First Notice of Loss (FNOL), relates to the initial contact of a claim or incident resulting in loss of an insured product. Collection of the important data elements during this initial contact or call is referred to as claim intake and is crucial to the success of an FNOL program. Reporting is another critical element of any successful FNOL program. Full-cycle claim reporting includes 5 key elements, sometimes referred to as the “Five C’s of Full-Cycle Claim Reporting”. Let’s examine each of these elements in greater detail.

• Configure – After evaluating FNOL goals and current process, create a custom workflow that reflects all aspects of your FNOL process. Use clear and concise business rules to ensure accuracy, minimize call times, and reduce follow-up calls.
• Capture – Organizations must quickly and accurately capture complete information, and need to do so the first time, contact is made. Claims intake is often a 24/7 requirement for FNOL programs, and accurate data capture should reflect this requirement. The capture phase needs to include collection of all critical information, including commercial and personal lines claims, non-claim reports and inquiries, employee absences, fraud, and catastrophic events.
• Complete – Complete post-notice services, including cast resolution, follow-up, and documentation are essential for Full-Cycle Claim Reporting. This includes triage to ensure escalation of critical situations with full-service notification procedures that are automatically triggered based on defined criteria. Medical coding must be performed in accordance with the National Correct Coding Initiative (NCCI), duplicate checking to flag matches or possible matches to previous claims and handle them according to your business requirements is also necessary. Quality Assurance Reviews of all claims, Notice Pending, and claim number assignment are some of the other important elements to ensure complete post-notice service requirements.
• Communicate – It is important to expedite completed incident reports to key recipients, including government agencies, which can include any or all of the following: electronic data interchange (EDI), mail, fax, phone, text message, or e-mail. Filing for first reports of injury (FROI) and subsequent reports of injury (SROI), as well as medical bills via EDI must also be completed accurately and efficiently as mandated. Other forms of communication relating to Full-Cycle Claim Reporting include Notice Distributions, Jurisdictional FROIs, supplemental report summaries, custom forms, and regulatory documents.
• Control – Effective control begins with the first notice intake and dissemination process which must reflect a well defined and executed FNOL process. This should be structured, yet flexible, professional and personal. It should be thorough, yet efficient, ensuring it is not onerous during the intake process.

Effective full-cycle claim reporting should include contact center statistics, incident report summaries, state filing acknowledgments, and all dissemination log information whether scheduled or ad-hoc reports. Companies which follow the Five C’s of Full-Cycle Claim Reporting can help ensure a more robust and effective First Notice of Loss program.