August 14, 2022

Archives for March 2013

Boost Claim Department Meetings by Appointing a “Meeting Fairy”

Do you still believe in fairies?

Bad Meeting

Most of us don’t any longer. As a kid, though, it was different. I definitely believed in the Tooth Fairie. Back then, a dime or quarter for a lost tooth was a pretty good haul. With inflation, those numbers are now probably running higher, maybe $5 to $10 a tooth. In fact, now my dentist would refer me to an endodontist for a five-session treatment plan that would involve me cracking into my 401(k) to pay for the treatments.

So maybe you no longer believe in Santa, the Easter Bunny or the Tooth Fairy. However, you can revive the fairy concept for better claim department meeting management and productivity.

For your next claim department meeting, appoint a Meeting Faerie. This concept draws from author Seth Godin, who in one of his blogs ( described the duties of the “Meeting Faerie.”

Apply the concept to your claim department meetings to improve their impact and productivity.

The fairy’s job would be to ensure that meetings were short, efficient and effective. He [or she] would focus on:
• Getting precisely the right people invited, but no others.
• Making the meeting start right on time.
• Scheduling meetings so that they don’t end when Outlook says they should, but so that they end when they need to.
• Ensuring that every meeting has a clearly defined purpose, and accomplishes that purpose, then ends.
• Welcoming guests appropriately. If you are hosting someone, the fairie makes sure the guest has adequate directions, a place to productively wait before the meeting starts, access to the internet, something to drink, biographies of who else will be in the room and a clear understanding of the goals of the meeting.
• Managing the flow of information, including agendas and PowerPoint’s. This includes eliminating the last minute running around looking for a VGA cable or a monitor that works. The fairie would make sure that everyone left with a copy of whatever they needed.
• Issuing a follow up memo to everyone who attended the meeting, clearly delineating who came and what was decided.


Not necessarily. You need not wave a magic wand. Just appoint a Meeting Faerie, review the ground rules and begin your next claim staff meeting.

Then see if the meetings are more productive and to-the-point!

Liability Claims Gnaw at Punxatawney Phil

Though the calendar says it’s Springtime, Mother Nature is messin’ with us. As I sit in my office near Richmond, Virginia, it’s a chilly 31 degrees with forecast of snow on the way.

Spring Break?

Ha! Hand me the sweater and crank up the heat. This is a cruel joke.

Ground Hog

Instead of railing against the injustice, some disgruntled and chilly parties are using the good old American legal system to enforce accountability. You thought setting a wrong claim reserve would get you in trouble? Punxatawney Phil of Groundhog Day fame now faces indictment for mis-forecasting and misrepresenting the onset of Spring.

Ohio prosecutor Michael Gmoser is pressing charges against said rodent for his misrepresentation of Spring and seeks the death penalty. Criminal indictment is the least of his worries, though.

In the past two weeks, seven civil lawsuits have been filed against Punxatawney Phil, asserting that the Ground Hog “knew, or in the exercise of reasonable care should have known that his forecast was negligent and fell below the standard of care in weather forecasting.” Civil lawsuits, many clustered in Cook County, IL and Los Angeles County, seek both compensatory and punitive damages. (Punxatawney Phil has tendered the suit to its liability insurer, Woodchuck Mutual, which has stated “We are not willing to comment on pending litigation and are closely reviewing the matter for coverage.”)

Coverage experts are burrowing through court filings currently to assess the scope of potential financial liabilities for Punxatawney Phil.

While some scoff at the odds of such civil suits succeeding, other legal observers caution that such claims have teeth. Lawsuits against such American icons — once unthinkable — are now increasingly common. Recent years have brought:

* Class action suits against St. Valentine by jilted lovers who failed to find true romance on February 14th.
* Premises suits against the Easter Bunny from slips and falls occasioned by “leftovers” deposited during the hippety-hoppity rabbit’s travels.
* Lawsuits by LGBT groups, challenging state laws making it illegal for Tooth Fairies to intermarry.
* Twelve bad boys in Austin, TX — overlooked by Santa for not helping with the dishes, leaving their rooms messy, and writing nasty words in public bathrooms — won a landmark “fair share” decision in 2008. Evidence showed that Santa had bypassed their houses in an “arbitrary and capricious way.”

Reached at his rural Pennsylvania lair, a spokesperson for Punxatawney Phil insists on his innocence, maintains that he met the requisite standard of care for ground hogs and demands that his insurer settle all claims within policy limits.

(A spokesman for American Attorneys for Justice announced that the organization, comprised of the nation’s personal injury lawyers, are forming a Ground Hog Litigation Interest Group during its upcoming meeting in Boca Raton, FL.)

Unsucking Claim Department Customer Service (continued)

This photo captures the essence of my earlier rant regarding voice-mail as the modern corporate substitute for customer service.

Your Call is Unimportant to Us

(“For quality purposes, this message is being recorded …”)

Book Review: Risk Managing for the Zombie Apocalypse

Disaster preparedness is a renewed preoccupation of many risk managers and businesses. This is particularly true in the wake of natural disasters such as hurricane/storm Sandy, tsunamis, tornadoes, earthquakes and the prospect of global warming.

Disaster Diaries

On a personal level, authorities and government entities urge individuals and families to develop disaster preparedness plans . . . just in case. 9/11 rocked our world and — at least for a while — prompted people to build or purchase emergency preparedness kits.

On a lighter note, TV shows such as “Doomsday Preppers” on the National Geographic Channel garner strong viewership ratings. There is almost a morbid preoccupation with preparing for the apocalypse and — TEOTWAWKI — the end of the world as we know it (cue the REM tune).

Into this genre comes Sam Sheridan, author of the new book “Disaster Diaries.”  (Sheridan’s prior works include two excellent books on mixed martial arts.)  The premise of “Disaster Diaries” is that Sheridan is schooling and preparing himself for surviving the upcoming apocalypse. This apocalypse could be a massive natural disaster such as an earthquake. It could come in the form of a zombie apocalypse.

Parenthetically, even the Center for Disease Control has issued a tongue-in-cheek manual on surviving the zombie apocalypse.  (If you really want to see the Undead shuffling and shambling, though, just head down to the nearest DMV.)

In any event, Sheridan posits a scenario where he and his family, living in Los Angeles, face a huge natural disaster that eventually forces them to flee their home and make do on foot. Think of Cormac McCarthy’s “The Road” in real-life.

Each chapter addresses Sheridan’s first-person plunge into attempting to acquire survival skills that will presumably help him and his family survive the apocalypse. These include chapters on physical fitness, foraging for food, shooting guns, wilderness medicine, survival tracking, knife- and stick (escrima) fighting, surviving extreme cold conditions, etc.

It’s hard to understand whether “Disaster Diaries” intends to be entertainment or a how-to manual for survival. Probably more the former than the latter.

There is a chilling aspect and undercurrent to “The Disaster Diaries,” that being that most of mankind is woefully prepared to live off of the grid if it ever had to. Many of these doomsday preppers  come across as kooks and worrywarts, but Sheridan focuses on skills needed for survival.  Even then, survival may be a dicey proposition and all bets are off if the apocalypse comes in the form of some type of nuclear cataclysm.

Nevertheless, despite its grim undercurrent, I found “Disaster Diaries” difficult to put down. Sheridan is not a doomsayer, but rather believes that individuals and families can take steps to enhance their chances of survival. Perhaps that is why he has subtitled his book, “How I learned to stop worrying and love the apocalypse.”

“Disaster Diaries” probably will not cause anyone to stop worrying more or to love the apocalypse, but it provides and interesting side trip into an American subculture and adds a whole new dimension to the topic of personal risk management.

“Six Steps to Un-Suck Your Claim Department Voice Mail Service (This is a recording …)”

Remember quaint bygone days of yore?  Living, breathing people actually answered phones?  This era now resides in the gauzy memories of the past.  Technology rules now, especially in customer service and telephone interactions.  Fewer claim transactions occur face-to-face.  While email rules, people still phone the claims department.  When they do, chances are they hear an automated voice mail response.  While this may be efficient for insurers or claim organizations, it may not be effective from a customer service standpoint.

As Jason Gay of the Wall Street Journal asks rhetorically, “When did calling a customer service line become the new hitting yourself in the face with a brick?”  (Answer:  Probably when companies discovered they could handle customers cheaper by installing recorded systems instead of hiring people to answer phones.)

In fairness, the insurance and claims industry is not unique in adopting automated response systems.  However, one component of claim service is managing communication exchanges conducted by phone.

Remember hearing, “You have only one chance to make a good impression.”  Make it a good one!  Voice-mail response systems thwart efforts to start off the claims process with a positive impression.  Here is my own biased, idiosyncratic list of six beefs with automated systems:

“Due to an unusually high call volume ..”  I get suspicious when every call triggers this ecycled message.  If the call volume is ALWAYS high, it’s no longer an “unusually high call volume.”  It is the new normal.  It means that the company – not the customer – should adjust.  If you call Monday morning, Wednesday afternoon and Thursday at mid-day and EVERY TIME the recording refers to an unusually high call volume, B.S. detectors should activate.  It’s hard to believe that, by coincidence, every time I call, there is an “unusually high call volume.”  Really?  No, it’s easier to blame an “unusually high call volume” than to say, “We just don’t want to hire enough staff to answer the phones.”  Just like airlines find it cheaper to tell passengers to get to the airport two hours early than to hire enough people to process luggage and tickets expeditiously.

“For quality purposes, this call may be recorded …”  Oh boy, I hope it is.  It has never been clear to me just how recording a customer exchange somehow magically improves quality.  In fact, I have had unsatisfactory exchanges that were still recorded.  Example:  recently, I had to cancel an Xbox on-line renewal.  Flummoxed by trying to do it on-line, I made the mistake of calling Customer Support (an oxymoron.)  After ten minutes on the phone, the Customer Support Rep told me he really didn’t have any more time to spend with me, that I was taking up too much of his time.  Now that’s customer service!  I sure hope that exchange was duly recorded.  For “quality purposes,” of course!

Hey, if you are really so fixated on quality, pick up the %^&# phone!  Now that’s quality!  Staff the phones — not with robotic canned messages — but with living, breathing humans.  What a radical notion!  Occasionally, I have finally hacked through the voice mail maze to reach a human, gotten the run-around and then said, “Boy I hope that this conversation has been recorded for training and quality purposes.”  Usually, it is a case study in how NOT to address customer needs.

“To avoid long wait times, please visit our website at …”  Translation:  “We prefer not to deal with you by phone, so go hunt for the answer on our website and hope that your problem neatly fits into one of our FAQ’s.”  Great message for your customers – “You are a nuisance.  Please just pay us your money and then leave us alone!”

“Please enter your [account number/Social Security Number/policy number]…”  Invariably, after doing this, I eventually connect with a living, breathing human.  Guess what is the first thing that they ask me for?  My account number, Social Security Number, policy number, etc.!  Go through the hassle of entering this long string of numbers onto the computer keypad, only to have to repeat these same numbers?  Makes no sense.  When I ask why the customer must give the same data twice, I get some mumbled response like, “Well, I don’t have access to the information you entered in ..”  Lame-oh!

“Your call is important to us. Please continue to hold …”  Pinocchio’s nose must grow as this mantra repeats.   If my call is so important, why not have people answer the phone?  If my call really is so important, why not hire more staff to field calls and trim wait-time?  On the credibility scale, this line is right up there with,

“Yes – I’ll respect you in the morning,”

“Your check is in the mail,” and ,

”Officer – I had only one beer.”

It gives the illusion of being customer-focused without the substance.

“All of our representatives are busy serving other customers .. Please try your call again later.”  This is a real blow-off.  When later?  Two hours?  Tomorrow?  Next year?  What if your issue, question or problem – like a claim – is time-sensitive?

Claim service means we put ourselves in the client’s shoes.  Walk a mile in them by dialing in and you may discover new opportunities to upgrade the customer service experience for your company and claims office!


Six Questions to Help Unsuck Your Claim Service…

  • Pretend you are a policyholder or business partner.  Call your office.  Put yourself in the customer’s shoes.  How is the experience?
  • Is a recorded greeting and voice mail menu the “default mode” or do living, breathing humans pick up?
  • Do callers have a “bail out” option if they want to quickly advance to speak with a person or want to bypass voice-mail options?
  • Does your recording always cite “an unusually high volume” of incoming calls or is this message reserved only for genuine peak times?
  • Is your voice-mail system designed for your convenience and cost-savings or for customer service needs?
  • If the recording says that calls may be recorded for quality/training purposes, when was the last time you actually used a recording for quality or training purposes?


TMI is a GOOD Thing in Adjuster Communication!


Too Much Information.  Over-sharing.  It’s not a good thing.  We really don’t need to know that you’re standing in line at Starbucks or have you posting on Facebook pictures of your recent surgical scar.  The sonogram from your colonoscopy?  I think I’ll pass.  Some things should remain a mystery between us and are better left to the imagination.

When it comes to adjuster-to-insured communication, though, TMI is probably — as Martha Stewart would say — a good thing!

A huge communication challenge that can spawn bad-faith claims is failure to communicate with insureds regarding exactly how the claims process will unfold. This involves educating the policyholder on what to expect. Claims people are so steeped and immersed in their own work that they may assume that other people innately understand what will happen on a claim and that people will appreciate the amount time that it takes.

That is a faulty assumption.



Preoccupied with their own caseloads, distracted adjusters may fail to communicate to a policyholder about various components, aspects and facets of a claim. This includes:

*  What steps are involved in processing the claim

*  What the adjuster will need from the insured

*  Perhaps most importantly, how long claims process will take

Adjusters have their own understanding and expectations of these features. Policyholders may have vastly different expectations. It is important for adjusters to educate and communicate with policyholders as early as possible regarding

*  what has to be done,

*  what will be needed from the policyholder, and

*  how long the claim process may take.

These are, of course, good faith estimates.

This communication is crucial, regardless of whether the adjuster is handling a first party property loss or a third-party liability claim. Clearly, this communication is also more crucial in settings and dealings with unrepresented policyholders and unrepresented claimants. If the policyholder or claimant has an attorney, the latter can explain the procedure. The point, however, is to communicate so clearly and proactively with policyholders and claimant’s that they will not feel the need to run to a lawyer, a development which will invariably increase the claim’s cost and likely ensure additional delays.

Communicating and educating the policyholder takes time. Unfortunately, time is the adjusters scarcest commodity. This is particularly true in work environments where adjusters carry heavy caseloads. Management teams may weigh adjusters down with extreme caseloads either due to cost pressures or believing that they are leveraging technology to a point where adjusters can ride herd over 200-250 claim files. When adjusters are stretched for time, one of the first items jettisoned will be the taking time to explain the policyholders what is going to happen on a claim and when.

However, if this time is not invested upfront, it can create additional time pressures later in the form of having to deal with bad faith claims. Short of that, adjusters and claim staff may have to deal with complaints, irate policyholders, inquiries from the state insurance commission, etc.  Dealing with these also bleeds time.

The take-away:  err on the side of over communicating with policyholders and claimant’s. Admittedly, this is easier said than done. Claims adjusters are extremely busy. However, we have at our disposal more communication tools than we have ever had before. We have not only the mail, but we have phones, fax, e-mail, even text messaging, etc.

Communication with policyholders and claimants is a best practice and a discipline. Moreover, it is not a one off phenomenon during the life of a claim. It is an ongoing process that must be cultivated and tended to throughout the lifecycle of the claim.  This is done not only to attain a high level of customer service and customer relations, but also to avoid financial leakage which may flow from insureds and claimants running to attorneys because they feel they’ve been kept in the dark by the claims adjuster.

So, go ahead.  Be guilty of giving TMI.  There are worse sins as a claims adjuster.

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