April 14, 2021

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?

——————-
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.

Adjusters: Learn from Medical Offices on How NOT to Handle Customers

Don’t get me wrong. I like my family doctor.  But it’s the outlook of the medical establishment and the administrative procedures of offices that drive me crazy.

Ernestine

Exhibit A: I just got an automated “robo-call” from my family doctor’s office telling me that it is time to schedule an appointment. It says call the office to schedule an appointment.

End of story.

So, I dutifully call the office.  The first four times I call, the line is busy.

Finally, I get through.

Them:  “Doctors’ Offices – please hold.”  [Nice greeting!]

After a few minutes on hold, them “How can I help you”

Me:  “I received an

automated `robo call’ from your office telling me to schedule an appointment.”

Them:  “What’s the reason for the appointment?” [WTF??]

Me:  “I’m not sure, you called me.”

Them:  “Did it say the reason for the appointment?”

Me:  “It was an automated robo-call. You called me. It didn’t go into any detail or reason.”

Only after this exchange did I get an appointment. Does that make any sense?

Call the doctor’s office at mid-day and you get a recording, “We are closed for lunch. Please call back later…”

I really like my dentist too. BUT, by the way, don’t call her on Fridays. She’s closed that day. If you make the mistake of phoning on that day, you can’t leave a message on her machine.

When I have an upcoming dentist appointment, the office secretary phones me to confirm and — if I do not happen to be sitting by my phone awaiting her call at that moment — she leaves a message telling me to call her back to confirm. (Note: I have no track record of missing or being a “no-show” at dentist appointments. But, I’m not going to waste my time phoning her to confirm that I got her confirming phone call.)  Where does it end?

And don’t get me started about completing the obligatory New Patient Forms. Years after we started hearing about electronic medical records, it still seems like we have to reconstruct our medical histories from scratch for every new referral. Far be it from the docs to simply request the records from another office. Much better to have the patient take the time to fill out more forms. Plus, making them fill out forms keeps them busy, distracting them from the fact that the medical office is always running behind. But don’t forget to show up 15 minutes early, “just in case”!!

Your time has no value to the medical industrial complex.

Who is the customer here and who’s the service provider?

Could any successful business run its operation in such a customer-hostile method?

Rhetorical questions, admittedly.

Moral:  Assess your own front-line procedures, intake processes  and administrative systems in your claim offices and operations. Ask yourself, “Are these designed for the convenience of the claim staff or for the convenience of paying customers?”

It’s like Lily Tomlin’s Ernestine skit where she says, “We don’t have to care – we’re the phone company.”

Many hospitals and doctor’s offices seem to exude the same attitude. It is a privilege for you to utilize their services and you should be grateful and thankful.

Don’t emulate the medical establishment’s hubris.

(P.S. Please confirm that you received this message J )

Defense Lawyers – 3 Reasons You Should Join the CLM

I admit it. Some of my best friends are attorneys. I am also a member of the Claims and Litigation Management Alliance, better known as the CLM. As a member of CLM, I try to be a promoter and ambassador of the organization and nominate defense attorneys for membership. Some of them are receptive to these nominations. Others are skeptical.  Others confess that they are too busy to join yet another professional organization.

CLM

I get it. Many of these same lawyers belong to FDIC, DRI, the ABA, ALFA, the Harmonie Group, etc. After a while, it’s alphabet-soup. Attorneys could literally spend every workday attending some organizational conference, seminar or event.

So why add more one more organization the next in the form of CLM?

So the question is – why should a defense attorney join the CLM?

Disclaimer: I admit to being biased in favor of CLM. With that disclaimer, I think the benefits are multiple.

First, the organization includes a huge chunk of decision-makers from the insurance claims and risk management sectors. Involvement with CLM events puts you in contact with individuals who could be sources of new assignments and engagements for you and your firm.

Second, the annual conference, the periodic seminars and the webinars sponsored by subject matter groups provide value-added and substantive continuing education. They also provide presentation opportunities for attorneys who specialize in insurance coverage and defense. These types of presentations are often the best marketing efforts available, since they position the attorney in the firm as thought leaders in this particular area of the law. I’m a firm believer that the best form of marketing is not self-promotion, but generating and delivering value-added content to your prospective market. That content can be through articles, seminars, webinars, podcasts, etc.

Third, the publications (Claims Management and Litigation Management), committee involvement and

the events just cited provide an opportunity for you to get involved, to showcase your expertise and project your firm’s brand as

a thought leader in certain areas of the law.

All of this with the caveat of the car commercials, “your mileage may vary.”

Like any organization, you will get out of it as much as you put into it. There is no turnkey operation here, where you join the CLM and then turn on the faucet for flowing business opportunities. You have to work it. The results may not be instantaneous. You have to plant seeds, develop your network, grow your network and tend to it over a period of time. Before the harvest comes the planting. CLM is a wonderful field in which to plant.

Any lawyer doing insurance defense work is making a mistake to bypass opportunities to get involved in this organization.

Benefits from joining CLM accrue not only to defense attorneys of course but to insurance company claim personnel and risk management professionals. The tougher sell appears to be to defense attorneys.

To connect with customers, to build your own knowledge base, to establish your leadership role and to harness channels through which to generate value-added content in your subject matter area of the law, CLM membership is a terrific investment for defense attorneys!

Would YOU recommend CLM membership to your defense attorneys? Why or why not? Share your thoughts here…

 

 

Book Review — Recent IIA Claims Management Text Fills Needed Void

Claims Leadership and Organizational Alignment, First Edition, edited by Martin J. Frappolli and Ann E. Myhr, 2013, Insurance Institute of America

The Insurance Institute of America has long been a leader in claim publishing. Its Associate in Claims – AIC – designation is one of the premier continuing education distinctions that a claims professional can acquire. For all of its excellence, however, one “knock” on the AIC program is that it took more of a micro than a macro view of claims, focusing on desk-level claims-handling with less attention to the broader areas of claims supervision and management.

That missing piece of the puzzle is filled with the introduction of this relatively new text from the Insurance Institute that aims to fill that void. It is the foundational text for the new AIC 47 course that leads to an AIC-M designation.

Both authors, Frappolli and Myhr, are on the staff of the Insurance Institute’s Knowledge Resources Department. They have teamed to provide a useful introduction to help claim professionals who navigate the often dicey transition from an operational to a management/leadership capacity.

The authors divide the text into nine major chapters:

*  The Aligned Organization

*  Cultivating Organizational Alignment

*  Aligning

Claims within the Insurance Organization

*  Employee Development

*  Managing Across Organizational Boundaries

*  Managing the Claims Function

*  Creating Competitive Advantage

*  Business Continuity Planning

*  Claims Decision Support

Executives at many companies assume that the qualities that make an excellent claims adjuster translate into being a skilled claim supervisor or manager. Unfortunately, that is not the case.

Some qualities will be easily transferable, while other new traits must be honed and polished. The new claims management textbook should assist claim professionals who are making this transition, helping them avoid some of the rocks, shoals and pitfalls that they might otherwise confront. The preamble

of the text makes it clear that the book is not aimed at C-suite executives.

That is a laudable disclaimer, since there are scant resources on how to manage or supervise a claims team while bookshelves groan under the weight of tones regarding the nuts and bolts of claims adjusting.

Some of the more nettlesome claims management issues that future iterations may address in greater depth

include:

*  How to determine the optimal caseload per adjuster?

*  What is the ideal span of

control that claim supervisors should have over adjusters?

*  What factors enter into assignment of cases or accounts to individual adjusters?

*  How can claim managers make meetings more effective and productive?

*  What are best practices in conducting adjuster performance appraisals and reviews?

*  What are the best practices in mentoring adjusters and fostering a culture of continuing education?

*  What management techniques invite bad faith claims against insurance companies?

Claim managers and supervisors seek guidance to address these questions. The text touches upon the subjects that does not deal with them in a thorough manner. Those looking for a hands-on cookbook or guidebook of do’s and don’ts for claims management may be disappointed.

Regardless of whether you plan to sit for the AIC 47 exam or not, I highly recommend a close reading of Claims Leadership and Organizational Alignment. Admittedly, it is not the kind of book that you would curl up with for pleasure reading. Nevertheless, any claim-handler who aspires to making the transition into middle or upper management should view this text as a must read.

Likewise, those who already occupy positions of middle or upper management in claim organizations – cialis gratis whether in an insurance company, a third-party administrator (TPA) or a corporate risk management department – owe it to themselves professionally to familiarize themselves with this text and the principles contained therein.

 

 

 

 

 

White and Williams “Coverage College” Gets High Marks Again — Conference Recap

Apple’s iPhone muse and general know-it-all, Siri made a guest appearance at the recent 2014 White and Williams Coverage College in Philadelphia.  Name partner Gale White opened the proceedings with a dialogue with Apple’s Siri, who quickly informed the audience that the eighth annual event had over 530 registrants from 22 states. For the third straight year, I attended the recent White and Williams Coverage College on October 2nd at the Pennsylvania convention Center in downtown Philadelphia. If you get a chance to go, I strongly recommend that you grab it!

2014 Coverage College

As usual, the event runs with Swiss-watch precision. There are two morning and two afternoon concurrent sets of master classes. Like a Chinese takeout menu, the event brochure lets you pick and choose the breakout session that suits your needs and interests the best. Highlights for me were the breakout sessions on “Insurance Coverage 101 and the Life of a CGL Claim” and “The Bad and the Ugly: Ten Worst Recent Decisions on Bad-Faith Liability.”

Lunch at Coverage College features no food fights, but typically some celebrity or mystery guest. In 2012, it was the Philly Phanatic, mascot for the local major-league baseball team. Last year, it was Benjamin Franklin. This year, four Jersey Boys impersonators appeared and lip synced — Milli Vanilli style — a medley of Four Seasons classics. The lyrics were not totally clear, but I believe they must have been tailored to the audience since one of the songs went like this:

“Who Loves You”

Who loves you, pretty baby?
Who’s gonna’ reserve coverage rights?
Who loves you, pretty mama?
Who’s gonna’ make your claim DENIED?

Perhaps the high point of the day was the final speaker. A tradition of late is to have a policyholder attorney from the opposing camp offer perspectives regarding insurance coverage and bad faith. This year did not disappoint. Subbing in at the last minute for the scheduled speaker was Carl Salisbury, a partner from the Kilpatrick Townsend firm in New York City, addressing the topic “Ten Things I Really, Really Wish You Wouldn’t Do.” This was more than a list of gripes against insurance company claim representatives, but certainly has implications for the scenarios that ignite coverage litigation and bad-faith suits. The top ten traits were:

#1.  The five-minute claim investigation

#2.  The kitchen sink information request

#3.  The kitchen sink reservation of rights letter

#4.  The passive/aggressive excess carrier

#5.  The thumb-in-the-eye settlement offer

#6.  The sprint to the courthouse

#7.  The “other insurance” brouhaha

#8.  The misdirected allocation brouhaha

#9.  The impossible billing guidelines

#10.  The “notice of circumstances” shell game

Again, if you get a chance to attend White and Williams’ event, take advantage of it. Since virtually all of the presenters are from the firm, one might think that the program has an inbred quality to it. However, the firm now is so far-flung and with such a deep bench of talent in the insurance coverage area, that a diversity of perspectives is locked in and guaranteed.

The other caveat: each session is 45 minutes long.  So, presenters sometimes struggle to adequately cover the topic within that time constraint. No time is given over to Q&A and audience interaction, which are hallmarks of superb breakout sessions. These are, however, minor quibbles on a first-class event packed with substantive content that should catch the attention and close study of any insurance claim professional.

An intriguing note was the announcement from partner Randy Maniloff that next year’s Coverage College will address the insurance implications of the growing trend toward marijuana legalization, both for medical and recreational use. White and Williams will hash out various topics, weeding out the best from the marginal and will leave no stone unturned to assemble an interesting session around this topic. (No word as to whether the presentation will leave you giggling uncontrollably, with an intense craving for junk food.)

This approach of the 2015 Coverage College could lend a whole new meaning to the term CGL, with the development of a Cannabis Growers Liability policy. One would expect a special joint session covering both first- and third-party exposures. In any event, the audience appeared to be buzzed by this ground-breaking topic.

Would marijuana risks be addressed by existing CGL policies? Stay tuned for further commentary from White and Williams, as Siri does not have the answer to that question.

“My Biggest Barrier to Claims Productivity is __________.”

On a recent LinkedIn insurance claims management forum, I posed the question above.

Extreme Productivity

Here are the responses listed, in no particular order. I posed this question in preparation for a September CPCU webinar that I led (with Cindy Khin) on the topic of “Turbo-Charging Your Claims Productivity.”

It’s only fair to post the answers to provide a flavor for what is on the mind of today’s adjusters in terms of barriers to their own professional productivity.

In no particular order (drum-roll, please):

1. Getting sucked into email at the start of the day.

2.  Complaints from claimants or others who want to go “over my head” to appeal to my manager.

3.  Reprioritizing after interruptions.

4.  Dealing with incompetent management.

5.  Dealing with faulty computer systems.  It’s like bringing a spoon to shovel your driveway.

6.  Inconsistent and ever-changing goals.

7.  Slogging through all the emails.

8.  Lots of time-consuming claims needing special attention.

9.  levitra drug uk man co HUGE amounts of windshield drive times — I live in a very rural area.

10.  Management requests for information they can access themselves.

11.  “Redundant work. Redundant work. Here we are, it’s 2014 and many carrier legacy systems require several programs, log-ins and redundant entries of the same 411. Trying to glean good data from apples-and-oranges systems is lengthy and frustrating.”

12.  Reviewing defense firm fee bills in conjunction with litigation management guidelines

13.  Satisfying Medicare reporting guidelines and ensuring proper documentation before making payment. Claimants and their attorneys do not care that we meet the requirements they simply want their money yesterday.

14.  Lack of planning. “Adjusters who do not plan their day, especially field adjusters in big cities like Los Angeles. It is essential to plan your appointments so that you go in a straight line and have no need to double back and forth. For example you can set appointments along the north bound 405 freeway then transition to the 210 and down the 710 and back to your start. Some adjusters add 50 miles of driving by failing to plan their investigative route.”

15.  “Too much technology — not enough personal contact.  Does anyone remember the days of the handshake and looking in to the whites of that persons eyes and thinking I trust that individual -I don’t need ANOTHER email to set out what is already agreed! How old fashioned! apparently what we have now is terrific progress and we can’t change the process because ‘change’ is all we

will ever see. Can’t wait for the day my mobile device is http://www.cialispharmaciefr24.com/achat-cialis-pas-cher/ injected into my wrist!”

16.  Paperless systems focus adjusters on task completion instead of file resolution. We have too much technology, but a dearth of holistic claim analysis and action.

In future installments of the claims Coach blog, I will tackle each of these barriers and offer some tips and tactics for neutralizing them and boosting your professional productivity. Stay tuned!

Podcast Interview: “Common Risk Manager Mistakes … and How to Avoid Them!”

Our periodic focus on industry thought leaders today spotlights a conversation with insurance consultant and expert Nancy Germond. Nancy has served as a risk manager, as a consultant, and is a prolific author and lively speaker on topics related to insurance, claims and risk management.

Nancy GermondIn this interview, Nancy addresses five common mistakes that new risk managers often make as they enter their organizations.

More importantly, generic levitra super active Nancy offers tips and tactics for risk managers to manage the risk of their own job failure and suggests alternative strategies to maximize the odds of career success.

Enjoy!

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