Where the Rubber Meets the Road - Claims
have all the insurance you need but it means very little until you actually need to file a claim and set into motion the very reason why you got the insurance in the first place. It doesn't matter what kind of insurance you have, if the claims process is handled incorrectly or the insurance company blinks for even a second then all the premiums paid and promises made mean very little.
Have you ever known someone who had a bad claims experience? What did they do? More often than not they dropped their coverage at one of two times...either when the insurance company FINALLY paid the claim or when the client just got tired of fighting the "red tape" that some insurance carriers put up at claim time.
- SIDE NOTE - One important factor I look at with the companies I choose to work with is in the area of claims. I want to know what happens at claims time. I want to know that the client comes first and that everything is being done orderly to assure proper and timely communications with the clients above all else.
When a claim is filed, one thing is certain...some sort of loss has occurred. With loss comes many different thoughts and emotions that all equal uncertainty. The LAST thing a person needs is to deal with a person in the claims department of the big insurance company who drags their feet and acts like this client is almost an inconvenience to their day. Shame on anyone reading this who has the important claims position and acts this way.
I will address claims from the two perspectives with some thoughts to keep in mind as you go through the process:
1 - The claimant. This person has been paying premiums for what seems like forever. The day arrives where they need help because something has happened. The insurance they have been paying on now should "do its thing" and help them in this time of need. Now, some claims issues start right here (sorry guys). There is usually a process and a protocol that the insurance company (by law) must follow. If anything is missing from that process, a claim can not be completed. The claimant also needs to be patient. I know it's hard, especially at a difficult time. However, imagine someone dumping a mountain of paperwork (usually unorganized) on you and saying, "I need a decision by the end of the day." Be realistic and realize that the insurance company has only so many claims people in their office and hundreds of claims coming in every day. To do right by everyone involved takes time. So basically claimant...do all the work you're asked to on the claim and be patient. Also, don't be afraid to follow up. Don't expect a claims person to call you with updates every day.
2 - The claims professional. For you I have one important thing for you to keep in mind...please remember that at the point of a claim needing to be completed YOU are the face of the company. YOU are the light at the end of the tunnel in a tough situation. Now, I will say this about the claims people and that is that they are going to be able to make one of three answers to your claim:
- "Yes, your money is on the way." This is the ideal answer everyone is looking for. Most often than not it's the answer you will get (at least with the companies I deal with) but as long as everything lines up and adds up.
- "I'm sorry, but the policy does not pay claims in this area." Not all policies are created equally and not all policies pay for every loss. The claims professional has to be fair to all parties and if the policy in question does not meet the claim in a particular area they have to deny the claim. Period.
- "We need more information and/or more time." As I stated above, the claimant has a job to do as well for the claims process to complete properly. If anything is missing or something does not add up, the claims professional has to be sure that everything is complete and in order.
Lastly...please claims professional...be kind no matter what. Be timely. Keep the claimant "in the loop". There are claims that get denied but when that happens YOU are difference between a person dropping their much needed coverage or keeping it for another day.
Claims is a team effort. The claimant and the claims professional must work together and understand what each person is going through in the process. No one entity can work without the other. Claims is truly "where the rubber meets the road".
I am happy to report that any and all claims I have been associated with have gone well...even if the answer was no. It's as simple as being kind and understanding in the process for all parties involved.
Gene Ramsay is a health and life insurance professional with many major carriers. He is ready to connect with you and help. Feel free to head over to http://www.generamsay.com to find out more.
I try to be a phone call (205-370-8453) or an email (gene@generamsay.com) away.
Have you ever known someone who had a bad claims experience? What did they do? More often than not they dropped their coverage at one of two times...either when the insurance company FINALLY paid the claim or when the client just got tired of fighting the "red tape" that some insurance carriers put up at claim time.
- SIDE NOTE - One important factor I look at with the companies I choose to work with is in the area of claims. I want to know what happens at claims time. I want to know that the client comes first and that everything is being done orderly to assure proper and timely communications with the clients above all else.
When a claim is filed, one thing is certain...some sort of loss has occurred. With loss comes many different thoughts and emotions that all equal uncertainty. The LAST thing a person needs is to deal with a person in the claims department of the big insurance company who drags their feet and acts like this client is almost an inconvenience to their day. Shame on anyone reading this who has the important claims position and acts this way.
I will address claims from the two perspectives with some thoughts to keep in mind as you go through the process:
1 - The claimant. This person has been paying premiums for what seems like forever. The day arrives where they need help because something has happened. The insurance they have been paying on now should "do its thing" and help them in this time of need. Now, some claims issues start right here (sorry guys). There is usually a process and a protocol that the insurance company (by law) must follow. If anything is missing from that process, a claim can not be completed. The claimant also needs to be patient. I know it's hard, especially at a difficult time. However, imagine someone dumping a mountain of paperwork (usually unorganized) on you and saying, "I need a decision by the end of the day." Be realistic and realize that the insurance company has only so many claims people in their office and hundreds of claims coming in every day. To do right by everyone involved takes time. So basically claimant...do all the work you're asked to on the claim and be patient. Also, don't be afraid to follow up. Don't expect a claims person to call you with updates every day.
2 - The claims professional. For you I have one important thing for you to keep in mind...please remember that at the point of a claim needing to be completed YOU are the face of the company. YOU are the light at the end of the tunnel in a tough situation. Now, I will say this about the claims people and that is that they are going to be able to make one of three answers to your claim:
- "Yes, your money is on the way." This is the ideal answer everyone is looking for. Most often than not it's the answer you will get (at least with the companies I deal with) but as long as everything lines up and adds up.
- "I'm sorry, but the policy does not pay claims in this area." Not all policies are created equally and not all policies pay for every loss. The claims professional has to be fair to all parties and if the policy in question does not meet the claim in a particular area they have to deny the claim. Period.
- "We need more information and/or more time." As I stated above, the claimant has a job to do as well for the claims process to complete properly. If anything is missing or something does not add up, the claims professional has to be sure that everything is complete and in order.
Lastly...please claims professional...be kind no matter what. Be timely. Keep the claimant "in the loop". There are claims that get denied but when that happens YOU are difference between a person dropping their much needed coverage or keeping it for another day.
Claims is a team effort. The claimant and the claims professional must work together and understand what each person is going through in the process. No one entity can work without the other. Claims is truly "where the rubber meets the road".
I am happy to report that any and all claims I have been associated with have gone well...even if the answer was no. It's as simple as being kind and understanding in the process for all parties involved.
Gene Ramsay is a health and life insurance professional with many major carriers. He is ready to connect with you and help. Feel free to head over to http://www.generamsay.com to find out more.
I try to be a phone call (205-370-8453) or an email (gene@generamsay.com) away.
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