Pursuing a Better Claims Experience

Moderator 00:09 – 00:20

What makes the best in class claims experience and what are clients and brokers looking for from their insurer partners?

Pat Nails 00:20 – 01:29

You know, Arch’s best in class claims experience is really centered. It all starts with culture. Culture and people. That’s the foundation upon which we build a Claims Department and build a company, quite frankly, and then it is about a consistent experience. So let me give you an example of that.

I think at Arch, we really are solution minded, we have a saying, “Be the Solution.” Try to drive whatever the problem may be, whatever the claim may be to a solution. And that’s just one of many behaviors that I think exist at the company.

I think another broad idea that we really focus on is understanding the customer’s risk, combined with our own experience. How do we help with our experience with claims, to understand the customer’s risk and to work with them to mitigate that risk going forward? As far as you know, what your clients and brokers expect from the carrier partners, I think we’ve got a good example of that with our claims account managers, and maybe, Mario, you can address that and how it how it fits in to the claims experience.

Mario Bracuti 01:30 – 02:30

You’ll probably hear us reference the CAM, or claim account manager, throughout today’s roundtable. The CAM is really at the center of the customer experience. At Arch, every customer is assigned a CAM. And that CAM is the quarterback, the central point of contact for the customer, the broker and underwriting. And what that means for our customers is really it’s an ease of doing business. Whenever there’s an issue, the customer can go straight to the claim account manager, and the CAM owns resolution of that issue.

What sets Arch part as well, I think, is that the CAM has significant responsibility for the oversight of the program, as well as claims. They have authority to create and amend customer service protocols, as well as get involved in reserving and settlement discussions. So it’s really an ease of doing business, and the CAMs develop these relationships with the customers over long periods of time. So they get to know our customers’ needs and wants. And because of that we generally provide better outcomes.

Moderator 00:09 – 00:19

So Arch’s brand promise is Pursuing Better Together. And Pat, can you tell me a little bit about how you’re implementing that in claims? And what does that actually mean?

Pat Nails 00:19 – 01:32

Let’s first talk about what it actually means. Pursuing Better Together is an approach based upon collaboration, responsiveness, a genuine drive to continuous improvement, continually raising the bar and a customer-focused mindset. I think if I were to really state it, very briefly, it’s not us and them, it’s us together. And that exists in a number of different ways.

It’s working together as employees. It’s working with our vendors. And then most importantly, it’s working with our clients and our customers. And we’re really implementing Pursuing Better Together in claims organization in three key areas. The number one, really want to work with our customers to drive claims to resolution as efficiently as possible, and where it’s appropriate, as quickly as possible.

Number two, we want to be transparent about our position as soon as we possibly can. And then number three, we want to use data to help customers to identify risk, and to help them run their businesses and to mitigate that risk going forward. So those are the three key areas where we’re really focusing on implementing Pursuing Better Together.

Moderator 00:09 – 00:21

One of the ways that Arch is Pursuing Better Together for your customers is by driving claims to resolution as quickly and efficiently as possible. How are you achieving that Arch?

Gia Guzman 00:23 – 03:02

Part of Pursuing Better Together is first really listening, listening to our customers, hearing what they want and need. And one of the big needs that we heard was being efficient and really driving the resolution a little quicker than we had been. So how do we formulate that? How do we put through processes to make that claim reach a resolution a little quicker than maybe we had in the past?

This may not apply to every claim, but what we ended up doing is really digging deep into the claim handling process to find the areas where the processes might have been slowing us down a little bit. So what was holding us back from a quicker and more efficient resolution? What we found was there were certain types of claims that may be better handled with different types of analysts, and in a different group with consistent processes and procedures in place. So we created something called the Direct Resolution Claims Group. And this was a key initiative for our transformation.

Some of the benefits we’ve already seen is an increase in claim resolution and claim closure rates. From 70%, getting closed within 90 days, depending on the line of business. And what’s great about Direct Resolution Claims Group is that we actually work with all the line of businesses, and we work together. So what we’re able to do is get out of our silos that we were in and share and collaborate on some of the efficient ways that we were handling claims.

So someone in the health care department might have been employing a special way of handling their claims that produced a more efficient outcome. And maybe someone in the employment practices liability claims group was able to adopt those same processes. So part of collaborating brought upon these amazing transformations and more direct resolutions. And then what we did was we put all that in a document. And we made sure that our analysts that were in the claim, the Direct Resolution Claims Group, were using those procedures that are now consistent, clear and transparent, to drive that outcome that we heard from our clients as far as what they wanted. So we’re very happy about that outcome. And that’s definitely a big part of Pursuing Better Together.

Moderator 00:09 – 00:19

Can you share some examples of how your culture of active listening and collaboration has really helped to speed up the claims process within Arch?

Francine Minervini 00:20 – 02:30

We at Arch through all the business lines collaborate on claims that either have technical issues or coverage issues, or are challenging to reaching the ultimate goal of an efficient resolution in a cost effective and timely manner.

So that discussion happens across all the business lines with the technical claim office. It really brings in all the experience of our various experience claims people, including our CAMs, the business line leaders. It’s really given us an opportunity to create faster pathways to getting to efficient resolution.

For example, there was a collapse of a condominium building in Florida recently. Very significant loss with bodily injury claims and property damage claims. While we were only implicated on the property damage claims, we worked very quickly in discussing the claim among the claims division with the business unit, and our insured and look to resolve it quickly and we’re able to achieve that really within a very short window of time. Internally and that that’s with our insureds, but also internally, we have processes, like trial committee, that give us an opportunity to talk about the claims, how case is going to trial, how we can most efficiently either prepare the case for trial, or really maybe increase the likelihood that we can resolve the case before we get to trial. So there’s a lot of discussion. And that discussion is usually a big factor in that discussion is our conversations with our insureds.

Moderator 00:09 – 00:29

So I understand that part of this Pursuing Better Together is sort of also about being transparent and being open and upfront really with customers about claims. Why is this important? And again, how does this improve your sort of overall claims proposition and your reputation with clients and brokers?

Mario Bracuti 00:30 – 02:44

I think this is a great example of how our CAMs or claim account managers work with our customers, as well as our workers’ compensation directors.

Our workers’ compensation directors oversee our largest and most complex Workers’ Compensation Claims across the organization. Now, Arch is an unbundled model, we don’t have a work comp claim department. All of our customers have their claims handled by third party administrators.

So when COVID first broke out, we knew this was going to be new to our customers, because quite honestly, it was new to the workers’ compensation industry. Infectious disease usually is not covered under a workers’ compensation statute or policy. But we knew we were in uncharted territory, with many states enacting presumptive liability legislation specific to COVID.

So our claiming account managers again, knowing our customers, reached out to all of them, and asked them if they had any questions or concerns. And if they did, they coordinated calls with the Workers’ Compensation directors, and or the brokers. And the purpose of that was to discuss any concerns they may have and determine if we needed to bring in the third party administrator assigned to the customer.

Many times with our customers that foresaw a lot of frequency with COVID, we brought in a third party administrator to make sure claims are being handled correctly. We brought in the customers’ risk management departments to ensure they knew what needed to be investigated. Some of our customers had thousands of claims that were coming in. Some that wouldn’t have a thousand claims in a year, we’re getting hundreds a week. So this was an important part of ease of doing business, but also getting the right outcome.

These employers wanted to make sure their employees were treated correctly getting the right treatment. But based upon statute. Some of these customers then want to have weekly and monthly calls to review every claim. And that was set up. So the bottom line is that the claim account manager, again acting as the quarterback, and knowing their customers’ needs quickly assembles the team to put together to discuss COVID concerns. And I can say as of today out of all the claims received, we’ve closed 95% of all our COVID claims.

Francine Minervini 02:56 – 03:30

Mario’s example, the workers’ comp and the COVID really is an excellent example of that. And in addition, when we have coverage issues that may arise in a particular claim, there is a very quick identification of those issues. There’s conversation with the insured about issues that we may have. And the dialogue continues as we continue our analysis. I think that is special to Arch. Truly our commitment to our insureds and the relationship there.

Moderator 00:09 – 00:21

The third pillar of Pursuing Better Together revolves around the use of technology, data and analytics. Now, how are these tools revolutionizing the claims process at Arch?

Mario Bracuti 00:22 – 01:33

All carriers and most TPAs have predictive analytics and tools they use. I think what differentiates Arch is how we use them. We that to enhance our intellectual capital. On a claim level perspective on workers’ compensation, we’ll use it to identify changes in claims early on that may have our work comp directors engage the CAM to third party administrator, whether to readdress reserves to redress strategy.

But more importantly, we also look at it at a program level. If the CAM sees frequency or severity going up in a specific customer we’ll have a combined approach with the CAM, the TPA and sometimes the broker, look at the predictive analytics and see if there’s any change. Is the frequency or severity because of a specific location? Is it a jurisdiction that’s driving it? Or is a type of injury? And then once we review all the information, we’ll meet again, with the insured and a TPA and discuss what can we do to mitigate the issue, whether it’s involve risk engineering, whether it’s additional training at an insured level, we use it as talking points to reduce our customers’ total cost of risk.

Gia Guzman 01:37 – 03:02

So I’ll add to that by explaining some of the efficiencies and technology that we’ve used in the Direct Resolution Claims group. One of the things we’ve used, and we’re rolling this out through all throughout all claims was Smartsheet.

Smartsheet provides us with a dashboard for every individual claim handler, but also the managers. And it collects the data in a certain way that is flexible. So what each individual user can do is manipulate that spreadsheet or that dashboard, to highlight the things that are important for them on any given day. You can change the font size, the color, you can list in different ways so that those things are highlighted, to help you understand how to manage and prioritize your day to day.

For managers, we’ve found this to be particularly invaluable. One, it really helps with our capacity models, as we go forward and understand trends. We’re able to implement quality control checklists.

And we’re also able to embed continuous improvements in our day to day. Because once you see those trends, then you know what to focus on, then you know how to implement those changes going forward. So it’s been really invaluable in that respect that particular piece of technology.

Moderator 00:09 – 00:15

What other tools have you introduced within Arch to sort of make your claims process better?

Gia Guzman 00:16 – 02:25

There was a time when, as claim handlers we had, we for the most part did everything ourselves, whether it be choosing counsel, keeping our panelists together and organized, whether it be making our payments. Very rarely did we have a situation where there was a separate department where these services were collected in one place of knowledge. And now we have something called Shared Services.

What Shared Services does is kind of an umbrella for we put all of the types of needs for claim handling, but maybe not directly technical claim handling. Because that stays with the line of business claims. Whether it be workers’ comp, whether it be healthcare directors and officers.

In Shared Services, we have the SIU unit, we have the litigation management unit and vendor management unit. We have subrogation, recovery, we have the claim administrators that actually help. They’re basically the helpers for our claim handlers. So we’ve been able to put that that unit together, which provides a lot of consistency.

It allows our examiners to actually use more of their time to focus on just examining a claim, just the technical stuff that we really want them to focus on, and not have to focus on all those other kind of ancillary things that really should be part of this group called Shared Services, which I think is tremendous.

The other thing I would say is we’ve implemented an outlook, if you will, of putting the right work at the right talent level. And that really coincides with this whole theory of the Shared Services group in general as well. Why not put vendor experts why not put litigation management experts together to organize those things versus having our examiners doing that stuff.

I love the fact that we’ve offloaded some of those other ancillary things to this other group. And that’s really created an amazing amount of one collaboration, but also efficiency.

Moderator 00:09 – 02:23

So at the crux of all this is culture. Why does that resonate so well with your clients and brokers? And how Arch continuing to strengthen and enhance its culture? So in the claims process?

Pat Nails 02:24 – 02:55

When I was starting out, I’m a lawyer by training, so when I was starting out working for a law firm, I didn’t care about culture. And that just showed, my inexperience and how naive I was. I thought, well give me give me interesting work to do and pay me reasonably well, and everything will be fine.

But at the end of the day, I’ve learned over time that culture is absolutely everything and culture and people are inextricable. But if you have the right people in the right culture, and again, they’re inextricable everything else falls into place. And I think that is our competitive advantage at Arch.

And the reason it resonates with clients and brokers is because culture is not necessarily what you do. I mean, that’s part of it. But a big part of it is how you do it. And when you have a strong culture, you bring a consistency. And people know what to expect when they pick up the phone and call you each day.

Now how do we continue to strengthen and enhance the culture? Well, first of all, you had to define the culture and people smarter than I sat down one day, and they were talking about what, what are the things that go on at Arch because its culture that we developed, and I do believe it’s our competitive advantage.

They began to list it in different behaviors that they saw. Things like “Be the Solution,” you know, “Be Relentless about Improvement.” And we began something called the Arch Experience, where in groups we talk about these behaviors. And we give examples throughout the company of what are the examples of these behaviors, and how do they benefit our clients?

But then you can also tie that to Pursuing Better Together, because it really is about your customers and your clients. So for example, one of our behaviors that I think we see throughout Arch is “Be Bold”, to try something new step outside the box to try to solve a problem.

One of our taglines with Pursuing Better Together is “Better challenges the status quo.” Another one is to “Be Passionate about the Voice of the Customer”, and to “Be the Solution”. I think that ties to “Better collaborates creating positive outcomes” and “Better responds and builds lasting relationships.” We consistently talk about these things. And we point out the successes we’ve had, or how we’ve helped our clients, because of our cultural behaviors that are consistent across the company, and then also how that ties to Pursuing Better Together.

Gia Guzman 02:57 – 03:45

I love all everything you just said. And the only thing I would add is, I would say that culture is really an ever present reality of the shared values, and practices. And what I like about how we’ve really focused on it recently is, I love the way that it helps with speeding up the orientation of new hires, for example, in a really dependable way.

That really reinforces our ability to get our new folks out there and providing the services that we are expecting of all of us in a quicker way. I’m really grateful that Arch has been focusing on our culture more recently in the past couple years.