As underwriters, we analyze risk in insurance proposals and determine policy terms and premiums on the basis of actuarial, statistical, and background information. We receive intense training and amass great amounts of knowledge through hands-on training. We accordingly possess stellar analytical skills, keen attention to detail, and advanced verbal communication skills.
Moreover, we exercise sound judgement, show consummate negotiation skills, and maintain an extraordinary ability to think outside the box in making the pieces of insurability evidence fit together like a jigsaw puzzle. These special powers make us the superheroes of the insurance industry.
Now once all of the puzzle pieces are in place, meaning we’ve met the necessary requirements and navigated the company protocols, we have a whole picture. And then we arrive at a decision. Victory!
What if the auditor doesn't agree?
But not so fast. When it’s time to have your files audited, what if the auditor doesn’t agree with your underwriting decision?
Enter the auditor, who will scrutinize every aspect of the underwriting process from beginning to end, reviewing each puzzle piece to make them all come together in adherence to the company guidelines and philosophy.
The auditor’s job is multifaceted. Auditors ensure the appropriateness of risk assessment and classification for medical, financial, and non-medical risks. Besides, they ensure adherence to internal underwriting guidelines, substantiate financial eligibility, review the adequacy of file documentation to support the rendered decision, and review the final decision.
Erroneous underwriting decisions make for unhappy customers
Audits are necessary for but not limited to measuring consistency in underwriting decisions that directly impact the customer/client experience, identifying training gaps, establishing opportunities for providing appropriate training, and evaluating underwriters’ performances.
Erroneous underwriting decisions and practices can result in unfair rates and decisions, resulting in wasted time and money, loss of business, and damage to the company’s and/or client’s reputation. Bottom line: unhappy customer.
But aside from judging the underwriter’s adherence to the guidelines and rules, and of course, whether he or she made the right decision, what are some other ways we can evaluate an underwriter’s superpowers? What qualities make an underwriter stand out?
Successful underwriters are hungry for knowledge. They do their best to keep on top of changes in the medical world: learning continuously throughout their career, enrolling in courses, attending industry seminars, and receiving certifications.
Effective underwriters are well-oiled machines. They’re on top of everything; they don’t let anything fall through the cracks. That’s why they’re the epitome of organization and communication as they achieve accuracy from beginning to end.
Remarkable underwriters support their fellow teammates. They continuously reach-out to ensure questions are answered and concerns are handled; they offer feedback (both negative and positive); they job shadow; and they make themselves available as sounding boards.
Being open to feedback from peers, managers, and clients is crucial. Requesting managers’ feedback clearly demonstrates their desire to continue improving.
Successful underwriters welcome change. They embrace it and encourage others to as well. They either flow TO the work or WITH the work. Ultimately, they can pivot easily.
Analytical skills and technical medical expertise will always be paramount to completing applications for underwriting decisions. Audit results offer objective proof of an underwriter’s capability. However, as important as they are, they are not the only metrics for assessing an underwriter's capabilities.