August 14, 2022

Archives for September 2013

3 Ways to Curb “Info-Pollution” in the Claims Department!

A scarce resource in any claim operation — whether an insurer, TPA or self-insured setting — is the time and attention of the claim staff.  To harness this time and attention for maximum effectiveness and productivity, claim supervisors and management should create a work environment that fosters sustained attention.  This involves eliminating distractions and interruptions that can get in the way of adjusters investigating, evaluating and negotiating. 


Here are three tips:

·         #1.  Avoid REPLY ALL.  Be sparing in using the REPLY ALL button.  Does everyone really need to see the reply?  Is it just a CYA maneuver?  In some cases, adjusters who have slipped and have used the REPLY ALL key have experience embarrassment, humiliation or even termination.  It can also be a massive time waster. Think about it. Does everyone need to see your reply that says, “Thank you”? How about the reply that says, “I can’t cannot attend the scheduled meeting”? There are even software plug-ins that offices and companies can buy to force employees to policy forgetting reply all and inquires as to whether it’s really necessary for everyone to see the reply. Every minute spent by the claim staff reading unnecessary incoming e-mails is time siphoned from investigating and handling claims.

 ·        #2. Curb after-hours email.  Do you really need to send an email over the weekend or after hours?  This can create a false sense of urgency and create a climate where adjusters feel they are never fully away from the job.  (Some businesses have adopted rules designating no email on Fridays or on weekend.) 

 ·        #3.  Don’t carpet-bomb your claim staff.  Are you inundating your staff with FYI emails?  A friend worked for an insurer whose President sends 5-8 emails a day, articles pulled from various trade and business publication.  It’s not that these articles lack relevance; they all pertain to the market space of this specialty insurer (health care).  It’s just that the staff feels it would need to spend an hour or more a day keeping up with all these articles passed along.  In the meantime, there are accounts to underwrite and claims to handle.  Were they to actually read all the material, they would fall hopelessly behind in handling claims and underwriting submissions, and catch flak for that.  On the other hand, they have angst about the overlooking some important information nugget – or at least a nugget that the CEO views as important.  Or, they worry that the CEO may ask then about some item she passed along and be caught unawares, looking unprepared to the boss.  Both scenarios are stressful. 

Bosses who carpet-bomb their staff with emails, memo’s, voice mails and communiqués invite burnout, disaffection and operational sludge.  Information overload and data fatigue sets in.  Barraged by the President’s emails, the staff can either burn lots of time trying to keep up (this, on top of their own professional reading that they think is relevant) or delete most of these and feel guilty or angst over missing out on something that the boss thinks is important.  This is not to say that claim bosses should sit on their hands or be uncommunicative.  It means be selective in the frequency of your communication.  By all means, get the word out on issues vital to the claim department.  Be judicious.  Pick and choose your spots.  When you emphasize everything, you end up emphasizing nothing.

 Q:  What ways have YOU seen where information pollution has cluttered the claims operation and how have you seen it addressed?  Post here or email me at

Reframe Claim “Audits” for a More Constructive Approach!

In Shakespeare’s play, Romeo and Juliet, the latter tells her loverboy, “A rose by any other name would smell as sweet ..”


            Words matter.  That is true not only in courtship, but in claim audits. 

            Like it or not, fair or unfair, the word “audit” has a punitive, pejorative connotation that is negative.  If you want to do an audit, tell the TPA or claim unit that you want to do a “claim review.”  Others call it a “statistical claim analysis.”  This sounds more benign and less adversarial than “audit.”  Careful word choice may help dissolve resistance and foster more  cooperation.  No one should care what you call it as long as you follow best practices.

            Sadly, the word audit evokes defensiveness and may trigger that reaction.

            When you go for an annual physical checkup, does your doctor say that he or she is conducting a “health audit”? No, but that’s basically what they’re doing.

            When you visit your dentist routinely, does he or she tell you that they are doing a “tooth/mouth audit”? No, even though you could say that’s exactly what it is when they lecture you for the 18th time on why you should floss six times a day.

            Word choice matters.

            With claim audits, tis’ probably better to give than to receive. 

            If you’re the one getting an audit, try to frame the exercise differently.

            If you are receiving an audit, try to view the exercise as an opportunity to improve claim operations. Get beyond the often pejorative connotation that the word audit has.

            No doubt, audits are about as welcome as an involuntary colonoscopy … often leaving you feel like you’ve been equally reamed out. They are a distraction and an occasional drag on productivity.

            Nevertheless, they are a necessary evil and maybe even not evil if you can reframe the exercise as one that can spotlight opportunities to improve your claims handling and claim operation.

            An improvement is one word that we all can agree that we like!

Question:  What ways have YOU found to make claim audits go smoother? 


Adjusters — Defend Your Calendar with these 4 Tactics!

I’ve often heard the adage, “If you want to discern somebody’s priorities, you should look at their checkbook and their calendar.”


Here, let’s focus on the latter part of that two-pronged test.

Adjusters often find themselves pushed and pulled by forces outside themselves that intrude on their limited amount of time to work files and accomplish claim-related tasks and projects. In many offices, coworkers or others can unilaterally schedule and block out time with the adjuster. In addition, adjusters have discretion over appointments and other commitments that they place on their calendars. It is common for coworkers and bosses to be able to go online and view the calendar of a claims person within a busy claims office.

In terms of attaining optimal productivity and effectiveness, however, adjusters often lose sight of the calendar as a useful tool. Often, adjusters just play defense in defending their time against the incursions of meetings, conferences, interruptions, and other distractions.

To be sure, many of these are unavoidable and inherent in the very work that adjusters do. Nevertheless, adjusters have tools at their disposal to proactively use their work calendars in order to facilitate their productivity and effectiveness. Here are four tactics:

#1.  Get proactive about your own calendar.  Don’t just view your calendar as a passive receptacle for meetings and appointments. Proactively block out time that you need for your own claim-related work and projects.  projects. Treat it like an inviolable appointment. 

Unfortunately, many claim professionals feel uneasy blocking out time for ourselves on our calendar. It feels selfish. We have become so conditioned to doing a calendar as simply a place to memorialize commitments that others impose on us: meetings, appointments, etc. Again, calendars should be used for this purpose, but you should not just play defense.  Play offense in proactively blocking out time on your calendar that you need to get work done. Don’t view it as selfish but as a necessary discipline that you need to embrace in order to accomplish your goals.

Surely, like any other discipline, it can be overdone. You don’t block out so much time that you leave no breathing room in your schedule and no margin for the inevitable crises and other “unforeseeables” which can arise in the course of a busy day in a typical claims operation.

            #2.  Be a gatekeeper regarding other’s entering your calendar.  Determine if there is some way that you can either prevent others from scheduling time on your calendar or at least creating the option of needing to review and approve before its placement on your calendar.

            #3.  Set “self-appointments” for 90 minutes, max.  If you make an appointment with yourself to work on a project, limit that-block to a maximum of 90 minutes. If you block out two, three or four hours at a time, others will see it skeptically just and likely not believe that you are genuinely using that for work-related project related purposes. You lose credibility.  Moreover, you may not be unable to sustain focus attention for longer than 90 minutes.

            #4.  Honor your time commitment for self-appointments.  If you make an appointment with yourself to work on a claims project, performance appraisal preparation, etc. honor that time block. The temptation will be to use that time to catch up on e-mails, incoming mail, etc. This will not do you much good. Honor the time commitment by focusing on that task and that task alone for 30, 60 or 90 minute block that you have set aside.

Calendar management is a key skill that effective claim professionals must possess, whether they are in entry level adjuster for the senior vice president of claims and a corporate home office. It is a skill often untaught, but is instead presumed.

Get the most out of your calendar by using it not only as a reminder system for appointments and meetings, but also as an intentional tool for focusing your daily energies on your specific claim-related goals, tasks and accountabilities!

Practice Tip #10: Support Your Marketing Folks & Brokers

As a product liability claim specialist, see the Big Picture.  Work with marketing and insurance brokers to articulate your company’s value proposition as respects product liability claims -handling.

What sets you apart?

What skill sets do you bring to this claims area?  Access to top notch attorneys?  Adjusters with law degrees, engineering backgrounds, or deep product liability expertise?  A database of experts?  An impressive trial scorecard of defense verdicts in product cases?

Drill down.  Dig deep. 

Figure out what makes you different from other carriers or TPA’s that handle product liability cases. Be prepared to articulate those differences. Anyone can compete on price.  That is a rare to the bottom, though.

This is a specialized field. Articulate a strong rationale for why you’re suited for this specialty.

Help attract new business to your company, help competitively differentiate your services and boost your company’s ability to compete on something other than price.

Product Liability Practice Tip #9: Five Ways to Work WITH Your Underwriters!

For adjusters and other claims people, it’s so easy to start to view underwriters as adversaries. An old joke told by many adjusters is that, “Doctors bury their mistakes — underwriters simply pass theirs on to the claims department.”


Adjusters often feel that underwriting is the glamor spot in the insurance hierarchy and that the claims people are a necessary evil, sweating down in the boiler room so that the luxury yacht can forge ahead.

Underwriters high-five each other after hitting their premium production goals — maybe collect bonuses for doing so —  while months later the proverbial chickens come home to roost and the #$&^ hits the fan in the adjuster’s face in the form of claims spawned by marginal or sub-marginal accounts put on the books. (“OK, the loss ratios suck… but boy, did we hit those production targets!!”)

Adjusters must deliver the unwelcome message many times that certain types of losses or claims are not covered. Irate policyholders or insurance brokers may even appeal to the underwriting department to bring the adjuster to heel and to reverse a coverage decision for political reasons.

For whatever reason, it is easy for adjusters to feel a sense of rivalry if not downright antagonism toward their brethren in the underwriting wing of the department.

This is understandable at times but also a mistake.

In the realm of product liability losses in particular, it is critical that collaboration reign amongst the claims people and the underwriters. In fact, adjusters can and should take initiative to extend a hand and build bridges with underwriters. This will benefit both the claims person and the underwriter.

What are best practices in terms of working with underwriters?

Here are five ideas.  Best practice is to work with underwriters to provide a claims perspective on:

         Emerging risk areas that you see in loss trends;

         Perceived threats “over the horizon” that may not yet be manifest in claims;

         Red-flag danger “recipes,” like low insurance limits on companies that make products with catastrophic loss potential;

         “Claim control” issues like: choice of counsel, insured input on settlement,  insured’s autonomy in self-insured retentions, account proclivity  toward  do-it-yourself claims-handling, etc.;

         Drafting customized claim protocols for high-SIR accounts.

Build good relationships with underwriters.  Don’t view them as The Enemy!  So, please don’t malign underwriters.

After all, so of my best friends are underwriters.


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