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First Notice of Loss, like many insurance related niches, leverages a litany of acronyms in describing the methodologies and nuances relevant to both providers and “consumers”. It is complex for those who use it, including both the providers and consumers. For the purposes of this article, consumers can be considered claimants, and providers can include insurance carriers, TPAs and FNOL Call Centers. Let’s begin by defining First Notice of Loss. A First Notice of Loss alerts the responsible insurance provider as to the theft or destruction of something which is covered under the terms of a given policy. Notification can often precede the filing of a formal claim. Many insurance providers utilize a specific process and or documentation to log a first notice of loss, while others simply provide basic guidelines. The concept is simple enough, an individual or business encounters a loss (fire, theft, vandalism, healthcare, etc.) and contacts an insurance provider or third party representative to alert them of this loss. From here however, there are a litany of acronyms utilized in this process. Some of the more common acronyms and definitions are noted below in alphabetical order:
Absence Reporting Systems (ARS): Employee feedback systems which can increase employee satisfaction while decreasing employer costs.
Average Speed to Answer (ASA): The metric used for determining efficiency in which a company responds to incoming FNOL calls and claims.
Average Time to Abandonment (ATA): The average amount of time a claimant waits before they disconnect their call.
All Trunks Busy (ATB): A telephone status, indicating limited call throughput, denoting that all trunks are in use. It means the trunk group cannot accept any new inbound or outbound calls.
Call Handling Times (CHT): The amount of time an FNOL call center representative spends with a claimant including post call processing. This is also referred to as Average Handling Time.
Electronic Data Interchange (EDI): An industry standard for transferring data electronically, allowing efficient and accurate communication for all parties involved in claims management. Accurate EDI integration is important with FNOL as missing or inaccurate data can result in fines and penalties.
First Notice of Loss (FNOL): A compressive process which can or should include incident reporting, claims management, state filing, data recording and retrieval, and customer service.
First Report of Incident (FROI): The instant that the claim handling begins or notice of absence is provided.
First Report of Injury (FROI): FROI relates to workers compensation compliance. Regardless of whether or not an employer agrees with a claimant an FROI must be filed. These reports are typically required when an injury causes an employee to miss 5 or more paid workdays, and must be submitted within seven business days of the fifth missed day of work. Each state uses its own FROI form.
Full-Cycle Claim and Incident Reporting (FCCR): Solutions that improve productivity and reduce costs for commercial and personal insurance carriers, self-insured companies, third party administrators, and managed care organizations.
Incident Reporting (IR): Well defined incident reporting procedures help with claims processing and to reduce claims paid out, handling expenses, and administrative costs. Both medical expenses and litigation can also be mitigated through effective incident reporting.
Intake Specialists (IS): FNOL call center personnel trained in the procedures relating to claim handling and FROI.
Subsequent Report of Incident (SROI): Reconciling the status of the reported issue with the status and methodology of resolution.
Third Party Administrators (TPA): An organization which processes insurance claims or certain aspects of employee benefit plans for a separate entity. A TPA typically handles the claims processing for employers that fully self-insures its employees.
Accurate, timely and efficient First Notice of Loss response, intake and reporting are important for both employer and employee. Some of the most important work can take place in the first few minutes. A well documented FNOL process and procedures dramatically improves data accuracy and reduces the amount of work required later in the process. An efficient and automated process can mitigate costs and reduce errors. This can result in consistently better outcomes for all involved.
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Source by Paul Neleman
