Claims professionals weigh in on the value of discussion.
When we hear the word “roundtable,” many of us call to mind the stories of King Arthur and his legendary knights. Some say that King Arthur was an imaginary character while others claim him as a historical figure, but most agree that his knights made decisions while seated at the Round Table in a place called Camelot.
The significance of the round shape spoke to the individuals there: they all were equals. No one, not even King Arthur himself, could sit at the “head” since there was none. Each person’s opinion was important.
While King Arthur’s table of old may be a work of fiction, the roundtable of today is a very real and valuable tool for claims handlers. It presents one of the best opportunities for learning available to claims professionals, regardless of tenure.
Roundtable Defined
A claims “roundtable” is simply a conference in which a claim is discussed. There are many reasons this approach can benefit claims departments and handlers. Many utilize the roundtable approach as a learning environment for the less experienced.
“When I worked in the auto and homeowners liability side of claims, we had weekly roundtable meetings wherein the newer adjusters were required to attend for the learning experience,” says Marcus Jones, a claims manager at SCF Arizona.
Additionally, having a new set of eyes on a claim can present options or strategies that had not yet been thought of. For example, sometimes claims professionals who have handled similar situations can weigh in to help identify ways to proceed with the handling. Or, sometimes adjusters may need help in determining a case’s value and want to get others’ opinions. It also can happen that the claim is on the right track and nothing different needs to be done.
When deciding who will attend the roundtable, don’t overlook its value to even the most seasoned employees.
“Some of the biggest blunders I have seen in my 32 years in the business were delivered by managers who were making major decisions from within their own ‘goldfish bowl,’ and thus without the benefit of the vast knowledge of others around them,” says Jim Heing, president and CEO of the same-named adjusting firm. “Not to mention that bringing newer staff into the roundtable is a fabulous way to identify unknown skill and talent.”
Every office is comprised of handlers with varying degrees of experience who can lend an ear and a hand in formulating a plan for ongoing file handling. “You are able to hear others’ interpretations of coverage and policy provisions, and someone always seems to play devil’s advocate,” says Marty Smith, a catastrophe claims team manager. And that’s not all. Regardless of how long someone has been handling claims, there is almost always something new to share or to learn. “I’ve also had folks offer different perspectives on how to proceed with handling in ways that I had not considered,” he says.
Sherry Norris, an IT project manager at Equitable Life Canada, concurs. “A roundtable is a way to prevent the errors that come from unilateral decisions, not to mention the obvious benefit of preventing missed claim issues.”
Setting the Table
What is involved in putting together a roundtable? Often, it depends on the type of claim, the kind of exposure, or the potential outcomes desired. While most roundtables are populated by claims professionals, it is not unusual to have other input as well, such as legal counsel, nurses, doctors, and other experts. Preparation is a key factor in creating a successful roundtable.
“I prepare for a roundtable by doing a written summary with photos for each case being presented,” says Carolyn Solo, AIC of Allegany Co-Op Insurance. “The summary is distributed ahead of time, which gives participants an opportunity to formulate questions and suggestions related to the investigation.”
Such preparation is one way to expedite the process and get everyone on the same page.
“The success of a good roundtable often depends on the initial communications by the adjuster to succinctly capture the essence of the case as well as the degree of preparation by those participating in the roundtable,” says Jane Asbury, a technical claims specialist II at Liberty Mutual Insurance.
Here are some additional considerations when setting the table for discussion:
Table Manners
As with any meeting, it’s important to set some ground rules to which everyone must adhere.
First and foremost, participants must be mindful of the time allotted for each file review and keep to the parameters. One of the challenges is to get participants to refrain from talking during a presentation. In other words, people must listen in order to opine about where the claim is going. Sidebar conversations should be discouraged.
Next, understand that there will be those who see the roundtable as just another meeting taking away from their hectic work schedule. Participation can change this opinion, and sometimes asking these individuals to lead a roundtable can defuse negativity. This is something Travelers’ Margo Leiser has experienced firsthand
“Initially when roundtables get brought up, people roll their eyes and think about more time away from their desks,” she says. “But when people come together to tackle a problem, results usually happen because of the group effort. So in the end it is worth the short time away from their desks.”
Location, Location, Location
While most roundtables are held in places like a conference room, the advent of the digital age now affords the ability to roundtable in a virtual environment. This is especially good when participants have scheduling or distance concerns. Video conferencing is the best method since all parties can see one another. The conference call, which has been the mainstay of many businesses, can work well if properly monitored. Either way allows for flexibility and inclusion.
Kathy Schilling, a regional claims supervisor for PMA Management Corp of New England, says her office recently began using the roundtable approach in weekly meetings.
“Our roundtables usually consist of no more than six to eight people of varying levels of experience and backgrounds,” she says. “People bring not only claims experiences but also life experiences to the discussion. I certainly can appreciate extending these meetings to include remote participants.”
Once everyone is together, one of the most important things to consider is how to document what transpires. Is the information placed in a file? Does each person simply make notes? Is there a verbal agreement as to what will take place? This is important because the question then becomes, did the file handler follow up on all recommendations? Could the follow-up or lack thereof lead to a bad-faith situation? Are the notes discoverable in certain circumstances? These questions probably are best analyzed by counsel because of the various jurisdictions and laws involved, but each claims department should decide this as part of the planning process.
Is the Roundtable for You?
Most insurance professionals agree that the roundtable should be considered just one of the many important pieces that are part of the overall claims process.
“Roundtabling of claims has proven to be a very valuable tool in arriving at an agreed-upon strategy between the adjuster, the team leader, and management to resolve a given claim or issue,” says Ted Morgenbesser, a claims manager at American Claims Services Inc.
Conducting a roundtable can build claims knowledge and camaraderie and is good for team building. No claim should be considered too small or too complex for discussion. Adding medical, fraud, legal, and other perspectives to the mix can broaden the horizons of all involved and lead to better claims handling overall.
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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
