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Getting It Right

Five steps for improving claims template letters.

January 17, 2013 Photo
 
It’s the same old media story: A major network interviews Sandy survivors who are angry at insurers because their homeowners’ policies and explanations in claim denial letters seem out of sync with what was expected when they bought their catastrophe coverage. To underscore the point, the reporter reads from a claims adjuster’s awkwardly phrased letter and asks, “Do you understand what this means, because I don’t?” The unhappy survivors collectively shake their heads and say, “No!”

Adjusters often have trouble explaining coverage using plain English. If you are part of a claims department at a carrier, third-party administrator, independent agency, or municipality, you probably use a form or template to guide you in writing claims letters. The wording in these forms and templates is critical, especially during catastrophes such as Superstorm Sandy.

Some carriers have templates that are written for almost every conceivable type of loss, from a lightning strike to a dog bite, while others may have only a handful of letters dealing with reservations of rights, denials, requests for information, subrogation, acknowledgement of claims, and a few other coverage issues. Templates contain reusable components that help reduce the time it takes to write letters and eliminate errors from manual rekeying of data. A component can be a paragraph, a sentence specific to a state law, a claimant’s name, address block, signature, logo, etc. Instead of starting from scratch each time, claims professionals can reuse the entire letter or a paragraph from a prior letter to keep the language consistent.

Top claims executives hold high hopes that template letters will add consistency and professionalism to departmental communications. They expect that a form letter will eliminate errors in phrasing, punctuation, grammar, spelling, format, and organization. At some companies, new template letters are created to guide a department when an embarrassment or a potential bad faith lawsuit arises out of a free-form letter. Given their importance, why are so many templates poorly written?

There can be many reasons. Perhaps the template letters have been delegated to an IT person or attorney to write. IT professionals often create the letter format, but are they the logical choice to manage the writing, as well? Perhaps some managers may reason that attorneys are there to protect them from legal entanglements, so why not let them write the letters? With all due respect to attorneys, that approach can wind up causing more problems than it solves. Good writers are trained to be clear, have a friendly tone, and use simple language. Alas, some attorneys do not subscribe to these stylistic goals.

The following five steps for improving your department’s template letters (and best practices guidelines, as well) suggest a process by which you can bring templates up to speed, whether you do it in-house or by using a competent outsider. They aim to show you various choice points along the way, as well as point out some nuances that may aid the process.

1. Admit That Current Letters Need Help.

Some template letters in your system may be stodgy, unfriendly, wordy, and downright embarrassing. You can either perpetuate them or bring them into the 21st century. Don’t wait for a letter to cause trouble for the department. Instead, be proactive.

Ask yourself whether the corporate culture will support this type of project. For example, a claims executive at a midsize property and casualty company asked the systems people to format a few template letters but got tired of contacting them to see if any progress had been made. Another manager, using an HR manager to help rewrite the company’s claims letters, was met with a bit of hostility from one of the higher-ups who had written the original templates and wasn’t happy to see his prose changed. In this case, a credentialed writer outside the corporate structure might have met with success by being able to justify the revision of phrases, punctuation marks, and other matters citing claims as well as literary authorities.

A survey conducted during the recent revision of 80 claims letters for a Texas insurance carrier revealed an average of seven problems per page, per letter. Problems included everything from typos and misspellings to poor punctuation, lengthy sentences, wordiness, poor word choice, stodgy phrases, inappropriate salutations and closings, hedging, poor organization, and lack of persuasiveness.

Here’s a small sample of what was found in the letters—letters that have probably been mailed as-is dozens, if not hundreds, of times to claimants, physicians, attorneys, agents, reinsurers, and commissioners.

Wordy Phrases: “This letter serves to acknowledge,” or “We ask that you contact us immediately.”

Stodgy or Inappropriate Phrases and Clichés: “Please advise,” “Should you have any questions,” “Please forward your bill,” “Pursuant to,” “Thanking you in advance for your cooperation,” or its presumptuous twin “Your cooperation is appreciated,” “Do not hesitate to contact me,” and “The above claim,” and its longer cousin “The above-captioned claim.”

Poor Word Choice: Incorrect use of “i.e.” and “e.g.” (“i.e., CAT scan, MRI, EKG”); use of “advising” when “telling” or “informing” is more accurate.

Redundancy: “Under age eighteen (18),” “chemotherapy treatment,” and “current status.”

Format Issues: “Re:” lines that do not spell out dates; use of “#” instead of “number”; lack of indentation, and superfluous categories.

Faulty Grammar: Dangling modifiers, such as “When received, we will give your claim prompt attention.” (when we are received?); subject and verb disagreement.

Poor Punctuation: Extra or missing commas (e.g., before “which” clauses), missing hyphens (e.g., “case by case basis” or “day to day progress notes”), missing apostrophes, and salutations such as “Dear Counselor,” in which the colon is preferred.

The more vital problems include wishy-washy denials, tangled phraseology, lack of cohesiveness, and unpleasant tone. Some of the letters, though technically correct, were unpersuasive, abrupt, and insincere.

2. Count Your Template Letters.

Once you decide to do something about updating and revising template letters, count the number of distinct examples that need work. (There’s no need to tally those letters that have just a bit of exclusionary language.) See if the template letters are easy to recognize based on their name within your system. Here are several names that differentiate template letters in a brief, simple, and intuitive phrase:

  • Acknowledgement of Receipt of Theft Claim
  • Medical Status Request
  • Letter to Claimant, Release of All Claims
  • Claim Denial Letter
  • Attorney Settlement Offer
  • Payment to Lienholder

Then, identify each letter in your system by a descriptive phrase (e.g., WCSchedMedAppt) or by some numbering system (WCsched5). Then ask yourself, “What do these letters need? A little polishing or a complete overhaul?”

3. Make Templates a Priority.

Now that you’ve decided to completely revise and update your letters—whether there are 20 or 200—see if you have an in-house resource to do the job. Alternatively, to take politics completely out of the equation, assign the work to an outside writing consultant who will make decisions based on best practices and plain English and is able to defend the choices made.

4. Have a Plan.

When you contract with an outside resource to revise your template letters, you need to arrive at a fee that will be based on the number of letters to be completed, the deadlines assigned, and the manner in which suggested changes will be made (e.g., using the “comment” feature of Word, which allows comments to be placed on the same line that is being changed). Make it clear that policy language is exempt from the consultant’s commentary, unless its format seems to be in error. Ask yourself, “Do I want the suggested revision in a commentary section, or do I want the editor to make the change in the letter itself? Or both?”

While many issues in writing are open to disagreement, never be afraid to ask for a reference or a citation for any comment that is unconvincing (e.g., use of the serial comma, use of “advise,” forming the plural of singular nouns ending in “s,” etc.).

Ask anyone who is chosen to revise the template letters to comment on a variety of issues. On a basic level, you want to make sure that the punctuation, grammar, spelling, abbreviations, margins, type size, and capitalization are perfect. You also want to know about each letter’s phrasing, word choice, conciseness, readability, and structure. Finally, you want comments about matters of tone, accuracy, and friendliness.

Finally, let the consultant know if you prefer having a comment mentioned once (e.g., “Use a colon after the salutation if you are on a last-name basis with the recipient.”) or that you’d like that same comment repeated on every single letter in which the issue occurs.

5. Give Speedy Feedback.

If you can have 10 or 20 revised letters approved by the powers that be within a week or two, you will be able to meet reasonable deadlines for the project and give your writing consultant speedy feedback throughout the revision process. This helps keep you and the person revising the letters focused on the mutual goal. Make sure that you are able to request rewrites or revisions or discuss any comments whenever needed as part of your agreement.

If the job is done properly, it will pay dividends every time a revised template letter is sent out. The letters will not cause embarrassment and will be professional yet friendly, mitigate the possibility of a bad faith lawsuit, improve customer service ratings, and improve the morale of signers. Another benefit: If you go through the comments of each letter, you will have done the groundwork for a claims department style guide that can be a valuable resource for all department members and is something that can be given to new hires for years to come. This will produce a consistency of writing style and quality that will make top managers proud.

 


Gary Blake, Ph.D., is director of The Communication Workshop, a firm that offers writing seminars, webinars, and editorial services to insurance companies. He has been a CLM Fellow since 2011 and can be reached at garyblake725@gmail.com, www.writingworkshop.com.

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About The Authors
Gary Blake

Gary Blake, Ph.D., is director of The Communication Workshop, a firm that offers writing seminars, webinars, and editorial services to insurance companies. He has been a CLM Fellow since 2011 and can be reached at garyblake725@gmail.com, www.writingworkshop.com.  

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