ACT’s Claims Process Framework – IndependentAgent.com

Provide clarity, consistency and certainty when your customers need it most

When customers experience complaints, our industry has an opportunity to demonstrate its true value. A claim often arises after an unexpected, stressful, sometimes life-changing event. At these times, customers rely on the guidance, support and expertise of their insurance agency and carrier.

Helping customers through the claims process is one of the most important promises we make. This is an opportunity to build trust and show the value of insurance when it matters most.

Because claims situations can be emotional and complex, agencies should establish well-defined, documented processes for both agency staff and clients. Clear expectations and consistent enforcement help ensure a positive experience while supporting efficient claims handling. (Templates are available for download at the bottom of this page.)

ACT has developed high-level process frameworks to help agencies create a differentiated and customer-centric claims experience. As you review these frameworks and adapt them to your agency’s specific needs, consider the following factors that may significantly influence your approach.

Evaluate your current processes

Before making any significant procedural changes, take the time to review your existing claims processes with your team.

Consider:

• What is working well today?
• Where are customers or employees experiencing friction?
• What feedback has your team received from customers?
• Are expectations and responsibilities clearly defined?

Involving employees in the review process helps identify opportunities for improvement, creating alignment around any future changes. It also provides an opportunity to reinforce why providing an exceptional claims handling experience is important to your agency and your customers.

Think about your agency’s business mix

While all clients expect support and advocacy when filing a claim, how you get that experience may vary depending on your agency’s client base, lines of business, and service model.

While excessive segmentation can create unnecessary complexity, thoughtful differentiation can help align service delivery with client expectations and agency goals. If your agency uses different claims handling approaches for different customer segments, make sure those differences are clearly documented, communicated and consistently applied.

Examples of customer segmentation

Personal lines vs. commercial lines

Commercial and personal lines customers often have different expectations for communication and support.

For example:

• Personal lines customers may be more likely to use direct carrier reporting options.
• Commercial customers may require additional consulting support and coordination.
• Communication preferences can vary, with some customers preferring phone conversations, while others prefer email, text messaging, or digital portals.

High value personal lines, standard and custom

Agencies can choose different levels of coverage, monitoring or personalized service based on client needs, expectations and the value of the relationship.

Small commercial versus mid-market and large commercial accounts

Commercial claims service models can vary depending on:

• Premium size
• Income contribution
• Complexity of operations
• The length and depth of the relationship with the client
• Risk management requirements

Other areas of activity

Specialized products such as surety, life and other niche covers may require unique claims workflows and additional planning.

Use existing technologies

Assessing opportunities to improve efficiency and consistency, many agencies immediately begin looking for new technology solutions.

Before investing in additional tools, take a hard look at the capabilities you already have in your existing technology ecosystem. Agency management systems, customer communication platforms, CRM solutions and carrier integration can already offer functionality that supports automation, workflow management, task reminders, reporting and customer communication.

If gaps remain, explore solutions that align with your agency’s strategy and customer engagement goals. Many claims-related processes can be automated and customized to improve operational efficiency and customer satisfaction.

Understand the capabilities of the operator

Carriers play an important role in the overall claims experience. Because the capabilities of different carriers vary, agencies should maintain a current understanding of the tools, services, and support options available to policyholders.

Make it a regular practice to review your carrier’s offerings and stay up-to-date on enhancements, new technologies, and service improvements.

Key opportunities for assessment include:

• First Notice of Loss (FNOL)
• Direct reporting of claims
• Claim status tracking
• Preferred vendor or contractor programs
• Programs for glass repair
• Claims download and integration capabilities
• Digital communication and customer self-service capabilities

Understanding these opportunities can help agencies develop service models that maximize both efficiency and value for clients.

Consider related business processes

The primary goal of any claims process is to provide customer support with accuracy, efficiency and compassion. However, claims engagement can also create opportunities to strengthen relationships and improve other areas of the agency.

Examples:

Referrals

After a satisfactory resolution of a claim, customers may be more willing to refer family members, friends or colleagues to your agency.

Customer feedback and experience measurement

If your agency tracks customer satisfaction, Net Promoter Score (NPS), or other customer experience metrics, the post-claim period can provide valuable feedback and insight.

Coverage reviews and cross-selling

Claims often reveal gaps in coverage or changes in a customer’s circumstances. A post-claim review may identify opportunities to strengthen risk management strategies or discuss additional coverage needs.

Customer information updates

Interacting with claims may allow you to check and update:

• Contact information
• Communication benefits
• Household or business changes
• Other customer data that supports future services and marketing efforts

Internal and external communication

Successful process improvement requires effective communication.

Internally, ensure employees understand:

• What is expected
• Why is this process important?
• How to perform duties
• How performance will be measured

Make claims guidance available externally via:

• Your agency’s website
• Mobile applications
• Client portals
• Social media channels
• Communications by e-mail
• Materials for adaptation of new clients

Customers don’t always expect immediate answers, but they do appreciate clear expectations, consistent communication, and reliable execution. Agencies that create and meet these expectations can create significant differentiation and build trust with clients at some of life’s most challenging times.