Many insurance adjusters and third party administrators (TPAs) provide claims systems as part of their services. While this is undoubtedly convenient, you may be leaving a lot on the table in terms of flexibility, independence, and data ownership. This post outlines some reasons why your organizations should consider seeking out an external claims system as opposed to relying solely on your adjuster’s or TPA’s built-in system.

3 Things You Aren't Getting From Your Adjuster's Claims System

1. Flexibility

Every organization is set up slightly differently, no matter how similar they may seem from the outside. Many adjusting companies provide their in-house claims systems to their clients to allow them to see their claims and perform some basic tasks like making requests and adding notes. To be sure, this is much better than not having this functionality, but you need to ask yourself what you need and what you hope to get from a Claims system.  

Compare this to an external claims and risk system that can be tailored to the organization’s exact specifications. The system can account for unique layouts, departments, or workflows and be as robust or as simple as users desire. It can quickly adapt as the organization expands and changes, unlike standardized systems where modifications can be difficult and time-consuming, if not impossible.

External systems also provide the ability to pick and choose modules, functionality, and data fields. The vast level of options allows the risk management team to use the system in any way and capture any type of data while removing features that won’t be used or aren’t applicable.

Implementing a new system into an existing process is a challenge, but flexibility eases that transition. Forms and databases are customizable to appear as they always have. For example, when municipalities start using the ClearRisk platform, the development team modifies the data submission web form to exactly resemble the form that residents and employees have always used to submit claims and incidents. This streamlines the submission process without creating confusion or the need for re-training.

Risk management teams can be limited by the types of information that are stored within a broker’s system. In many cases, adjusting systems primarily store data for claims they are involved in. However, it’s incredibly useful to track incidents and small losses as well: they are the #1 indicator of future claims and enable mitigation strategies through trend analysis. This is just one example — in an external system, users are free to store and easily access any data they find valuable, including insurance certificates, vendor details, or property information.

Along with storing various risk and claims data, a separate system can be integrated with other departments. For instance, the risk management team could collaborate with Health and Safety to eliminate redundant work between the two departments.

2. Independence

In addition to physical system flexibility, an external system provides more flexibility in terms of independent partnerships.

If an organization doesn’t choose their adjuster’s system, they are free to evaluate multiple systems and pick the one that is most suited for them. There are many risk management systems on the market, each slightly different, and risk management teams should pick the one that makes the most sense for daily work processes and long-term goals.

The organization will also have a better ability to negotiate. If they’re locked into an adjuster’s system, they will likely be locked into that adjuster’s claims handling services.  But if the risk management team is considering several competing systems, they will have more control and may be able to achieve some advantage, such as a discounted price or superior capability. Also, if you use more than one adjuster for your claims, you have your claims data spread out and have to log in to multiple systems of disparate data.

In today’s rapidly changing environment, quick responses are crucial. The ability to customize the system or change providers altogether to meet a new business need can have a significant impact on the risk management team and their ability to prevent losses.

3. Data insights

If all you are doing is storing claims information and using the system to administer the claims process, then you are losing out on the most valuable part of a claims and risk management system: the data insights.

Large sets of claims data over time is priceless in terms of the value that can be extracted with the right software. Adjuster’s systems are great for viewing your claims statuses, seeing how much has been paid on what, but do they look for trends in your losses?  Do they allow you to allocate claims and premium costs to your various departments and divisions? Can they help you see problems before they arise in time to take corrective action These and thousands of other data insights can be gleaned from the right system.

While adjusters and TPAs are an important part of your claims processes, that doesn’t mean their systems are the solution to your problem. Choosing an externally provided system increases flexibility, provides independence and choice, and delivers meaningful data insights that can provide significant reductions in your overall cost of risk.

If you’re currently unsatisfied with your system (or don’t have one at all!), ClearRisk may be the answer. Our system is fully customizable to your exact needs and provides independence — with the added benefit of automatically integrating with your adjuster’s system. Want more information? Learn more below. 

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