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Management Process

Collection of information includes: a) formulation of the order of identification, collection, classification, maintenance of the storage and destruction of records, b) keeping records at all stages of the claim and maintain these record in working condition, paying particular attention to the protection of electronic files and magnetic disks, since data on these media may be lost as a result of negligent treatment or obsolescence; c) keeping records of training and instructions received by staff involved in the process of claims management; O1) formulation of the organization criteria for response to a request for of records and registration papers submitted by the person asserting the claim, or his / her representative; to these criteria may include time limits, what kind of information should be provided to whom or in what format and e) formulating about providing the public with statistical data on claims, not disclosing personal information. All claims must be classified and then analyzed to identify systematic, repetitive and single issues and trends and eliminate causes of complaints. Regularly to determine the degree of satisfaction of persons, presenting the claims management process claims. To this end, may conduct surveys randomly selected persons, presenting a claim or other research. note – One method to improve customer satisfaction management process claims is to strengthen contacts between the person to bring a claim, and the organization. Should be carried out constant monitoring of the management of claims, adequate resources (including staff) and the recorded data. Functioning of the claims management should be measured relative to predetermined criteria (see Appendix C).

In order to assess the functioning of the claims management organization must conduct regular audits of its own forces or by a third party. The audit should provide information about: – under the management of the claims of existing procedures – fitness process to achieve the goals in the management of claims. Audit of claims management can be carried out as part of an audit of quality management system, for example, in accordance with iso 19011. Results audits should be taken into account during the management review to identify problems and to improve claims management process. An audit of all activities should be carried out by competent experts not connected with the activity being audited.