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Handling an Unreasonable Caseload

Regaining control with FOCUS.

April 25, 2014 Photo

By Pamela Tyree Griffin, Regional Claims Supervisor,
PMA New England

Ask yourself a few questions. Do you successfully manage your busy caseload—or does it manage you? Are you proactive and organized—or does chaos rule the day? Many adjusters feel like victims of a large caseload. It overwhelms and leaves them at their wits’ end. The problem is that this perception will not clear those cases and, more importantly, it is not always reality.

 Before we can address solutions to what may seem like an unreasonable caseload, let’s try to define it. Given the subjective nature of the “beast,” it can be defined in different ways by different people. Suffice it to say that it can mean a high number of cases, a large mix of cases having different values, cases that require considerable legwork, or a combination of all of these.

But it’s not just the number or types of files. A claims handler has multiple interruptions during the day, whether it be phone calls, meetings, or other job requirements. Unavoidable as they may be, they can hinder one’s ability to get through the files. Unless there is a plan in place to manage the work, handlers will become frustrated and overwhelmed.

In a perfect world, whether assigned by a human being or by a claims system, each file would be matched to the right adjuster with the right background and level of experience. This does not always occur, though, for various reasons.

The bottom line is that most of us have experienced a large caseload. Managing it can indeed be daunting and there is no one-size-fits-all solution, but many solutions abound and it’s up to us to determine what works best.

When you start the process of trying to get a handle on a demanding caseload, understand that doing so requires planning and organization. No matter how good the plan, it must always be evolving. You’ll need to get in the habit of rethinking your solutions and changing them as needs change.

For those new to claims, I suggest a word to the wise: communication. Don’t overlook the importance of it. If your workload is truly causing difficulty, discuss it with your manager. That individual may have ideas or can implement changes to assist you. It’s best to discuss it before things get out of hand and internal and external customer issues arise. Additionally, you should powwow with your colleagues, who likely have been down the same road and may have some ideas to help you.

Here is a strategy that has helped me and others get better organized. Try using the acronym “FOCUS.” It’s easy to remember and it can inform your approach. Understand that the following information is informational and should not fly in the face of any state laws, regulations, or your own company’s best practices.

Formulate a Plan

To begin, make a plan for your unfinished work by revisiting those files that you have had for what seems like forever. What should you look for? Potential closures, incomplete investigations, or correspondence that requires a response is a great place to start.

Organize Your Small/Routine Tasks

Next, organize only your smaller tasks by listing what you find and then prioritizing tasks and grouping them together. Some people do this electronically by creating desktop folders or setting calendar diary reminders, but an old-fashioned pad of paper will do the trick, too.

  • Identify what files await initial or follow-up contact and decide when you are going to complete those steps.
  • Do you have claims that need to be indexed or need weather or police reports? Some adjusters designate one day a week to accomplish such requests.
  • Do you check email several times a day? Why not designate times to do this for a better use of your time? Do you delete email once you have responded? If you keep them, make individual folders as opposed to letting it take up space in your inbox.

Systematically continue this until you have tracked, categorized, and documented all of the more routine tasks. This may take several hours or even days, but it is an important—if not the most important—step in this process. Then, according to your diary, do the work. Be careful not to put too many activities on each day so you can perform the work but still be responsive to those interruptions that are bound to crop up.

As you complete each task, cross it off your list or purge it from your computer system. If it is not complete, set a diary in order to continue work on it.

Consolidate the Larger Tasks

What should remain are the larger, more involved tasks. This could be a litigation plan, writing a report, or preparing for a claims review—basically anything at all that is detailed or time-consuming. Tackling these all at once along with other work may be counterproductive. You’ll be better able to manage the tasks if you decide to consolidate this work. Here is how to accomplish it.

Perhaps you have claims that need to be evaluated and reserved, and you also have claims reviews to write. Sort this work by order of importance and due date. Diary a specific day to perform these tasks and indicate how much time you will devote to each.

Part two of this process is to break each large task into smaller tasks, each of which is given a due date. This way, you get closer to completing the task as a whole. Persistence will ensure total completion and move the case to closure.

Update the Plan

It’s at this point where you will update your overall plan. You will have started to complete work and will have a handle on what’s left to be done. As the saying goes, if it ain’t broke, don’t fix it. Anything that’s not bringing you closer to resolving the claim must be discarded.

Streamline the Process

As you get more used to applying a systematic approach to your workload management, you’ll be better able to streamline the process. The more you work at it, the more in control you will be.

Lastly, it takes time to get to the point of an untenable workload—it can’t be resolved in a short period of time so don’t expect immediate results. Have some patience with yourself, even as you build your plan. Taking sufficient time to FOCUS, apply, and then refine such a plan for the pile of files will go a long way toward job satisfaction and less frustration for you.   

About The Authors
Pamela Tyree Griffin

Pamela Tyree Griffin is a regional claims supervisor for PMA of New England. She has been a CLM Fellow since 2009 and can be reached at  Pamela_TyreeGriffin@pmagroup.com

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