Tag Archives: Good Practice

3 Ways to Make Your Claim Notes Better

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Writing Shouldn’t Be a Chore

Recently I have been spending a lot of time auditing claim files.  It’s really a great exercise to review files, and an important part of well-run claims organization.  One thing that continues to amaze me is the number of files that have poor documentation.  Writing good claim file notes are an important part of handling a claim file. Claim notes record the history of what is going on in addition to the reasoning behind claims decisions.  Good claim notes tell a story.

For some reason, putting notes in a file has turned into a painful exercise for many claims professionals. I am not sure why this has happened, but maybe it’s because of added pressure to document files – the dotting of the “i” mentality – or maybe it’s increasing file loads. Either way, good claim notations have suffered.

I am a big advocate that claim notes do not need to be treatises on what has taken place.  There should be no reason to write paragraphs and paragraphs to explain events when a sentence or two will do. You are a claims PROFESSIONAL and are being paid for your professional abilities to summarize and analyze the facts.  Be brief and get to the point and you will find notes will be easier to write and certainly easier to read.

Write Better Notes with These 3 Suggestions

  • Reserve Notes: When reviewing a reserve, and certainly when changing a reserve, a brief note should be put in the file explaining the reasoning behind the reserve. There is no need to write a book, rather simply state “I have changed the reserve to $10,000 because we received new information about medical treatment that had not been considered.”  A good note will explain the action taken in 2 to 3 sentences.
  • Speak English: I know this seems like a silly statement, but I have often read claim notes that are so full of abbreviations that it would be impossible for anyone to know what was being said except for the author.  Does this type of note make sense?

49 year old Private Bar Attendant who sustained injury to her RUE subsequent to her U&C duties on a CT basis.Rcv’d ltr from DA re EE dcsn 2 c new MD. Have been advised that clmnt no longer has TPD but is now a PPD.

  • Plans of Action: Before you get into your car I am fairly certain you know where you are going to go and how you are going to get there.  When you look at a claim file the same should be true. Every file should have a direction, a plan, a way to get from point “a” to point “b”.  A concise plan of action describing the next steps and plans to bring the claim to a conclusion should be a regular part of your note taking habits.

There are certainly more ways to improve notes. Regardless, these three establish a foundation to improving your ability to properly document all that great work you do.

Are There Any Other Suggestions To Improve File Notes?

5 Business Basics Every Claims Person Should Live By

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Going back to the basics is a great way to manage the pressures of claims

I have often advocated here that business ideas can come from outside the insurance industry and adopted by claims very easily.  It’s a matter of taking the time to look at what is out there. As we all know, claims folks have little time to look and that is where I hope the Claims SPOT can help. Sometimes claims organizations get so involved in the day-to-day that they have little time do the basics. Common sense practical business practices are easily forgotten when you just set up your 10th claim of the week and you have two other claims going to trial.

Donna Flagg, writing for the Huffington Post, recently posted an article, Five Things They Don’t Teach You in Business School.  This wonderful list of common sense no no’s couldn’t be more applicable in claims organizations.  I have followed Donna’s list below with comments on how they apply to our wonderful world of claims.

  1. Don’t yell at people. Flying off the handle does little to affect the other person(s) in anything other than a negative way, but instead, it makes you look crazy and unable to handle pressure.

    2. TCS: Claims can be a pressure packed world, and maintaining control is critical to success. Keeping your cool in a negotiation, or even when the paper work just keeps piling up, will help you achieve the best results. If you feel yourself loosing a little control, get up and take a walk or grab a drink of water.  Diffuse the issue before it becomes an issue and reflect poorly on you.

  2. Don’t lie in the presence of others. They will figure out that you either do not tell the truth, or selectively tell the truth when it suits you and they will doubt your authenticity as a result. You will end up with people who don’t take you seriously and keep you at arm’s length because you make them feel unsafe and uncomfortable.

    3. TCS: Lying in claims is the surest way to an early exit in this industry. The claims department is responsible for paying out significant amounts of company assets and the utmost integrity and honesty is an absolute.  Mistakes happen so come clean and don’t try and cover it up or bend the truth.

  3. Don’t tell someone something “in confidence” that you swore to someone else you would keep under wraps. All it does is show firsthand that you can’t be trusted with confidential information, which is definitely not a promotable quality.

    4. TCS: This is especially true in claims when much of the information contained in a claim file is provided in confidence.  It may seem innocent to discuss the details of someone’s claim, but that information is confidential and must be maintained as private.

    Ask yourself, if it was your claim and it involved personal information about your life, would you want it disclosed to others not involved in handling that matter?

  4. Don’t be negative and lower yourself to childish, irrelevant, gossipy games. Rise above it and stay focused on the business, not the bulls**t.

    5. TCS: I hate to say this, but I have seen this so often in claims. Most claims offices have staff seated in cubicles and tight spaces.  It’s very easy to know what is going on in the cube next to you and loose focus on what is truly important.

    As a manager I had a claims person come up to me and complain that “so and so” leaves the office early. I informed her that the person actually gets to the office earlier, stays focused on her work only, and was extremely productive. The one complaining, as is usually the case, was one of the least productive professionals in the office. Had she spent as much time worrying about getting her own work done instead of worrying about other then she might have excelled.  Trust me, your managers know who plays the games and who does the work.

    We all know this person so don’t become one.

  5. Don’t ignore people who need a response. It’s like playing a game of catch; if you don’t throw the ball back to the person who threw it, everyone just stands around waiting. Not a good business model. Not a good reputation builder. Not a good choice.

    6. TCS: One of the biggest customer complaints against claims departments is failing to timely respond to inquiries.  I have also heard this from attorney’s who complain that they can never get the claims professional to call them back.  I know I hate it when I am waiting on a response, which is one of the most common things I have to deal with as a consultant. For someone trying to grow a business it is tough enough, in claims it is almost always going to result in higher costs.

    Counsel looking to make decisions, customers who feel neglected, or a claimant who decides to hire an attorney because they can’t get a call back are all real examples where costs will increase because of a failure to respond.  The bottom line is make time to call people back within 24 hours of a call. It’s sometimes a hard goal to achieve, but will save you aggravation,  money and time in the long run.

There are plenty more business basics where these came from, but I liked this list.

Common sense is sometimes hard to achieve when the pressures of mounting claim files take over your working life. Like in sports, focusing on the fundamentals will always be a good path to success.

What are some other basics claims professionals should live by?