settlement has to be within the terms of the contract. However, the terms should be fair and understood by the customers. They should not be written for the purpose of avoiding a fair settlement of the claims.

This is how an insurance company can excel in the settlement of claims, build up a good reputation and excel in customer service.

It the claim is fraudulent and intentional, the case has to be handled differently. it should be passed to a separate team of officers who are experienced in handling these fraudulent claims.

A badly managed insurance company does not have the right philosophy nor the proper approach towards settlement of claims. Their claim officers treat each claim with suspicion, rather than one where they can help the claimant recover the loss as contractually provided.

A well managed insurance company have the right process of segregating the small number of fraudulent claims to be handled separately and have the claim officers handle the genuine claim in a helpful manner. 

Tan Kin Lian


 


The right mindset on insurance claims
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Most claim officers, including those who have been in the industry for a few decades, carry the wrong mindset towards insurance claims. Whenever an accident or disaster occurs, they get depressed about the amount of claims that have to be paid. Their instinct is to look for a way to avoid paying the claim or to pass the burden back to the claimant or to another party. 

They look at every claim as a loss to the insurance company that they work for.

What is the correct mindset?

The purpose of insurance is to pay claims. If there are no losses, there is no need for insurance. It is only when losses arise that insurance can demonstrate its value to its customers. 

If you run a motor insurance business, you should expect to process 10% of all policies as claims in a year. If you insure 100,000 policies, you should expect to process 10,000 claims a year or 40 claims every day. The same ratio can apply to a health insurance portfolio.

You can expect about 5% of all the claims to be exceptionally large. When they arises, you should not be alarmed. It is in the normal course of business. 

Of course, it is your duty to make sure that the claims are not fraudulent and that the losses are not intentionally created for the purpose of cheating the company. 

If it is a genuine loss, and the claimant are decent people (and most of them are), the claims officer should have the mindset of helping the claimant to have a prompt and fair of the claim. It should be done without any hassle.

The claim settlement has to be within the terms of the contract. However, the terms should be fair and understood by the customers. They should not be written for the purpose of avoiding a fair settlement of the claims.

This is how an insurance company can excel in the settlement of claims, build up a good reputation and excel in customer service.

It the claim is fraudulent and intentional, the case has to be handled differently. it should be passed to a separate team of officers who are experienced in handling these fraudulent claims.

A badly managed insurance company does not have the right philosophy nor the proper approach towards settlement of claims. Their claim officers treat each claim with suspicion, rather than one where they can help the claimant recover the loss as contractually provided.

A well managed insurance company have the right process of segregating the small number of fraudulent claims to be handled separately and have the claim officers handle the genuine claim in a helpful manner. 

Tan Kin Lian