By Marc Lanzkowsky
– September 3, 2010
You can’t always get what you want but you can get what you need – If you ask for it!
Thank you Rolling Stones for reminding me what sometimes needs to be done to help get the job done better. As claims professionals we are always being stretched to do more with less, and sometimes can never get what we need from our partners in the industry; our hired defense counsel. Getting to the basics of claims management to evaluate losses, setting reserves and moving a case to resolution requires a good partnership with counsel. Given the current economic environment it has never made getting what you need from defense counsel so important.
So if you can’t always get what you want, less files and more staff to help, how do you get what you need to help?
Here is a novel response: Ask for it!
Defense counsel correctly spends much of their time focused on defending their clients. Unfortunately, and all to often, many counsel reports are designed to justify some activity in the invoice rather than providing useful information. Does reporting about sending medical authorization out really provide any valuable analysis to help the claims professional make a reserve or resolution decision?
Getting what you need
So how does one focus counsel to help provide better information for claims? Try these three suggestions to help them help you get better results:
- Educate counsel on the world of claims – Attorneys are great at defending their clients, but many no very little about what goes into a claims professional’s day. When speaking to attorney friends I am often amazed how little they truly know about the day-to-day business of claims. Spend a few minutes telling your counsel about your claim file responsibilities such as reserving, regulatory requirements, documentation and how many files you have, will help the understand your needs better. Even a basic discussion of file counts will enlighten counsel to what it means to have to go through hundreds of correspondence a week while still having to make appropriate decisions.
- Give counsel a clear understanding on what you need to make decisions – If you want counsel to provide damage assessments early in the case, even with limited information, then tell them exactly what you expect and hold them to it. If you don’t want them to put a number on a file until discovery is complete then be clear about that too (although I would not recommend waiting till the end – and we can save that for another blog article). Today’s attorneys are being asked to complete different reports and forms and follow different reporting guidelines for a variety of clients. If you don’t tell them specifically what you need to help you get your job done then you will never get what you need. It may take a little extra time when the case is assigned, however, it will pay dividends down the road with information that will help you make claim decisions better.
- Be persistent – The squeaky wheel always does get the grease. Attorneys I speak to want the interaction with their clients. If counsel doesn’t provide you what you need then call them up and remind them again. Getting what you need requires a little effort and there may be a break in period where they learn exactly what works and what doesn’t. Accepting what has always been is no way to ever get what you really need. So speak up, don’t be shy, and don’t accept what hasn’t worked in the past.
No attorney is going to say that they don’t want to make a claims professional’s job easier, so help them to help you. Start by telling them what you do, ask for what you want, and then make sure they do it.
You may not get what you want all the time, but you will get what you need.
How do you help counsel help you?
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Posted in Best Practices, Litigation Management, SPOT on Operations.
Tagged with Best Practices, Defense Counsel Reporting, Efficiencies, Good Claims Practices, Litigation Management.
Quick SPOT: 6 Security Tips To Keep Portable Technology Safe For Claims
August 27, 2010
Posted in Claims Technology, Due Diligence, SPOT on Operations.
If you are like me you keep everything on your laptop and cell phone. Numbers, corporate information, claims data, and even some of the dreaded non-private personal information of others. Claims data is filled with information that if lost or stolen could be detrimental to both the company and the individual. Many companies today issue corporate cell phones and blackberry devices as well as laptop computes in place of desktops. It’s a modern world and we are all expected to be connected. Partial work at home arrangements also mean this information is traveling from location to location which can increase the risk that things may be lost or stolen.
Take a look at these suggestions to help keep your claim information safe and secure in the latest post from the Claims SPOT.
AMA Study Finds Almost 1 Malpractice Claim Is Filed For Every Physician – Not Really Shocking
August 23, 2010
Posted in Medical Malpractice, SPOT on Claims Issues.
A study from the American Medical Association (AMA) reports that an average of 95 medical liability claims are filed for every 100 physicians, almost one per physician. The AMA study looked at 42 specialties and was from a sample size of over 5,800 physicians. The number of medical liability claims is not an indication of the frequency of medical error, as the physician prevails 90 percent of the time in cases that go to trial. While 65 percent of claims are dropped or dismissed, they are not cost-free.
The Claims SPOT Has Been Selected As One Of The Top 50 Insurance Blogs For 2009
August 17, 2010
Posted in My SPOT.
The claims SPOT has been designated one of the LexisNexis Top 50 Insurance Blog. Thank you to all our readers for reading and your continued support!
Promote Creative Thinking To Get The Most Out Of Your Claims Staff
August 16, 2010
Posted in Best Practices, SPOT on Claims Issues.
Good workers are sometimes all that claims departments look for and, given the nature of claims these days, it is not a bad thing. There is so much to do and so little time to do it and good workers, however you define them, are great to have. But how often are creative thinkers looked for? In a video lecture from, Sir Ken Robinson, he asks why don’t we get the best out of people? He argues that it’s because we’ve been educated to become good workers, rather than creative thinkers. Do you recognize that employee in your organization? How should we promote creative thinking in the claims world – read more in today’s post at the Claims SPOT.
What Paul Revere Can Teach Claims Professionals About The Benefits Of Building A Strong Professional Network
August 12, 2010
Posted in Best Practices, SPOT on Claims Issues.
Is professional networking (so-called social networking) relevant for claims professionals? Does it make them more effective, help them to identify resources they need to do their job better, find the right attorney, be creative, identify emerging technologies, spark their imagination, and set industry trends? Or are they a waste of time, an invasion of privacy, or just not part of your world?
To look at that, this article examines the effectiveness of Paul Revere and the analytical work done in several publications, including the Harvard Business Review, Tipping Point and Connected. It examines the potential of social and professional networks, what makes them successful and effective, and the applicability of technology platforms liked LinkedIn to the claims management profession.
3 Suggestions To Beat The Summer Slow Down In Claims (If You Do Slow Down)
August 3, 2010
Posted in Best Practices, SPOT on Claims Issues.
It’s summer time and the living is easy!
Take advantage of the summer slow down and make changes, clean things up and improve your operation. In the latest post from the Claims SPOT see three suggestions for ways to use your summer effectively. One for the manager, one for the claims handler and one for the claims executive, suggestions to use the slow down to improve your operation. Take a look and suggest others – we would love to hear from you.
Why Can’t We All Get Along? Making The Agent A Partner In The Claims Process
July 27, 2010
Posted in Customer Service, SPOT on Claims Issues, SPOT on Operations.
Creating a strategic advantage through improved agent carrier relations
The relationship between claim adjusters and agents can be an adversarial one. Each side often finds itself correcting issues created by the other side. Agents may set the wrong coverage expectation for a customer, leaving the adjuster to deliver the bad news. Adjusters may get overloaded and not return phone calls in a timely manner, resulting in a complaint to the agent’s office. In the worst case scenario, adjusters and agents may badmouth each other to customers, putting customers in the middle. Clearly, agencies have a role to play in the claim process. Enabling agents and their staff to perform their role efficiently with empathy and professionalism can benefit customers, agents, and the claims department. Read more this week from Melissa Loew.
Increasing Claims Satisfaction Doesn’t Mean Increasing Staff
July 21, 2010
Posted in Customer Service, SPOT on Operations.
Is it possible to increase claim satisfaction and decrease cost at the same time? Many claim representatives say no. Some view that satisfaction is driven by the ratio of adjusters to claims – having more people to handle claims means higher satisfaction, although also higher loss adjustment expense. Some believe that higher settlement amounts result in higher satisfaction and higher loss costs.
As the Claims SPOT welcomes new contributing author, Melissa Loew, see how customer satisfaction can be addressed in tight staffing markets.
Encounters of the Best Kind Can Create The Strongest Claims Organizations
July 20, 2010
Posted in Best Practices, Customer Service, SPOT on Claims Issues, SPOT on Operations.
Companies cannot define their core “brand” through brute marketing and advertising. Rather, customers define what that brand is in their individual interactions with the company. Those interactions can either be transactions or encounters. Encounters make the relationship stronger while transactions result in a worse relationship or one that stays the same. This is no different in the claims professional’s world. How can claims professionals create encounters, and avoid transactions, in their interactions with their customers?