Insurance Claims Advocacy: How Can It Make Your Journey Easier?

Insurance Claims Advocacy: How Can It Make Your Journey Easier?

The concept of insurance is almost as old as civilization itself. The Babylonian bottomry contracts of 3000 BCE have today been replaced by specialized insurance coverage for all kinds of risks. These include auto, home, life, health, and business insurance, to name a few. 

Such policies are designed to behave as a financial cushion during times of property damage, health issues, or workplace accidents as the case may be. The problem is that the claims process is not always straightforward. 

It may be rife with heavy paperwork but there are more pressing roadblocks like lengthy negotiations, claims denial by the insurer, or international stakeholders. Instead of yielding to the stress, you can escalate the process with the help of claims advocates. 

In this article, we will discuss the importance of insurance claims advocacy and how it makes the journey to a resolution easier. 

What is Insurance Claims Advocacy?

McKinsey & Company has highlighted the importance of digitization in the claims journey. The future of insurance will not involve traditional paperwork even though the industry is transitioning at a slow pace. 

This means one issue will leave the picture altogether. As for the others, insurance claims advocacy services can help. It is a practice focused on using specialized resources to help clients extract the best possible service from their insurance vendors. 

According to Brooks, Todd & McNeil, claims advocacy is a step ahead of claims management. You will have access to dedicated claims specialists who can render services like coverage advocacy, claims reviews, complex claims consulting, and vendor selection support, among others. 

Why You Need Claims Advocates in Your Insurance Journey

It has been estimated that the insurance claims services market will have a value of $638.3 billion by 2032. Since it is growing at a CAGR of 12.8%, it is worth exploring the reasons why claims advocacy is a good investment. Let’s look closely at why you need insurance claims advocates. 

To Help with Claims Filing 

The claims filing process is often too overwhelming and confusing for the insured, mainly due to the documentation and claims adjusters. A claims advocate will assist in the filing process by –

  • Helping you with filing the documents correctly 
  • Keeping you updated on the status of your claim 
  • Providing you with a strategic plan and direction for faster resolution 
  • Submitting the claims in a manner that triggers coverage response 
  • Assisting you in making claims follow-ups 

To Work on Your Behalf 

The primary focus of an insurance claims advocate is to improve outcomes with your insurer. Let’s learn more about this particular role of claims advocacy. 

  • The claims advocates will represent you based on your interests for a fair and fast resolution.
  • You will receive notifications and guidance on following coverage requirements and notice provisions. 
  • If a favorable outcome or negotiation is no longer possible, the advocates will manage your litigation. 
  • Your claims evaluation will be done early for cost-effective management. 
  • The process will involve mitigating claims’ impact on you or your organization. 

To Communicate and Coordinate 

As mentioned previously, the claims process for many insurance policies can be hauntingly complex. This is especially true in cases where multiple insurers are involved. Claims advocates will invest their resources in dissecting all stages of claims resolution into manageable parts. 

They will assist you in navigating the insurance maze until a suitable solution to your problem is provided. This will include helping you communicate with insurers regarding the claim’s complexity. The claims advocate will even coordinate the required conference calls, litigation strategies, and status updates to keep you on top of the claims process. 

To Walk You through a Crisis 

The unfortunate fact about insurance claims processing is that you may face a sudden unforeseen crisis. Another role that claims advocates play is that of proper crisis management. Let’s understand this with the help of an example. 

Suppose the complexity of your claims processing invites unnecessary media attention or you’re involved in litigation. Such situations often accompany intrusive and probing questions. A single misstep can cost you dearly. Claims advocates will help you mitigate the crisis by offering sound counsel on how to respond. 

Finally, given how time-consuming claims resolution can be, it is no surprise that expediting the process is imperative. The good news is that the overarching goal of claims advocacy services is to help reach a fair outcome in record time. 

The claims management software industry is indeed growing exponentially at a CAGR of 8.5%. However, processing speed is often impacted due to other factors like negotiation denials, litigation issues, etc. By extending 360-degree support, claims advocates will smoothen out all rough edges.

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