Triage is a French word meaning “to sort.” Developing a claims triage strategy allows a company to obtain a good overview of the claims situation and allocate resources appropriately. Attend this session to learn more about sorting your claims to make the best use of available resources.

1. Claims Triage
How to Do It Well
Phil Reynolds
CEO / Founder
BriteCore

2. Triage: /trēˈäZH,ˈtrēˌäZH/
“to assign degrees of urgency”.
French word trier ‘separate out orsort by nature.’
Developed by military physicians.

3. Claims Triage is the process of sorting and
responding to incoming losses.

4. Triage may be necessary
following a high volume claims event.

5. Plan Ahead

6. “Before anything else, preparation is the
key to success.”
-Alexander Graham Bell

7. “By failing to prepare, you are preparing to
fail.”
-Benjamin Franklin

8. “Success is where preparation and
opportunity meet.”
-Bobby Unser

9. Don’t bury your head in the sand!

10. Hope for the best. Plan for the Worst.

11. Complex Planning

12. Not great when drowning.

13. People tend to panic in a crisis.

14. Panic is a
survival
mechanism
for the brain.

15. Amygdala Sends Alarm
Triggering Fight or Flight Response

16. Effects Panic
1. Suppresses Pre Frontal Cortex, Inhibiting Rationality
• Emotional Outbursts
2. Reduces our Ability to Make Decisions
• Analysis Paralysis or Self-Destructive Behavior
3. Hyper Awareness of Threat-Related Information
• Exaggeration and Paranoia
4. Negative Bias Toward Ambiguous Stimuli
• False Conclusions and Red Herrings

17. Freak Out!

18. Staff under high Pressure.

19. Staff under high Pressure.
• Working Under Increased Volume
• Unfamiliar Procedures and Job Roles
• Extra Hours and Responsibilities
• Ratings Downgrade
• Forced Liquidation of Assets
• Insolvency

20. Customers experienced Loss

21. Customers experienced Loss
• Lost valuables, keepsakes, memories
• Lost loved ones
• Where do I live? What do I wear? How do I eat?
• How will I replace everything?
• Can I hold down a job and manage all this?
• Is the insurance company going to take care of me?

22. Perfect storm
to divide people.
You
Customers

23. Teamwork
and
Cooperation

24. Show Concern and
Empathy

25. Can’t Rely on
Willpower!
Our ability to exercise
judgement is limited
when we feel panicked.

26. Willpower is
Like a Muscle

27. Willpower Experiment

28. 8 minutes 19 minutes
Willpower Experiment

29. Performance Follows Practice

30. Practice Forms Habits

31. Cue
HabitReward
The Habit
Loop

32. Smoking
Habit

33. Eating
Habit

34. Habits Can Be Shaped

35. Willpower Becomes Automatic

36. Triage Planning

37. Carriers should devise a Triage Plan
that can be executed consistently
under high pressure.

38. Prioritizes and sorts losses.

39. Reduces unnecessary loss expense.

40. Increases customer satisfaction.

41. Lay a solid foundation.
Triage Planning

42. 1. Communication
2. Loss Notice
3. Response Team
4. Adjusting Losses
5. Risk Management
Triage Planning

43. 1. Communication
Triage Planning

44. • Build Awareness
• Show Concern and Empathy
• Proactively Advocate
• Set Expectations
GOALS

45. Awareness plays a critical role in preparing
for unfortunate claims events.

46. How do you build
awareness among
policyholders, staff,
and agents?

47. Educate before, during, and after events.

48. i. Contact Management
ii. Outbound Messaging
iii. Notification Channels
Communication

49. i. Contact Management

50. At the vary least, you need to be collecting name, risk
address, mailing address, email, phone number, and
preferred method(s) of contact.
Deploy a centralized CRM

51. Hubspot
• Manage contacts (syncs with Gmail or Outlook)
• Create, automate, measure, and optimize online marketing
• Publish search-friendly blog posts
• Build landing pages without IT
USE CASE: Contact Management, Agent and Insured Communication

53. ii. Outbound Messaging

54. Communication should be
sent to customers when a
threat is known.

55. • How to prepare for a natural disaster (each type)
• Disaster recovery locations and instructions for customers
• Periodic updates with recommendations
• How to seek assistance and file a claim
Outbound Examples

56. iii. Notification Channels

57. Dashboards
Website
Email
Push Notifications
Social Media
iii. Notification Channels

58. Channel - Dashboards

60. Consider All Audiences
Policyholders
Adjusters
Agents
Admin Staff

61. Channel - Website

62. Set up a landing page that can either
take over your company’s home page
during a disaster or direct traffic flow
to a specific task page.

63. Page Purpose: To help claimant’s
quickly and efficiently file claims
directly following a catastrophe.

64. SquareSpace
• Quick WebSites from Beautiful Templates
• Fully Managed Deployment
• Business User Can Build and Edit
• Optimized for SEO, Search, Usability, etc.
USE CASE: Landing Pages

66. Channel - Email

67. Email Campaigns
Email is a great way to send frequent
communication that drives traffic to other
landing pages and dashboards.

68. Once you’ve created content on your
website or blog, you can easily paste it into
an email to send to your customer base.
Recycle Content

70. Mail Chimp
• Email Communications
• Stock and Customizable Templates
• List Management
• Analytics
USE CASE: Agent and Insured Communication, Warnings, Alerts

71. Channel - Push Notifications

72. Percentage Opened
2%
98%
Opened within 3 min
10%
90%
https://www.txt180.com/article/insurance-agents-mobile-marketing/
Texts and Push Notification

73. Texts and Push Notification
A disaster warning has been issued in
your area. If you experience a loss, file
a claim at www.britecore.com/losses.
Text STOP to 17568 to unsubscribe
from notifications.

75. Automated Call Systems
“A disasterwarning has been
issued in yourarea. Fortips on
how to prepare fora disaster,
please visit ourwebsite
www.britecore.com/disaster."

76. Plum Voice (IVR)
• Easily launch campaigns
• Completely cloud-based
• Decision trees with business logic
• Simple opt out options
• Integration with policy and claims systems
USE CASE: Automated phone campaigns

78. Channel - Social Platforms

79. Social Platforms
Policyholders / Community

80. You should already have an
established Social Media
presence and actively connect
with customers via Facebook,
Instagram, Twitter, Youtube, etc.

81. Buffer
• Share to All Social Media Platforms Equally
• Schedule Posts For Peak Times
• Promote Consistent Messaging
• Reduce Administrative Overhead
USE CASE: Facebook, Twitter, Linked In, Instagram, Google+, Pintrest

83. YouTube
• Channel for Your Company
• Playlists Per Project
• General and Personalized Training
• Allow People to Learn Onsite
USE CASE: Agency Training, Insured How Tos, General Promotions

84. Company-Wide Disaster Training

85. 2. Loss Notice
Triage Planning

86. Develop a Script

87. To effectively assign levels of priority to
incoming claims, you’ll need to develop a
standard script to use at FNOL.

88. Ask policyholders 5-10
questions to determine how
quickly they need your
assistance.
How Urgent is the Claim?

89. Example Questionnaire
Major Weather Event

90. 1. What are the names, current or temporary addresses,
and phone numbers for each policyholder?
Example Questionnaire

91. 2. What is the extent and severity of the loss?
Example Questionnaire

92. 3. Is your home livable? Do you have a place to stay?
Example Questionnaire

93. 4. Is there any property damage that might worsen if left untreated?
Example Questionnaire

94. 5. Did you lose personal property?
Example Questionnaire

95. 6. If so, do you have a way to
purchase replacement items
until the company can reimburse
based on policy coverages?
Example Questionnaire

96. 7. Are you planning to
return to work? If so,
what is best time to
reach you?
Example Questionnaire

97. 8. What else can we do
to make your family
more comfortable?
Example Questionnaire

98. Rank Losses

99. To make the best use of available
resources, sort claims by severity.

100. Prioritization takes an overwhelming
number of claims and classifies them into
manageable groups.

101. Going from this…

102. … to this.

103. Carriers can use a 3 Level Model to help
determine which policyholders need
assistance first.

104. Involve conditions that are likely to deteriorate
or change, or the scope of the loss requires
an adjuster’s immediate attention.
Level 1 Claims

106. Require field inspection but the conditions of
the claim aren’t immediately urgent.
Level 2 Claims

107. Field inspection
for these claims
could be
scheduled out
further without
significantly
impacting the
outcome.

108. Can easily be handled in the office and do not
require an adjuster’s field inspection.
Level 3 Claims

110. Digital Assistant
Instant Message
Mobile App
Web Form
Phone
You should offer many convenient channels for a
policy hold to file a first notice of loss.
1
2
3
4
5

111. 1. Phone
• Call center / CSRs
• BPO providers can assist
• VoIP systems
• IVR for automated screening

112. Plum Voice (IVR)
• Self-service phone interactions
• Speech recognition
• Interactive dialogues with rules engines
• Integration with Policy and Claims Admin Systems
USE CASE: Loss Notices, Ranking, and Routing.

114. 2. Web Form
Create web form that can automatically
post to your claims system. Setup
workflows to notify staff when a FNOL is
filed from the web.

115. SquareSpace
• Quick WebSites from Beautiful Templates
• Fully Managed Deployment
• Business User Can Build and Edit
• Optimized for SEO, Search, Usability, etc.
USE CASE: Landing Pages

117. Dedicated FNOL Vendors
• Complex rules engines
• Connected to other service providers
• Frequently include a BPO service as well

118. • File a claim directly from your
policyholder app
• Leverage phone features such
as gps, and camera
• Post directly into your claims
management system
3. Mobile App

119. 4. Instant Message
I want to file a claim. >>
I want to view coverage. >>
I want to add coverage. >>
I want to pay my bill. >>
Automated chat assistants
can be added to your
customer apps or portals
to help policyholders
quickly find answers to
questions.

120. 5. Digital Assistant
Services like Amazon Alexa allow
customers to file a claim by talking to a
digital assistant.

121. 3. Response Team
Triage Planning

122. Help staff prepare. Create a company-wide First
Response Plan that outlines responsibilities.

123. COMPONENTS
A. Notify Team
B. Dispatch Responders
C. Set Up a Crisis Center

124. A. Notify Team
Triage Planning > Response Team

125. Who should be
contacted when
help is needed?

126. Notification Tree
• Company Directory
• Assigned Order
• Response Team
• Notification System
• Signal v. Noise

127. Channels
Direct Messages
Threads
Integrations
Alerts
Search
VoIP
Screen Share

128. B. Dispatch Responders
Triage Planning > Response Team

129. Activate those with
designated responsibilities
to ensure all functions of
the Triage Plan are carried
out as quickly and
efficiently as possible.
Dispatch Key Responders

130. Key Responders
• Home Office Administrators
• Claims Director
• Claims Assistant
• Marketing / Communications
• Department Managers
• Catastrophe Response Team
• Triage Team Directors
• Triage Team Members
• Adjusters
• BPO Providers

131. C. Setup Crisis Center
Triage Planning > Response Team

132. • Secure a facility for triage, media, and housing.
• Secure a lease if needed for the remote site.
• Transport and setup supplies and equipment.
Setup a Mobile Office

133. Mobile Office
Will you rent or
buy chairs, desks,
computers, etc?

134. Necessary Supplies
• Emergency Supply Kits
• Emergency Vehicles
• Power Tools
• Company Signage

135. Hardware Needs
• Computers / Devices
• Phones
• Printers
• Chargers
• Internet

136. Software Needs
• Communications
• Claims Management
• Payment Systems
• Productivity Suite
• Expense Tracking

137. Ring Central
• VoIP, Conferences, Video Chat, Messaging
• Includes PBX Features (Forwarding, Voicemail, Extensions, etc)
• Supports All Desktop and Mobile Devices
• Very High Quality
USE CASE: Call forwarding, Automated Voice Alerts, Remote Access

139. Web-Based Claims Admin
• Accessible from anywhere
• Supported from a wide range of devices
• Minimal infrastructure requirements
• Team-based interaction
USE CASE: All software systems, mobility, accessibility.

141. Google Docs
• Accessible from Anywhere
• Replaces Microsoft Office
• Realtime Collaboration
• Advanced Permissions
USE CASE: Documents, Spreadsheets, Slides, Forms, Diagrams

143. Amazon Workspaces
• Virtual Windows Workstations
• Centrally Managed Environments
• Mobile Device Access!
• Integrates with Work Docs
USE CASE: Mobile,Temp Employees, Remote Workers, Tech Partners

145. Expensify
• Expense tracking in the cloud
• Per Diem allotments
• Image recognition with auto-categorization
• Auto generates receipts below $75!!!
USE CASE: Expense Tracking, Expense Reports, Audits

147. 4. Settle Claims
Triage Planning

148. A) Independent Adjusters
B) Web Software
C) Mobile Apps
D) Drones
E) Electronic Signature
F) Electronic Funds Transfer
Settling Claims

149. A) Independent Adjusters

150. Use independent adjuster networks for overflow capacity
during high claims generating events.

151. How do you build great
relationships with
independent
adjusters?

152. You will receive better service from independent adjusters
if you are working to build relationships with them on a
regular basis and not just during an emergency.

153. Regular contact
maintains a healthy
working relationship.
Engage Often

154. Kindess Wins Loyalty
Be Nice!

155. Make jobs a piece of
• Write good estimates using accurate measurements.
• Include detailed explanations as much as possible.
• Submit all pertinent pictures for adjuster’s file.
• Make timely submissions with few supplements.

156. Support your
adjusters in front of
policyholders
whenever you
possibly can.
Be Supportive

157. Resolve customer issues.
Happy customers make for happy adjusters.
Give adjuster a heads up on customer complaints.
Notify the adjuster of action plan with customer.
Send updates to adjuster regarding issue.

158. B) Web Software
• Accessible from Any Location
• Desktop and Mobile Support
• Managed and Dependable
• Connected to Data Sources

159. C) Mobile Apps
• Accessible without an internet connection
• Process claims on the go, upload data later
• Utilize device features such as camera and gps

161. D) Drones
• Review damage quickly
• Take photos and measurements easily
• Limit risk of adjuster injury
• FPV goggles make it very easy to fly

162. Not This!!!

163. This

164. E) E-Signature
• Review and settle onsite
• Reduce processing and turn around time
• Encrypted and secure
• Legally binding

166. F) Electronic Funds Transfer
• Remit Payment Immediately
• Requires simple account information
• Encrypted and secure
• Close many claims in the field

168. Questions?
How to Contact Me
www.britecore.com
phil@britecore.com
(417)299-1119
Phil Reynolds
CEO / Founder
BriteCore