- How does ACM streamline their claims process? It starts with their state-of-the-art claims platform.
- ACM has added various Insurtech tools to increase claims handling speed and accuracy, from chatbots and drones, to inspection tools and automated first contacts.
American Claims Management (ACM), one of National Programs’ services companies, is a nationwide third-party claims administrator specializing in both commercial and personal lines. Continually innovating to streamline the claims process, ACM has added numerous Insurtech tools to solve claims more accurately and timely.
Industry-leading claims platform
ACM’s claims platform is a pure browser-based system built by enterprise system architects and ACM’s insurance experts. A paperless role-based system, the system handles any requirements needed to capture data at its most granular level.
The claims platform is completely integrated with ACM’s nursing, bill review, investigative and recovery teams. All appropriate data is shared and can be leveraged to obtain the most accurate outcomes. It also allows the team to easily create customized reports on the fly. The technology not only works to streamline the claims process, but also acts as a safeguard to circumvent human error.
“Our reports ensure that our carriers and self-insured entities are getting real value from their data,” said Brock Howard, senior VP of property & casualty. “Because the reports are derived from client requests, each answers real business questions that users have, from claim statistics to adjuster performance. Most are generated from the platform’s data warehouse, which ensures fast performance and avoids impacts to the transactional database.”
He went on to explain, “It can create any customized reports, customized automation and customized alerts/triggers that a carrier or self-insured entity needs, notifying different parties at various intervals regarding transactions that occur in the system. As our fail-safe to circumvent human error, we use a combination of alerts in the form of an email, a diary notification, or daily, weekly and monthly reports delivered automatically to the adjuster, manager and executive management.”
The claims platform is “real-time,” he added. Once the adjuster enters the document into the system, it’s available for viewing by all parties. Clients can view all notes in the system except for HIV/John Doe notes.
“The most critical part of any system conversion is the data conversion,” said Howard. “Ensuring accuracy and thoroughness is crucial. Our platform makes this process straightforward and reliable.”
The data conversion process starts with trial conversions of the client’s data into ACM’s system and continues with the validation, approval and final conversion. Proven comprehensive conversion reports are used for validation.
All ACM team members plus ancillary teams such as medical management, investigation and recovery specialists work in the same claims platform, to further streamline the claims process. Documentation is shared to ensure seamless transfer of knowledge and data. All parties facilitating on the claim file are on the same page, having access to the same data, so that no time is lost. Parties can execute all tasks efficiently, effectively and in the least amount of time.
Team members save considerable time by not having to log in and out of different systems to retrieve crucial information. It minimizes mistakes that can happen if key information is missing. It also streamlines action steps that should be performed in minimal time.
“For our customers, the key advantage is the ability to track data and metrics in one easy place, with access to literally any information they need,” said Howard. “Better yet are the checks and balances that exist to ensure actions on a claim file are performed on a timely basis.”
Additional claims tools to streamline the claims process
Claims chatbot. The chatbot allows claimants to report a claim24/7 through an interactive online process. The claimant can quickly outline their loss, improving the accuracy of the information needed to get started on their claim.
Content inventory program. Used in property losses, the software incorporates each carrier’s specific SOPs and walks the field adjuster through a series of ‘scripts’ to capture content inventory and document the loss.
CAT volume first contacts. When a catastrophe hits, ACM’s team calls every policyholder within the designated area – and that can be a huge number of calls. This program uploads claim data into a call center which begins an automated first contact response. Calls are made with pre-recorded scripts designed specifically to the client. Calls include claim details (claim number, policy number, etc.) crucial to the first contact. Hundreds of calls are completed within minutes and document first contact
Inspections management. Another ACM tool handles field adjuster scheduling, reporting and documentation of insured contacts and inspections. The system uses automated calling with voice response, allowing the insured to select an option that works best for them or opt to speak with someone directly. The field adjuster is better able to manage their own schedule and report real-time; inspections are monitored until closed. Field agents can communicate via text with claimants. Drone inspections are also used for some property claims.