Casualty Claims Manager

Title: Casualty Claims Manager (WORD version ) (Customer diagram)

Industry: Insurance

Function: Customer Service

Value-Added Results/Weights Performance Standards

Motivated and productive work group (30%)
• Direction

• Guidance

• Training

• Priorities

• Positive feedback

• Support on decisions

• Equipment

• Budget

• Settlement authority
• The Branch Claims Manager is satisfied that:
• All employees have written performance standards.

• All employees know how they’re doing compared with their standards.

• All employees receive at least 1 informal interim review/year.

• All employees receive an annual written performance appraisal.

• All employees are meeting their performance standards or a performance improvement plan is in place.

• A reward and recognition system exists and is being used.

• Salary increases are differentiated based on performance.

• Surveyed regional claims employees say:

• They understand the Company's direction, region’s goals and their role in achieving these goals.

• They understand specifically what their supervisor expects of them.

• They understand how well they are performing and where they need to improve.

• They have the necessary authority to perform their job.

• Their performance appraisal accurately reflects their performance.

• They have the skills and knowledge they need to do their jobs, or a plan to obtain them.

• Their good performances are acknowledged and appreciated.

• Their decisions are not reversed without reason or explanation and their suggestions are taken seriously.

Justified claims decisions (20%)
• Policy interpretations
• No more than 1—3 claims decisions/year are reversed by a higher authority.
• Branch Claims Manager is satisfied that all the complaints are handled within a reasonable time frame.

Answers to agents’ questions (5%) • No more than 2—4 complaints/year to district manager because the agents are unable to reach the Casualty Claims Manager (CCM) when they need to or the CCM doesn’t get back to the agent when promised.

Quarterly reports (5%) • Delivered by agreed-upon date.
• Contains information for all topics requested.

Satisfied customers (25%)
• Resolved problems
• 60%—70% of surveyed policyholders and claimants say they:
• Received help to solve their problems

• Feel the CCM understood their situation.

• Felt the Company's decision was a fair one.

• Were contacted by the CCM when promised.

• Settlements • 60%—70% of surveyed policyholders and claimants say they:
• Are pleased with how quickly they were contacted initially.

• Feel the claims examiner understood their situation.

• Were able to contact someone when they needed to.

• Received help to address their problems.

• Felt the settlement was a fair one.

Qualified new hires (5%) • (Shared with HR) 70%—80% of management trainee employees stay for at least 1 year.
• 70%—80% of clerical employees stay for at least 8 to 10 months.

• Clerical employees meet their position’s performance standards within 2—3 months.

Customer Diagram: Casualty Claims Manager

Value-Added Results/Weights	Performance Standards
Motivated and productive work group (30%) • Direction • Guidance • Training • Priorities • Positive feedback • Support on decisions • Equipment • Budget • Settlement authority	• The Branch Claims Manager is satisfied that: • All employees have written performance standards. • All employees know how they’re doing compared with their standards. • All employees receive at least 1 informal interim review/year. • All employees receive an annual written performance appraisal. • All employees are meeting their performance standards or a performance improvement plan is in place. • A reward and recognition system exists and is being used. • Salary increases are differentiated based on performance. • Surveyed regional claims employees say: • They understand the Company's direction, region’s goals and their role in achieving these goals. • They understand specifically what their supervisor expects of them. • They understand how well they are performing and where they need to improve. • They have the necessary authority to perform their job. • Their performance appraisal accurately reflects their performance. • They have the skills and knowledge they need to do their jobs, or a plan to obtain them. • Their good performances are acknowledged and appreciated. • Their decisions are not reversed without reason or explanation and their suggestions are taken seriously.
Justified claims decisions (20%) • Policy interpretations	• No more than 1—3 claims decisions/year are reversed by a higher authority. • Branch Claims Manager is satisfied that all the complaints are handled within a reasonable time frame.
Answers to agents’ questions (5%)	• No more than 2—4 complaints/year to district manager because the agents are unable to reach the Casualty Claims Manager (CCM) when they need to or the CCM doesn’t get back to the agent when promised.
Quarterly reports (5%)	• Delivered by agreed-upon date. • Contains information for all topics requested.
Satisfied customers (25%) • Resolved problems	• 60%—70% of surveyed policyholders and claimants say they: • Received help to solve their problems • Feel the CCM understood their situation. • Felt the Company's decision was a fair one. • Were contacted by the CCM when promised.
• Settlements	• 60%—70% of surveyed policyholders and claimants say they: • Are pleased with how quickly they were contacted initially. • Feel the claims examiner understood their situation. • Were able to contact someone when they needed to. • Received help to address their problems. • Felt the settlement was a fair one.
Qualified new hires (5%)	• (Shared with HR) 70%—80% of management trainee employees stay for at least 1 year. • 70%—80% of clerical employees stay for at least 8 to 10 months. • Clerical employees meet their position’s performance standards within 2—3 months.