Insurance claims personnel's year-end summary and writing work summary can help them review their work performance in a period of time, help them to work more purposefully in the future and improve their ability. However, many people don't know how to write a work summary. In order to solve this problem, I bring you the year-end summary of insurance claims personnel.
Insurance claims personnel summarized the key claims work in 1 and xxxx.
Xxxx is a year of steady improvement of claims center. The claim center adheres to the transformation direction of "customer-centered" throughout the year, closely focuses on the core work requirements of "service improvement, process control, scientific claim settlement and team building", optimizes and integrates resource allocation, continuously improves customer satisfaction, improves the scientificity of cost control, improves the scientific and technological content of claim management, effectively stimulates the vitality of claim settlement team and strongly promotes the overall business development of the company.
Two. Xxxx specific work measures
(1) Carry out the service promise of "fast, good and economical" and realize the intimacy of claims service. First, according to the service brand of "fast, good and cheap" launched by provincial companies, on the basis of previous service commitments, we will promote the whole process of receiving newspapers, surveying, determining losses, repairing, filing and financial payment to remind and promise services within a limited time.
Second, adhere to the "customer satisfaction" as the test standard, firmly grasp the two key points of personal customer feeling and overall customer satisfaction, stand on the customer's point of view, sort out the nodes that contact customers in the whole process from reporting to paying compensation, and realize the standardization of claims personnel's dress, terminology, vehicle identification and claim service window setting.
The third is to strengthen cooperation with various product lines and improve the internal service level. Cooperate with the car dealer department to supervise the input of maintenance coding system corresponding to maintenance resources in some county branches on the spot; Implement product line periodic reporting system, strengthen product line claims service and risk feedback function; Establish a communication and feedback mechanism between companies at the city and county levels.
(b) Effectively strengthen process control and realize scientific cost control.
First, pay close attention to the management of auto insurance maintenance costs. Focus on improving the backward repair resources of county companies.
The second is to strengthen foreign cooperation by increasing the adjustment of personal injury. Achieve effective salary reduction. The specific measures for personal injury adjustment are: 1, and small personal injury cases are adjusted by themselves and handled on the spot.
2, hospitalized patients negotiate one-time medical expenses.
The specific measures of foreign cooperation include: under the unfavorable environment of traffic accident disability assessment, which leads to high injury cases, our company actively cooperates with other property insurance entities in the city, reaches an understanding and establishes cooperation with Gulun disability assessment agency, and issues an assessment report after the final assessment result is approved by both parties through consultation.
The third is to set up a re-survey team, combined with the recovery of damaged goods, to effectively prevent moral hazard and save the cost of claims.
Scope and measures of retest: (1) Any case exceeding 10000 yuan will be retested. (2) Reconnaissance one by one, and the impairment amount is eliminated directly through adjustment. (3) No matter how much the amount is, 100% should be re-investigated for the doubtful loss and underwriting cases. (4) If the undertaking unit fails to notify the retest, and the retest cannot be carried out, 10% of the loss amount of the undertaking unit shall be deducted.
Residual loss: (1) 1 vehicle with more than 10,000 yuan retested 1 vehicle. (2) One vehicle and one recycling list shall be audited and sealed by the quotation post. (3) For cases with a price below 1 10,000 yuan, the recovery of core parts should be completed within 5 working days.
(3) Strengthen the process control, honor the assessment system, and work hard on the law.
First, monitor the case damage assessment in real time, regularly clean up abnormal cases of case damage assessment, and make the case damage assessment change and adjust at any time. Through this system, the adequacy ratio of loss estimation is included in personal performance appraisal, which effectively improves the accuracy of loss estimation.
Second, according to the assessment methods of provincial companies, the Management Measures for Mobile Survey and Loss Determination is formulated in line with the actual situation of the company, and the data is split into individuals to realize monthly assessment and monthly cash. Effectively stimulate the initiative of employees.
Third, strengthen the management of legal cases, analyze them case by case, provide lawyers with our company's defense opinions before the trial, and communicate with lawyers and courts when encountering difficult problems. At the same time, strengthen the assessment of lawyers, regularly check the trial situation of lawyers, record the assigned scores, and link them with the renewal of lawyers.
(four) to further strengthen the team building, realize the professionalization of the claims team.
First, on the basis of publicizing the core values of the head office, "share weal and woe, truly love each other", we advocate the concept of "I serve, I am happy", and vigorously create a working atmosphere for claims settlement through various forms such as morning (evening) meetings and cultural theme activities.
The second is to further strengthen internal training, and constantly improve the professional skills of the claims team from different levels such as basic training, professional training and intensive training.
The third is to deepen performance appraisal, stimulate team vitality, enhance team cohesion and execution, and at the same time enhance the sense of responsibility and service of the claims team.
Third, the results of the current claim settlement work
(1) The average compensation per case decreased steadily, exceeding the budget target.
As of June 5438+ 10, the average compensation for injury cases in the city was 29029 yuan, ranking eighth in the province; It decreased by 17% compared with the same period, ranking second in the province. And lower than the provincial average of 227 yuan, exceeding the budget target.
The average compensation for cases involving no injury in the city is 33 14 yuan, ranking fifth in the province; Compared with the same period, it decreased by 15%, ranking third in the province. It is lower than the provincial average of 242 yuan.
(b) The efficiency of claims needs to be improved.
The auto insurance claim cycle did not maintain the good momentum at the beginning of the year. In the first half of the year, the division of labor was enriched and improved by introducing college students and adjusting within counties, which effectively balanced the per capita workload. However, due to the lack of systematic training, the lack of solid professional foundation and the lack of case handling skills, the efficiency of case handling has been affected. At present, it is higher than the average level of the whole province, ranking tenth in the province.
The non-auto insurance claims cycle performed well, and it has been in the top three in the province, which is worthy of recognition.
(3) Standardized management of legal cases and institutionalized management of lawyers have effectively improved the success rate.
By the end of 10, there were 7 12 legal cases in our company, with accumulated impairment of 29.4935 million yuan, and the winning rate reached 5 1%. Through the defense of the case, the misunderstanding of insurance was resolved, and the judge's judgment was more fair and accurate.
(4) The adequacy ratio of loss assessment has been significantly improved.
By the end of 10, compared with the outstanding list at the end of 20 16, the expected loss adequacy ratio is 83. 15%. Compared with the outstanding list last month, the estimated loss adequacy ratio has increased to 100. 19%, ranking fifth in the province. Due to the good loss assessment this year, it is expected that the loss assessment adequacy ratio in xxxx will be greatly improved.
(5) The utilization rate of tablet computers reached the budget target ahead of schedule.
By the end of 10, the survey utilization rate of tablet computers in the whole city was 95. 13%, and the fixed loss utilization rate was 65.46%, ranking sixth in the whole city, fulfilling the challenge goal ahead of schedule.
(vi) Slow processing of pending detention cases.
The retention rate of unsolved cases is high, 1, and there is no targeted method. 2. The assessment is not strong enough to arouse the enthusiasm of relevant personnel. 3. The personnel changes greatly, and the newcomers are not familiar with the handling of detention cases.
Four. Xxxx annual work plan
(a) strict internal management, improve service level and promote business development.
1, through the effective implementation of various management systems, strengthen the internal control of the claims center, and enhance the sense of team, responsibility and service of the claims center.
2. Strengthen the assessment, strictly control and purge the claims team, so as to enhance the cohesion and execution of the team.
3. Improve the professional skills, service level and service awareness of claim settlement through regular training for claim settlement personnel. Strengthen the concept of sincerity, sincerity and sincere service to customers.
(2) Strengthen link monitoring and improve efficiency.
1. Take the claims manager as the leading factor, track and monitor all aspects of the case at any time, establish an overtime warning mechanism, and realize the overall improvement of the timeliness of claims.
2, strengthen the cooperation of all links, so that the case can be urged and handled at any time to avoid delay. Make the case flow smoother and faster.
(three) to establish and improve the system, improve the claim procedure.
1, standardize the responsibilities and authority of each post, scientifically allocate personnel to the maximum extent, effectively prevent buck passing, improve work efficiency and quality, and standardize operation behavior. Provide a basis for the smooth implementation of the assessment.
2. Formulate a targeted assessment system, set reasonable expectations around the weak links in claims settlement, conduct regular follow-up assessment, and timely cash rewards and punishments measures. Effectively motivate employees and enhance their sense of responsibility.
Strengthen the mediation of litigation cases and effectively reduce compensation.
1. Strengthen communication with courts and traffic police departments, solve insurance disputes and contradictions quickly and efficiently, safeguard the legitimate rights and interests of the company, improve customer satisfaction and enhance the social image of the company. Based on the principle of "respecting facts, negotiating on an equal footing, being able to adjust without litigation, and saving costs", an insurance dispute settlement mechanism linking mediation with litigation is established.
2. According to the actual situation, cooperate with the traffic police and the court to build a special mediation platform.
Year-end summary of insurance claims personnel In the past 2 1 year, we have taken the initiative, made clear the objectives, taken solid measures, and made concerted efforts with Qi Xin to overcome difficulties and make solid progress. During this year, all the staff of the claims department closely focused on the center of "based on reform, accelerating development, sincere service and improving efficiency", kept pace with the times, worked diligently, paid attention to practical results and served in a civilized manner, and successfully completed all tasks assigned by the superior company and the general manager's office of the company. By the end of February, xxxx, 65438, our department had handled all kinds of compensation cases, and paid nearly * * * million yuan in compensation, which effectively guaranteed the city's economic construction and people's property safety. (1) focus on the goal, implement the plan and pay close attention to the work.
I. Summary of work
As of June 365438+February 3, xxxx1day, special postal service * * * accepted all kinds of reports, with a year-on-year increase of * *%; Among them: motor vehicle insurance (compulsory insurance, commercial insurance), accident insurance, enterprise property insurance, public liability insurance, employer liability insurance, freight insurance, family property insurance, campus liability insurance and product quality assurance insurance. First site deployment rate * *%. * * * The case investigation was fixed, with a year-on-year increase of * *%; Among them: * * motor vehicle insurance, up by * *% year-on-year, personal insurance, * * enterprise property insurance, * * freight insurance, * * liability insurance and * * family property insurance. * * * Adjusted * * cases of various compensation cases, with a year-on-year increase of * *%, cancelled * * cases and rejected * * cases; Among them, there were * * cases of motor vehicle on-site compensation, amounting to * * million yuan, accounting for * *% of the total number of compensation cases; * * Ten thousand yuan is a case of compensation in advance; * * Litigation request, the prosecution amount is * * million yuan, and the overall settlement rate is * *%. In view of injury cases, our department specially invites professional doctors to review the medical expenses in motor vehicle injury claims and various personal insurance and liability insurance claims. As of February 25th, xxxx, 65438, all kinds of claims have been audited, with the amount of * * ten thousand yuan, and the excluded amount accounts for * *% of the compensation amount for medical expenses.
⑵ Use new assessment methods to guide the work, standardize the operation, improve the management level and highlight the business focus.
In xxxx, we intensified the reform in all aspects of our work. By reforming the management methods of salary accounting for personnel in various positions in our department, the income of all employees in our department is divided into two parts: basic salary and performance salary, and the performance salary is linked with the actual work quality of individuals, and the performance salary is approved and paid according to the work quality. Furthermore, the unified post salary is transformed into more work and more pay, less work and less pay, and pay according to work. Through a series of measures, the execution of on-site claims cases has been strengthened, the circulation speed of cases in all links has been accelerated, the quality of insurance claims service has been improved, and the special services of Chinese insurance brands have been further recognized by the society, and the high-quality and fast claims service has won the trust of customers.
⑶ Take the slogan of "compare, learn, catch up, help and surpass" to improve the professional skills of post personnel and form a high-quality claim team.
In the past year, we have continuously increased our investment in the training of personnel in various positions in this department. From June 5438 to September, xxxx, our department organized training, job skills assessment and business knowledge exchange activities 10 times, invited professionals to teach, and taught insurance loss assessment knowledge and claims business skills. Send employees to participate in various trainings organized by the society and the company; Organize survey and damage assessment personnel to carry out vehicle survey skills competition for specific accidents in Huayuan Automobile Company of No.202 Factory; Visiting and studying in Brother Cizhi Company and conducting business exchanges; By organizing and holding various activities, the business skills and work level of department employees have been effectively improved.
⑷ Increase hardware investment to provide customers with high-quality and fast claims service.
On June 5438+ 10, xxxx, Yibao Auto Insurance Claims System was officially put into use. In order to meet the needs of work development, the claim department provided laptops for each investigation team in time and added digital cameras in groups, so that each investigation team has one laptop and two digital cameras. At the same time, the claims department also installed a GPS positioning system on each survey vehicle. In addition, the dedicated line personnel can more intuitively grasp the traffic situation in Baotou and its surrounding areas, as well as the location and use of vehicles surveyed by departments, which makes the on-site dispatching more reasonable, avoids "wrong dispatch" and "wrong dispatch", improves the dispatching quality, and further ensures a higher on-site survey rate. Strong hardware investment and advanced auto insurance claims system have laid a solid foundation for the healthy and orderly development of China Insurance's featured claims service.
(5) intensify the investigation and punishment of insurance fraud cases, and earnestly achieve "no compensation, no compensation".
In xxxx, the work of "counterfeiting, fraud prevention and insurance fraud prevention" was intensified and obvious results were achieved. By the end of June, xxxx, 65438+February, 3 1, our department had cooperated closely with relevant departments to investigate and deal with insurance fraud cases, which avoided economic losses of more than RMB * *, effectively safeguarded the company's rights and interests, and served as a warning to those with ulterior motives.
[6] Send warm messages and provide humanistic care for customers.
Every time it rains or snows, the accident rate of motor vehicles increases. Our department uses a special information platform to send warm messages to customers' mobile phones to remind customers to drive carefully, and it is slow in rain and snow. This can not only effectively reduce the accident rate, but also fully reflect the meticulous humanistic care of China Insurance.
Two. Xxxx annual work plan
Through one year's efforts, our brand has been widely recognized by all walks of life, and our high-quality and fast claims service has won the trust of customers. However, in our work, we still find many problems and shortcomings, such as the high insurance payout ratio and the lack of ways and methods to deal with cases of refusing insurance. Therefore, improving the quality and management level of claims in an all-round way is still the focus of our future work. In the work, we should further strengthen the work of key links such as auto insurance survey, loss assessment, quotation, claim verification and physical examination, so as to achieve objectives, measures and audits. Therefore, we should seriously:
(1) The reporting time of the special line shall be controlled within 3 minutes of each case, and the return visit rate shall reach 95%; The on-site arrival rate of the damaged post should reach 100%, and the overdue delivery rate should be controlled within 10%; 1 day, the quotation post shall report the vehicle control, and the coordination between the vehicle reported by the branch and the branch shall be controlled within 2 days as far as possible; The settlement rate of the number of adjustment posts and the settlement rate of the amount strive to reach 85%.
In xxxx, we will continue to strengthen the assessment of on-site claims cases, expand our influence, create momentum, and establish the characteristics of China Insurance Claims Service in Baotou market.
⑵ Control the fixed loss quality of car damage insurance, and ensure that the payout ratio of auto insurance drops obviously. Therefore, we should improve the first-site survey rate, squeeze out the moisture in the car damage insurance claims, effectively implement the damage assessment review and nuclear damage, and strengthen the supervision of the survey and damage assessment work.
(3) Strengthen the construction of claims team, strictly enforce discipline, comprehensively and seriously receive reports, arrive in time, accurately quote, provide enthusiastic service and make reasonable claims. Further improve the fast claim settlement method, ensure the simplification, convenience and quickness of case handling under the principle of initiative, quickness, accuracy and reasonableness, and highlight the characteristics of China Insurance. Establish and improve the service network of maintenance, rescue and spare parts, and review the automobile maintenance cooperation units that have signed cooperation agreements on the principle of mutual benefit and risk control. Strengthen the construction of survey and damage assessment team, reserve personnel one step ahead of time, and prevent survey and damage assessment from delaying business development.
With the continuous expansion of business scale, it is necessary to further improve the business skills of all claim adjusters, strengthen the supervision and assessment of claim adjusters, improve the work efficiency of claim adjusters, standardize the words and deeds of claim adjusters, put an end to behaviors that are detrimental to the company's image and interests, and require survey personnel to be neat in vehicles, tidy in clothes, polite in speech, humble, patient and meticulous, efficient in service, deal with customers with a brand-new look, and educate every claim adjuster.
(4) In XXXX, on the premise of ensuring the on-site reporting rate, we will further improve the on-site reporting rate, increase the intensity of crime scene verification of cases without on-site self-reporting, and reduce the occurrence of false insurance fraud cases. Our department issued a reward method for refusing compensation cases, mobilized the enthusiasm of all staff, further reduced the payout ratio, increased the profit margin, focused on strengthening the investigation and handling of non-auto insurance and major difficult cases, and sent professional teams to carry out the investigation and handling of non-auto insurance and difficult cases.
5] Strengthen quotation management, do a good job in price localization, squeeze out the moisture in the price of auto parts and maintenance, and make sure that the models are consistent and the quotation amount is unified.
[6] Strengthen the review of damage compensation cases.
Once actively prevent insurance fraud, do a good job in the investigation and handling of difficult claims.
(8) Standardize the management of outstanding claims, strictly implement the regulations of the Head Office on the management of outstanding claims, standardize the handling principles and operational procedures of outstanding claims, improve the accuracy of the loss estimation of outstanding claims, and strive to prevent the occurrence of zero loss estimation of outstanding claims.
(9) Strengthen internal information feedback. Feedback the problems found in the process of claim settlement to the underwriting department in time, so as to promote the underwriting risk control of the company, supervise the implementation of the underwriting system, curb the upward trend of payout ratio from the source, and coordinate the relationship between business development and claim settlement control.
⑽ Strengthen the control and supervision of insurance claims. All departments and branches of the Company collect the problems and guiding opinions and suggestions found in the process of insurance claims service and management, and adopt useful opinions and suggestions to rectify insurance claims service and management and comprehensively improve the quality and efficiency of insurance claims service and management.
In the next time, our department will aim at improving customer satisfaction and safeguarding the company's interests, strive to improve the quality and efficiency of insurance claims, enhance the company's social reputation, establish the company's brand, show the company's service advantages, and strive to promote efficiency through service, so as to make due contributions to building our company into a first-class modern insurance enterprise.
Year-end summary of insurance claims personnel III. The work of insurance claim settlement is very complicated, which belongs to the last stage of the claim settlement process and needs patience and care. Looking back on what has been done in this regard in the past year, there are gains and losses, which are worthy of recognition and need to be improved. Specifically, there are the following points:
First of all, their professional quality and skills have been improved. This year, in the insurance claim settlement work, the new and old types of insurance have changed, and the way of claim settlement has also changed. In order to adjust more conveniently and quickly, I keep learning the insurance responsibilities, operating procedures and rules and regulations of various types of insurance, so as to better apply them to my work. After continuous study and practice, I have made necessary progress in my work and my adjustment efficiency has been greatly improved. And in the work, learn from the strengths of others, so that their potential has been greatly improved.
Secondly, through cooperation with colleagues, we have made great contributions to the settlement of claims. The whole process of claim settlement is that after the customer reports the case, the customer submits the claim data, inputs it into the new system after the loss is determined, transfers it to the price verification post, completes the adjustment, and then transfers it to the finance department for remittance after the leader approves and signs it. By the end of February, 65438+,more than 2000 claims had been settled. Through the efforts of all departments of the Claims Department at the end of the year, the settlement rate of closed cases was successfully increased from 70% to over 85%, and the task of settlement rate of claims issued by the Head Office was completed.
Thirdly, I deeply realized the improvement of professional ethics such as loving my job and being strict with myself. With the decrease of personnel and the increase of business volume in this year, the company tried its best not to delay the compensation case, and worked overtime during the special period of handling cases, which successfully ensured the work efficiency. In this case, I really cultivated a spirit of dedication.
Finally, I want to say that the most important thing is to be careful in filing a case, which is also my progress day by day in my continuous work. Filing a case means that after the compensation of a case is completed, the claim file should be sorted out according to the report and the name should be filled in. Each case has different material, thickness and time. After arranging the order of each box, punch holes with a binding machine. After punching, thread each case with binding thread, and then stick the back cover of the case with a stick. Classify the types of insurance according to the requirements, then classify them according to the claim number, put them in the file box respectively, mark the file number clearly, and then file them in the file cabinet for future reference and file search.
In short, from my summary of insurance claims, it is not difficult to see that the claims post reflects the company's image and is the company's external service window. Therefore, whether answering the phone or greeting delivery, we should always pay attention to our manners, pay attention to the company image and promote the all-round development of our business.
In the past year, with the trust, care and training of leaders, individuals have improved in their work and other comprehensive qualities. Here, I am very grateful to the leaders for their cultivation and colleagues for their help. The year's work has ended, and we will continue to work hard in the coming year. This is an irresistible problem, which has been our summary at the end of the year. Every year has its own progress, every year will have its own growth! I believe everyone will achieve the most complete success in the new year!