Call Centers

Highlights
  • This insurance company had a long established reputation for quality but wanted to exceed customer expectations through productivity and quality improvements such as accurate and expedited claims processing and service representative availability
  • Applying ADI’s behavior-based solutions they identified key areas for focused improvement and the performance gaps that hindered or prevented those improvements and also helped the center’s team identify the specific behaviors necessary to close the performance gaps
  • Despite being their busiest time of year, they reported a 50 percent decrease in number of customer complaints and a 50 percent increase in number of same-day closed claims

Customer Claims Processing – Insurance Claims Call Center

A national insurance firm applies ADI’s behavior-based solutions to productivity and quality initiatives using an overall systems redesign that positively impacts customer satisfaction ratings.

Situation:

With a long established reputation for quality, this insurance company with 7500 employees wanted to exceed customer expectations through productivity and quality improvements such as accurate and expedited claims processing and service representative availability. These goals also included increased employee job satisfaction through the creation of a more positive workplace. However, the organization had no consistent measurement system in place with the exception of several productivity standards. Despite attempts to consistently meet and/or exceed quality and productivity objectives, the organization could not sustain gains in employee performance.

Solution Implemented:

ADI specialists assessed the center’s current strategies using a process mapping system for identifying key areas for focused improvement and the performance gaps that hindered or prevented those improvements. Examining the work process, they helped the center’s team identify the specific behaviors necessary to close the performance gaps, then specified measures for those behaviors and monitored the impact on desired results. The ADI specialists also guided the group through the development of employee feedback and recognition plans, modified existing measurement tools to integrate with the new process, and designed an accountability system to ensure that all areas of the new initiative were sustained.

The beginning phases of the new system took place during the winter storm season, coinciding with high activity in weather-related claims. However, even with the elevated work load, the team showed marked advances in the areas of phone availability, higher quality of claim log notes for facilitating claims processing, increased closure of claims after one call and an overall decrease in the number of calls necessary to complete and close a customer claim file successfully.

Results of Intervention:

  • 13 percent average increase in number of calls answered despite weather-related technical problems paired with increased claims activity and holiday employee shortages
  • 50 percent decrease in number of customer complaints
  • 50 percent increase in number of same-day closed claims
  • Expressed heightened clarity of performance requirements, reduced stress levels, and fewer employee job-related complaints

“The focus has shifted from just answering as many calls as possible to handling each call as completely as possible.”

– Claims center representative

 

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