Regional Claims Manager

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

Industry: Insurance

Function: Customer Service

Value-Added Results/Weights Performance Standards

Motivated and productive regional claims team (45%) • The Regional Operations Director 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 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 jobs.

• 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.

Satisfied policy holders and claimants (20%) • 85%—90% of surveyed policyholders say:
• They were pleased with how quickly they were contacted.

• The settlement process was quick, easy and caused no surprises.

• The settlement was a fair one.

• They were able to contact someone when they needed to.

• 65%—70% of surveyed claimants say they understand why they received what they did as a settlement.

Improvements to regional claims operations (15%) • 4%—5% increase in policies/employee.
• 4%—5% increase in claims/employee.

• X%—Y% reduction in claims expenses.

Satisfied agencies (10%)
• Explanations of claims decisions and policies

• Resolved conflicts
• No more than 10—15 repeat complaints/year reach the regional director about Claims not getting back to customers or agents on a timely basis.
• No more than 5—10 repeat complaints/year reach the regional director from agents about inconsistent claims decisions.

Regional buy-in to the Project A (5%) • Regional director hears regional claims employees describing the system consistent with his/her understanding of how the system will work.
• Regional committee receives input on the system from each office in the region.

Good working relationship with government insurance departments (5%)
• Resolution of complaints

• Informed consumer affairs personnel

• 5%—10% improvement in the ratio of claims to complaints reported/quarter to the insurance department.

• Government Affairs hears positive feedback on Company claims activities.

Customer Diagram: Regional Claims Manager

Value-Added Results/Weights	Performance Standards
Motivated and productive regional claims team (45%)	• The Regional Operations Director 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 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 jobs. • 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.
Satisfied policy holders and claimants (20%)	• 85%—90% of surveyed policyholders say: • They were pleased with how quickly they were contacted. • The settlement process was quick, easy and caused no surprises. • The settlement was a fair one. • They were able to contact someone when they needed to. • 65%—70% of surveyed claimants say they understand why they received what they did as a settlement.
Improvements to regional claims operations (15%)	• 4%—5% increase in policies/employee. • 4%—5% increase in claims/employee. • X%—Y% reduction in claims expenses.
Satisfied agencies (10%) • Explanations of claims decisions and policies • Resolved conflicts	• No more than 10—15 repeat complaints/year reach the regional director about Claims not getting back to customers or agents on a timely basis. • No more than 5—10 repeat complaints/year reach the regional director from agents about inconsistent claims decisions.
Regional buy-in to the Project A (5%)	• Regional director hears regional claims employees describing the system consistent with his/her understanding of how the system will work. • Regional committee receives input on the system from each office in the region.
Good working relationship with government insurance departments (5%) • Resolution of complaints • Informed consumer affairs personnel	• 5%—10% improvement in the ratio of claims to complaints reported/quarter to the insurance department. • Government Affairs hears positive feedback on Company claims activities.