What to Look for When Shopping for a Quality Claim Service

When looking to hire a third party vendor or administrator to handle claims, it’s important to consider the experience and history of not just the company, but also the claims handlers.

That’s according to Kevin Quinley, founder and principal of Quinley Risk Associates. He spoke with Claims Journal during his podcast, Claims Insights, to explain why vetting claim service providers is important and offered tips on evaluating potential vendors.

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Quality claim service should factor in more on an insurer’s purchasing decisions, he said.

“I think the drumbeat of price competition, of marketing message, of insurance being a commodity, degrades the valuation and the weight that quality claims services should have in that decision,” said Quinley.

The first step in the shopping process is to request references. Ask for a list of some current or past clients, as well as clients with comparable types of claims, he said.

In addition, he recommended tapping into an insurance broker’s network to assess the industry perception about a carrier or a TPA’s claim service.

“Have the broker put the word out, discreetly, and gather intel. However anecdotal, this will be part of the picture that you’re getting before signing on with an insurer or TPA. The broker can report on what’s the buzz about the quality of claims service out there on the market, which servicing locations are strong and which are weak,” said Quinley.

Brokers and agents can also assist in offering their thoughts on adjuster expertise.

“Are there glowing reviews and endorsements, or guarded comments, or none of the above,” said Quinley.

His third tip is to check for any red flags about a potential claims service. A state Department of Insurance is often a good starting point. Quinley cautioned that a vendor shouldn’t be discounted just because complaints exist.

“You’ve got to remember, that just having complaints doesn’t automatically mean that those complaints are legitimate, in fairness to the providers,” said Quinley.

Besides a company’s profile, it’s a good idea to drill down to staff level to determine if a claim service would be a good fit.

“Adjusters vary…significantly in terms of experience, competence and attitude,” said Quinley.

The following questions are good ones to start with:

  1. How many years of claims experience does the person have?
  2. Is there any experience, specifically geared to your coverage or to the areas where, historically, you’ve had or expect claims?
  3. Does the adjuster’s work history reflect stability?

He also suggested looking for continuing education credentials, like Associate in Claims (AIC) or Society of Claims Law Associates (SCLA) designations.

Quinley explained the most important question to ask a perspective claims service provider.

“Press for what I call differentiators. Ask for reasons why their claims service is better than the competition. If they bumble, stumble or fumble, or give you just really generic answers, move on to the next candidate,” he said, adding that astute claim service providers can articulate their value proposition.

Differentiators can include:

  1. Bench strengths.
  2. Specialized expertise.
  3. Exacting written service standards and commitments.
  4. Claims training tailored to the needs of the client.
  5. Low caseloads to maximize file quality.
  6. In-house quality assurance systems to assure consistent claim handling and close supervision of claims.
  7. Ongoing continuing education of the claims staff.
  8. Loss control insights or expertise to address conditions that cause claims and can help prevent them in the future.

Quinley suggested getting written service standard commitments that will govern the claim handling procedures. He also recommended researching a claim service’s litigation history.