Tag Archives: insurance claim

claims

Visual Technology Is Changing Claims

One of the common challenges insurance companies face when it comes to claims is how they can make the process more efficient for customers. Processing claims takes time and resources regardless of size, especially for claims valued at $10,000 or less, where it is not cost-effective to have an adjuster evaluate the damage onsite.

Mobile changes customer expectations 
Customers’ today are demanding. They want instant results. Mobile technology is transforming customer expectations. Nigel Walsh, who is the head of insurance in the UK for CapGemini, stated at a recent TechUK meeting that. “Customers are getting more savvy. Expectations have gone up, but insurers are not meeting those expectations.”

Traditional claim processes meet disruptive technology
Using technology to engage with the customer, the InsurTech transformation is addressing the gap between self-serve applications and traditional onsite visits with video. Solutions such as SightCall Visual Claims are using mobile video to allow policyholders to file claims in real time. It is all about the customer using technology that engages them and allows them to show the damage with their smartphone. Here is a quick example of how it works.

Don’t fall short of customer expectations. They are ready
While starting in early stages of implementation, major insurance companies were only expecting 10% of their customers to accept this new approach. Instead, they reported receiving more than 80% positive participation. The mobile mind definitely shifted the expectation that “I can get what I want immediately.” Providing an instantaneous solution to customers has become essential in how successful insurance companies distinguish their value from the competition.

Is insurance ready?
Reducing claim cycle times from days to hours not only results in high customer satisfaction but also creates massive savings. The monthly cost of the technology can usually be covered by one single video session that avoids an onsite visit. Decision is a no brainer. Now the challenge resides in the change management. Insurance customers are ready, but are insurance employees ready to change their way of working?

get along

Why Can’t We All Get Along?

More often than not, a large property and business interruption insurance claim turns into an “us vs. them” scenario, creating a rough process for all involved. Not unlike a football game, someone is always trying to win and is willing to do so at any cost. As a forensic accountant for more than 20 years specializing in quantifying business interruption losses and documenting property claims for policyholders, I’ve seen the good, the bad and the ugly. The problem is that the process is designed to focus on disagreements.

We’ve heard the concerns from our clients and the insurers, and we can understand both perspectives. Policyholders accuse the adjuster of being unreasonable, trying to stick it to the policyholder at every turn. Insurers accuse policyholders of trying to take advantage of the claim in an attempt to get more than they deserve. The battles can become very heated, even on a personal level. Once, during a claim meeting on a large loss, the discussion between the parties intensified until an executive from the insured side of the disagreement ordered the adjustment team to “get out of my building!”

Disagreement in the course of a property insurance claim is an anticipated part of the process, but there are ways to keep it civilized and productive. It is possible to come to a fair representation of the loss without all the aggravation. The fix is really quite simple, but it will require the insured and insurer to take responsibility for their contribution to both the problem and the solution.

Here are some ways insurers can improve the claim process:

Take time to understand the insured’s business 

Too often the adjuster wants to appear to know it all. It is better to listen first and try to understand the insured’s position. Understanding your customer is common business sense.

Adjusters should have superlative people skills

A big part of an adjuster’s role is to coordinate with experts needed for a given situation. These are management and organizational skills. In other words, the adjuster does not need to know all the technical aspects of every loss and would be better served knowing more about how to manage people and deal with customers. Whether it’s from retiring baby boomers or cost cutting, there is a lack of well-trained and experienced adjusters.

Give the adjuster more control 

Even the best adjusters are impaired by the current claim process; Adjusters seem to have limited authority to make decisions. Policyholders find it pointless to explain their issues in great detail when the real decision maker is somewhere in the background. When pressed to make a decision, policyholders just throw their hands up. It’s difficult to make any progress when the adjuster has to get every little decision approved by superiors. To the insured, it just seems like a delay tactic to put off payment and only adds to feeding mistrust.

Here are some ways policyholders can improve the claims process:

Give the process a chance 

While there are many times you will experience some of the problems mentioned above, the process can work with the right people involved. Communicate with the adjuster and his or her team. Be responsive to all requests that are reasonable and appropriate and ask for clarification and address your concerns right away.

Maintain good relations with realistic expectations

Set realistic expectations for what you want, such as advance payments and resolution of differences. Though insurers are not obligated to finance a rebuild project, they should be willing to advance money to stay ahead of the cash expenditure. By maintaining good relations with the adjuster, insurers will be more open to working with – rather than against  you.

The best defense is a good offense 

On your end, be prepared and organized so you can require the same of the insurance company. You cannot withhold information until the last minute and then demand resolution and payment. The faster you answer questions and requests, the faster the insurance company can review them. Often times, it takes them longer to review the support you provide because they review the information in a vacuum. Don’t assume they understand what to ask for or what has been presented. Promote frequent meetings and discussion to make sure misunderstandings are not made part of their reports to underwriters. Once it is on the record, it is harder to change.

Escalate when needed

If issues start to arise that cannot be resolved, rather than letting it fester, escalate it to the markets involved. It is no different than speaking to a manager at a restaurant. It’s better to deal with decision-makers when action is needed. However, this should only be used as a last resort to avoid litigation.

The insurance claim process has its flaws. I don’t think it’s intentional but rather a result of how it has evolved. The best approach to improving the process is by recognizing the challenges with an “us vs. them” mentality and finding a way to work cooperatively through the claim. Both sides need to help to fix it so that more claims get resolved as they should.

‘Gig Economy’ Comes to Claims Handling

Why is this taking so long?!

The challenge I hear echoed throughout the insurance industry is, “How do we speed up the claims process for customers?” Insurance companies often bear the brunt of frustrations from customers stressed out about delays. As we all know, processing claims takes time and patience to gather information, details, photographs and a myriad of other documentation. Getting the right information and accurate documentation takes even longer.

Based on the volume of claims, resources and personnel can become stretched thin quickly. Despite all the efforts within organizations, it’s not uncommon to see claims departments contorting themselves like Gumby to get it all done. Insurance claims are stressful, and relying on customers to reliably and quickly provide information is a challenge — even when it’s to their benefit.

The problem becomes exacerbated following natural disasters or claims in geographic locations where companies have little to no footprint and limited resources to document and gather the information needed. In those situations, companies have to reallocate and sometimes relocate resources, which is expensive, time-consuming and a logistical nightmare.

Saving time and improving data quality and accuracy are all key components to avoiding customer frustration and increasing customer satisfaction and loyalty.

Traditional Challenges Meet Disruptive Solutions

Recently, there’s been a lot of handwringing about the “sharing economy,” the “gig economy” and what it means for traditional lines of business and workers. Will the workplace as we know it change completely? As Tony Canas shared in his Insurance Thought Leadership piece, “What Will Be the Uber of Insurance?,” the gig economy is hardly the end of the world, and the insurance industry is probably due for some disruption.

What a number of traditional lines of business are beginning to discover is that the gig economy presents an opportunity to leverage the power of crowdsourcing to solve challenges, eliminate inefficiencies and even spark innovation within their organizations. Target and Instacart, GM and Lyft, are great examples of how large, traditional verticals are finding ways to integrate the gig economy into new products and services to attract and keep customers while increasing the bottom line.

Now going back to one of insurance’s greatest challenges — saving time and improving accuracy in the claims process, particularly when it comes to getting information such as photographs, records, police reports and inspections. These tasks sometimes feel like they can go on forever with a single claim as companies try to coordinate logistics with policyholders.

What if there was an Uber for insurers? A service that could dispatch an objective third party with a smartphone to quickly take pictures and gather exactly the information needed in the claims process almost immediately?

There is.

Disruption Gets Good for Insurance

Like Uber, WeGoLook is changing the way the gig economy is disrupting B2B by providing inspection and custom tasking services. Building on the strength of the gig economy and using the crowdsourcing model, WeGoLook has built a nationwide network of field agents that provides a nimbleness that is often buried alive in large enterprises.

Here’s how it works at one of the nation’s largest auto insurance companies, where WeGoLook is incorporated into the claims-handling process:

  • A claim handler places an order on a custom dashboard and chooses a service: (1) vehicle photos, (2) scene inspections, (3) salvage retrieval, (4) police record retrieval.
  • A WeGoLook representative calls the onsite contact/policyholder to verify address/item information and schedule an appointment.
  • The “Looker” arrives on-site and captures the data needed for the service/task.
  • Data is submitted via the mobile WeGoLook app and reviewed by internal staff at WGL for quality assurance.
  • The completed report is sent directly to the claim file.

Turning to the gig economy and its on-demand workforce is generating economic benefits and creating true efficiency. We’ve witnessed the process being replicated in companies both large and small and in a variety of categories.

Since starting the company in 2009, I’m continually inspired by the creativity of entrepreneurs and how they’ve found new and inspirational ways to apply crowdsourcing. From crowdfunding, ridesharing, coworking and delivery services to even “pet Airbnb,” the gig economy marketplace is homing in on specific consumer and business needs and delivering.

Insurance Jobs of the (Near) Future

As the insurance industry continues its slow but steady journey into a digital future, the skills required by the insurance workforce of tomorrow will also change. Here is my take on some of the insurance jobs we can expect to see in (I hope) the near future.

Digital Forensic Investigator

It’s happening more and more – fraudsters submit an insurance claim only to have it thrown out because someone’s discovered footage showing the whole thing was staged. My two favorite examples of recent times are the pregnant woman case and the Bugatti Veyron case. With more of our lives shared online, it’s easy for insurers to check our digital alibis, and digital forensic investigators (basically people who get paid for trawling social media) are the mechanism to do this.

Cyber Actuary

Cyber insurance is becoming a must have for corporations, but it won’t be long until it becomes a must have for individuals, as well. To effectively price this insurance, a new breed of digital natives with actuarial skills will be required to work out the risk and loss associated with a personal hack of your Facebook, Twitter, Instagram, LinkedIn and email accounts.

Drone Pilot

If you’re currently working as an insurance assessor, I recommend you start learning how to fly a drone. On any given day in the future, you could have five drones at your command, each one automatically programmed with a flight path of claim sites to visit. As each drone arrives on site, you take manual control to get a good look with the on-board camera. Same job, but no more climbing roofs or visiting wreckers.

Telemedicine Nurse

Panel doctors beware! Five years from now, most medical examinations will be done at your local “telemedicine booth,” where you’ll self-assess using the same tools a doctor would use. A live telemedicine nurse, located anywhere in the world, will be on a video conference screen located in the booth to guide you through any tricky parts and to verify that it’s actually you taking the tests.

Internet of Things Solution Architect

It’s already possible to control many Internet-connected things in your home – televisions, fridges, air-conditioners, door locks, lamps and pet food dispensers – using smart phone apps. So, in theory, it should also be possible for these devices to notify you when they’ve been stolen (televisions), had food spoil because of a power failure (fridges) or been broken into (door locks), or when a pet stops eating and falls ill (pet food dispensers) – all of which are also insurable events. The challenge for IOT solution architects is to take the data and use it to trigger automated claim applications and approvals. It’s an exciting (though less private) future.

Have we missed anything?

These are just a few of the jobs that insurers can expect to start recruiting for shortly, if they haven’t already. Do you agree? Have we missed anything? Please comment below!

Rental Car Waiver: To Buy or Not to Buy?

When I Googled “should I buy the rental car damage waiver, I got 40.6 million hits. Needless to say, much has been written about this issue. But much of what has been written is BAD (aka horrible and dangerous) advice.

If you have auto insurance, is that good enough? What about credit card coverage? This article explores the issues and suggests some answers, at least one of which you might not like. (Note: This article builds on an article I first published in 1998, titled “Top 10 Reasons to Purchase the Rental Car Damage Waiver.”]

The vast majority of consumer articles suggest that the purchase of the loss damage waiver (LDW) is not necessary if you have auto insurance or credit card coverage. For example, in a 2014 article in U.S. News & World Reports titled “7 Costly Car Rental Mistakes to Avoid,” the very first “mistake” involves buying insurance you don’t need. The article says your auto insurance policy “may” cover collision and quotes someone who says, “The credit card coverage will kick in for anything your personal policy doesn’t cover.” Needless to say, “may” and “will” are two different things.

While many auto policies and some credit cards may provide coverage for damage to a rental car, it is almost certainly not complete, and four- to five-figure uncovered losses are not at all uncommon. The purchase of the LDW (with caveats), along with auto insurance, provides a belt and suspenders approach to risk managing the rental car exposure.

Let’s explore the value and deficiencies of auto insurance, credit card coverage and loss damage waivers.

Personal Auto Policies

In the article I wrote in 1998 and have since updated, I enumerate many reasons why buying the loss damage waiver is a good idea. I won’t repeat those reasons in their entirety, but I’ll highlight the more important issues that have resulted in uncovered claims that I’m personally aware of, based on more than 20 years of managing such issues. We’ll start with the current 2005 ISO Personal Auto Policy (PAP) as the basis of our discussion, with some references to non-ISO auto policies.

The ISO PAP extends physical damage coverage to private passenger autos, pickups, vans and trailers you don’t own if at least one declared auto on your policy has such physical damage coverage. But physical damage coverage does not extend to a motor home, moving truck, motorcycle, etc. that you are renting.

Damage valuation is on an actual cash value (ACV) basis, while most rental agreements require coverage for “full value” (translation: whatever the rental car company says is the value), and most PAPs exclude any “betterment” in value.

Many non-ISO PAPs have an exclusion or dollar limitation on non-owned autos or specific types of rental vehicles such that rental, for example, of an upscale SUV or sports car may have limited or even no coverage.

Many PAPs limit or do not cover the rental company’s loss of rental income on a damaged auto. There is often an option to provide increased limits for this coverage, but many price-focused consumers may decline such coverage. Even where this coverage is provided, many insurers may only be willing to pay for the usage indicated by fleet logs while the rental agency wants the full daily rental value. In one claim, the renter was charged $2,000 more than his insurer was willing to pay. In another claim involving a luxury car that was stolen from his hotel parking lot, the renter was hit with the maximum daily rental rate of $300, for a total loss of use charge of $9,000 (that he negotiated down to $4,500). In still another claim, following the 2011 tsunami that hit Japan, replacement parts for a rental car were unavailable for several months, and the renter incurred a $6,000 loss-of-use charge by the rental car company.

Probably the most significant deficiency in the PAP is the lack of coverage for diminished value claims. That’s the #1 reason I always buy the LDW. I’m personally aware of uncovered diminished value charges of $3,000, $5,000, $7,000 and $8,000 and read about one from a reliable source that totaled $15,000 on an upscale SUV rental.

In one case, a Florida insured traveled to Colorado for a rock-climbing vacation. He passed on purchasing the LDW for his four-day rental because “I’m an excellent driver, and I’ve got car insurance and credit card coverage.” Apparently, the driver of the vehicle that sideswiped his rental car while it was parked was not an excellent driver. The damage totaled $4,400 for repairs, $370 for administrative fees, $620 for loss of use and $3,100 in diminished value. Of the $8,490 total, $3,990 was uninsured and not covered by his credit card, the biggest component being the $3,100 diminished value charge. In addition, the driver ended up having to hire a Colorado attorney to assist in resolving the claim. The cost of the LDW for the entire trip would have been less than $100, a small fraction of the total cost of his vacation trip.

When insureds travel on business or vacation, a rental car is often valet-parked at a hotel or restaurant. The ISO PAP extends physical damage coverage for non-owned autos “while in the custody of or being operated by you or any ‘family member’.” So, the question is whether the vehicle is still in the custody of the insured while it’s being valet-parked or otherwise in the custody of the valet service. If you don’t know and you’re relying on your PAP for coverage, the best advice is probably to not valet-park a rental car.

There are many other deficiencies in the ISO PAP that apply, and you can read about them in the previously mentioned “Top 10” article on our website. The last point I’ll make is a reminder that the majority of auto policies in the marketplace are not “ISO-standard” forms. (To learn more about that, Google “independent agent magazine price check.”) Despite what you may be led to believe by auto insurance advertisements or articles that imply that all auto policies and insurers are the same, there are potentially catastrophic differences, including coverage deficiencies with regard to rental cars. There are unendorsed non-ISO policies that don’t cover non-owned autos, period; others that exclude business use of such autos or non-private passenger vehicles (this one shows up in policies of major national carriers, not just “nonstandard” auto insurers); others that exclude vehicles that weigh more than 10,000 pounds; and so on.

Conclusion? An auto policy simply is not adequate to cover the rental car physical damage exposure.

Credit Card Coverages

Read a few of the many articles on the Internet about using credit card programs to fund damage to rental cars, and you would think that little more is needed to adequately address the exposure. Unfortunately, credit card programs have as many, or more, deficiencies as does the PAP alone. Anyone relying on auto insurance and credit cards would be well-advised to study the credit card programs. In his article, “Rental Car Agreements, LDWs, PAPs, and Credit Cards,” David Thompson, CPCU writes:

“Many major credit cards provide some limited, free coverage for rental cars. Most post the provisions related to rental cars on the card issuer’s web site. While these can run several pages, three specific conditions [that] limit, restrict or invalidate the free coverage are show-stoppers. For example:

“The following conditions limit, restrict, void or invalidate the auto rental damage waiver (DW) coverage provided by your credit card:

“(1) This auto rental DW supplements, and applies as excess of, any valid and collectible insurance. For coverage to apply, you must decline the DW offered by the rental company.

“(2) The following losses are not covered by this auto rental DW coverage: (a) Any loss [that] violated the rental agreement of the rental company; (b) Any claim for diminished value of the rental car.

“(3) Any loss or damage to certain types of vehicles—see list.”

In other words, (1) credit card coverage is excess over ANY collectible insurance, (2) you must decline the rental company’s LDW, (3) violation of the rental agreement precludes coverage, (4) like the PAP, there is no coverage for diminished value, which we’ve seen can total thousands of dollars and (5) certain types of vehicles are excluded. Excluded vehicles may include pick-up trucks, full- sized vans and certain luxury cars.

And these are only part of the full list of limitations often found in these programs. Another common limitation is that loss of use is only paid to the extent that the assessment is based on fleet utilization logs. One major credit card only covers collision and theft even though the rental agreement typically makes the user almost absolutely liable for all damage, including fire, flood and vandalism. Some credit cards offer broader optional protection plans, but typically they also exclude coverage if there is a violation of the rental agreement and don’t cover diminished value.

Another issue with reliance on credit cards is that the rental company may charge uncovered fees that max out the credit limit on the card. If you’re 1,000 miles from home on vacation with a maxed-out credit card, that can present problems.

Loss Damage Waivers

Many people don’t buy the rental car company’s LDW because they think they have “full coverage” between their auto policy and credit cards. Many see what can be a significant charge and choose not to buy the LDW on the premise, “This’ll never happen to me.”

I rarely rent cars on business trips or vacation, but I experienced a major claim with a hit-and-run in a restaurant parking lot the night before a 6 a.m. flight. I had bought the $12.95 LDW for my four-day trip, so I simply turned in the vehicle at the airport with little more than a shrug.

Thompson, who rents cars fairly often, says he has walked away from damaged cars three times. Returning a rental at the Ft. Lauderdale airport, Thompson asked the attendant how many cars a month are returned with damage. She responded that, in her typical 12-hour shift, 15 cars are returned with damage and, in most cases, the damage was allegedly caused by someone else, not the renter. She estimated that only about 15% of renters buy the LDW.

The cost of the LDW admittedly can be significant, especially if you extrapolate what the effective physical damage insurance cost would be at that daily rate. But that’s only one way to view the investment in peace of mind, not to mention the avoidance of what can be significant claims.

On an eight-day vacation last year, the LDW cost me more than the actual rental and, in fact, more than my airline ticket. But I considered the LDW part of the cost of the vacation.

Is the LDW all you need? Is it foolproof? Well, kind of, as long as you follow the rental agreement. If you violate the rental agreement, you are likely to void the LDW. Many rental agreements consider the following to be violations:

  • Driving on an unpaved road or off-road (often the case in state or national parks or states like Alaska and Hawaii).
  • Operation while impaired by alcohol or drugs.
  • Any illegal use (parking violations?), reckless driving, racing or pushing or towing another vehicle.
  • Use outside a designated territorial limit.
  • Operation by an unauthorized driver.

This illustrates the advantage of using the belt and suspenders approach of the PAP plus the LDW. The ISO PAP does not exclude the first three rental agreement violations, and the territorial limit is usually broader than any restrictive rental agreement territory outside of Mexico.

As for unauthorized drivers, some rental companies may automatically include a spouse or fellow employee or authorize them to drive for a fee. More often, the renter never reads the rental agreement and presumes anyone on the trip can drive. In one claim, a father and son were on vacation, and the father rented a car. The son had a driver’s license but was too young under the rental agreement to drive the car. The rental clerk made this clear at the time of rental. Despite knowing this, the father allowed the son to drive, and he wrecked the vehicle. Not only was the LDW voided, the father’s non-ISO PAP excluded the claim because the son was not permitted to drive the car.

A special case of unauthorized drivers could be-valet parking at a hotel or restaurant. Some agreements might except valet parking, so it’s important to determine at the time of rental whether valet parking is covered.

A note on third-party LDWs: In 2011, a fellow CPCU rented a car through Orbitz or Expedia, which offered an LDW at the time of the reservation. He mistakenly assumed this was the same LDW offered by the rental car company, but it was underwritten by a separate entity. During his trip, the rental car was damaged by a deer on a rural Montana road. To make a long story short, the third-party LDW was not a true “no liability” LDW warranty of the type offered by the rental car agency, and the result was, after negotiations on the uncovered portion of the charges (including diminished value), he had to pay in excess of $1,000 out of pocket.

Conclusions

When I rent a car on a business trip or vacation, I price the rental to include the LDW and make my decision, in part, on that basis. The peace of mind alone is invaluable, and, again, I consider the cost to be comparable to my decision to stay in a decent, secure hotel.

If you rent cars frequently, consider negotiating a price including LDW with one or more rental car agencies. Otherwise, caveat emptor. If you are an insurance professional giving advice to consumers about whether to purchase the LDW, it would likely be in your and your customer’s best interest to recommend consideration of the LDW. Your E&O insurer will appreciate it.