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Five Things Claims Managers Wish Adjusters Would Do (Or Not Do)

Claims representatives may feel, at times, that they are without guidance on how to improve one’s claims handling practices to the satisfaction of their claims manager. To find out the kinds of things that claims managers wish their adjusters would or would not do, we solicited a variety of insurance-related groups

June 26, 2012 Photo

Claims representatives may feel, at times, that they are without guidance on how to improve one’s claims handling practices to the satisfaction of their claims manager. To find out the kinds of things that claims managers wish their adjusters would or would not do, we solicited a variety of insurance-related groups via LinkedIn.

The response was enthusiastic, as many claims management professionals willingly offered up their thoughts and suggestions. Their responses have been compiled below in a revealing, albeit unscientific, fashion.

Don’t Procrastinate. A number of claims managers who responded to the question of what they wanted from their adjusters pointed to procrastination by claims adjusters as a primary pet peeve of theirs.

Procrastination usually rears its ugly head in the face of difficult, complex cases. Some adjusters work under the belief that closing five simple claims today is more rewarding than closing one large complex claim.  However, more than one respondent stated that most claims professionals find that, once they have jumped into a complex claim and really dig in, the resolution of that file almost takes care of itself over time. 

In contrast, where the complex file is ignored under the general thought that it can be addressed some other time, the complexity and size of the unattended “monster” file will unfortunately continue to grow, usually into a more unfavorable resolution than if the file had been pushed ahead.

So, whenever possible, rather than succumbing to and engaging in procrastination, which will likely be readily apparent to the claims manager when she or he reviews the claims log, attempt to be proactive in your file handling practices. As for those files you may hate to look at? Keep in mind that each time you review it and complete a task relative to that file, you move the claim one step closer to resolution—and off your desk.

Extend Courtesies. A number of claims managers believe that the prospects of resolution improve when claims adjusters extend common courtesies while handling a claim.

Several managers noted that every small gesture on the part of a claims handler—something as simple as smiling while on the phone or using courtesies in written communication—can help facilitate a prompt and reasonable resolution. It also reminds the claimant or claimant’s attorney that they are dealing with a real person and not a big, bad insurance company as a whole.

Simply put, a happy claimant is a less litigious claimant. An angry claimant or claimant’s attorney who feels slighted by a failure to extend courtesies may become defensive or close themselves off from resolution talks.

Avoid Negativity. Other respondents cautioned against writing negative or biased comments in the log notes regarding insureds, claimants, or other parties involved in a claim.

One person stated that when documenting a file, it is best to keep personal comments private and just state the facts in the claim. Using inflammatory or biased language about an insured, claimant, or other party could end up costing an adjuster his job and the company he works for a great deal of money.

With respect to verbal or written settlement negotiations, a resolution may be fostered by emphasizing in a positive and objective light the strong points of the carrier’s case, as opposed to focusing on why the claimant’s position is “wrong.”

Secure Better Photos. Claims managers would also like their adjusters to improve the quality of photographs secured, keep them in proper sequence, and label them better for future reference.

It was noted that in this day and age of digital photography and reviewable results, bad photos are not acceptable. If the photo is bad, take a better one. Don’t erase the bad photo, though. It should be kept in the file to avoid any allegations by opposing counsel of spoliation or destruction of pertinent evidence.

It was also suggested that when taking photos of a damaged building, the first photo should be a wide shot of the entire building, followed by closer, more specific photos. Once inside the damaged building, some respondents suggested taking a photo of a piece of paper that indicates the room that is about to be documented.

When photographing scenes of motor vehicle accidents, have the photos printed and affixed to a sheet of paper. This allows adjusters to write a short description stating what is being depicted, such as “Main Street looking in the direction claimant was traveling.”

Give and Take. One member of claims management said he appreciated open communication between the claims representatives and management. In this way, the claims manager is kept apprised of the file status, and ideas can be exchanged on how to move the claim ahead towards resolution.

Another claims manager said he very much values claims adjusters who are not intimidated by his position and are not afraid to challenge him when they think he is taking the wrong track on a claim. 

Obviously, how freely a claims representative can vent his views about a claim will vary from claims manager to claims manager.  Yet there can be no dispute that where claims management and adjusters have open lines of communication, free of any fear or repercussions for speaking one’s mind on an evaluation of a claim, all will benefit.


Daniel E. Cummins is an insurance defense attorney with Foley, Cognetti, Comerford, Cimini & Cummins. He has been a CLM Member since 2010 and can be reached at dancummins@comcast.net, www.foleycognettilaw.com.

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About The Authors
Daniel Cummins

Daniel E. Cummins is the managing partner of Cummins Law and has over 25 years of insurance defense and civil litigation experience.  

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