Fal­con In­surance and In­sure­soft Ex­pand Part­ner­ship, Col­lab­o­rat­ing to Au­to­mate Claims Let­ter Pro­cesses and Be­yond

Digital Insurance - - CLAIMS - Linde Wolff, VP of Client Ser­vices, In­sure­soft

Since its in­cep­tion in 2013, Fal­con In­surance Com­pany has ex­pe­ri­enced rapid growth and di­ver­si­fi­ca­tion. Now writ­ing in three states, the com­pany wrote over $52 mil­lion in 2016. To ac­com­mo­date their grow­ing num­ber of pol­i­cy­hold­ers and the re­sult­ing claims, Fal­con has in­creased its claims staff to over 50 per­son­nel and opened a claims of­fice in Dal­las, Texas. As with any com­pany’s swift suc­cess comes some grow­ing pains, and there be­came a need to iden­tify and im­ple­ment new and ef­fi­cient ways to man­age and process the in­creased vol­ume. In times like th­ese, a tech­nol­ogy part­ner can bring ex­per­tise and a fresh per­spec­tive to help iden­tify and de­velop im­proved busi­ness pro­cesses. Fal­con, an In­sure­soft part­ner since 2013 (they im­ple­mented the Di­a­mond Suite to au­to­mate pol­icy, billing, and claims ad­min­is­tra­tion) turned to us to ex­plore new ways to help man­age their out­go­ing let­ters and claims cor­re­spon­dence.

Prior to Dy­namic Claim Let­ter Pro­cess­ing

Early on, Fal­con’s claims man­age­ment de­vel­oped and main­tained a cat­a­log of stan­dard­ized claims let­ters. The let­ters were made avail­able to the ad­justers and clerks via a shared file folder. Ad­justers would cre­ate and cus­tom­ize the doc­u­ments as Mi­crosoft Word doc­u­ments out­side of the Di­a­mond claim sys­tem and then at­tach the cor­re­spon­dence to the par­tic­u­lar claim file. Ad­justers and the cler­i­cal sup­port were re­spon­si­ble for print­ing, assem­bly, and mail­ing of their claim let­ters. As Fal­con’s busi­ness grew and diver­si­fied into ad­di­tional states, man­age­ment iden­ti­fied the need for a more ef­fi­cient and state spe­cific print and mail so­lu­tion.

En­ter Di­a­mond’s Dy­namic Claims Let­ters

Fal­con and In­sure­soft col­lab­o­rated to iden­tify an au­to­mated and more ef­fi­cient process by de­sign­ing a fully func­tional, dy­namic claims let­ter so­lu­tion. Fal­con im­ple­mented the ini­tial ver­sion for Illi­nois in Novem­ber 2016, and re­leased the lat­est ver­sion for In­di­ana in March of 2017. All the pol­icy and claim in­for­ma­tion in Di­a­mond is avail­able to pull into the let­ters. Fal­con au­to­mated the map­ping of ad­dress and claim in­for­ma­tion, while still be­ing able to en­ter dy­namic data into the let­ters. The dy­namic let­ter so­lu­tion pro­vides Fal­con con­sis­tent for­mat­ting of let­ters, while main­tain­ing proper struc­ture and con­tent. Let­ters are now avail­able in nightly batches to be printed and/or sent to the ful­fill­ment fa­cil­ity. Sep­a­rate jobs were cre­ated for the print­ing of cer­ti­fied let­ters and those that need to be sent with ad­di­tional doc­u­ments. All other let­ters are cre­ated as PDFs and sent elec­tron­i­cally to a ful­fill­ment fa­cil­ity for pre-sort­ing, assem­bly, and mail­ing. The let­ters’ ad­dresses are aligned to a fixed po­si­tion that the ful­fill­ment fa­cil­ity needs in order to process. Cover let­ters are de­signed into the let­ters where the fixed ad­dress po­si­tion is non-ap­pli­ca­ble. Batch was en­hanced to be called from a com­mand line. This al­lowed Fal­con to au­to­mate the ex­e­cu­tion of Pub­lisher (Di­a­mond’s on-de­mand doc­u­ment plat­form), creation of PDFs, and elec­tronic pack­ag­ing and send­ing of let­ters to the ful­fill­ment ven­dor for proper assem­bly and mail­ing on a daily ba­sis.

Busi­ness Ben­e­fits

With au­to­mated dy­namic data let­ters Fal­con has fully tran­si­tioned to an out­sourced mail pro­cess­ing fa­cil­ity. Fal­con’s uti­liza­tion of the dy­namic let­ter process has in­creased ad­juster pro­duc­tiv­ity an es­ti­mated 10-15%. With the in­crease in ef­fi­ciency, em­ploy­ees are in­creas­ingly sat­is­fied with their abil­ity to fo­cus on man­ag­ing claims and not hav­ing to deal with more cler­i­cal func­tions. Show­cas­ing the power of Di­a­mond with this suc­cess­ful ef­fort, Fal­con will look to ex­pand their part­ner­ship with In­sure­soft to help op­ti­mize other func­tions within the claims oper­a­tion. Fal­con has sev­eral projects in progress now, in­clud­ing au­to­mated iden­ti­fi­ca­tion of cov­er­age is­sues, SIU scor­ing, and im­proved ven­dor in­te­gra­tions for the sal­vage and ap­praisal pro­cesses. Fu­ture col­lab­o­ra­tions in­clude au­to­mated ad­juster as­sign­ment and au­to­mated work plan and pro­duc­tiv­ity track­ing.

Fal­con is now equipped with an au­to­mated let­ter man­age­ment process that will adapt with their growth for years to come. This project be­gan with a con­ver­sa­tion around a need for ef­fi­ciency, and re­sulted in a suc­cess­ful en­deavor sav­ing Fal­con time and money within their claims depart­ment. At In­sure­soft, we con­sider our­selves “pur­pose­ful part­ners”, mean­ing we are with you ev­ery step of the way to help solve busi­ness chal­lenges and make you more suc­cess­ful. Fal­con is a great ex­am­ple of how work­ing to­gether can bring ef­fi­cien­cies way be­yond the orig­i­nal scope of a core sys­tem in­te­gra­tion. We are cre­at­ing in­no­va­tions for our part­ners. They rely on us to bring the high­est stan­dards, and in­no­va­tive so­lu­tions that stand out amongst the com­pe­ti­tion. Is your core sys­tem provider a pur­pose­ful part­ner?

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