Insurance Industry: How to fix bad claim decisions due to poor report writing

There is a growing concern in the insurance industry about professional reports and their accuracy in determining claim outcomes, especially in relation to residential property claims.

The problem relates more specifically where ambiguous terminology is causing incorrect decisions or outcomes and its affecting consumers, who during their time of need expect clear outcomes.

As an industry, this needs to be resolved especially where financial outcomes are made based on report writing.

Recently as stated by the General Insurance Code Governance Committee: “too many insurers are relying on maintenance or wear and tear exclusions and poor-quality reports from builders, plumbers and electricians to deny claims,” stated in a recent report: Making Better Claims Decisions.

Out of 42,956 home insurance claims denied, there were 10,903 complaints with 5108 being resolved upon review, in favour of the customer. That is almost half of the complaints which is a direct result of insurers' reliance on builders, plumbers, electricians, and other tradespeople’s reporting methods, (Insurance News, July 2023).

47% of the claim denials were due to experts on site recommending the denial but according to the CGC, this decision may be “insufficient”.

Like anything that involves field service teams completing on-site inspections, there is a level of complexity and accuracy required to determine or qualify property claim outcomes.

We can solve this problem today! Enter Crunchworks’ Report Writer...

Codafication recognised this growing problem and developed Report Writer. A mobile first, Sofware-as-a-Service application that is purpose built for field service teams generating complex reports in the field.

Report Writer simplifies the data and image capture process on site when creating any type of report. For the insurance industry we have adapted this for building inspection, engineering, hydrology, restoration or loss adjustor reporting.

Teams using Report Writer are put on 'guardrails' when creating complex reports, ensuring the correct language and outcome is achieved.

Report Writer says what it does on the box - structures complex report writing with one-click selections or structured decision logic. With smart conditional forms, it enables the user to author complex reports based on inputs from the field. It then structures this information into easy-to-understand PDF, Word, Excel, or PowerPoint outputs which can be sent to the consumer or to other internal teams.

Additionally, Report Writer has a ‘snippets’ feature which templates complex long description text or paragraphs allowing your teams in the field to use this feature to quote complex language such as building codes or PDS (Product Disclosure Statements).

Additionally, we have enterprise grade features such as version control, collaborative editing, and a secure publishing workflow that ensures the appropriate checks and balances are in place before formal artifacts are created and sent to customers.

Report Writer makes it easy to capture and annotate images as well on any modern mobile or tablet device, assisting the communication back to base or to the insurer to see what was visually inspected.

Every edit, change, update, or delete is tracked in a forensic log which can be relied upon for quality auditing and training of new staff.

Additionally, every Report Writer field can be made visible on our powerful GraphAPI which can be interrogated for datasets, models, or additional workflow controls or integrated into your existing platform or technology stack.

Don’t wait for the regulator to direct you!

It is time to put the power and control back in the hands of your claims business and the supply chain that you rely on to service it (correctly).

Crunchwork and Report Writer has a range of success stories in the Australian and New Zealand markets that have proven business cases and value around adopting the tools. Reach out to find out how Crunchwork can help you: hello@codafication.com.

Resources

Check out the Report referenced here: https://rb.gy/qsujt

Read the full article here: https://rb.gy/y1hi3