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Download: Claims-Tools-Agents ACT's mission is to bring the stakeholders in the independent insurance agency distribution system together to advance the use of the most effective business processes, practices and technologies, in order to enhance productivity, service, marketing, sales and security.
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Tools that Enhance Claims Information & Efficiency for Independent Agents & Brokers
by Donna J. LaGoy AIT, ACE
About this article: Several tools are now available to agents that can streamline their claims processes significantly and enable them to automatically download claims information. The author demonstrates how an agency can fit each of these tools together to create more efficient claims workflows. The article also points out the critical role agents play in advocating for their carriers and vendors to provide these tools and then to implement them in their agency.  
 
Tools that Enhance Claims Information & Efficiency for Independent Agents & Brokers
by
Donna J. LaGoy AIT, ACE
 
This article discusses technology tools that have been introduced to permit independent agents and brokers to serve their clients more promptly and effectively in claims situations. Claims download, real-time claim inquiry, real-time filing of First Notice of Loss (FNOL), real-time requests for loss runs, and Activity Notes all have great promise to make agency workflows more efficient.
 
Most of these new capabilities have already been introduced by some carriers, but we need to see much broader usage. The agents will play the critical role in making this happen, but first they need to be convinced that these new technologies will materially improve their workflows. This article seeks to make that case. 
 
Claims Download
One of the most exciting new opportunities is for the automatic downloading of new claims and claims status information into agency management systems. An ACORD standard has been put in place for claims download, and several vendors and carriers have begun to implement the new capability.
 
However, an agent might ask: “How exactly will claims download benefit me? I already have claim inquiry available via carrier websites or through my agency management system using real-time inquiry.” Or, the agent might say: “Why do I need download, when I already receive an e-mail or Activity Note into my agency management system that tells me there is a claim?”
 
Real-time claim inquiry has been a great enhancement for agents and will continue to be so for up-to-the-minute information. But, it is only beneficial if the agent knows the claim has taken place!  Further, real-time claim inquiry does not populate the agency management system’s database, and so the agent must enter the claims information into his or her system.
 
E-mails or Activity Notes[1] are also great “incremental” steps, but again, the agent has to enter the claim into the agency management system and update the information as the status of the claim changes.
 
The goal is for all of the latest features of technology to work hand-in-hand to make the claims process as streamlined as possible.
 
Claims Download Critical in Disaster Situations
The horrific storm seasons we have had in recent years provide an instructive example as to how claims download can help agencies. If an agent has had no power and has had clients reporting claims directly to the carrier, how does he or she know what claims have been filed? Once the agency finds out about the claims, who is going to enter the hundreds or thousands of claims into its agency management system? Who is going to update the status on each of the claims, as it is paid or closed? The agency’s employees are already working overtime under terrific stress, and they want the needed claims information to be handy in their system. They want to spend their limited time assisting their clients regarding the claim and demonstrating the value added that their agency provides to its clients. The last thing these employees want to spend hours upon hours doing is entering all of this claims information into their system.
 
Claims download allows for all of the claims to be:
  • automatically entered into the agency management system
  • updated as the status is changed, and
  • closed when the carrier closes it.  
 
Claims download would save the typical agency hundreds of hours per year, as well as enable agency employees to provide better service to their clients should a claim occur.
 
Recommended Claims Workflow
The question, then, is how do claims download, real-time claims inquiries and e-mail or Activity Notes work most efficiently together? Consider the following workflow:
 
1)      The claim is reported directly to the carrier by the client (FNOL reported by the agent is a different workflow and is addressed below.).
2)      An e-mail message or Activity Note is sent to the agency instantly notifying it of the loss.
3)      Overnight, the claims are processed via a batch process and downloaded into the agency management system.
4)      A log is waiting for the agent in the morning, when he or she comes in to review what was attached (similar to policy download) and what went to suspense to be attached.
5)      The claim is now in the agency management system and is ready to be serviced.
6)      Claim inquiry can be used at this point to look at anything that has transpired during the current day, if necessary. An example would be that the adjuster had not been assigned when the claim was downloaded, and you need to get that information today.
7)      Any updates to the claim will download each night (or at given intervals during the day, if the carrier and vendor provide this feature). Again, this download information will populate a log for review.
8)      The agency is now in the position to run reports from the agency management system to track losses.
 
First Notice of Loss (FNOL) Claim Reporting
Another very important technology for agencies is real-time FNOL claim reporting, where the agent can submit the claim to the carrier and instantly get back the claim number and adjuster for the claim.  What a terrific service to be able to provide the client with this information on the spot! Even where the agent is using real-time FNOL, however, claims download still plays an important role, because it allows for the automatic updating of the status of the claim, including payments made, adjuster notes, and the closure of the file.
 
Real-Time Loss Runs
Requesting loss runs through the agency management system and receiving them back in Real Time from the carrier is another significant improvement for agents, providing clients with immediate service and saving considerable time for the agent.
 
Agents Play Key Role
Whether we are talking about claims download or real-time claim inquiry, FNOL, loss runs, or Activity Notes, agents will play the critical role in making these improved workflows a reality within our industry. Agents should advocate for these improvements with their carriers, and then “walk the walk” by implementing them within their agencies when they are introduced by particular carriers.  High agency usage will be the dominant factor in convincing additional carriers to leave the sidelines and join the game by implementing these new capabilities.
 
The Future
As exciting as these new technologies are, the future will require the industry to take yet another step, and that is to permit the agency’s clients to access their claims information directly from the agency’s website. Claims download and real-time claims inquiry will provide the foundation for this enhanced consumer capability. Consider once again what this would mean to an agency devastated by a disaster, struggling to make or receive phone calls of any kind. What a godsend it would be if anxious clients could go to the agency’s website and learn that their claim has been received and is in processing, and receive the assigned adjuster’s contact information. Organizations like ACT will continue to work with carriers and vendors to make this future a reality.
 
Most important today, agents, carriers, and vendors should continue to collaborate to harness the exciting technologies that are available to us now to significantly improve the overall customer experience and to make our distribution system more efficient and responsive. 
 
Donna LaGoy is a Client Partner of Applied Systems, Inc. and is Chair of the ACORD Claims Download Working Group. Before taking her current role, Donna was an independent agent, with many years of experience working for a national broker and then owning her own agency. She is dedicated to improving the technologies and workflows available to independent agents and brokers, both internally and with their insurance carriers. She has been deeply involved in ACT, AUGIE, ACORD, and ASCnet. Donna LaGoy can be reached at dlagoy@appliedsystems.com. She prepared this updated article for the Agents Council for Technology (ACT) which is part of the Independent Insurance Agents & Brokers of America. For more information about ACT, contact Ron Berg, ACT’s incoming Executive Director, who can be reached at ron.berg@iiaba.net. This article reflects the views of the author and should not be construed as an official statement by ACT.


[1] Note that Activity Notes today are typically downloaded after the close of the business day. In the future, it is hoped that carriers will deliver time sensitive Activity Notes multiple times a day to their agents’ IVANS mailboxes and agencies will pick up those messages several times a day as well.