The Risk Management Society (RIMS) recently released a report that reviews claims management principles, as well as steps for establishing, implementing and maintaining an effective claims management program.
Proactive claims reporting and management can contribute positively to the ongoing sustainability of an organization in a number of financial and nonfinancial ways – according to RIMS new executive report titled, “Claims Reporting and Management Practices.”
The reference guide, authored by members of the RIMS Standards and Practices Council, reviews the principles of claims management, steps for establishing a claims management program, managing, reporting, monitoring claims and improving the claims management program, as well as integrating claims management into an Enterprise Risk Management program. Tips on claims management are highlighted in the report.
For example, the report outlines how claims reporting can be used as an ERM tool when standards are created such as:
- Standardized incident reports. Information fields should be tied into existing collection and reporting systems.
- Staff should be trained to create an incident report for each occurrence.
- Accident investigations should be completed immediately after an accident.
- Claims data should be reviewed and evaluated to ensure compliance with the policy.
- Communication with management should be consistent.
“Claim reporting may be perceived as reactive, but risk professionals who have taken proactive steps to develop and implement a structured claims management process will be prepared to fairly and efficiently address a claim. Perhaps more importantly, analyzing trends not only can prevent future incidents, but can also improve operations,” said Yvette Ho Sang, chair of RIMS Standards & Practices Council. “In this Executive Report, we aimed to help risk professionals develop comprehensive and transparent claim reporting programs that tie into their organization’s strategic and operational initiatives.”
Additionally, the report highlights the need for continual monitoring of complex claims to ensure they are appropriately managed. According to the report, “Poorly managed highly reserved claim files that are commercially insured lead to higher insur- ance costs and poor loss ratios.”
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