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ACT Process Framework - Claims Experience


As most of us would likely agree, our industry shines and shows its value to our customers when they experience a claim.  It is our promise and commitment to help them work through an unfortunate, stressful, confusing, and potentially horrific event in their life.  It may be bold, but this is in many ways why all of us are here.

Given all the dynamics at play during the time of a loss, it is important for agencies to have a well-defined and communicated set of processes for agency staff to follow, as well as a set for consumers to follow, to make certain we uphold our promise to our clients. (Downloadable templates are located at the bottom of this web page)

The ACT Customer Experience Work Group has built high-level process framework for both of these distinct opportunities to differentiate your agency and add value to your customers in their time of need.

As you review these and consider how to best amend and adapt them to your specific agency (which we strongly recommend!), we offer a few thoughts that will materially impact how you approach this work.

Please consider the following: 

  • Your Current Processes:  Before making any procedural overhaul, it is a good step to revisit, chat  current processes and procedures with your team to see what is working or not, gather any feedback, and let them know you are looking to drive more clarity and consistency to this specific process.  Let them know why it is important to you and your agency.

  • Agency Mix of Business: While all your customer segments go through claims and ultimately have similar needs and expectations of being taken care of by your agency, how you bring this to life in your agency can vary greatly by your mix of business, customer profile, and how you position your overall experience expectations. 

    While too much segmentation can create more confusion than it solves, there is some value in being intentional and thinking through how or if you create any unique processes.  The point here is to be clear with your team should you create different experience approaches within your overall book, explain why, and prepare auditable processes to support your decisions. 

    Here are some examples and additional considerations:
    • Personal lines vs commercial lines:  You may opt to have a different level of personal touch vs. automated communication for commercial or personal clients.  You may direct personal clients to career-direct reporting solutions more than your commercial clients.  Email or text may be more efficient and acceptable as opposed to personal phone calls based on client type as well.
    • High Net Worth vs Standard vs Non-Standard personal lines:  Based on the mix of your personal lines book, you may also choose to consider deviating your processes or how you execute them based on the amount of revenue they drive to your agency.
    • Small/Micro commercial vs middle/large market:  Following our theme of sub-segmenting, you may identify different values in how you choose to tailor your claims experience within your commercial lines book as well.  This could be done based on premium or revenue, level of relationship, or some other factor specific to your agency.
    • Other: Lines of business such as Surety or Life require additional thought as well

  • Current Technology Options:  As you consider which segments of your customer base you'd like to use more technology to enable automation and efficiency, you may have a tendency to begin looking at new tools.  And you may end up with new tools over time or as you enhance your capabilities.  But we always recommend doing a deep dive with your current technology solutions.  You may already have some great capabilities in-house and ready to implement.  If not, it's definitely worth doing some homework (starting with the list of amazing ACT-supporting companies) as many of these steps can be highly automated and customized to your needs.

  • Carrier capabilities:  Your carriers can play a key role in your overall claims experience.  As not all carriers offer the same solutions, it is important to make sure you have the most current understanding of what they offer you and your customers as options when reporting and staying current with the claims process.   It's also worth making a point of asking them about any changes or enhancements a couple of times a year if you are not clear.  

    As you consider how you segment your customers, here are some carrier capabilities to understand as you define your processes.
    • First notice of loss
    • Direct reporting of claims
    • Preferred provider/contractor programs
    • Auto glass repair
    • Claims download

  • Other Process Implications: The most important reason for your claims processes is to take care of your customer as accurately and efficiently as possible and with the most empathy as appropriate within your brand.  However there are several other processes and opportunities that could be impacted. 
    Several examples are:
    • Referrals – once a claim is settled, presumably to the customer's satisfaction, it could be a good time to work in your referral generation process.
    • NPS – if your agency uses net promoter score for marketing, training, and overall process improvement, post-claim is a great place to solicit this insight.  You could even ask 3rd party claimants.
    • Cross-sell:  As with referrals, timing and appropriateness are important.  However, the claim may expose a gap in coverage or an opportunity to learn of customer risk changes.
    • Customer Info: This may be a time you can update customer demographic info, communication preferences, or other information you can use in other programs.

  • Internal and External Communications:  As with any process or expectation-setting activity, it is critical to communicate with your team, so they know what and why you expect, how they are supposed to accomplish any new/revised tasks, and how they'll be assessed.  Similarly, as you build out your internal and client-facing processes, post them on your website, social media, agency app, and other means by which you communicate with clients.  Often, you don't necessarily need to be the fastest if you can set and meet very clear expectations.

Claim Process Templates For Agency Use



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fax: 703.683.7556
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