Claims management

Claims management

Written by Ana Canteli on 17 October 2022

Since it is difficult for an entity to survive without the presence of customers and the incorporation of new ones, providing excellent customer service is one of, if not the most critical, organizational responsibilities.  Whether we are discussing for-profit or nonprofit businesses that offer public services, the client is always at the center of every business.

Customers frequently encounter a variety of businesses. As a result, there is a natural competition for customers, making it increasingly sensitive to work to improve customer service since every company wants to position itself as the most attractive option for customers. Social platforms act as a platform for companies to engage with their customers and find out what people say about their business.

Customers frequently express their opinions on social media in predictable circumstances, such as when they are thrilled or regrettably had a bad experience. When businesses can physically interact with their customers, there are more opportunities for them to address any concerns their clients may have and handle any negative experiences appropriately.

However, with so many channels available for businesses to reach out to their clients, an omnichannel strategy is becoming increasingly important as it allows for better control over the client journey regardless of the client's profile.

Even though your staff may value the extra time and money they save by not having to commute to work, you and your team will need to put in more effort to provide excellent customer service because disputes or disagreements are typically more challenging to resolve online.

Any business should always strive to work with satisfied customers because doing so ensures customer loyalty, encapsulating any commercial department's success.

There are a few types of customers that businesses usually face.

1. Reactive: the customer reacts to any (negative) difference between their expectations and the service or product received.
2. Proactive; customers willing to provide companies with extra information, for example, by filling out a satisfaction survey.

Any company that wants to offer quality customer service must design a customer service system capable of dealing with most scenarios quickly and efficiently. Because in today's market, a customer who waits only takes a split second to become dissatisfied.

With OpenKM, you can develop a round-the-clock customer service platform that provides quick answers to common inquiries and enables individualized care in the trickiest situations. Any virtual platform can be integrated with document management software. Suppose your business chooses to offer an omnichannel experience for customers. In that case, the document manager can compile all the concerns, recommendations, and suggestions from stakeholders and customers as data to improve your customer’s journey and sales process.

The document management system can give users access to different forms: complaints, questions, advice, and gratitude.  States may present menus with one or more options or even permit text input from data subjects.

Customers who are currently logged in to the system will already have parts of their metadata, such as their contact information, covered; the only time they will need to edit it is if they want to make changes to it.

The system then loads the form, providing the user with the registration number, the date in the entry register, and a contact email.

OpenKM can automatically identify the type of document that enters the system—whether it's a claim, a suggestion, or a thank you note—extract the metadata from the record, name the file using the company's vocabulary, and file it in the taxonomy route. This is made possible by optical character recognition and text extraction. When the customer service system assigns you, the staff of the department customer service will be notified via email.

OpenKM provides workflows that can be customized to meet the needs of each incident for more complex cases. The client can contact us by email if their situation does not fit the earlier documents. Email archiving features are available in OpenKM document management software. The business can always recover the email and all attachments to continue providing the service.

Another advantage of the OpenKM platform is that it helps to implement the privacy policy required by your company.  It can manage instant messaging services, get reports on clients’ life cycles, obtain statistics on their behavior, etc.  To provide a positive experience for customers, system users who provide customer service, and the general public through many channels, including telephone attention, OpenKM customer service gathers all the information entered by the customer.

Claims management use case

The solution that manages customer complaints should consist of the following:

• A web-based contact form, where each submission would result in the management of a new claim. Some mandatory document fields would be used as metadata to categorize the contacts.
• the salesperson gets a notification in their application session each time a potential customer fills out a form on a website. Depending on the type of claim, allocation rules can be developed.
• The application will make distinctions between clients assigned to commercial, new claims, and requests for various types of information.
• The commercial department will be able to see the contact’s basic information. You should have the ability to update the contact information. Among other things, email templates are used to respond to common topics.
• Whenever a communication action is performed by the commercial or client, the claims service catalogs the mail and associates it with the client.
• The commercial can:
  • Update the status of the contact
  • Transfer it to another commercial
  • View the chain of communications that have taken place, including attached documents
  • Set alerts on the calendar to change the “Days Elapsed” indicator to draw the client’s attention.

You can use the filter rules to search and find a contact.  Examples of search criteria are:

• Email
• Contact Name
• Status: pending from the commercial – the client is waiting for a response-not started – it is a potential client-pending from the client – ​​he has received a response, and we are waiting for his reaction or closed – no further action is required on our part.
• Waiting Days
• Alert system, including due alerts, alerts on the current date, and future alerts

Contact us by phone, e-mail, and social networks for more information.