Have we forgotten something fundamental in claims handling?

I'm developing a customer service training for adjusters and supervisors for a national carrier. Before we began developing this training, we reviewed the complaints the claim managers received from various customers and agents. One particular complaint chrystalized the focus of the training.

Insureds and claimants were complaining about the length of time it was taking to achieve settlement. Adjuster were responding defensively, saying, "We're within legal time limits." Wow, now that helps the customer feel better, doesn't it?

To reduce complaints, adjusters need to be reminded that they aren't just technicians, they are providing a valuable service to the customer. As I worked with this claim manager, I recalled just how much my early mentors taught me as I learned claims handling the old-fashioned way.

I was trained in the days where we usually, after rigorous training, learned in the field at the hands of old-time claims handlers. One of the first things I remember when I was still handling med-only and small non-injury claims was these words of my boss. "We're much closer to social workers than we are adjusters," he maintained. Over the years, I've rememberd that phrase many times as I've dealt with the emotional aftermath in people's lives that claims frequently leave.

When I was a claim manager, it became my philosophy that I couldn't get mad at my adjusters when they made mistakes such as stating something like "We're within legal time limits" if they didn't know any better. It was up to me to ferret out where the problems lay with my staff members, and it was always slightly different with each one, and then train to those shortcomings.

My thought about this exchange and some of the other complaints made me realize that their adjusters were missing a critical step in the adjusting process. Everything the adjuster does is to ensure that both sides, and this includes the insured, receive an equitable settlement.

If the adjuster lays the groundwork by explaining in the first few conversations with the customer that the process may take some time because the settlement must be fair to both sides, customers may not complain as frequently about the length of the process. If they do, the adjuster can remind the insured or claimant of what was said early in the process, that it's in both parties best interest to be as thorough as possible.

Rather than saying "We're within the time limits," we must change adjusters' mindsets to "I understand how frustrated you must be with the length of the time this is taking. However, we want to make sure that you receive a fair and equitable settlement! That’s why you pay premiums."

If the adjuster knows that it is his or her job to achieve a settlement that is fair to both sides of the contract or event, and can articulate that thought early in the process, then complaints will drop. Then claim managers can spend time supervising people, not problems.