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What You Say

Email exchanges with members and fellows

September 05, 2018 Photo

Letters from readers always make my pulse flutter—will it be a compliment? Gripe? Unsolicited commentary? While I certainly appreciate the former, the latter is especially relished, since I always enjoy engaging our members and fellows in discussion.

Take, for instance, last month’s letter I received from Dennis J. Wall, author of Litigation and Prevention of Insurer Bad Faith, who’s email subject line guaranteed a click from me: “Quiet in the Courts! Your Claims File Is Your Best Evidence of Good Faith in the Bad-Faith Case.” In part, he writes:

It seems that almost every insurance bad-faith case in litigation includes fights over production of claims files. But it doesn’t have to be this way. There is an alternative to refusing to produce all or any part of the claims file in litigation, or even settling the lawsuit and keeping the contents of the claim file a secret because of some generalized, non-specific “risk.” Maybe not all fights over production of your claims file are necessary. Maybe not all bad-faith claims need to be settled, either. Consider putting good faith on display.

I think Wall is promoting transparency in order to avoid a supposition that there is something to hide, as mentioned in the feature “Listen, Learn, and Be Ethical,” on page 42. In the opening of this article, the author poses a scenario in which a claims professional who does his job successfully doesn’t always translate into doing it ethically. The question the author asks (and attempts to answer) is “How do we balance paying the lowest number possible with making the claimant whole and paying a settlement that is fair for both sides?”

I think another good question to ask ourselves is “How do we wield the sword of industry knowledge over our policyholders?” Like Wall suggests, putting your good-faith claims handling on display should be of utmost priority. In the quest to do our jobs successfully, claims professionals must be careful to consider that the ethical part of adjusting might include being an open book.

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About The Authors
Eric Gilkey

Eric Gilkey is vice president of content at the CLM, and serves as executive editor of CLM magazine, the flagship publication of the CLM.  eric.gilkey@theclm.org

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CLM’s Insurance Fraud Committee identifies, analyzes, and offers education on emerging fraud schemes and tactics; monitors and reports on developments in case law, state fraud statutes and applicable regulations; collaborates with other anti-fraud industry organizations and associations; and seeks to provide amicus support in matters of importance in the fight against insurance fraud.

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