Case Studies—are you smarter than other consumer affairs professionals?

Back by popular demand—attendees raved about the case studies workshop first presented in 2013 and so the decision was made to play it again. What other industry than insurance could feature the unusual, peculiar, and educational by presenting actual case studies to encourage attendees to share expertise, insights and solutions from the consumer, insurer and regulator perspectives. The 2014 case studies did NOT disappoint to distill strong professionalism, laughter, and more than a few surprises.

The process
Participants were divided into six working groups—each with a sprinkling of regulators, consumer affairs professionals with product expertise, and consumer affairs professionals without the exact product expertise for the case study (representing the unhappy consumer voice).  After a test case study, where all present got the hang of it, each group was presented with the facts of a different case study—but not the actual outcome.  Then, the real work began…

The case studies provided each group the opportunity to analyze the facts across product line, regulatory oversight, and consumer emotions (yes, the consumer vigilante showed up…see article on Beyond Wow).  Each group worked its cases to determine the key points; articulate any questions from the perspective of the consumer, the regulator and the carrier; and ultimately produce a recommended course of action to resolve the complaint. Then, and only then, did the big reveal occur of what actually happened in the real-world situation.

The cases
The cases included:

•    Waiver of premium
A tragic story of love and loss with Ms. Waiver complaining that her request to apply for a waiver of premium benefit for life insurance policy had been ignored.

•    You call that customer service?
Heartwarming story of Mrs. Elderly Widow who was denied claims for death benefits from whole life policies.

•    Mistakes to Die For
A true-to-life mystery as Mr. Angry files a complaint against an insurer for $1 million. Multiple insurance company errors triggered a cancer relapse after a three-year remission, but…who done it?

•    Valid or Invalid?
You be Judge Judy and review the facts.  Can an insured have a policy reinstated when the owner is already dead but the family paid up the non-paid premiums?

•    Whose Universal Life?
Just like a game of Jeopardy, what are the right questions to the answers presented?  And what could be more exciting than questions revolving around who owns a universal life policy?

•    Lightning strike
A compelling story of destruction and the human spirit as an insurance company holds some funds to ensure a lightning strike repair has been completed to stated standards.

And the winners are…
Each group presented the case facts and recommendations and was rated (informally by an applause-o-meter) on how well group members analyzed the facts and rendered a decision that was fair to consumer and carrier.

The winners were:

•    Lightning Strike was awarded highest marks for a variety of reasons—most importantly, the group carefully aligned its handling of a difficult client with the skills learned from the morning session on working with emotional customers and detailed a three-point resolution process.  (Most interestingly, the regulator in the group said document and walk away—enough already!)

•    Valid or Invalid came in as first runner-up due to the insightful analysis that distilled about 1,000 questions that should have been answered by both the carrier and the consumer before the case was reviewed and the complaint was settled.

On-site activity
The cases, collaboration, and outcomes were so impressive that participants suggested the cases be made available online to be used by DOIs and carriers alike for training and or staff meeting functions.  On-site groups could be voluntold *to participate.  To read all case study profiles, (Please login to access this link).

*ICAE – specific vocabulary word, three are found in this newsletter.

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