MANAGING CUSTOMER FROM SALES TO CLAIM SETTLEMENT

BY

MR. SAMUEL MUHINDI

FOUNDER CEO OF INSURANCE GROUP OF TANZANIA LIMITED

OUTLINE

• CUSTOMER SERVICE PHILOSOPHY

• CLAIMS-DEFINING ASPECTS

• EFFECTIVE NEGOTIATION TIPS- MINDSET – FACTS DIFFER IN EVERY CASE

• CLAIMS PROCEDURE

• SOME TECHNICALITIES

1. CUSTOMER SERVICE PHILOSOPHY – DELIGHT THE CUSTOMER/EXCEED CUSTOMER’S EXPECTATIONS

.

CUSTOMER SERVICE PHILOSOPHY – DELIGHT THE CUSTOMER/EXCEED CUSTOMER’S EXPECTATIONS

A. BUSINESSES ARE CREATED; BUSINESS PLANS AND MISSION STATEMENTS CRAFTED TO DIFFERENTIATE AND OFFER THE COMPANY COMPETITIVE ADVANTAGE; CUSTOMER SERVICE CHARTERS ARE PUT IN PLACE IN A BID TO GET MORE CUSTOMERS AND THEREBY GROW THE REVENUE

• GET NEW CUSTOMERS

• GET EXISTING CUSTOMERS TO BUY MORE E.G. ENHANCEMENT OF COVER

• GET EXISTING SATISFIED CUSTOMERS TO BUY ADDITIONAL COVERS

• GET EXISTING SATISFIED CUSTOMERS TO BUY MORE FREQUENTLY

• GET EXISTING SATISFIED CUSTOMERS TO GIVE YOU REFERRALS- HENCE THE NEED TO HARNESS AND LEVERAGE ON CUSTOMERS

CUSTOMER SERVICE PHILOSOPHY CONT.

B. ALL STAFF ARE DEEMED TO BE IN THE FRONT OFFICE – THEY DIRECTLY OR INDIRECTLY INTERACT WITH CUSTOMERS AND REPRESENT THE COMPANY’S IMAGE. SATISFIED CUSTOMERS BUY MORE OF THE SAME PRODUCTS AND ADDITIONAL PRODUCTS INTERNAL/EXTERNAL CUSTOMERS-AGENTS /BROKERS/ POLICYHOLDERS/LEGAL REPRESENTATIVES

• DISSATISFIED CUSTOMERS TELLS 24 OTHERS

• COSTS 6TIMES TO ACQUIRE A NEW CUSTOMER THAN TO RETAIN A NEW ONE

• LIFETIME VALUE OF A CUSTOMER

CUSTOMER SERVICE PHILOSOPHY CONT.

C. CUSTOMER SATISFACTION

• CUSTOMERS BUY UNIQUE EXPERIENCE -SELL A SIGNATURE BELIEF /EVOKE FEELINGS E.G NIKE-GREAT ATHLETE, VOLVO –SAFETY FIRST

• FOCUS ON THE CUSTOMER’S NEED MAY IT BE BUSINESS, DECISION OR PERSONAL NEED-SELL THE BENEFITS, NOT THE PRODUCTS

• UNIQUE EXPERIENCE CAN ONLY BE PROVIDED BY STAFF WHO ARE PASSIONATE AND INSPIRED BY THE MISSION STATEMENT /

• UNIQUE EXPERIENCE ENTAILS COURTESY – GREETINGS BY THE RECEPTIONIST CREATES THE FIRST CONNECTION- WE ARE GLAD YOU ARE HERE, SOME TEA; WE CARE TRANSMITTED THROUGH : CALLING THEM BY NAME, LISTENING, EYE CONTACT, SMILING, REPEATING TO SHOW UNDERSTANDING; VERBAL AND NON VERBAL COMMUNICATION EXPRESSES WILLINGNESS AND EXCITEMENT IN SERVING THE CUSTOMER, HENCE VERY CRUCIAL.

• SET BENCHMARKS/SLA - UNDER PROMISE BUT OVER DELIVER/BE RELIABLE AND CONSISTENT/SINCERITY

• EMPATHIZE WITH THE CUSTOMER, ESPECIALLY IF THERE IS A COMPLAINT AND APOLOGIZE WHEREVER NECESSARY PUTTING YOURSELF IN HIS SHOES RATHER THAN LOOKING FOR SCAPEGOATS, AND HE WILL TRUST YOU TO SOLVE THE PROBLEM

CUSTOMER SERVICE PHILOSOPHY CONT.

C. CUSTOMER SATISFACTION CONT.

• BE SOLUTION – ORIENTED AND EXPLORE “OUT OF THE BOX” SOLUTIONS.

• OFFER A ONE-STOP SHOP SOLUTION- TAKE RESPONSIBILITY TO RESOLVE THE PROBLEM YOURSELF RATHER THAN PASSING IT ON

• CUSTOMER RECOVERY -ENSURE THE CUSTOMER LEAVES SATISFIED, EVEN IF IT INVOLVES EXTENDING A FAVOR IN A BID TO REGAIN HIS TRUST.

2. CLAIMS-DEFINING ASPECTS

CLAIMS-DEFINING ASPECTS

A. FRAUD FEATURES

• INDUSTRY’S FRAUD STATISTICS

• NATURE OF CLAIMS FRAUD- SOFT AND HARD

• BEWARE OF RECYCLED CLAIMS

• THE NEED FOR INTEGRATED DATABASE

CLAIMS-DEFINING ASPECTS CONT.

B. PROPER UNDERWRITING -CLAIMS SERVICE IS HEAVILY DEPENDENT ON UNDERWRITING SERVICE; DATABASE FOR THE COVER IS CRITICAL

• CLAIMS DEPARTMENT IS THE FLAGSHIP OF THE COMPANY

• UNDERWRITING CANNOT BE DONE AT THE TIME OF CLAIM – PRIOR RISK INSPECTIONS, SURVEYS, PHOTOGRAPHS, CHASSIS NUMBERS, PROPOSAL FORMS, CLAIMS EXPERIENCE ANALYSIS ARE CRITICAL.

• CLAIMS PRONE TO DISPUTES AS NOT PREDICATED ON AN EXACT SCIENCE

• COMMON DISPUTES E.G. PRE-ACCIDENT VALUE, AVERAGE CONDITION, REPAIR COSTS, COMPLIANCE WITH WARRANTIES- USE CLAUSE

C. REQUIRED SKILLS SET

• SOFT SKILLS-HAPPY TO SERVE/A PEOPLE PERSON/CARED FOR/UNDERSTOOD/EMPATHIZING

• TECHNICAL KNOWLEDGE AND KNOW-HOW

• NEGOTIATION SKILLS – RAPPORT BUILDING, PROBLEM SOLVING, DECISION MAKING, ASSERTIVENESS

3. EFFECTIVE NEGOTIATION TIPS- MINDSET – FACTS DIFFER IN EVERY

CASE

EFFECTIVE NEGOTIATION TIPS- MINDSET – FACTS DIFFER IN EVERY CASE

• ARE GOOD NEGOTIATORS BORN OR MADE?

• AIM AT ACHIEVING A WIN – WIN OUTCOME

• CORROBORATIVE OR ADVERSARIAL STRATEGY?

• BE SOFT TO PEOPLE BUT TOUGH TO THE CAUSE

• SPEAK TO THE HEART- CONSIDER THE FACTS, EMOTIONS AND REPUTATION(CULTURE)

• NEGOTIATE WITH A RIGHT PARTY

• CONSIDER THE OTHER PARTY’S PERSPECTIVE - DIFFERENTIATE AN ELEPHANT FROM AN ANT ; A WAR FROM A BATTLE

• NEGOTIATE FOR A PACKAGE SETTLEMENT

• ESTABLISH THE BATNA, BUT NEVER DISCLOSE IT EVEN AFTER THE DEAL

• ALWAYS ACT, NEVER REACT

• DON’T LOSE BALANCE, WATCH OUT YOUR LANGUAGE, REPOSITION YOURSELF, TAKE AWAY THE REMOTE CONTROL AND KEEP BLOOD PRESSURE DOWN.

• USE SOFT POWER TO WIN

• BUILD A REPUTATION BRAND – REASONABLE LITIGATION AVERS

• ACCOUNTABILITY – DON’T ACCEPT THE BLAME, YOU ARE ANSWERABLE TO HIGHER AUTHORITIES

4. CLAIMS PROCEDURE

CLAIMS PROCEDURE CONT.

The basic process is similar for all type of claims, arising under different policies. A. Intimation- a)Email, Phone calls, Letters from Agent, Broker, Policy holder

b) Register the claim against the underwriting details c) Call for the necessary information and documentation

B. Evaluation: validate the cover - a) Premium payment- Insurance Act/Regulation b) Operative clause- Insured perils, non-insured, excluded perils c) Conditions- precedent to policy, subsequent to policy, precedent to liability under the policy d) Exclusions- Specific and general exclusions e) Legal principles- utmost good faith-Daladala insured as a private minibus, Insurable interest-car sold with insurance, methods of indemnity-reinstatement, Proximate cause- Robinson’s case, Contribution& subrogation

CLAIMS PROCEDURE CONT.C. VALIDATE INFORMATION AND DOCUMENTATION- POLICE ABSTRACTS (PF 90,93,PF 115),SKETCH MAPS, CLAIM FORMS, GARAGE ESTIMATES, DRIVER’S LICENSE, COPIES OF REGISTRATION CARDS DEPENDING ON THE NATURE OF CLAIM E.G. SELF-INVOLVING VIS A VIS INCEPTION DATE, COLLISION WITH TP, HIT AND RUN VIS A VIS EXTENT OF DAMAGE,

D. CONDUCT ANALYTICS- ANALYZE DATA, STUDY PAST HISTORICAL DATA, RESEARCH TRENDS, ANALYZE THE EFFECTS OF CERTAIN DECISIONS/EVENTS, EVALUATE THE PRFORMANCE OF GIVEN SCENARIOS, KAIZEN PHILOSOPHY

E. APPRAISAL – APPOINT ASSESSOR, LOSS ADJUSTOR AND INVESTIGATOR

F. SETTLEMENT - COMMUNICATION OF OFFER

5. SOME TECHNICALITIES

SOME TECHNICALITIES CONT.

I. MOTOR

• TPPI, COURT ATTITUDE, INCONSISTENT AWARDS, LAW REPORTING SYSTEMS, LEGAL LIABILITY TO PASSENGERS, LIMIT OF INDEMNITY EXCEEDED

• TPPD-LOSS OF USE

• FIRE DAMAGE CLAIMS,

• THEFT CLAIMS

• POLITICAL TERRORISM, SPECIAL PERILS, NON PAYMENT OF PREMIUM FROM AGENTS/BROKERS, BACKDATING OF COVERS

SOME TECHNICALITIES CONT.

II. NON MOTOR

• STOCK AND BOOKS CLAUSE

• ALARM SYSTEMS

• SECURITY /ASKARI CLAUSE

• CONVICTION CLAUSE

• CYBER CRIME EXCLUSION

• ARBITRATION CLAUSE

THE END

QUESTIONS?