How to Choose a Claims Management Software System

You can find a variety of claims management software systems on the market, but how do you decide which one is the best one for your organization?

Tips for Choosing the Right Claims System:

Whether you are a self-insured, a third-party administrator, an insurance broker or a regional insurer, here are a few tips to help you as you explore vendors offering claims management systems.

• How long has the vendor been in business? Software developers frequently enter the lucrative insurance marketplace, so be sure your vendor has been in business long enough to ensure their software is client tested.


• Is the vendor servicing other system users in your niche? For example, if you are a self-insured group, you may need different data and indicators than you would as a worldwide insurance broker. Be sure your vendor can provide the specific types of data you need to appropriately manage your risks.


• Will your claims data system integrate with underwriting and allow access by other departments? Data integration across departments and when adding lines of business is critical in claims management.


• Does the system feature all the data categories you need? The ability to build your own data fields is a necessity as your organization grows and risk becomes more complex. If you venture into a new line of business, can the claims system provide support for that endeavor?


• How easy is the data to review and manipulate? Can you track your data in one single snapshot yet also pull data into a spreadsheet for more concentrated analysis?


• How effective is the vendor's documentation and customer support? In today's 24/7 world, risk management and claims professionals often need specific data in minutes. If you need data beyond your normal reporting needs, can your vendor respond quickly?


• Is your software cloud-based and easily viewed on a browser? Effective data retrieval and customizable reports allow your team to make superior real-time decisions. Search for software-as-a-service (SaaS) architecture, which provides state-of-the-art, browser-based access to your data.


• Will your vendors help you survive the data conversion process? From initial bid design to final implementation, changing your RMIS system is a very time-consuming process. How effective is your vendor at ensuring the conversion process goes smoothly no matter what data conversion issues you face?


• Can your Claims Management System provide expert litigation management support? Managing today's complex litigation projects requires extensive expertise and increasing sophistication.


• What will your system cost? These costs include first-year costs, annual use costs, any "per-user" costs, data storage costs and charges for custom reporting. You do not want to lock into a system and then find additional charges that are not in your budget.


• How secure is your data? With frequent data breaches, how safe is your data? What additional steps does your vendor take besides passwords and encryption to ensure your data remains in the hands of authorized users only?

The task of choosing the risk management system that best fits your needs is important. Choosing the wrong RMIS will be costly. In addition, you may not be able provide your clients with the best possible service or have the instant access you often need to effectively manage your risks. You will be living with the system for a long while, so make sure the vendor you choose can provide flexibility, scalability and stellar customer service.

Tips for Picking the Right Motor Trade Insurance Policy

If you have just gone into business in the motor trade, then you will need motor trade insurance. This can be a daunting task because you will not know what you need exactly. You might get snowed under and you will just pick any old policy whether it is relevant to you or not.

You don't want to get stuck paying for a policy that is no good for you, so you need to take your time and do your research. Don't be rushed into making a decision before you are ready and have a list of questions that you want to ask the insurer before you sign on the dotted line.

What type of policy do you need?

It is best if you know what type of policy that you need before you have contacted your potential insurer. The type of policy that you need depends on what business that you have.

If you are driving vehicles that you don't own, then you will need a Road Risks policy so you can drive the cars off your car lot. Most traders combined policies can be tailored towards the needs of the policyholder. When you phone up to get the insurance policy, you should ask if you can add cover for business interruption, money loss, road risks, material damage and even public liability.

You just have to tell the insurance company what type of policy you are looking for and they should be able to tell you which policy would better suit your needs.

You do have the choice of just buying a policy that is 'off the shelf.' This means that you buy the policy as it is listed. You don't have to add anything and it is just as simple as phoning up and getting the insurance.

The problem with these types of policies is that they don't necessarily cover everything that you need. You might find yourself in trouble down the line and try to claim on your insurance, only to find out that you aren't covered.

That is why you should find out what is included on all policies and make sure that you are covered for everything that you need from the moment that you contact the insurers. Just make sure that all the covers are relevant to your business.

What is the value of whatever you are covering?

You have to make sure that all your values are correct. This is because you might have an insurance policy that only covers you for so much. If you have incorrectly valued something and something goes wrong, then you might have a policy that is useless to you.

Health and Safety

With your motor trade policy, you need to make sure that you are covered for health and safety issues. First, you should make sure that your place of work is up to the standards of health and safety policies. Then you should make sure the policy will cover you if there is an accident and one of your workers is hurt.

This is one of the most important things you should have cover for because if there is an accident and you don't have the correct policies in place, you could be liable for prosecution.

Shop around

When you are picking your insurance policy, you should get some quotes from more than one insurer and then you should pick the cheapest one as long as it covers the areas that you need it to. There is no point getting the cheapest policy if it is useless to you.

How to Research Insurance Companies

Before you subscribe an insurance you need to understand how insurance companies work. To help understand that we have provided a detailed explanation of Insurance Companies Business Model based on internet research and talking with some friends that are experts and work on the insurance professional field. Let's breakdown the model in components:

• Underwriting and investing
• Claim
• Marketing

Underwriting and investing

On raw terms we can say that the Insurance Companies business model is to bring together more value in premium and investment income than the value that is expended in losses and at the same time to present a reasonable price which the clients will accept.

The earnings can be described by the following formula:

Earnings = earned premium + investment income - incurred loss - underwriting expenses.

Insurance Companies gain their wealth with these two methods:

• Underwriting, is the process that Insurance companies use to select the risk to be insured and chooses the value of the premiums to be charged for accepting those risks.
• Investing the values received on premiums.

There is a complex side aspect on the Insurance Companies business model that is the actuarial science of price setting, based on statistics and probability to estimate the value of future claims within a given risk. Following the price setting, the insurance company will consent or refuse the risks using the underwriting process.

Taking a look at the frequency and severity of the insured liabilities and estimated payment average is what ratemaking at a simple level is. What companies do is check all those historical data concerning losses they had and update it on today's values and then comparing it to the premiums earned for a rate adequacy assessment. Companies use also expense load and loss ratios. Simply putting this we can say that the comparison of losses with loss relativities is how rating different risks characteristics are done. For example a policy with the double losses should charge a premium with the double value. Of course there is space for more complexes calculations with multivariable analysis and parametric calculation, always taking data history as it inputs to be used on the probability of future losses assessment.

The companies underwriting profit is the amount of premium value collected when the policy ends minus the amount of paid value on claims. Also we have the underwriting performance A.K.A. the combined ratio. This is measured by dividing the losses and expenses values by the premium values. If it is over 100% we call it underwriting loss and if it is below the 100% then we call it the underwriting profit. Don't forget as part of the Companies business model there is the investment part which means that the companies can have profit even with the existence of underwriting losses.

The Float is how insurance companies earn their investment profits. It is amount of value collected in premium within a given time and that has not paid out in claims. The investment of the float starts when the insurance companies receive the payments from the premiums and end when the claims are paid out. As it is this time frame is the duration from which the interest is earned.

The insurance companies from the United States that operate on casualty and property insurance had an underwriting loss of $142 Billion in the five years ending on the year of 2003, and for the same period had an overall profit of $68 Billion consequence of the float. Many professionals from the industry think that is possible to always achieve profit from the float not having necessarily a underwriting profit. Of course there are many thinking streams on this matter.

Finally one important think you should consider when subscribing a new insurance is that in economically depressed times the markets have bear trends and the insurance companies run away from float investments and causes a need to reassess the values of the premiums which means higher prices. So this is not a good time to subscribe or renew your insurances.

The changing on profit and nonprofit times is called underwriting cycles.

Claims

The actual "product" paid for in insurance companies industry are the claims and loss handling as we can call it the materialized utility of insurance companies. The Insurance Companies representatives or negotiators can help the clients fill the claims or they can be filled directly by the companies.

The massive amount of claims are employed by the claim adjusters and supported by the records management staff and data entry clerks within the Companies claims department. The classification of the clams are made on severity criteria basis and allocated to the claim adjusters. The claim adjusters have variable settlement authority according to each ones experience and knowledge. After the allocation, follows the investigation with collaboration of the customer to define if it is covered by the contract. The investigation outputs de value and the payment approval to the client.

Sometimes a public adjuster can be hired by the client to negotiate an agreement with the insurance companies on his behalf. On more complex policies where the claims are hard to manage the client may and normally uses the a separate policy add on for the cover of the cost of the public adjuster, called the loss recovery insurance.

When managing claims handling functions, the companies tries to steady the requirements for customer contentment, expenses of administrative and over payment leakages. Insurance bad faith usually comes from this equilibrium act that causes fraudulent insurance practices which are a major risk that are manage and overcome by the companies. The dispute between the clients and insurance companies often leads to litigation. The claims handling practices and the validity of claims are the escalating issues.

Marketing

Insurance Companies use negotiators and representatives to initiate the market and underwrite their clients. These negotiators are bond to a sole company or they are freelancers, which mean that they can rules and terms from many other insurance companies. It is proven the accomplishment of Insurance Companies goals is due to dedicated and tailored made services supplied by the representatives.

Set Up For Failure In Sales Career

There are those who aspire to a career in Insurance sales. This choice can lead exceptional financial rewards, prestige and a solid profession. There are many benefits with a career in Insurance sales.

Yet when people apply to become an agent I find that the depiction of the new career tells only one side. New agents hear about the money, freedom, positions and benefits of the position. Yet there is always another side to any story. That story not only shares the positive but the negative aspects to the decision to pursue this career.

I am not a negative person. But it is time to share the story so that people know exactly what they are getting into before they make the decision. Consider the following;

1) This is not a job, but a career choice to become self employed - when you are looking for a job you should not consider a career in Insurance sales. With a job you work and get a check after a few weeks. With insurance you have no guarantee of a check even if you go to work, prospect as they tell you to and do all that is required. The average income for a 1st year agent is under $25,000. Yes there are some high producers but that is the exception, not the norm. For most self employed businesses it takes years to earn a profit.

2) Consider this position from an accounting perspective - On a balance sheet it lists the assets (things you own) and liabilities (what you owe) along with owners equity and it all must balance. In sales you have your assets(benefits from your new position) and that is where most managers stay when they are interviewing. But the liabilities (expenses) associated with this position are not offset by income initially. You have to pay to keep your car running; gas to get to appointments; lunch money; money to pay your household bills; money to cover expenses that need to paid in order to work. These expenses must be covered by someone and it typically is not the insurance company.

3) Great rewards involve great risk- you can get great rewards from taking great risks. If you are willing to handle all the risks associated with succeeding big in Insurance, you can see great rewards. The key is to see where you want to be and then pay the price to get there.

This is a great career for the person who is prepared to cover all expenses until income starts to come in.

The Insurance Loopholes That Public Adjusters Maximize On

Insurance companies have always marketed themselves by portraying their companies as honest, 'charitable' organizations ready to help you in case of any peril. Although they are helpful in protecting assets, they are still businesses. That means their main goal is making profit and staying in business. The only way they can do this is ensuring that the pay outs are far much lower than the overall premiums being paid.

One of the tricks insurance companies use to do that is introducing loopholes to help them avoid compensating some of their clients when claims are filed. Fortunately for them, most people do not pay attention to the 'fine print' before signing insurance papers. They therefore willingly commit themselves to insurance contracts without a comprehensive understanding of the terms and prospective 'loopholes'.
So, what happens when you file for a claim and you are shocked to find out that you cannot be compensated because of a particular loophole? That's exactly where public adjusters come in. They challenge the insurance companies on the loopholes to negotiate for a fair compensation. Some of the common loopholes they deal with include:

Double Tragedies

Some people lose their property through double tragedies. For instance, your house may be hit by a hurricane and still get swept up by floods. In such a case, some insurance companies can only compensate you if both tragedies are covered regardless of the sequence in which the tragedies occurred. Therefore, if you were covered for hurricanes but not floods, your claim will probably be turned down. Public adjusters however, can negotiate your claim to help you avoid falling victim to such a loophole.

Pre-existing Conditions

Many insurance companies will not compensate you if you file a claim for a condition that existed prior to being insured. For example, a cancer patient may not benefit from his health insurance if the insurance company discovered that he had already been diagnosed prior to applying for the insurance cover. Many times insurance company adjusters mistakenly associate new damage to a pre-existing condition, when they are actually unrelated. In other words, a homeowner might have their claim wrongly denied under a pre-existing condition. Public adjusters are very helpful especially in cases where the victims were not knowledgeable on the existing condition, and how damage is evaluated.

The best way to avoid falling victim to such loopholes is comprehensively reading the policies on the respective insurance covers. Do not sign anything without comprehending the terms and conditions. In addition, if you think you are thinking of filing an insurance claim, contact a public adjuster.

Effective Workers' Compensation Using Claims Management Software

No matter how many health and safety measures an employer implements, industrial jobs are still vulnerable to workplace injuries and deaths as they deal with heavy machinery and work in hazardous conditions. Insurance providers are liable to pay employees the compensation benefits in case of occurrence of any such incidents.

It covers all the medical bills, compensates lost wages, compensates for loss or death of an employee to his/her dependents, etc. So, processing these claims accurately is very crucial to the insurance company as well as the employer as it directly impacts the revenue and growth of the organization.

Workers' compensation software is an application that helps insurance providers in managing and settling the claims effectively, compensating the insuree with accurate amount and avoiding fraudulent claims.

Workers' compensation system helps insurance providers in many ways. It

Enables fast reporting of an incident
It is important that the incident must be reported immediately after the occurrence (reporting doesn't mean that the claim is accepted). But, immediate reporting is critical for both claimant and the employer as claimant receives compensation quickly and employer saves additional cost that he has to pay towards late settlement. It provides template to report the claim making it easier and faster to report the incident immediately after the occurrence.

Records, maintains and tracks the previous claims
Workers' compensation software and its claim management software records all the critical information of the claim and saves them. The critical information of the claims will be useful in settling them. Claims manager of workers' compensation system avoids tedious paper work, effort and time of recording, updating and verification of the claims. It is also helpful in tracking and retrieving the records easily.

Measures the claim settlement amount accurately
Settling claim is the key phase of claims management. With the help of all the critical information stored, claims management system calculates the premium or settling amount fairly and accurately. This avoids headache for the insurer to calculate the settling amount manually or worry about over or under-payment. Workers' compensation software itself calculates the accurate amount.

Helps in avoiding fraudulent claims
Avoiding fraudulent claims is the most critical factor that determines the growth and respect of the organization. Fraudulent claiming is commonly a single employee claiming for compensation frequently. Workers' compensation software avoids the fraudulent claims by verifying previous records every time a claim is made to identify if the same employee have claimed before or how frequently the claims are made.

By using effective workers' compensation software, claim performance of the organization can be improved. By effective claims management and settlement you can not only compensate fairly and quickly but also save operational costs.

The Importance of Vaccinations When Travelling

It is quite likely that you spend considerable amounts of time planning your yearly holidays. You probably consider the merits of different hotels and research the kinds of activities that can be enjoyed in various parts of the world. However, it is important to remember that there are quite a number of holiday risks: your flights could be unexpectedly delayed; you might require medical attention after a nasty fall; there may even be a chance of contracting serious diseases. If you were worried about such scenarios (and you should be), it would be worth investing in single trip travel insurance and following the advice in this article.

Planning Ahead

It is worth pointing out there is some variation in the types of vaccinations required before travelling to different countries. It is possible to obtain information from specialist medical websites, however you should visit your local doctor for further clarification regarding the necessary ones. This visit should be made at the earliest possible opportunity, as the medical practitioners may have to arrange a course of immunisation. Your single trip travel insurance provider may reject claims if you haven't taken the advised precautions.

Different Kinds Of Inoculations

There are three kinds of vaccinations required by those travelling abroad. The routine immunisations are given as a means of protection against common diseases such as measles and rubella, and doctors may recommend others depending upon the countries visited. People planning trips to India are advised to take precautions against hepatitis A and polio, while rabies shots are recommended to those planning trips to Thailand. Others may be required before travellers are allowed to enter some foreign countries; for instance, it is necessary to provide proof of yellow fever inoculation before entering Anguilla and Angola. Travellers may also take tablets and other medical provisions to reduce the chances of having to make single trip travel insurance claims against the costs of medical care.

Serious Travel Risks

Those who have scheduled trips to the more developed countries may mistakenly believe that immunizations aren't required. However, it is worth pointing out that there is a chance of contracting influenza and tick borne encephalitis in certain parts of Scandinavia, for example. People travelling to the UK or America for the first time may also be surprised by the need. Of course, the risks are far greater in the developing countries of Latin America, Africa and the Middle East and it is also worth noting that the levels of medical provision are fairly poor in these regions - travellers may even have to be airlifted to quality medical establishments in other parts of the world. The costs of foreign medical transfers are particularly high and travellers may be glad of the financial protection guaranteed by single trip travel insurance.