Tackling First Notice of Loss Claims Assignments With Technology

Assigning claims upon receipt of the first notice of loss (FNOL) can be a cumbersome process. Evaluating an adjuster’s file load, availability and appropriate state licensing can be time consuming and may delay initial contact with the claimant or policyholder.

To address the problem, IAS Claims Services, an Austin, Texas-based insurance adjusting company and third party administrator, developed tools in house to streamline FNOL assignments. The company handles a large volume of claims it receives from up to 100 different insurers each year.

By using intelligent claims routing technology, the new tools streamline and automate claims distribution by giving insurers the ability to automatically and quickly dispatch claims to the best-matched claims resource, bypassing traditional bottlenecks in the process.

“We’ve always been looking for tools that would help us better manage our own business,” said Larry Cochran, CEO of IAS Claim Services and Claimatic. “We embarked on developing this tool…really about seven years ago because we didn’t like what was out in the marketplace. We completely did a ground up product development project.”

Cochran recognized the company’s management team spent a lot of their time trying to match claims to the right adjuster. It’s a difficult process, he said, because the information related to an adjuster’s location, calendar, skills and licenses changes constantly.

The software for both insurers and vendors was created after several failed attempts, d Cochran said. After the last failure, the company conducted a post mortem to evaluate what could be done differently. Changes were made to the team and claims staff were given the opportunity to lead in the development of the software.

“That really was the turning point. Before we had the tech people taking the lead and interviewing claims people about their processes and how they go about their work. Then they would go back, jump into the production mode, crank out a bunch of code and put a system together,” Cochran explained.

The initial projects failed, he said, because there were too many steps, key strokes or clicks of a mouse or actions that just didn’t make sense. The product had to be easy to use, he explained.

“In our business, in the insurance industry in general, we have people coming and going all the time,” Cochran said. “We don’t want to waste a lot of…time training people how to upload files, go through the workflows, send claims…to dispatch, to inspection…whatever it is we have to do to close the file out or send checks out.”

The end product, Claimatic, not only helps the company in-house, it is available to insurers and other vendors. The software frees up a manager’s time by triaging and dispatching new claims based on information gleaned from the FNOL. Designed to match new claims to the most appropriate claims personnel, it processes multiple data sources in real-time to identify the best adjuster assignment using loss location, adjuster qualifications and availability.

Because it is a Software as a Service (SaaS) product, it integrates easily with most existing systems, Cochran said, and doesn’t require updates. It can be integrated with calendar systems, claims systems, internal portals and even human resources’ systems. The system won’t disrupt current claims management systems.

An insurer can implement business rules where an adjuster scheduled for vacation won’t be assigned any claims the day before and the day after.

“For instance, we can integrate with an HR application that would update the system to let Claimatic know when someone has to schedule the week off,” Cochran said.
Cochran explained that most insurers have a workflow already in place as to how they would like claims to be distributed, based on the attributes of a claim: location, insured information, policy coverage, main peril and sub perils involved. Severity, too, is important in claims assignments. Then they look to see the availability of inside and outside adjusters, as well as their current claim load and state licensing. File loads change constantly, he said. Combine all that information together and it’s a lot to sort through.

“What we did was we developed a software to really be a hub to connect to all the different systems a company have that will feed off live dynamic data to make those decisions to keep the balance of workload that is desired within that company,” said Cochran. “It’s a very…challenging issue for most companies. I don’t think there’s a company out there that we’ve talked to that doesn’t have that as a challenge. They use spreadsheets. They use calendars. They use all kinds of things to try to manage that and put a lot of people on those different systems, trying to make sure that they’re routing claims to the right folks.”

This past April, the company launched a mobile app to allow for automated field dispatch. The app tracks adjusters in real time and by location, intelligently matching the best resource in the field to claims almost instantly.

“Claimatic Mobile is a dramatic multiplier effect on automation by tracking live claims resources in real time to identify those that are closest to the claim, available and with the proper credentials to handle the claim. Think of it as the Uber for Claims,” Cochran said.

Similar to how Uber works, Cochran explained the mobile app tracks in real time by pinging off of a person’s mobile phone their current status and where they are. Once logged on, it already knows all of an adjuster’s attributes like skillsets, current insurance licenses and when they expire.

“It also knows and has populated the files that you have open currently,” said Cochran. “You can…use the app to open a file and generate statuses and updates that will immediately populate the client’s claims system to update that information.”

The mobile app allows an adjuster already out in the field and near a new claim to respond to it.

“It would send you a notice asking you to accept a new claim. All you have to do is click a check box and that claim is yours. It instantly gives you the contact information and the FNOL for that claim,” said Cochran. “It also allows you to click a hyperlink that allows you to…easily make a phone call.”

There are multiple benefits to both the software and mobile app, he said. These include saving time and money by routing claims quickly to the most appropriate adjuster. In addition, there are regulatory/compliance benefits in automatically assigning adjusters with valid state licenses. The mobile app cuts cycle time down considerably, he said, by using geographical data.

“A big driver for many companies looking at this technology is the ability to better control the distribution of claims to folks who have the right credentials and also that their licenses have not lapsed or that they have the correct license,” Cochran explained. “Once a person is populated in Claimatic, whether they’re an employee or a vendor, there’s time data element on their information that will trigger alerts to supervisors and to that resource themselves way in advance of…a problem with some certification or a license lapsing. Once that does happen, Claimatic will not make an assignment to an individual or a vendor that is not in compliance. It’s maintaining that information in real time.”

The company also recently launched Claimatic ICM, which offers a full intelligent claims management system for independent adjusting firms and other vendors.

“I’ve been in the claims industry as an owner and CEO for 10 years,” Cochran said. “I’ve been in all kinds of other industries and been involved in technology innovations, but I’ve never had anything catch fire like this, with the kind of interest that we have, from the largest carriers to small independent adjusting firms.”

In the past twelve months, Cochran said the product has assigned tens of thousands of claims and reduced thousands of hours of manual processing time while also reducing claims cycle time. For example, overall time in process of claims has been reduced by 20 percent and drive distance to claims has been reduced by nearly 35 percent.