In January 2017 we thought we had a problem with the Quálitas claims hotline in Mexico City. It all started in August of 2016. That’s when we started offering Asistencia Vial Quálitas (AVQ) at MexInsurance.com® to complement the standard Tourist Auto Insurance policy. By January 2017 we had a serious issue with the AVQ service. A client complaint indicated she was stranded in a Baja desert and struggled just to prove she had Roadside Assistance. During our history of 15 years, accident claims have been solid (since 2003). So these AVQ issues we figured, hoped, were just growing pains surrounding a new product.
On March 28th, 2017 we traveled to Mexico City to discuss claims handling with the Corporate Claims Helpdesk (Cabina Nacional) and those executives in charge of the process. We toured the facility, reviewed the technology, and strategized how we can make things better for our clients. Our complete audit resulted in some interesting discoveries related to claims validation. We identified the gap – related to AVQ Certificate Validation and identified high-level action items required to fix the problem. This new project will take 3-6 months. In the meantime, AVQ leadership at Qualitas will immediately assist all mexinsurance.com clients who identify themselves as such without further validation.
The Hotline in Mexico City
The executives received us warmly and listened to our concerns. They gave us a tour of the rather impressive claims hotline. It is an impressive setup, and not at all what we expected. Two floors with hundreds of employees working full time handling claims for the company. The hotline is set up in two distinct sections, downstairs are for auto accidents/theft and upstairs is for Roadside Assistance. Both groups are staffed 24/7 and have a bi-lingual representative at all times available to assist tourists. After the tour we sat down to discuss business.
After the tour, they sat us down and showed us how the claims process works.
- The call comes in and is answered, the operator will send it to either AVQ, Collision or Theft call bank
- The call bank will validate the caller has coverage
- If coverage confirmation results in the creation of a claim number, and dispatch of attorney, tow, ambulance, adjuster, etc.
- The claim and adjuster attach to a monitoring system with three gates, 5 minutes, 15 minutes, and 30 minutes. Each claim is a visual representation on the activity Board. The claim represented by colors on this board and the Red items send an alert to the manager
- The manager engages the adjuster and looks into those claims that take longer than 30 minutes to respond. Usually, those are related to remote areas or complex accidents involving many vehicles and authorities, possibly death. Each claim assignment is by area, and each area has a responsible manager for escalation.
We communicated to Quálitas a specific incidents that brought us there. A client, vulnerable young woman broke down in a remote area of Baja California and the agent took 1 hour before dispatching assistance. The claims hotline dispatcher asked our client to email a photo of her insurance policy to prove that she had coverage. Our client barely had internet service, only had digital copies of her policy and her frustration began to magnify in an already challenging situation.
Together we realized that the problem is not with how Quálitas handles claims. And for growing pains? They seemed very well established, organized and with a solid structure of escalation and authority. The issue was validating the coverage through the Quálitas claims hotline, for our tourist clients.
The executives called in their technology gurus and helped us understand the technology infrastructure and how we might integrate more seamlessly.
Quálitas Claims Hotline: Conclusion
I went back to the hotel that night and created a project charter that would eliminate our problem through the responsible use of technology. We met again with the executives at Quálitas and agreed on a path moving forward that would include a connection project called “Quálitas Connect”. This will allow our tourist clients to receive the same service as their domestic clients when handling a claim.
Qualitas-Connect project complete
We completed the Quálitas Connect project in early 2018 so that claims validation can happen instantly. Aside from a few hiccups, we have eliminated complaints from clients related to claims handling. Specifically, our clients now have instant validation without having to send copies of policies through email. Because let’s face it, tourists can’t really depend on having great internet on their trip to Mexico – especially in situations where they are calling for assistance!
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