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Category Archives: Best Practices

  1. Why Extending More Claims Authority Means Extending More Responsibility September 10, 2010

    Posted in Best Practices, SPOT on Issues.

    Extending additional authority to a number of claim handlers can have a dramatic affect on the department’s total incurred. Make sure claim handlers understand the impact, both good and bad, to the company. Deciding when, and how much authority to extend will always depend on the line of business, and experience of the claims professional. Giving more authority also means extending more responsibility to the junior claims professional to make greater financial decisions for the company.

    In today’s post we discuss the authority-responsibility correlation and the importance of ensuring claims authority is extended only when responsibilities associated with that authority are understood.

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  2. 3 Ways To Help Defense Counsel Help You Make Claims Management More Efficient September 3, 2010

    Posted in Best Practices, Litigation Management, SPOT on Ops.

    We all talk about collaboration with counsel as a means to get better results at a lower costs. But getting what you want is not so easy. How about trying to get what you truly need to get your job done. In our latest post, we discuss three suggestions for helping counsel help you get better results. 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. Take a look at the latest – from the Claims SPOT.

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  3. Promote Creative Thinking To Get The Most Out Of Your Claims Staff August 16, 2010

    Posted in Best Practices, SPOT on 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.

    2 comments
  4. 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 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.

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  5. 3 Suggestions To Beat The Summer Slow Down In Claims (If You Do Slow Down) August 3, 2010

    Posted in Best Practices, SPOT on 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.

    2 comments
  6. Encounters of the Best Kind Can Create The Strongest Claims Organizations July 20, 2010

    Posted in Best Practices, Customer Service, SPOT on Issues, SPOT on Ops.

    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?

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  7. In Claims Don’t Let The Process “Thing” Get In The Way Of Doing The “Right” Thing July 19, 2010

    Posted in Best Practices, SPOT on Issues.

    Making a check in the process won’t ensure the matter is done right. I have written, and am a big proponent of, the importance of good process as a way to ensure good results. Putting a proper process in place is a road-map to help move claims to a prompt fair resolution. Nonetheless, doing and focusing on the process without making sure the outcome is sound is doing things right without doing the right thing. It’s so easy in claims to focus on the process and not use the process as a means to the end

    2 comments
  8. Social Media And Claims Investigation: Do You Know About Foursquare? June 28, 2010

    Posted in Best Practices, SPOT on Issues.

    Undoubtedly, you’ve read plenty of articles or have been to numerous presentations regarding the use of social media to investigate claimants. At this point, the novelty of Facebook and MySpace has worn off. The same can be said about Twitter. Everyone knows at this point to take a look at those platforms when searching a claimant’s background. Enough said. However, seemingly with every new day comes a new social media application. One relatively new application that you should also take a look at during your claims investigation is Foursquare.

    Learn more from out latest contributor, Christian Stegmaier, JD and look for more articles from Christian in the weeks to come.

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  9. The Need For Claim Auditing In Catastrophe Loss Situations Such As The Gulf Tragedy June 15, 2010

    Posted in Best Practices, Claims Auditing, Rick Woollams (Chartis Chief Claims Officer), SPOT on Issues.

    The tragedy of the Deepwater Horizon and the aftermath seem to be a topic of constant conversation. From an insurance perspective there is a large amount of criticism being brought to bear on the claims process. The massive administrative organization that has been established to handle what are already tens of thousands of claims is an undertaking that could be fraught with problems. In today’s post from The Claims SPOT we discuss how auditing in the Catastrophe situation is an important part of the process to ensure claims are paid quickly and appropriately while at the same time preventing fraud.

    Take a look and join the conversation.

    Like what you read? Pass it along to a friend and suggest they subscribe.

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  10. Change Hats With Someone And Free Your Mind To Make Your Claims Operation Better June 9, 2010

    Posted in Best Practices, SPOT on Issues.

    Don’t limit what you can imagine by what you know – look to others to help improve your claims department.

    In Trading Places: A Smart Way to Change Your Mind, Harvard Business Review contributor, Bill Taylor discusses the “power of a whole new mindset about innovation.” The article goes into what happened when two CEO’s switched companies for a day and the learning that came from the new perspectives they had. The Claims SPOT discusses how having claims adjusters switch roles with different disciplines can be a new way to expand their skills. Having managers sit with other business divisions, such as underwriting or actuarial, can be a great way to get a better understanding of the entire insurance process outside of claims. And lastly, looking outside of claims and insurance altogether to change hats and free your mind to new ways to make your operation better.

    2 comments
  11. How Do You Effectively Manage A TPA? Speak Up And Be Active! May 20, 2010

    Posted in Best Practices.

    Become The Squeaky Wheel To Actively Manage TPA Outcomes As claim practitioners, most of us are familiar with what to look for when we shop for a third-party claim administrator (“TPA”).  One recent discussion on this blog cited such elements as claims systems, data reporting capabilities, and quality control (6 Essential Elements When To Explore […]

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  12. 2 Chores that should not be neglected to become a stronger claims organization May 18, 2010

    Posted in Best Practices, Claims Auditing.

    Lets face it – no one really likes to do mundane things. Nonetheless, it’s those very chores that have to be done regularly to ensure a strong organization. Like cutting grass, the longer you let it go the worse it is for your grass, and the harder it will be to fix the mess that has been created. There are certainly enough chores that need to be done in the world of claims that no one likes to do. You know what they are – those things that you would prefer to not have to get to. They can include writing notes on files, keeping a diary and paying bills. But as any good claims handler knows, if you fail to do those tasks regularly not only won’t your grass grow, but you will have quite a clean-up.

    Two chores that can really help claim departments grow nice healthy grass are in the areas of training and managerial assessments. Learn a few chores that have to be done but will help grow your organization.

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  13. 7 Considerations When Drafting Claims Guidelines March 1, 2010

    Posted in Best Practices, Compliance, SPOT on Issues, SPOT on Ops.

    Claims departments employ professionals that want to do a good job for policy holders as well as the company, and claims guidelines should help foster those goals. Before drafting guidelines there are a few things that should be considered and we, along with our fellow blogger Phil Loree, suggest 7 things a company should consider when drafting claims guidelines.

    5 comments
  14. Absence of procedures to notify reinsurance is a basis for bad faith February 17, 2010

    Posted in Bad Faith, Best Practices, SPOT on Issues.

    Recently I was discussing bad faith and notice procedures with attorney Phil Loree Jr., an expert on reinsurance and arbitration issues and author of the the Loree Reinsurance and Arbitration Forum blog.  I thought this was a timely conversation as it reinforced the concepts regarding procedures and the potential risks when they are not in […]

    6 comments
  15. 5 Claims issues cited for non-compliance on market conduct exams & 3 tools to avoid them February 15, 2010

    Posted in Best Practices, Compliance, SPOT on Issues, SPOT on Ops.

    Insurance Market Conduct examinations are a regular part of the insurance business. Besides the stress of the exam itself, being cited for violations can result in costly fines. Regardless, many citations can be avoided. Every year, insurance compliance solutions provider Walters Kluwer releases its annual study of top ten reasons insurance companies are found to […]

    2 comments
  16. Improve bottom-line outcomes on claims by thinking outside-the-box! February 9, 2010

    Posted in Best Practices, SPOT on Issues.

    Claim handling is just as much an art as it is a science. Synthesizing facts and investigating losses requires, not only following process and procedures, but also the ability to look at new ways of solving established problems. Following best practices is of course an effective way to achieve consistently good claims results. Regardless, the […]

    1 comment
  17. Failing to properly document files can be costly – It cost one insurance agency $5.83 Million February 1, 2010

    Posted in Best Practices, Commentary, SPOT on Ops.

    Files should speak for themselves. A recent California decision is yet another example of what can happen if you don’t document your files and maintain procedures. In this case – it cost $5.83 million.

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