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5 ways you can improve your workflow through claims management best practices

5 ways you can improve your workflow through claims management best practices

Wouldn’t it be great to have more time in the day to get through a burgeoning workload and tick off all the items on the to-do list? Given that all of us in claims management are constantly being asked to take on more, being gifted extra time might be up there on the wish list, along with wealth, health and excellent hair.

But unless technology improves to such a degree that you can time-travel, you’re stuck with an unchanging amount of hours in a day.

And it’s not really about getting more hours in the day to get through your work, it could be as simple as looking at your current set-up and asking: how can we optimise our processes in order to be more efficient, more productive and close claims more quickly?

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Below we look at some simple things you can do to improve your claims management workflow.

Ditch the spreadsheets

Even the most rigorously maintained spreadsheets have severe limitations, especially when they contain the quantity of information found in a typical claim. Aside from human error, relying solely on spreadsheets can seriously impede your ability to easily analyse different data sets.

St Vincent’s Health Australia cited this as one of their biggest frustrations, before overhauling their systems in 2010. As Sarah Michael, Group Manager for SVHA explains:

‘Everything was manual and we primarily used Excel. We had wonderful spreadsheets, which were meticulously kept, but limited. As the set-up was sorted by year, it wouldn’t allow you to pivot or filter, and combining data for analysis and reports was a very difficult and slow process.’

And it’s not just spreadsheets that will slow your claims process down. The lifecycle of a claim is rife with all sorts of information and correspondence, be it emails, Word Docs or various forms. If members of your team have to trawl through the databases in order to find that specific piece of information, then it will considerably slow down your claims time.

In order to tighten these processes up, Ms Michael looked into adopting a Risk Management Information System (RMIS) which completely consolidated the process.

Because everything is stored in a single location, all information pertaining to a claim can be accessed very quickly and easily. As Ms Michael notes: ‘All the relevant information is now kept in one place, which means that searchability has vastly improved.’

Ensure that your workflows can withstand any emergency

Being able to access information in a single place, also cuts down on the back-and-forth those working on claims can face. For example, with an RMIS:

  • Multiple people can work on the same claim at once
  • Management can view where a claim is up to and see who needs to contribute
  • Allows management to set up reminders that go into the claim every month
  • Gives them the information they need to establish whether a claim needs urgent attention

You can also set up protection to ensure that only relevant parties are working on parts of the claim. As well as set-up different levels of financial delegations and easily track approvals.

This is especially important in emergency periods or spike times; when regular members of the team are off, or a natural disaster creates a higher volume of claims. If a workflow is set-up that anyone can jump on, know what their role is and what the expectations are of them, then the efficiency during these times won’t be as severely compromised.

Engender transparency and accountability

Another value that leads to an increase in productivity (even though it might not be immediately obvious) is promoting transparency and accountability within your team. By adopting the above processes, if you can see where a claim is at, and who is on it, then you become more aware of how quickly members of your team are working on the claim. With better quality data, you can also detect anomalies in the claims process (eg if there is a team member who has a conspicuously higher claim time than everyone else or whether a particular customer seems to be submitting a very high number of claims).

As touched upon in the SVHA example, by adopting a RMIS software, the SVHA claims team could easily combine different data sets in order to undertake deeper analysis and identify trends. It also allowed them to quickly generate reports for their board. According to Ms Michael having a richer source of data: ‘helps us to ensure that we are providing our board with credible, transparent and accessible information.’

Be proactive

Having access to this kind of data and being able to easily view it in different capacities allows you to identify trends that you may have missed. This enables you to be proactive in preventing future causes of incidents and ultimately reduce the number of claims your organisation will need to process.

For example, if you are a supermarket, you may discover that the number of ‘slips and trips’ is much higher in one location than in others. You can then do some research into what might be causing it (eg a leak from an air-conditioning unit or a roof leak from a large downpour) and take steps to remedy it. Even though the solutions may be small, they could add up and save your company a significant amount of revenue in the long term.


In all the above examples, you may have noticed a common theme: much of these processes involve adopting an online system. Given how much they:

  • Significantly streamline your workflows
  • Generate high-quality data
  • Empower you to get an overview of the business to see how you can prevent problems from arising

It could be time to consider how it could apply to your situation.

The idea of investing in a time-travel technology might not be the best investment, but to free up your time, the solution simply be overhauling your system, in order to create more efficient and productive practices.

Want more ideas on how to create better claims management practices? Then download our whitepaper on THE THREE D'S OF DIGITAL TRANSFORMATION today.


Aug 9, 2016

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