Insurance isn’t just all about the SALE! It is, however, all about relationships. A client’s claim experience will create a long-lasting impact and impression of that relationship, either as a positive or as a…I will probably be looking for another agency soon.
Keep in mind that any issues that arise during a claim’s experience can leave your clients with a bad opinion of you and your agency! Even if you have no control in the matter. After all, your client came to you because they needed to protect their assets and you won them over with how great your agency is along with the value you bring. If something goes wrong, they may ascribe their frustration with the carrier to you. Remember, you did recommend this carrier in the first place. All this being said, don’t underestimate the role you can play, the impact you can have on helping the claims process go smoothly for your client, and winning major points and even referral business, not to mention the potential of a long-term client.
The path for good service is clearly marked for a captive agent. The insurance company they work for instructs them on how to handle a claim. For the independent agent, things can get a little murky because every carrier has a different philosophy and follows different procedures. That said, you can still manage your client relationship by following and implementing these main steps within your agency:
What You Should Have in Place Prior to a Claim Even Being Filed
- Right from the start It all begins with making sure your entire Sales staff is able to educate your clients throughout the sales process by making the immediate distinction that insurance is not a commodity! It is not a one-size fits all or the lowest price wins, because all coverage options are NOT the same and the coverage selection can have a long-term impact on the wellbeing of your client’s future.• What your client is, in fact, buying and entrusting you with is a policy to help protect their assets, loved ones, and help mitigate their exposures and risks. Make sure your agency and all sales producers are trained not to just sell on price, but to give good counsel and advice, as it relates to your insured’s unique risks. This requires a mindset of not selling on price alone, but rather, your agency is truly invested in providing coverage options that are in your client’s best interest.
In addition, make sure a part of your sales processes consists of ALWAYS going over the coverage that your insured has elected NOT to take. (Some agencies provide coverage rejection forms, which may include, Earthquake, Flood, Underinsured Motorist, Rental Car, Towing, Comprehensive and/or Collision, including lower limits).
Make sure there is someone in the agency who is assigned, trained, and responsible for your agency’s claim process. They need to have a full list of contact numbers, properly direct your clients to the right claims departments, and provide claim numbers. means they are following a step by step process, which includes everything from start to finish. Make sure they know how to file a claim with each respective carrier and their process. They need to have a full list of contact numbers and be able to properly direct your clients to the right claims departments and provide claim numbers and provide your client with a claim number. A key function will be to make sure the claims process is moving forward and to make sure your clients have a proper expectation of what happens next! This means they will need to be able to know:
How to:
- Respond to an insured who wants to file a claim, (providing empathy, active listening skills)
- Educating your client on when it makes sense to file a small claim, but never implying they should NOT file, this decision is up to them. However, you can provide them with information on how a claim can impact their future rates, loss of discounts, and surcharges. With this knowledge, they can make an informed decision. AGAIN, NEVER RECOMMEND THAT THEY DO NOT FILE, ALWAYS LEAVE THAT DECISION UP TO THEM.
- Help them understand the entire claims process.
- Include, “What’s next and timeline, ALWAYS set proper expectations.”
- Explain your role and how you are there to help but inform them that the actual claims processing is handled by the carrier, and you are a liaison on their behalf.
- Let your client know you are here to assist if a problem should arise, and make sure FOLLOW UP is included in your process. Inform your client when additional information is needed. This step addresses their concerns and ensures the claim is moving forward. Finally, confirm all claims are closed and get feedback from your client on their claims experience.
IMPORTANT Things to keep in mind
Make sure your staff is trained to correctly identify CAT claim losses. This means they can identify a correct CAT loss date when filing. If not, this will adversely impact your loss ratios (As with most carriers CAT losses are not counted against you). If claims are not reported properly, your profit sharing (or PMSF) will be affected.
In addition, not monitoring your open claims will affect your PMSF, as an open reserve (The amount of money a carrier initially sets aside to payout a claim) can be higher than the actual amount paid out. This is why you will need to make sure outstanding claims are closed. Once closed, the reserve amount is then reconciled with the actual amount paid out.
Make sure you have an internal process that is monitored and adhered to. Making sure your sales team is properly underwriting the risk PRIOR to binding. • Writing bad business or not having set procedure to pre-underwrite your business leads to high loss ratios, loss of revenue, angry customers, and wasted time and energy.
Below is an Example of a Claims Process:
Personal Lines Claims Procedures: Activity – ACCOUNT MANAGER/PRODUCER:
1 Receives verbal or written claim information
a. From insured
i. Enter information in Agency Management system claims screens
ii. Counsels insured on claim information, handling and desire/recommendation to submit
• Deductibles applicable
• Possible scenarios/examples of the claim process
• Refer to preferred vendors if applicable
b. From third party/another carrier
i. Enter information in the Agency Management System claims screens
ii. Contact insured for confirmation of loss and desire to submit
iii. Counsel insured on claim information and handling
• Deductibles applicable
• Losses covered/excluded
• Possible scenarios/examples of the claim process
• Refer preferred vendors from referral list in S:/ Drive > Personal Lines if a client asks
c. From insurance company direct (Insured called into the carrier)
i. Enter information in the Agency Management System claims screens
• most now come through downloads
ii. Close the claim in Agency Management system, the same day
1 Submits claim onto company – same day info received within 24 hours
• Catastrophe Claims
i. Recommend insured call in directly to company
ii. Prep insured with info they will need to provide
iii. Provide the insured with company’s claim number to call and policy number for reference
• Call into company
i. Enter claim information into the Agency Management system same day
ii. Close claim in Agency Management system same day
• Online
i. Enter claim information in Agency Management system same day
ii. Close claim in Agency Management system same day
2 Send Claim confirmation email sent to insured
• See Signature Lines
3 Enter claim number and adjuster info into Agency System as available
4 Notify the Producer of claim – once it filed
• If major (large) loss/catastrophe
i. Fire
ii. Theft
iii. Water
iv. Death
v. Multiple Vehicle Damage (more than 2 cars)
• Potential claim declination
• Note If claim may need special handling
5 Assist insured with claim communication and processing as needed
6 Attach claim documents as received – mainly done by Processor
• Adjuster assignment
• Coverage notifications from adjuster
• Claim payment/settlement
• Closed claim notifications
Note: Some companies require claims to be filed within 6-12 months after the time of loss. If filing past that period, get an explanation why there was a delay in filing, for company consideration. Make sure you identify all Cat claims, if it was a big weather event, make sure the date you choose is the right date, as Cat claims in most cases will not count against your Loss ratios.