Claims handling best practice and tips

Claims handling, if managed efficiently is critical to the overall success of a business.  Any mishandled claim could lead to reputational damage, customer dissatisfaction, and even legal action. To avoid such negative consequences, it’s essential to have best practices in place. This article will explore tips and best practices for successful claims management in today’s market, including how to maximise efficiencies, automate routine tasks, utilise digital technologies, prioritise proactive communication with customers, ensure accuracy and timeliness, manage conflicts and disputes, and handle claims fraud.

The Importance of Claims Handling Best Practices

Claims handling can be a complex and time-consuming process that requires a high level of expertise, skills, and experience. With so many different factors involved, it’s easy to see why best practices are critical to success. Adopting best practices helps insurance claims management departments focus on what matters most while minimising errors and delays. It also helps ensure customers’ satisfaction and loyalty, as well as the company’s financial stability.

Key Strategies for improved efficiency

The key to efficient claims management is to be proactive, organised, and automated. There are several best practices you can implement to achieve success, including:

1. Automating Routine Tasks:

One of the biggest challenges is managing the sheer volume of claims that come in each day. Automating routine tasks, such as data entry, status updates, and documentation, can help reduce the workload and free up time for other critical tasks. This automation can be achieved through the creation of FNOL’s, email integration, document and image management, and workflow automation functionality within claims management software. By automating manual processes, you can also reduce the risk of error and ensure consistency in your processes.

2. Utilising Digital Technologies:

Utilising digital technologies can help streamline the claims management process by improving efficiency, reducing costs, and providing better customer service. For instance, digital tools such as mobile apps, and self-service portals, can help customers initiate and track their claims, leading to faster and more accurate processing. Additionally, digital technologies like AI and analytics can help identify fraudulent claims and improve the accuracy of claims processing.

3. Prioritising Proactive Communication with Customers:

Proactive communication is essential in claims handling since it helps keep customers informed and engaged throughout the process. By improving the efficiency in the claims management process it will allow you more time to provide updates, respond to questions and anticipate customers’ needs and expectations.  Furthermore, you can build trust and reduce the likelihood of errors or misunderstandings.

4. Ensuring Accuracy and Timeliness:

Accuracy and timeliness are crucial in ensuring customer satisfaction and loyalty. Claims handlers must be rigorously trained and provided with the necessary tools and resources to ensure accurate and timely claims management. This also includes creating a culture of quality and accountability where everyone in the process takes responsibility for their actions and strives for excellence.

5. Managing Conflicts and Disputes:

Conflicts and disputes are inevitable in claims handling, but they can be managed effectively by employing conflict resolution techniques, such as active listening, empathy, and negotiation. It’s crucial to have a clear and transparent process in place for resolving disputes, and employees should be trained to handle conflicts in a professional and ethical manner.

6. Handling Claims Fraud:

Claims fraud can be a severe issue for insurance companies and claims handlers since it can lead to significant financial losses. It’s essential to have robust fraud prevention measures in place, such as data analytics, fraud detection tools within the claims management software, and trained investigators.


Efficient claims handling is critical to the success of any insurance claims management company, department, or handler. By implementing best practices such as automating routine tasks and utilising digital technologies provides a host of benefits from delivering improved customer service, managing more claims in less time, minimising duplication of effort and improving accuracy, identifying, and managing insurance claim fraud. It’s essential to create a culture of quality and accountability that emphasises continuous improvement.

Alphatec can provide a claims management software solution with all the functionality needed to improve efficiency so that you can provide faster, more accurate, and more cost-effective claims processing while enhancing the customer experience.  Contact us for a demo.


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