Qualitative Claim Auditing Def:
The comprehensive review of claims files seeks to discover whether the claims are being appropriately managed. Some of the criteria used to measure the quality of the claim handling being delivered include experience and skill level of the adjusters and effectiveness of the internal communications system.
Quantitative vs. Qualitative Claim Auditing
Qualitative claims auditing adds invaluable insight into an insureds claims experience, but the more frequently used method to audit claims is based on quantitative data. Factors like response time from the initial claim, days to close, the total cost in relation to the original reserve and a number of other time and financial parameters are used by top claims adjusting firms to track and maintain standards.
It is debatable whether the qualitative or quantitative measurement is more important, but ALIGNED believes both are critical and that they should be used in combination to ensure clients are left with a positive overall experience and a lingering feeling of being helped.
To learn more about claim auditing or claims adjusting in general we would encourage you to speak with a licensed insurance adjuster or contact the Canadian Independent Adjusters Association.
We’d love to hear about your organization’s good or bad claims experience and would encourage you to share with an ALIGNED Insurance Advocate.