Claim Practices of Voluntary Carriers Spotlight™ Report

Cost: $3,000; published 2021

Employers know their employees need the protection voluntary benefits offer, and nothing highlights the importance of these products to everyone involved — employers, brokers and employees — than when a claim is paid.  And since the average employee is younger and more tech-savvy than in years past, expectations for the claim process to be easy, technologically driven and fast have increased. That makes it imperative for carriers to improve their overall claim processes and accuracy, communication methods and turnaround times if they want to remain competitive in the voluntary/worksite market.
The purpose of the Claim Practices of Voluntary Carriers SpotlightTM Report is to provide important information for carriers on claim practices including:

  • Claim area structures and organization
  • Claim filing and status options
  • Claim time standards by product and methods of measurement
  • Claim processes and services
  • Claim integration practices
  • Claim evaluation and tracking
  • Changes to claim practices due to COVID-19
  • Concerns, obstacles and future trends

With this information, carriers have a source for comparing their existing claim practices with carrier competitors, enabling them to plan for important future trends and expectations in this key administrative area.


View Table of Contents

1. Executive Summary

A. Report Objectives

B. Methodology

C. Key Findings

D. Recommendations

2. Findings by Carrier

A. Carrier Data

1. Separate Voluntary/Worksite Claim Area

2. Claim Structure and Organization

3. Outsourcing of Claims

B. Claim Filing and Status Capabilities

1. Ways to File a Claim

2. Notifications to Claimants

3. Claims Status Tracking

4. Follow-Ups to Claimants for More Information

5. Claims Tracking for Brokers and/or Employers

C. Claim Time Standards and Measurement

1. Claim Time Standards

2. Time Standard - Method of Measuring

3. Complex Claim Definition

4. Express Claim Payment

D. Claim Processes and Services

1. Pre-Payment of Disability Claims

2. Claim Payment Options for Life Products

3. Claims During the Contestable Period

4. Claims During the Pre-Existing Exclusion Period

5. Wellness Claim Processing

6. Employer Verification of Claims

7. Support for Non-English Speaking Claimants

E. Claim Integration Practices

1. Claim Integration Offered

2. Typies of Claim Integration Offered

3. Opt-In Requirement for Medical Claim Integration

4. Loss Ratio Impact Due to Claim Integration

5. Importance of Claim Integration Capability

F. Claim Evaluation and Tracking

1. Phone Call Standards

2. Percentange of Claims Submitted by Method

3. Claim Submission Method Variations by Product

4. Auto-Adjudicated Claims Percentage

5. Claims Settled in 10 Days

6. Claims Satisfaction Surveys

7. Other Claim Performance Measures

8. Artificial Intelligence/Machine Learning Practices

G. Claims Concerns/Obstacles/Trends

1. Changes to Claim Practices or Processes Due to COVID-19

2. Future Claim Concerns/Obstacles/Trends

 

 

 


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