An initial claim contact is based on any meaningful initial contact attempt made and documented in the claim file to a person or company (to someone considered the claimant or City employee involved in submitting any type of claim to us) by letter, in-person communication, by telephone, by email, or by fax. This meaningful initial contact attempt must be accomplished within 1 business day, or within 24 hours, after the claim file is assigned to the adjuster and set up in our claim handling software system.

This is a measure of our customer service performance by making initial contacts with anyone presenting a claim against the City.

This measure allows us to see how efficiently and effectively our division is responding to new claim submissions. The more timely we contact a person submitting a claim, internally and externally, the better the customer service we are providing. The higher the percentage, the more timely we have documented our attempts to contact a newly received claimant or City employee claim submission showing we are providing customer service. The lower the percentage, the less timely and efficiently we have documented contacting a newly received claimant or City employee claim matter and our customer service will need to be improved by providing and documenting the meaningful contact attempt.

Our target is 95% of initial contacts were performed and documented in the audited files. It is an ongoing measurement of our customer service and efficiency in claim file handling. The closer we are to 100% shows that our adjusters are properly handling the newly assigned claim files as expected. We also compare it to our prior year to see any improvement in our services. It is based on the number of completed contacts found in the randomly audited newly assigned files, pulled monthly, divided by the number of actual files audited. For instance, 4 completed contacts/5 assigned audited files = 80% completion ratio. I audit up to 5 random files assigned to each adjuster for the prior month or, if the adjuster received less than 5 new claim files, the amount actually received.

Data Source Details & Calculation Information:

Data for this KPI comes from Origami Risk Database, which is accessed by named users only. Currently only members of Risk Management have access to this database.

To download data:

1. Login to Origami Risk Database with proper username and password.

2. Select the Reports tab at the top of the page and scroll down to select Report Name: New Claim Report – Monthly J.

3. Run report as a pdf or excel spreadsheet. I prefer an excel report so I can cut and paste the required information.

4. Download the report. It is saved on Jason Barksdale’s desktop under a folder named Performance Review FYxx (the xx is based on the current fiscal year, i.e. FY17).

5. Inside Performance Review FY17 folder are individual folders named by adjuster.

6. Inside each adjuster folder is a Performance Audit excel spreadsheet titled: Adjuster – FY2017 pt1 Performance Office Audit Info.xlsx. The Audit sheet is set up for monthly audits for the 1^st half of the current fiscal year. The 2^nd half of the current fiscal year is designated by pt2 in the title. An example of the title is: Adam – FY2017 pt1 Performance Office Audit Info.xlsx.

7. Up to 5 claims are randomly selected from the New Claim Report – Monthly J report, per each adjuster, (if adjuster does not have 5 claims then just an actual amount opened for the adjuster is used) and transferred over, cut and paste the claim number and claimant name, to the Adjuster – FY2017 pt1 Performance Office Audit Info.xlsx audit spreadsheet and saved under each adjuster’s file in this folder. The claim number and claimant name are pasted into Column B and C in the excel spreadsheet.

8. Each adjuster’s randomly selected claims are audited according to the criteria established on the Adjuster – FY2017 pt1 Performance Audit Info report to determine if the contact was completed within the acceptable timeframe – which is 24 hours/1 business day of receipt by the adjuster. This information is gathered by going into the specific claim file in Origami Risk to review the dates and notes that document the date and person to which the contact was attempted or made. It is a Yes (Y) or No (N) answer on the audit in column H to determine if it was completed. The amount of Yesses are added up at the bottom of each month and used for the measure against the amount of claims selected for the audit for that month.

9. Once all of the adjuster audits are complete, the number of claims selected for audit and the number of Yesses generated from each adjuster audit spreadsheet are transferred over to another spreadsheet found in the Performance Review FY17 folder titled: Performance Office Information 2017.xlsx (it is also set up and saved as new for each fiscal year thus updating the title with the fiscal year). This is where the measurements are saved according to each individual adjuster. The total amount combined for all adjusters for audited claims and completed with a yes are found under columns AA and AB for the associated month. The combined numbers for the month are then transferred to the ClearPoint data sheet 407983. It is a ratio based on the number of Completed Yesses divided by the number of actual files audited (example: 23 completed Yesses / 25 files audited = 92% were successfully completed).

Series, Formula, & Target Information:

On the ClearPoint data sheet, laid out by month within the fiscal year, Column B captures the amount of contacts completed, yesses made, from the audit for that month; Column C captures the total files audited for that month. This measure shows our percentage of our documented customer service by verifying if the adjuster has made some type of meaningful contact attempt with the party submitting a claim.

Column B was changed to “Total # of completed contacts made in month”. Column C was changed to “Total # files audited in month”.

The calculation is (Column C/Column B = %) or Column C – Total # of contacts made in month / column B - # files audited in month. If 23 contacts were made in the audit / 25 files audited in month = 92% were successfully completed.

Targets:

There is a target of 95% of the audited files to successfully complete a meaningful contact attempt that was documented in the claim file.

High variance is 95% or greater.

Low variance is 89%, which is based on the 2^nd half of FY16 actual completion percentage of this measurement and when the standard was implemented

Evaluation:

The high variance percentage is attainable and still leaves room for an occasional mistake in either documenting a file or forgetting to make a meaningful contact on a claim within 1 business day/24 hour requirement for a claim. It reflects the level of customer service provided by the adjusters in claim handling.