During the Call pt 1
Lemonade
Created on September 10, 2024
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Transcript
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During the Phone Call
Mointor tone. Just like in emails, tone is absolutely crucial! However, similar to emails, it can be tricky to hone the tone skill. On phone calls, you're lacking non-verbal cues (i.e. body language), which is what makes it so tricky to figure out what tone to use. But when in doubt, be as positive as possible! It will come in time and with practice. Some balances to keep in mind include:Find the balance between being empathetic and not being overly apologetic. Have boundaries and allow your confidence to shine through, but stay away from being cold.Policy first, medical second. Start the conversation off by defining the policy exclusion (i.e. talk about what is considered a pre-existing condition) and then start talking about their pet's specific condition and how it applies to that policy. This method is beneficial because you might automatically lose the policyholder by stating "Fluffy's allergies aren't covered because..." - they won't hear anything after 'because,' including the reasoning why.Lean on the policy. Remember: do not 'own' the outcome of that claim; you didn't just decide to deny it for no reason. We came to that determination due to policy exclusions, not due to some personal vendetta you have against the policyholder. You are the messenger, so try to remove yourself emotionally from the outcome whenever possible. Easier said than done, I know.Confidence! Maintain a confident voice throughout the conversation. Some policyholders view the lack of a confident tone as weak and will try to walk all over you. Confidence doesn't equal rude, arrogant, or pushy. It is knowing what you're talking about with conviction.
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During the Phone Call Pt 2
Avoid hypotheticals. Hypotheticals are a slippery slope, especially if they involve promising future coverage. "Even though we can't cover Fluffy's allergies, we can cover other things like vomiting or cancer!" It's tempting to do this because you want to give them some proverbial light at the end of the tunnel, but it's detracting from their current concern and possibly opens us to covering those conditions in the future when we should never guarantee that (even if a medical record review was completed in full).Acknowledge the policyholders' frustration. If their claim has been denied, it's completely understandable that they'd be frustrated. Provide space for them to express that and you acknowledge it. Anger is a secondary emotion. That means it's secondary to a primary emotion such as fear or sadness. They could be feeling fearful about paying their credit card bill or sad about how they're going to treat their pet without insurance assistance. So acknowledgment is key.Hold your boundaries. There is a difference between being kind and empathetic towards a policyholder versus letting them dominate a conversation. If they are derailing from the conversation, pull them back. If they are becoming abusive or inappropriate, give them a firm warning. Sometimes holding boundaries will be allowing for a pause in the conversation. There shouldn't be more than a few seconds of dead air, but that can sometimes be what it takes to "reset" the conversation and get it back on track.Don't point fingers. As a Pet Specialist, you were not responsible for determining the outcome. But that doesn't mean that you should point fingers at the Claims Advocate, or anyone else for that matter. If you disagree the determination and/or the policyholder is becoming agitated and starts blaming you. Role delineation works as a team, so you can use "we" statements or "our team" type statements, but refrain from "passing the buck."Don't fake it. If you don't know something, don't make it up. Seems obvious, but it can be tempting to placate a policyholder in that moment. You can either research it on the spot or you can offer to research it for them and call them back later. Remember not to keep them on hold for more than 1 to 2 minutes. So if you don't feel confident where you can find the answer, or that you can find it quickly, just offer to call them back.
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After the Call
After a phone call, there are just a few additional steps you need to take before you can say you're finished:Document, document, document! Make sure you've left your notes in the Comms Timeline about what was discussed during the phone call.Follow up. If you made any promises to of action to the policyholder (i.e. a manager will follow up with them, sending the claim to SLR, doing additional research, etc.), make sure you follow up on that promise.If it was a tough phone call, take a break! Reme29mber! You get 2 15-minute paid breaks, so please use them. Pet a furry/feathery/scaley friend, take a brisk walk, scream into the void, check you pantry to see if any good snacks have magically appeared since the last time you checked, reminder yourself that you're a total bad@$$ and our policyholders are lucky to have you, etc.
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