February 25, 2021

Become a Sought-After Client: Assess Your Own “Payment Culture” With Outside Counsel

Recently I shared thoughts about specific questions that adjusters should pose to outside defense counsel to gauge the “billing culture” within the law firm.

This got me thinking about the “payment culture” within the insurance company or TPA overseeing claims and working with defense counsel. If it’s legitimate for claims people to poke and prod with regard to the law firm’s billing culture, it is legitimate as well for attorneys to inquire about the payment patterns of the insurer or claim department.

Admittedly, this is a delicate topic. Candidate law firms trying to win or keep business referrals from insurance companies do not wish to come across as being obsessed about billing. However, law firms — like insurance companies or businesses — and survive (or die) due to cash flow.

It’s no secret that some insurance companies (which will remain unnamed here), whether intentionally or through benign neglect, drag their feet and paying defense attorney bills. As a claim adjuster and supervisor, I knew of one multibillion-dollar insurance company that had an unwritten rule that no law firm Bill was considered for payment until it was 90 days old. Other insurance companies appear to operate on the basis that “the squeaky wheel gets the grease” (and the bill payment).

Tip: be a good client by paying bills on time.

Set expectations with outside counsel as to when bills get paid, within “x” number of days for example.

If there is a problem or question about a bill, communicate that quickly to the law firm so it can address it.

Consider issuing payment for the undisputed portion of the bill.

Help defense counsel maintain reasonable cash flow by not foot dragging bill payment.

Don’t put them in a bad spot vis-à-vis their firm management, which notes that there is a receivable problem with your files.

Avoid developing the appearance or reputation of a “deadbeat” client or a source of business. It’s going to be harder for the attorney to argue on coverage disputes that your company keeps its promises, knowing that the company drags its feet with regard to paying bills on time.

Claims people may be unaware that in many law firms, Insurance Defense Practice is looked down on by other departments of the firm. It can quickly be perceived as the orphaned stepchild of the different practice groups in a larger firm. Hourly billing rates for insurance work are much lower than those for other types of high prestige or cachet practices such as transactional work, tax, M&A, commercial litigation, intellectual property, etc. I’ve spoken to many attorneys in larger firms who do insurance work who privately tell me the pressure that they get from firm management to increase the rates.

Do you want to attract the best legal talent to your cases?

Do you want to be able to summon high-quality legal assistance on short notice in time-sensitive situations?

Do you want to be viewed as an attractive client, the kind that lawyers want to work for?

Set clear expectations with outside counsel as to payment cycles.

Honor those payment cycles.

Pay defense attorney bills promptly.

If there are issues or problems with the bill, communicate that quickly to outside counsel so that they can either explain the bill or consider writing it off or writing it down.
Assess your own corporate and departmental culture with regard to bill-paying. Strive to be a sought-after client by not creating undue financial hardship on the cash flow of your outside counsel and firms.

In the short run, you’re helping them.

In the long run, you’re helping yourself by demonstrating that you keep your promises and that you are a good business partner and somebody that high-quality law firms and attorneys want to work with.

Seven Questions to Ask Candidate Law Firms to Assess their “Billing Culture”

One huge aspect of shopping for legal services involves fee discussions. It is common to gather hourly rate information and fee schedules from candidate and incumbent law firms. Whether you are a claims professional, risk management, insurer employee, TPA rep or an in-house general counsel, you need to make sound cost decisions when selecting outside counsel for your legal needs.

A simple review of hourly rate or fee schedule may not tell you all you need to know, though, in managing litigation, controlling costs or assessing a good economic “fit” between yourself and a law firm. What hourly rates and fee schedules will never tell you is the “billing culture” within a firm. Hourly rate tells you nothing about how efficiently a lawyer works. It masks the situation where the firm low-balls the hourly rate but “makes it up” by laying on charges with a heavy pencil. If the firm arranges to take twice as long to draft a motion or research some point of law, the 10% reduction in fees you won are now offset.

That is a false economy.

While it’s easy to determine hourly rate, discerning a firm’s billing culture is notoriously difficult. That does not mean that it is impossible, however, or that the discerning buyer of legal services shouldn’t try nonetheless.

How do you get to the issue of a firm’s “billing culture,” the degree of pressure within a firm to pump up the volume on billings? One approach comes from asking the right questions during the “courtship phase.” This is part of doing due diligence on any attorney or law firm that you are considering. These may be out of the norm from the usual list of interview questions posed by risk managers, adjusters and other buyers of legal services.

Nevertheless, these questions can poke beneath the surface gloss, to probe the depths of the billing culture of the law firm in question. Consider these questions to discuss fee issues with any firm you are considering using. True confession time. I cannot take credit for these. They come from Chicago attorney Mitch Orpett of Tribler Orpett & Meyer.
Orpett rightly observes that few clients pose the following questions to law firms:

• What is the minimum number of hours your associates and partners are expected to bill? (We hear of some firms that have minimum billing quotas of 2000, 2200 or 2400 hrs. per year. That puts a premium on heavy billing.)

• What are the bases of attorney compensation and advancement? (Is work quality considered? How? What percentage of the evaluation is driven by production of billable hours?)

• Are billing minimums used, particularly by new attorneys who often handle the firm’s motion call for each day’s scheduled court appearances?

• What kind of training do new lawyers receive from the firm and who pays for training time? This tells you the commitment that the firm has or lacks with regard to ongoing continuing education.

• How are attorneys supervised? What is the firm’s general culture?

• Do your attorneys engage in non-billable activities? Who is responsible for reviewing and approving bills? Is there some kind of quality control or quality check on bills before they go out to the client or the insurance carrier?

• Do attorneys receive bonuses for hitting certain billing targets?

By posing these questions, you are putting yourself ahead of probably 90% of all clients. Many (most) client meetings with firms are “grip and grin” glorified social calls. It need not be this way. You do not have to transform yourself into The Grand Inquisitor, but pack the exchange with substance.
Let’s be clear and not dismiss out of hand the relevance of hourly rate as one data point to capture. None of this means that checking out the attorney’s or law firm’s hourly rate is irrelevant.

Do not throw away the fee schedule. Factor in those quantitative data points but leaven them with answers to these searching questions. Listen carefully to the answers. Then and only then decide if, financially, you and the law firm are a good fit.

What is missing here? What do you find are other ways to assess a law firm’s billing culture in order to help manage litigation costs? Share your thoughts here.

My Top 10 Books of 2014 …

Reflecting on 2014, I wrap up this year’s Claims Coach blog series by offering my end-of-year list of favorite books I’ve read over the past twelve months. (As you can see, none of them directly related to claims adjusting.) Nevertheless, here they are:

#1. A Guide to the Good Life by William Irvine. A philosophy professor from Wright State applies the ancient philosophy of Stoicism to modern life

#2. So Good they Can’t Ignore You by Cal Newport. Newport, a computer science professor and Georgetown University, punctures the myth that if you simply follow your passion, money and success will follow. Instead, he endorses the view that you become exceedingly good at a skill that can be monetized. Then, nurture that the point where you can set your own price and work terms.

#3. An Altar in the World by Barbara Brown Taylor. The former Episcopal priest who left the clergy explores the sacred in everyday life and ways to integrate faith into daily practices, transporting the practice of faith from the four walls of the church into the larger world.

#4. Being Mortal by Atul Gawande. I have read (and would strongly recommend) all of Gawande’s books and this one discusses the fundamental problem of aging, particularly in American society. Reading it should inspire anyone

to prepare a Living Will and an Advanced Directive.

#5. Pain Don’t Hurt: Fighting Inside and Outside the Ring by Mark Miller and Shelby Jones. This is a memoir of a kick-boxer who can write as well as deliver a roundhouse punch. An absorbing read of a cage-fighter who succeeds despite being diabetic and having a heart valve implanted. An amazing tale

of triumph over difficult life circumstances.

#6. Blue Mind: the Surprising Science that Shows how being Near, in, on or under Water Can Make you Happier, Healthier, more Connected and Better by Wallace Nichols. This book makes the case that being near water or in the water positively impacts your endorphins and quality of life. Since I live on a lake and read the book sitting beside a pool, this past summer, it was not a tough case to make.

#7. Untamed: The Wildest Woman in America and the Fight for Cumberland Island by Will Harlan. Hard to put down this true story of an iconoclastic woman who is a passionate environmentalist fighting to keep a relatively unspoiled island off of the Georgia Coast free from commercialization and development.

#8. The Elements of Legal Style by Bryan Garner. Not exactly the book that you curl up with and read cover to cover, but I found this book useful in my own consulting practice as an expert witness in insurance litigation, developing written reports for disputes in Federal Court. I am not an attorney and do not play one on TV. Nevertheless, I found the precepts of this book useful in crafting reports as an expert witness.

#9. A Factory of One: Applying Lean Principles to Banish Waste and Improve Your Personal Performance by Daniel Markovitz. I love being self-employed, but one downside of being a one-person shop is that the operation is not scalable. This book explains ways to optimize your efficiency, even if you’re a one-person operation.

#10. Another Great Day at Sea: Life Aboard the USS George H. W. Bush by Geoff Dyer. This is a rollicking good yarn that is a true story about daily life aboard a huge navy aircraft carrier. Dyer’s enthusiasm about the day-to-day workings of shipboard life is contagious.

A word about my reading habits. I average reading about eighty books a year. This year, I will come in at the low sixties. In other years, I’ve topped one hundred. I have been for any particular number, but have tracked my reading since 1986. I always have at least two books going at the same time and rarely work on three. I find it just too much to juggle.
I try to read at least twenty pages a day in each one of the two books. This lets me finish about three books every two weeks. If it takes longer, fine. If the book fails to grab me after about fifty pages, I’m more inclined to “bail” than in years past, were I would’ve greeted my teeth to the bitter end.

In any event, the Claims Coach wishes you a happy holiday and a successful new year!

Q: What were YOUR favorite or most impactful books of this past year?

Requiem for an (Insurance) Heavyweight: Don Malecki

I stray from my “usual” blog topics to pay tribute to a genuine titan of the insurance industry, Don Malecki, who passed away after a long illness on December 12th. The phrase “thought leader” is bandied about indiscriminately. In the case of Malecki, however, the shoe fits.

Malecki

It is no exaggeration to say that Don was a titan of the insurance industry. He was a authoritative source on insurance coverage matters and a prolific author. Malecki was most recently a Principal at the risk management consulting firm of Malecki, Deimling, Nielander & Associates. He was a frequent contributing author to various publications from the Dallas-based International Risk Management Institute (IRMI).

His insurance career spanned 50+ years, starting as a underwriter trainee with Fireman’s Insurance Company. He authored or co-authored 15 books, including three textbooks that have been used in the CPCU curriculum. He was a past President of the Cincinnati Chapter of the Society of CPCU and was an active member of the Society of Risk Management Consultants. Many may not know this, but Don was also a veteran of the U.S. Air Force, where he served from 1951 1955.

Don’s résumé is lengthy and astounding but he was anything but pretentious. I don’t pretend to have known Don as a close friend, but I did know him and enjoyed his prodigious intellectual content output, and his down-to-earth style.

I first met Don in the 1990s, when we were both speaking at one

of IRMI’s Construction Risk Management conferences. We had a speakers dinner the night

before the program. After dinner, Don proved to be a compelling raconteur and entertained the table with a trick that involve him being able to get a dinner spoon to stick to his nose. (After a few glasses of wine, this seemed hilarious…)

It encapsulates the fact that Don was anything but a pretentious egghead. Our paths intersected over the years at various insurance conferences and meetings. In 2008, I began to entertain the

notion of launching my own consulting an expert witness activists. One of the first individuals. I went to was Don. Don was extremely helpful in giving him his advice as to how to go about launching such a consulting practice. I deeply appreciated his thoughts and insights.

As an aside, Don said he was trying to wind down his own consulting an expert witness practice by jacking up his rate to $650 per hour. He observed wryly and ironically that, ever since increasing his hourly rate, is number of engagements had actually increased.

I last saw Don in October 2013, when we were both attending a conference in Charlotte, North Carolina of the Society of Risk Management Consultants. He was in good cheer, and I had no insight at the time of any health issue.

This did hit my radar screen, however, in December of 2013. I approached Don about the referral of an expert witnessing engagement from a Michigan attorney who sought an expert in underwriting and policy interpretation. The first recommendation that came to my mind was Don Malecki. I called Don about the prospective engagement and he explained that you just returned home to Cincinnati from a lengthy plane flight from the West Coast, and developed medical problems from that. He politely declined the engagement, citing his doctor’s advice that he not travel or take on any new work. At some point in early 2014, I learned of Don’s illness.

Don exemplifies a life well-lived — not just professionally but personally. He touched so many in the insurance industry but it would be difficult to underestimate his impact. His legacy perpetuates not only through his prodigious intellectual content in the field of insurance, but in the relationships in the lives of individuals that he touched. One risk professional, writing on an interest group listserv, commented “Everyone else in the insurance industry just moved up one notch.” Don was at the pinnacle and the likes of him are unlikely to be seen again in a very long while.

While we underfstandably mourn Don’s passing, we can celebrate his life and the ongoing, positive ripple effect of the legacy he leaves for the insurance industry.

Farewell and Godspeed my friend…

Confessions of a Claims Manager: 10 Ways Attorneys can Avoid Billing Tussles

Some of my best friends are defense lawyers.

To a person, however, they almost all feel frustration over insurance company cost pressures. Insurance companies face exquisite cost pressures. These filter down to claim departments and adjusters. In turn, they also filter down to defense attorneys.

How can defense attorneys whose practices focus on insurance claims foster improved relations with adjusters who assign cases and avoid contentious billing issues? Here are 10 tips from my years in the trenches of reviewing and paying legal bills:

#1. Read and follow the carrier’s guidelines! Virtually every firm at the courtship stage insists that they have seen all guidelines and will adapt happily to all guidelines. Often, this proves to be more lip service than substance. If you take on a new assignment for a carrier, study those guidelines as you would for a final exam.

#2. Avoid block billing, which is a red flag for auditors. One way to stay off the radar screen of bill auditors is to itemize each billing entry and avoid block building, where you describe a paragraph of activities and then put a bulk time charge next to it.

#3. Show “no charge” tasks on your bill with the notation “N/C.” There may be certain research or like tasks you have conducted in connection with the case for which – – for whatever reason – – you do not intend to charge. Include these on the bill, so that the client can see that you are handling the case frugally.

#4. Proactively revise budgets when case dynamics warrant. To paraphrase a popular car bumper sticker, “Stuff happens.” Budgets are useful disciplines, but they are subject to the caveat that circumstances change that can blow a budget to smithereens. Litigation is a dynamic setting, where factors beyond the defense attorneys control can necessitate additional work that would exceed an outdated budget. Do not wait for the client to ask for a revised budget. Part of your job is to scan the horizon for change in the circumstances. When these occur and drive a need for a revised budget, do that revised budget and send it to the client with some commentary.

#5. Quality check all bills before they leave your office. The client should not be the one catching billing errors.

#6. Never surprise the bill payer. Before sending forum achat cialis net out a “whopper bill,” pick up the phone and speak to the recipient. “The current bill is hefty and I wanted to prepare you and offer some context around it …”

#7. Provide context for expense accumulation. Further, if the bill is large, recap in your cover letter the factors that drove the significant activity on the case. E.g., “this billing period was a phase of intense activity due to the following

factors …”

#8. Make the proper introductions before having “strangers” bill on the file. Call the adjuster or the client to say, “If you have no objection, I’d like to involve Joe Blow on part of this case to do … I think this will be cost effective because …”

#9. Keep an eye on the Big Picture and the likely case value in the context of your bill. Do not run up a $50,000 bill on a case that has clear maximum exposure of, say, $25,000.

#10. Know thyself. Assess whether you really, really want to do insurance defense work. Hey — if billing guidelines and bill audits drive you crazy, consider another line of legal practice.

There are lots of other areas. If you chose to practice law in this space, though, understand the “ecosystem” in which you’ll operate and aim to cheerfully adapt! This is a whine-free zone!

Adopting these tips don’t guarantee that you will be free from all friction regarding legal fees. However, embracing these practices will go far toward getting paid, getting paid promptly, and avoiding being delisted from the carriers panel because of billing missteps.

Adjusters, has the policyholder hijacked your claim process?

In a past life as a claims-executive overseeing commercial lines liability accounts, a huge source of frustration was policyholders who — without authorization or communication — attempted to self handle their own claims. Then, when the claim blew up or bumbling attempts to resolve cases failed, they would transfer the wreckage to the insurance company claim department to somehow try to clean it up.

Handling claims was not their core expertise. Manufacturing wheelchairs, implantable heart valves or catheters was their core expertise. Such clients were no more qualified to handle product liability claims then I was to tell them how to design or manufacture a portable defibrillator or left ventricular assist device. Nevertheless, there were those accounts and clients – – often egged on by brokers – – who believed that they could do it better.

Perhaps part of the genesis for this is

the fear that if they report a claim, their insurance premiums will rise. Sometimes it may be because they have been burned by a bad experience with a prior insurance company and its inept claim department. Or, it could be because they believe that their superior product or technical expertise with regard to the product and technology carries over to their ability to adroitly navigate the claims process and bring a case to conclusion. Or, it could spring from hubris in believing that claims adjusting is not rocket science and that anyone can do it.

Sometimes, however, there’s a fine line between self-handling and self abuse. Further, in some cases corporate accounts have the in-house expertise and savvy to handle and manage their own claims.

(Although, if this is the case, why buy insurance? Why not just self-insure?)

Self handling a liability claim is fine if there is an understanding and agreement that the policyholder is authorized to self handle claims within their deductible or self-insured retention. In the absence of such agreement, many commercial accounts which are leaders in their market niche do not have the skill sets to adroitly handle claims.

Once, I saw a plumbing contractor’s van with the following assurance etched on its side, “We fix all your plumbing problems .… including your husband’s repairs.”

I had to chuckle. Sometimes the job calls for a pro, not a amateurish DIY attempt. Insurance claims fall into this category.

Russell B. Ross, president of the American Medical Association in the 1970’s once said, “Passengers who insist on flying the plane are called hijackers.”

Has your claims process ever been hijacked by well-intentioned but misguided policyholders who think that they can do a better job than the professionals in managing liability claims? Are the inmates running the asylum?

Question: How have you handled situations where a policyholder is attempting to self handle its own claims but is in over its head?

Recap of last week’s ACI “Bad Faith Claims & Litigation” Conference

On November 18th and 19th, I ventured to Orlando, Florida to attend ACI’s 29th National Forum bad faith claims and litigation at the Hyatt Regency. Approximately 40- 50 attendees heard two full days packed with interesting perspectives on bad faith litigation, viewpoints drawing predominantly from the defense bar.

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Included on day two of the program was a fascinating colloquy by a panel of six judges, a mix of state and federal court judges, regarding their perspectives on bad-faith litigation. Most of the audience was comprised of private practice attorneys defending bad-faith cases. Mixed into the attendance list were in-house counsel for major insurance carriers and claim executives.

What follows is a list of random nuggets, thoughts and observations gleaned from the ACI program. This doesn’t do justice to the program, and names have been omitted to protect the innocent:

1. Texas pro-business pendulum may be swinging back toward plaintiffs. Since the early 1990s, Texas has “gone red” politically, but the pendulum may be swinging back in favor of plaintiffs.

2. Curbs on institutional bad faith discovery (TX). A recent Texas case involving Lloyd’s constrains the extent of discovery plaintiffs can impose on institutional bad-faith claims. The claim involved producing tons of claim files for two TPAs who adjusted claims for an

insurer. The plaintiff’s bar is trying to narrow the scope of this case.

3. No need to breach policy to find Florida bad faith. A growing trend in Florida is courts saying that insurers need not be in violation of the policy contract to be in bad faith, especially in disputes over appraisal.

4. Assess appeal options in light of adverse impact on whole industry. When deciding whether or not to appeal a bad trial results, consider the risk to the industry that the appeal is lost. You could win for your company, but create that wall for the rest of the insurance industry.

5. Build a second-look process into bad faith appeal decisions. Local defense counsel and the adjuster who handled the “lost” trial may be so invested in that case but they want to “right a wrong.” These cases need

a second look process to make sure an objective decision is reached.

6. Cultivate a Devil’s Advocate inside the company. Claim departments need an internal devil’s advocate. “There’s a lot of Kool-Aid drinking that goes on when evaluating cases,” according to one in-house counsel for an insurance carrier.

7. Be careful in welding a carrier’s practice to an entire industry practice, especially when a court repudiates the practices, for example defense in juniors changing their opinion 180° because of an internal “peer review.”

8. Be careful in asserting the defense of “advice of counsel.” If you plead that, you often waive attorney-client privilege. If you don’t have a clean claim file, be careful in asserting the advice of counsel defense, which can waive privilege. For example, are there documents in the claim file that the defense may not want the plaintiff to see?

9. Careful on using in-house counsel for coverage opinions. In assessing use of staff counsel for coverage opinions, consider the potential issue of bias and arguments that plaintiff’s and policyholders can make.

10. It should be hard to deny a claim. Denying a claim is a big deal in the decision not to defend is one not to be taken lightly. It should not be easy to deny coverage.

11. Adjuster problems are really supervisory problems. According to one in-house claim executive: “I don’t have an adjuster problem, I have a supervisor problem. These the people I’ve entrusted to make quality assurance runs smoothly.”

12. Written protocols — good or bad? On the issue of whether or not to have written guidelines, one claim exec said, “a guideline is never an excuse for doing the wrong thing.” Another in-house counsel cautioned companies to “avoid a checklist mentality.”

13. “Florida bad faith set-ups? Watchya’ talking about?” A plaintiff attorney from Florida insisted, “they set up case is the quickest way for me to find another thing to do for a living. I don’t take set up cases.”

14. Bad faith attorneys can be pickier about what cases to accept. According to a plaintiff’s attorney from California, “unlike defense attorneys, we get to choose our cases. Defense lawyers have their cases assigned to them.”

15. Perspectives from the Bench. Observations from a panel of six judges:
Most jurists are resolution oriented, often due to docket backlog. (Surprise!!)
“There are cases that have to be tried, but those are few and far between.”
“There’s a reason why only about 2% of all cases filed in federal court go to trial.”
“Jurors tend to be predisposed against insurance companies.” (Surprise #2!!)
Ask yourself, “Does your trial theory match up with public opinion?”

16. Washington state is starting to run a close second to Florida in terms of being a challenging bad-faith environment.

If you have a chance to attend any future American Conference Institute forums on bad-faith, I highly recommend you do so. They are packed with engaging speakers, useful information and substantive handouts. There are also breakfasts and lunches that provide networking opportunities.

Coincidentally, the next ACI Bad Faith Claims & Litigation Conference will be in Philadelphia on March 16th – 17th at The Union League and yours truly will be speaking there.

Hope to see you in the City of Brotherly Love (and bad-faith litigation)!

Insurance Defense Lawyers – Defuse Adjuster “Hot Buttons” Up Front for Better Service

Every client has hot buttons.

Hot buttons have good and bad features.

Good features are things that clients like.

Some may like defense counsel who give them detailed reports. They are voracious consumers of information. They want a complete analysis of liability, damages and case value.

Other claim managers and adjusters hate slogging through multi-page reports and prefer short “executive summaries” or phone updates. Time pressed, they want to cut to the chase, to the

bottom line. They want the option of going back to fill in the analysis that they need. They may also resist paying for the time it takes to prepare lengthy reports, suspecting “padding.”

Others don’t like to take phone calls. They have enough interruptions in their busy work day in the claims department then to be fielding incoming calls from defense counsel, especially when the message does not convey time-sensitive information.

One thing that drove me crazy when working in the claims office was a defense attorney who would call, spend 20 minutes on the phone updating me about a case and then close by saying, “I’ll be putting this into a report for you.” WTF?!?! Why duplicate information in that way, unless it is to goose up a bill?

Some clients may want advice. They hire defense counsel to make recommendations. This is a big part of the value that they see in retaining outside lawyers.
Other clients view this as over-reaching and want your advice only if they explicitly ask you for it. They will make the decisions, thank you.

The moral: when it comes to insurance defense work and customizing your services to claim departments or third-party claim administrators, one size doesn’t fit all. Before stepping on landmines, best to first know where the tripwires are buried.

Often they’re veiled, so you have to tease them to get them out into the open. At the courtship, getting to know you stage, ask about these issues. You never know until you ask. Then, tailor your legal services accordingly.

Question: Adjusters, what other hot buttons do you have defense counsel would ask about at the front-end of the relationship?

5 Ways to Handle the Irate Insured/Claimant/Attorney Who Wants to go “Over Your Head”

One source of adjuster frustration and time “leakage” in the adjuster’s daily schedule is dealing with people — usually disgruntled insureds or third-party claimants — who “want to talk to the supervisor.” These are complaints from claimants or others who want to go “over my head” to appeal to a manager.

Complaint Dept

In one way, cialis generique this does not compound any time management problem. Put aside the annoyance factor. If the claimant goes around you or over your head to appeal to your boss, that’s time that you are not spending haggling with the claimant.

Of course, any time “savings” captured this way may be offset by the colloquy that you will necessarily have to have with the boss to explain the situation and to provide context.
Doubtlessly, the claimant will describe a litany of woes with regard to how you’re handling (or allegedly, mishandling) the claim: delays, false promises, wrongful claim denial, etc. Hopefully, you have a boss who will back you up, but that is not a given in today’s work setting. Just remember, “The flattest pancake has two sides.”

If you try to block or discourage the complainer from going around you, that only motivates them further to try the “end run.” They may perceive that you are afraid of this option, that you have something to hide. Therefore, discouraging them from going over your head is probably not a wise choice.
On the other hand, blithely encouraging them to do so does a disservice to your boss, who probably has better things to do than to field complaints from irate policyholders or insureds. There is a fine line and balance here.

Here are five tips:

1. Keep them happy. Deliver great service. Be ultra-responsive. Return phone calls. Reply to e-mails or letters. Be proactive in communicating, whether it’s with the policyholder or a claimant. Exercise emotional self-control. Be unfailingly polite. Make sure your stance on the claim has a firm foundation. None of these are failsafe tactics, but they lower the odds that you will have an irate person demand to speak to your supervisor.

2. Relay the message. Do not embargo the request or attempt to block a person from contacting your boss/supervisor. This will only incense them and incentivize them to try harder to go around you and over your head to appeal to a higher power. Let them know that you will relay the message to your supervisor, who may or may not be in the office or available at the very minute the irate person demands an audience.

3. Give the boss a heads-up. It’s best if you can alert the supervisor or boss as to what is coming, whether it is a phone call, e-mail, fax or letter. Explain the situation and the reasons why you have done which you have done, or not done. Ideally, you can get buy-in from the boss in advance of the dialogue with the claimant. It’s always preferable if you can avoid a situation where your boss is hit “cold” with the complaint about some file that you’re handling.

4. Establish a protocol before these situations arise. Proactively approach your boss about these situations. Different supervisors may have different perspectives and philosophies. Explain that, despite the best efforts, there’ll always be a few difficult claimants or policyholders who want to speak with the supervisor. Asked the boss, “How would you like me to handle these?” Having a claimant or policyholder go over your

head to the boss is not a sign of shame. The risk and practice is inherent in the adjuster’s job, which unfortunately involves the risk of making somebody profoundly unhappy, regardless of the adjuster’s decision. Don’t take it personally.

Of course, if these situations start recurring disproportionately and you hit the boss’s Ridge radar screen because of repeated or similar complaints, then you may have a problem and something to worry about. In that case, the irate claimant or policyholder may not be the problem. You may be the problem!

5. Determine if the boss “has your back.” After the exchange and the disgruntled person has said his or her piece with the supervisor, decide whether or not the boss supported you and back you up. Hopefully, he or she did. If not, engage in some introspection as to whether or not there something you can learn from the situation. If you strongly feel that you are in the right and that the boss repudiated or overruled your decision — throwing you under the bus — you have a different decision to make. Do you still want to work for that boss? If so, continue. If not, consider looking for another position.

None of these tactics are foolproof, but these five strategies provide a template response for dealing with the inevitable situations where unsatisfied customers or stakeholders – – policyholders, claimants, opposing attorneys, vendors, brokers or agents – – think they have a chance of overriding your decision by appealing to a higher authority.

Now, I please speak with your boss?

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Q: What tactics and techniques have YOU found successful in dealing with the “appeal to higher authority” ploy?

Taming the Adjuster In-Box …Take Out the Trash!

When I was a kid, one of my household chores was taking out the trash. At that time, there were no rolling trash bins equipped with wheels. These aluminum behemoths had a handle at each end and you had to muscle the full can down the driveway to the curved. I hated it and used to joke that, until the age of twelve, I thought my name was “Garbage,” because so often my parents would turn to me and yell, “GARBAGE!!!” on certain nights of the week, just before trash pickup.

Delete Key

Despite the fact that I hated the job, taking out the trash was – – and is – – a necessary function for a household. It is also a necessary function for claim professionals in taming their e-mail and their inbox. Sometimes when it comes to taming adjuster e-mail, we are our own worst enemies. One tactic to tame this beast is to get reacquainted with the.

Liberally use the “DEL’ key! Get reacquainted with this key! As you get an email, ask yourself:

• “Do I need to do anything in response?”
• “Should I save it?”
• “Is this task to delegate to someone else?”

If the answers are “no,” hit DEL.

Be done with it.

Were you copied in as a “CYA” gesture?

So much of what goes on in the claims office is to cover the backside in case there is a decision made big goes awry. In the interest of being kept “in the loop” we end up being bombarded with extraneous e-mail is not necessary for our job.

Put your inbox on Slim-Fast and … “When in doubt, delete it out.”
Make taking out the trash a regular feature of your e-mail in inbox management.

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