Insight

The three Cs of claims-handling: communication, clarity, and congeniality

July 2, 2024

By Elissa Doroff, Head of Americas, Claims

There’s a saying that you don’t close a sale in insurance, you open a relationship—and nowhere is that truism more apt than in the world of claims. How a carrier handles claims is a key determinant in whether policies are renewed and clients retained. In my experience, the needed claims-handling attributes to achieve successful outcomes can be categorised under “Three Cs,” namely, communication, clarity, and congeniality.

Communication

In all claims, some level of investigation will always be necessary. However, the most fundamental part of this process should be transparency: i.e. open communication on both sides. What does the insurer need from the insured to validate their loss, and, once received, how quickly can the insured expect a response? At Mosaic, as soon as we receive a notice of loss, we reach out to both the broker and insured to let them know it’s been received, we’re reviewing, and any additional information we may need. Mainly, we want to reassure them they can expect an efficient process going forward.

An early call involving insured, broker, and insurer can go a long way towards establishing clear expectations of what happens next, especially when the client is making their first claim. In the initial conversation, the insured can talk through details of the loss. Sometimes, it can be determined quickly that the policyholder would be best served hiring independent legal or financial experts—advice the insurer should share in the interests of enabling the claim to advance as smoothly as possible. Different product lines have different needs and recognizing the urgency and importance of getting the right experts involved early on can mean the difference between a quick resolution or a longer, more drawn-out process.

The insurer should strive to get a detailed picture of the client’s expectations of the policy, a conversation that can lead to clarification or adjustments of language to ensure that what is being covered is relevant to the client’s needs and as clearly articulated as possible. Likewise, the client should be fully briefed on what to expect when they submit a claim. Efforts to eliminate ambiguity at the start of the insurance relationship pay off in reduced friction during claims-handling.

Lines of communication need to be open and direct. Insureds are best served by being able to pick up the phone and speak to a claims professional with the necessary experience to answer their questions. Having this contact person introduced early on, ideally when a policy is first bound, will encourage a company to make it part of their incident response or business continuity plan.

Clarity

While general communication is paramount, clarity of that communication that is also essential. The work of establishing claims clarity starts before a policy is sold, through candid conversations with the broker as part of the pre-bind process. Once a claim is submitted, it is that initial request for information from the insurer that must be well thought out, with clear guidance on documentation the insured needs to supply to validate the claim.

The more information gleaned from the first round of questions, the less onerous the subsequent to-and-fro will be for all parties. The cardinal sin for an insurer is to ask the same question twice—a mistake that can lead to frustration for policyholders who may see this as an extended process signalling a reluctance to pay.

The more detail a claims-handling professional can share will form the best kind of communication, framing the context for the whole process and reducing concerns all round.

Congeniality

The arrangement between insurer, broker, and insured works best when it functions as a partnership, as opposed to a purely transactional relationship. To achieve this differentiation in practice depends heavily on the soft skills that constitute a congenial approach. Listening and flexibility, in particular, help nurture the spirit of partnership.

Personal relationships are integral to partnership-building. When a single, dedicated claims professional is the consistent first point of contact on a given policy, the human element is stronger than when brokers and insureds are speaking with different individuals at various levels each time they contact the claims team. Crucially, that one professional must be sufficiently experienced and empowered to answer questions and make decisions.

Another example of a trust-building approach is when an insurer offers the flexibility to endorse an insured’s preferred vendors in a policy, rather than stipulating the use of partners on the carrier’s preferred list. This is crucial in several product lines such as cyber and transactional liability, for example. Mosaic provides this flexibility, but many insurers do not.

Partnership builds trust, which, in turn, encourages the openness and efficient information exchange necessary for a fair and smooth claims process. The importance of all three Cs is evident in the building of trust—just as a lack of any one of them can erode it. In a process that involves many moving parts and inevitably varies among carriers, applying such best practices to handling of claims can also be a great opportunity for insurers to differentiate themselves from competitors.