Claim administration is growing increasingly reliant on claim systems, which provide tools to enable the adjuster to schedule work efficiently, record claim management activities and decisions, and retain information that is available on a real-time basis. In addition, these systems allow adjusters to manage the financial aspects of a claim that are critical to the insurer, third-party administrator (TPA), or corporation. To successfully develop, implement, and enhance such systems requires a cohesive partnership between the claim organization and the IT department. These two groups must combine their efforts and share a vision as to how the claim system will be used in order to create an effective end product and meet the needs of all parties involved.

As with all large projects, there is a possibility that the product of a joint Claims/IT effort will result in an outcome that does not meet the intended needs. Although a less-than-desirable outcome can occur for a variety of reasons, most often, it stems from a communication breakdown somewhere within the project. The primary focus of this article will be establishing and maintaining strong communications between the claim and IT departments. Some of the topics we'll address are defining the need; defining terms for mutual understanding; agreeing on the desired outcome; developing the project work plan; maintaining ongoing communications; testing the developed solution; and successfully implementing the system changes.

Defining Needs