In 2017, the personal injury claims department of a property insurance company’s claims center had six investigators, who were mainly responsible for on-site investigation and follow-up claims of personal injury cases in the suburbs of the county; two people were injured in the nuclear accident. Responsible for the determination of damages in the claim center for personal injury cases. On the one hand, the number of injured people continues to increase, while only six investigators are injured.
Each injured investigator not only conducts an inpatient investigation of the hospitalization of patients in the suburbs, but also understands the injured and the estimated medical costs; the injured investigator is also responsible for detailed understanding and judgment of the case and mediation of the disputes, Therefore, the scope of work requirements is relatively wide, which will result in fatigued overall control in the work, and greatly reduce the efficiency of the related claims, resulting in more time spent. In this process, the claimant will continue to raise Various requirements, which undoubtedly increased the workload while increasing the number of complaints. On the second level, only two people were injured in the personal injury compensation department. Take 2017 as an example. In 2017, the number of auto insurance claims in the Property Insurance Company’s claims center was 4,418.
It can be calculated that the average value of each person in the case review was almost 2209. According to the development trend of the past three years, the total number of injuries was The upward trend, the workload is constantly increasing, and the medical staff is obviously insufficient.
Complaint process for personal injury cases is complicated
According to company regulations, the documents required for medical expenses claim include hospital diagnosis certificate, discharge certificate, discharge summary, medication list, medical fee invoice, road traffic accident liability certificate, original ID card for insurance, required unit of insured unit, insured vehicle Copy of driving license, copy of driving license. Claims require more documentation, and customers often need multiple round trips to successfully process a claim with complete documentation, which can easily lead to customer complaints to the claimant. In 2017, there were a total of 117 complaints involving claim documents, accounting for 20.09% of the total number of complaints, ranking second in the number of personal injury claims service complaints (the first is “amount of personal injury damage”). A large number of complaints can also reduce customer satisfaction with the company.