Claim Files Are Evaluated Using A Form Of Root Cause Analysis So Why Not Do The Same When Evaluating The Department?

Posted on March 5, 2013 by Marc Lanzkowsky

Assessing operational ills requires the same skill needed to evaluate a claim file

We have heard the mantra time and time again about how treating the symptom of a problem doesn’t do anything to cure the cause of the problem. As one of my favorite bloggers Seth Godin recently wrote in Signals vs. causes, “A fever might be the symptom of a disease, but artificially lowering the fever (ice bath, anyone?) isn’t going to do anything at all to change the illness.”

Assessing a claim file is like doing a Root Cause Analysis. Looking at the damages and paying the claim may move a file but it doesn’t tell you whether the claim should be paid in the first place. Analyzing a claim file is learning to know the what, why and how an event happened which is essentially what Root Cause Analysis is.

Root causes are specific problem or faults that create a breakdown in an operation or process. Claim files are a result of some event that causes a claim to arise (i.e. an accident, malpractice, property damage). It is the claims professionals primary job to assess these events and determine what happened and why prior to paying a claim. In general, root causes can be defined as an event that is:

Underlying to the problem
Reasonably identifiable
Within managements control to correct
When corrected will be effective in preventing recurrences

Despite Root Cause Analysis being a core skill in handling a claim file, claims management doesn’t always approach departmental issues with same type of evaluative assessment. Using the same techniques in assessing the root cause of a claim, management can assess operational problems.

Since the techniques are already in use for claims analysis why not use them for operational assessments?

Doing a Basic Root Cause Analysis: The 5 Whys

Similar to a claim file analysis, operational problems require an assessment as to what happened, how it happened, how could it have been prevented, who was at fault, what’s it going to cost to fix the claim and are there any lessons learned. For example, let’s say payments are being delayed resulting in fines being assessed against the department. If one looks at the fines as a claim one would want to determine what caused the fine? how did it happen? and how can it be corrected? An analysis of the “claim” needs to take place prior to making any decisions.

A great technique for getting to the root cause of a problem is to ask the question “Why” question five times. “By repeatedly asking the question “Why” (five is a good rule of thumb), you can peel away the layers of symptoms which can lead to the root cause of a problem. Very often the ostensible reason for a problem will lead you to another question. Although this technique is called “5 Whys,” you may find that you will need to ask the question fewer or more times than five before you find the issue related to a problem.” (Determine the Root Cause: 5 Whys – from www.isixsigma.com)

Going back to our example of a payment delays causing fines, and using the 5 “whys” technique, one could assess the problem this way:

Why are we being fined?
Because payments are being delayed by 5 days
Why are payments being delayed 5 days?
Because they were delayed in getting to finance
Why were they delayed in getting to finance?
Because they were not in the outgoing tray for approved payments
Why were the not in the outgoing tray?
Because they were sitting on a manager’s desk for signature and the manager was on vacation
Why was there no plan to have another manager cover the vacationing manager’s desk?
Because there was not procedure in place

The example above is simplified but it truly demonstrates that similar types of issues can be explored with a series of basic questions. Getting to the root cause is essential to moving a problem to a solution.

What are other techniques used for assessing a claim file can be used to assess the operation?

3 Things Good Claims Professionals Won’t Do

Posted on January 24, 2013 by Marc Lanzkowsky

Follow what good claims professionals don’t do and you will lead the pack!

Recently I read an article about things doctors won’t do when it comes to treatment and procedures for themselves. It included things like not having their first child at home, getting a PSA screening test, or taking sleeping pills. Since it is highly unlikely they will sue themselves for malpractice, these are treatments they believe might be adding little value or could cause harm. While managing a claim file is certainly not like managing your health, it got me thinking (which is never a good thing) about what a good claims professional won’t do.

I have audited a lot of claim files over the years and consistently good claims professionals manage their claim files following best practices. And when looking at these well managed files there are certain patterns that develop. I found that there are three things that good claims professionals won’t do and they are:

Fail to document: The best claim files are concisely and appropriately documented regularly. When reading a file the claim should speak for itself and tell a story as to what the issues are, potential pitfalls, and an understanding of the plan to resolve the claims. Good documentation is concise, free from extraneous commentary and reflects an understanding of the issues. Recording the events surrounding the claim is part of a well managed file and a good claims professional would never fail to document their file.

Assume this file is the same as the last one: Claim file management requires an understanding of the liability to the company and exposure to the insured, value of the loss and a plan to resolve the matter. Good claims professionals won’t skip any of the key steps needed to evaluate their files. If there is one thing that is consistent across all claim files it is that every file is different with different facts and nuances. One cannot assume that because one case had a certain outcome or facts a similar case will follow the same pattern. No matter what the issues are the best claims professionals never assume things they don’t know and never assume the file was like the last one.

Stick with the basics: There are no short cuts to getting to the bottom line. Claims professionals are always growing and learning and tyring to improve their craft. Sticking with basics won’t help when a new claim throws in a curve ball. One has to work outside the box looking for new ways to understand a claim or resolve a difficult matter. Trying to go beyond the basics is one reason handling claims can be so interesting. Previously we posted about thinking outside the box about innovative ways claims can be managed. This post generated over 40 comments in the Linked-In Claims Management Group. The reason for all the comments is that good claims professionals don’t just stick with what they know and wanted others to learn from what they had done (and maybe one up one another with a better war story).

Good claims practice is about common sense. Like any business it is important to grow and learn and adopt to changing environments. Good claims professionals are always looking for new ways to make sure that they are providing prompt service to assist their clients to secure fair compensation where appropriate. Seek out the good ones and learn from them!

What are other things that good claims professionals don’t do?

How Would Albert Einstein Approach Claims

Posted on January 3, 2013 by Marc Lanzkowsky

Albert Einstein must have been a claims manager!

As we begin the New Year it is always a time to reflect and look forward to new beginnings. Recently an executive in my company sent along some words of wisdom from Albert Einstein. Einstein was an interesting character known not only for his scientific brilliance but also for his quick wit. He produced some wonderful quotes which I believe were directed to the claims industry.

OK maybe they weren’t written with the world of claims in mind, they are nonetheless applicable.

“Setting an example is not the main means of influencing others, it is the only means.”

Claims departments should be leading companies in how they run their business. Claims departments are the fruits of the product being sold and when an insured buys a policy it is claims that serves up the services paid for. One of the best ways to retain and grow new customers is by “setting an example” in claims. Ensuring customer service metrics are met and exceeded and developing new ways to assist the customer is not the “main means of influencing others, it’s the only means.”

“Any intelligent fool can make things bigger and more complex…it takes a touch of genius—and a lot of courage to move in the opposite direction.”

There is a trend for more systems, more technology and better information in claims departments. I am a big supporter and believe it’s about time the industry wakes up to the power more claims data can have in making departments more efficient and providing robust information to improve the business. Regardless, providing more complexity and bigger technology solutions is not the only answer. Be a “genius” and go smaller and less complex in building and implementing claims software. We have the technology it just needs to be used correctly.

“Not everything that can be counted counts and not everything that counts can be counted.”

This is one of the biggest claims dilemmas. We are being overwhelmed with data and that can be a good thing. Regardless, the fact that it can be measured doesn’t mean it is actually adding value to the process. Take a look at your metrics and really explore if what is being counted “counts.” On the other side, there are things in claims that unfortunately can’t be counted perfectly. Given how climate, legal issues and other external factors change rapidly, comparing claim metrics from period to period is sometimes a difficult exercise. Regardless, striving to “count” what “counts” is what the industry needs to continue to do.

“If you can’t explain it to a six-year old, you didn’t understand it yourself.”

Wouldn’t it be great if we could all work like this? Let’s be realistic, if you can’t explain your claim to management, opposing counsel, the claimant, in an easy simplified way then you probably don’t understand it yourself and will never get to the desired outcome. Like his quote on being a genius by making things smaller and less complex I say get to the point. It is still important to get all the facts and make sure all the “i’s” are dotted and the “t’s” are crossed, but do it in a way that will allow you to truly understand the claim and be able to explain it.

“Nothing happens until someone does something.” So go make it happen!

Everybody Wants to Make Improvements In Claims But No One Actually Makes It Happen

Posted on June 15, 2012 by Marc Lanzkowsky

It’s Like Selling World Peace. Everyone Is For It But No One Wants To Pay For It

There is so much that needs to be done in the world of claims. Operations need fixing, technology needs improving and a futures need to be defined. For some reason however, we are all really good at talking about it and not so good about doing anything about it. The industry needs to take action.

We need leaders who will drive the initiatives needed to improve and modernize the claims industry. We are mired in an “it’s always been done that way” mentality and not doing anything about it. I know the day-to-day is an ever growing series of issues. It is because we are forever being asked to do more with less that action is needed. Strategic planning is a necessary evil and a plan must be put into place to improve the whole or we will be destined to “always do it that way.”

Claims departments need to think creatively and “out-of-the-box” if we are going to attract new talent to the industry. This also means acting and not just talking about acting.

Take Action With These 3 Ideas

So how do you act? check out these three suggestions for getting out from the wanting to improve to actually taking action:

Bring in a consultant for a fresh set of eyes… there is more there than you realize and having someone removed from the day-to-day operation will be like cleaning dirty windows. The clarity will allow you to see both good and bad and will give you the first steps to make improvement.
Buy one small application to help fix some aspect of the department. There are plenty of innovative technologies out there to help with everything from adjuster compliance (Xeneros) to claims auditing (the Audit Portal). Try one, they won’t cost too much but they will save you so much in time and expense.
Talk to your claims professionals. Spend a day with a few of the people on the floor and listen to them. Unfortunately many continue to do tasks they know to add little value because they too fall into the “it’s always been that way” frame of mind. I promise you they know more and if given the chance will provide some fairly decent suggestions to improve the operation. And guess what – this one won’t cost you anything.

How are you going to take action today?

What Would Steve Jobs Do In A Claims Organization?

Posted on March 15, 2012 by Marc Lanzkowsky

Innovation can be learned from the master

Thank you Bill Schoeffler and Catherine Oak of the Oak & Associates Consulting firm for the idea for this article. They wrote a wonderful piece for Insurance Journal called, What Steve Jobs Would Do In Insurance, where they so aptly lay out how Mr. Jobs would change the insurance world. They pick out several ways a Steve Jobs run insurance agency would be different and innovative.

Like many, I am a huge fan of Apple products and have been for a long time. Clearly there has been a revolution in the computer industry as a result of innovation led by Steve Jobs. One thing that is most interesting about Apple is how they not only changed computing, with the iPod and iPad, but also changed the way people listen to music, access the internet and buy and use software applications. The iPod and iPad were perfect examples of thinking outside the box. (And I like thinking outside the box – Improve bottom-line outcomes on claims by thinking outside-the-box!)

As they wrote:

Steve Jobs’ primary focus was to create great products. All else was secondary. The product of an insurance agency is the service it provides to clients. The direction Steve Jobs would take would be to provide a seamless, integrated experience for the client. People have too many things to worry about and not enough time to be able to focus on their insurance needs and problem. They want to be taken care of.

Schoeffler and Oak suggest that a Steve Jobs run agency would:

Seamlessly integrate the customer experience
Capture data about client needs easily to analyze and allow products to be tailored to individual customer
Innovative at it’s core providing products clients didn’t even know they needed
Create teams would work collaboratively at all levels
Hire only the best talent passionate about providing services

Steve Jobs in Claims

So what would Steve Jobs say about our claims industry? Well, having heard about his reputation I think I will leave what he would say out of this post. Regardless, I think Mr. Jobs would see an industry with tremendous opportunities to innovate and improve the way they deliver and manage claims services.

Following the lead of Shoerffler and Oak, I would agree that Jobs would likely create a seamless way to integrate external claims information with internal business related data. Underwriting and policy information would easily flow into claims systems and be available to the customer and claims professional easily. Claims filed through a variety of input sources would simply display information needed for all those touching the claims. The claims department, management teams, outside providers, underwriters, and of course the claimants, would have easy to understand graphical representations of relevant information. Apps would help direct those particular parties to help move the claim to resolution and seamlessly provide analytics to the company in real time. And of course there would be beautifully designed hardware to deliver this integration in the sharpest possible way.

Claims teams would work collaboratively with other parts of the organization to deliver better claims products to customers and real time relevant data to assist in underwriting. Good companies understand the relationship claims has to the health of the organization way before a claim even comes into the office. Steve Jobs would ensure underwriters would understand the claims process and how policies sold end up yielding claims. He would make sure that claims people understand how the claims organization’s activities affect the financial health of the company on pricing and expense ratios.

Steve Jobs was a brilliant marketer. He seemed to know how and when a product was going to change the world reshaping whole industries (when was the last time you actually psychically bought a CD?). Claims departments could benefit from a little marketing as well. Whether to internal or external customers, claims departments can certainly do a better job of getting their “brand” out to their market place.

The reality is that a Steve Jobs led Apple and its success can be obtained in claims departments. It takes a little more focus and the ability to step outside “what’s always been done” to innovate the future.

Tell us how else do you think Steve Jobs could have changed the claims world?

“Summer’s Here And I’m For That” With 2 Ideas To Improve Your Claims Operations

Posted on July 11, 2011 by Marc Lanzkowsky

Don’t Let The Hazy Lazy Days Of Summer Prevent You From Making Some Real Improvements

Let’s face it, no one wants to work in the summer. It is OK you can admit it. Vacations are being taken and it’s just not that easy to get work done. People are away and it’s harder to schedule meetings and get calls returned. Offices receive less claims and courts close down often resulting in a small chance to catch up with the work piling up.

Because of this, summer can also be a great time to look inward and focus on refining your organization. Last year I wrote about 3 Suggestions To Beat The Summer Slow Down In Claims. In that article I suggested ways for Claim Handlers, Managers and Claims Executives to productively use summer slow downs to improve operations. Those suggestions still hold true and can be a valuable way to improve your group.

This year, 2 ideas come to mind as a way to put your organization in the right position to improve quality and productivity long past the summer.

Improve Your Claim Review Process

Are you conducting internal or external claims audits? If not, then you really need to consider them. As W. Edwards Deming, famed management consultant said, “you can only expect what you inspect”. If you are not inspecting then you really have no way of predicting quality or productivity and your results will most certainly vary or deteriorate. In order to plan, to stay ahead of the curve, and to be competitive, you must conduct regular claim file reviews to check for quality and ensure expectations are being met.

Doing reviews are a good thing as long as they go beyond the need to dot an “I” or cross a “T”. Audits are a great way to see what is is going on and make improvements. Successful reviews are looked at as a positive, not negative, event and are always done in an organized consistent manner.

If you are doing reviews then how would you answer these questions:

Do you have a process in place for conducting reviews?
Are you getting any value from these reviews or are they just another requirement that needs to be done?
Are you producing consistent reports from review to review or are all reviews different?
Are you able to look at data in different ways, or are you just receiving what is provided in an anecdotal narrative report?
How long does it take you to produce a report?
Can you provide immediate feedback, or does it take time to produce results?

Reviews can have such value when done in an organized consistent fashion. Take a look at your review process and ask yourself the questions above. It may be time to put an audit process in place and build more structure around your claim reviews.

Improve your process by establishing best practices which includes information on file selection, review criteria and an easily defined rating system. Get the most out of your reviews by collecting data not just commentary. It’s 2011 and it’s time to get away from the handwritten forms for conducting a review. Data is key and using a system like The Audit Portal™ will create a structure around the review and provide information not previously available.

Conduct A Workflow Audit

I have often referred to Seth Godin who writes a wonderful blog on leadership, marketing, change and productivity. In a recent post, Seth described conducting a Workflow Audit. In it he wrote:

Go find a geek. Someone who understands gmail, Outlook, Excel and other basic tools.

Pay her to sit next to you for an hour and watch you work.

Then say, “tell me five ways I can save an hour a day.”

Whatever you need to pay for this service, it will pay for itself in a week.

I think this is one of the best ideas I have heard in a long time that would go a long way to saving time and money. I cannot tell you how many times I would sit in a room with a colleague watching them struggle with the most basic Excel or Word skills. There is so much power in the basic tools and people are only using a small percentage of features making their jobs more difficult. Have you ever had to reformat the work of another person because they didn’t know how to indent a paragraph and used the space bar instead? Enough said.

This type of workflow audit does not have to be limited to the “office” suite of tools either. Let your best claims processor go around and sit and watch how other claims handlers use the system. I bet you will find that there are hours being wasted because of inefficient use of your systems.

What Are Your Summer Improvement Plans?

Claims And A Half Plate Of Vegetables – Teachings From The New Dietary Guidelines

Posted on February 3, 2011 by Marc Lanzkowsky

Creating A Visual Reference To A Complex Issue Can Simplify It

The government just announced new dietary guidelines for the American public (see New Dietary Advice From Government: Just Eat Less). One of the best pieces of advice that made the most sense was to fill half your plate with fruits and vegetables. This is so simple to understand and makes a lot more sense then telling people to eat an extra serving of healthy food. What is a serving anyway?

Margo Wootan, the director of nutrition policy at the Center for Science in the Public Interest, said previous guidelines — which are revised every five years — offered “big vague messages” about reducing cholesterol, salt and sugar. The guidelines released Monday, she said, were “much more understandable and actionable.”

OK I know you are asking why this should in any way relate to claims? Well I will tell you. Simplicity and looking at the obvious in an easy to understand way is a tool that would go a long way to helping the claims professionals be better at what they do. Being understandable and actionable can only be a good thing in claims.

What the government did by saying to have half your plate covered in fruits and vegetables was to provide an easy to understand visual cue as to what they were talking about. In claims, there are often complex issues that could benefit from shifting the perspective to something completely different. Using a new visual representation to demonstrate an issue may make it easier to understand.

Simplify The Complex Issue With A Visual Representation

Whether having to explain to a novel claim issue to a company executive, or trying to convince a claimant to accept a fair settlement, getting them to understand the issue will lead to more action. Changing the way these issues are presented can be the difference.

For example, I once had a complex medical malpractice case that involved a brain damaged infant and the management of the mother’s blood pressure prior to delivery. There were dozens of notes and lab records and blood pressure readings to sort out. To help understand the process better, I put all the critical readings into a spreadsheet and then represented them on a graph. Being able to look at the numbers visually, instead of just as numbers, made it easier to see just how much the blood pressures were rising over time. It was a complex issue that became very easy to understand and explain to others.

When looking at claims issues involving numbers – break out the spreadsheet and make a graph or chart. I am not saying it will always carry the day, but taking a look at it differently will almost always make it easier to understand. It may also open your eyes to an issue lost between the numbers.

Operations Can Benefit From Visual Cues

Operational issues are almost always easier to grasp when seen visually. Getting from here to there can seem like a daunting task when seen as written steps on paper. Take the steps and throw them into a flow chart. You don’t need special software or experience to show steps flowing through a process.

When putting steps into a visual box you almost always have to shorten the text and get to the point of the process. Also, operational processes almost never move in a linear fashion across an organization. There are always intersecting parts and steps that can get lost when written down as just steps. Drawing it out will open your eyes to steps in the process that may not be adding value. Once a new process is developed you will also be able to easily see what improvement will look like.

I was able to do this with a client as it related to their first notice of loss process. Before we drew the process out as a flow chart it appeared that there were some areas for improvement, however, all in all it did not seem that bad. Drawing it out created a flow chart that covered 4 pages. In looking at the flow, we were able to see redundancy and wasted efforts in the process. The new process was now able to be reflected in a one page diagram. More importantly, we eliminated wasted steps and reduced the time to set up a claim file by an average of 7 days.

Simply put, looking at things a different way is always a good thing. Trying to explain complex issues visually will always be worth the effort. This is often done in multi-layer and participant policy situations. Looking at coverages in a grid gives a much better picture of the who is covering what, at what layer and for what amount. Trying to figure that out by reading it on a sheet of paper is never as clear.

How have you used visual representations to understand a complex claims issue?

Time to Get Creative – Reducing Claim Costs without Sacrificing Quality (or your sanity)

Posted on November 22, 2010 by Suzanne Ganier

Bright ideas will help reduce legal costs while still getting great service

Even as the country continues its difficult economic recovery, Moody’s recently concluded that P&C personal lines insurers remain financially sound. While such a report is good news, Moody’s also noted that challenges such as rising claim severity trends and significant property catastrophe risk remain. All this leads to an increased pressure to reduce costs and close claims.

The reality that claim and litigation departments are cost centers as opposed to income generators increases these pressures. Claim and litigation departments are also asked to do more with less resources and are under increasing pressure to close claims and litigated files faster than ever, while still maintaining claim handling and litigation management best practices. With all these challenges, how do claims professionals succeed? They get creative.

What You Know and More Importantly, What You Don’t Know

Before you can make changes and employ new processes, you have to know what you know and what you don’t know. Obtain as much information as you can regarding the following:

Number of current litigated and non-litigated claims, broken down by type and severity
Average length of pending litigated and non-litigated claims
Average cost per closed litigated and non-litigated claim file
Average number of days necessary to close litigated and non-litigated claims
Average amount paid (indemnity) per closed litigated and non-litigated claim

These are just the basics. If you have more information available, get it.If you don’t have this information, you have gained some valuable knowledge as well, namely, that you will need to develop or implement ways of tracking such information as part of your plan.

Who Is Doing the Work?

Next, you have to evaluate the strengths and weaknesses of your claim handlers, claim managers, outside counsel, and any other vendors you employ to handle claims and litigation. If you haven’t formally evaluated these folks in a while, now would be a good time to do so.

Find out what they do, how they do it, and ask them for feedback regarding how they think that they can do their jobs better. One of the biggest problems I’ve seen are companies that get in the way of their employees being successful often through employing processes and procedures that look good on paper, but don’t make sense in practice. The only way to know if this is occurring in your organization is to spend some quality time with the people who are doing the work.

And don’t leave out the lawyers! Although some may believe that panel counsel are only interested in billing you as much as they can, the good ones are also in an excellent position to know if your litigation procedures are costing the carrier money. They can also provide procedural and process changes that may result in moving litigation to conclusion more quickly.

Know Thy Carrier

While all carriers want to decrease costs, decrease claims, and decrease litigation, there are different philosophies as to how to accomplish these goals. Some carriers may want to avoid litigation at all costs because they don’t want to pay legal fees and thus, they may be willing to pay more on questionable claims in order to avoid litigation. Some carriers may want to take a hard-line approach with all claims and litigation (i.e. if they can’t prove it, we’re not paying it). Some carriers take a more practical, business approach and want to do a cost-benefit analysis regarding the payment of claims and litigation.

You must know your carrier’s philosophy before you can make changes that count. Moreover, the philosophy you choose is the one that is going to be the face of your claim and litigation department for the world to see, so make sure it’s the face you want to display consistently. Companies that do not have, or do not know, what their claim and litigation philosophy is will not be successful at consistently reducing costs and closing claims and litigation.

In order to develop your philosophy, you will need to work with the balance of senior management and other relevant stakeholders to discuss the options and arrive at a conclusion that everyone is comfortable with promoting throughout the organization. Depending upon the size of your carrier, the number of people involved, and the difficulty you have obtaining information, going through steps one through three may take approximately two to six months. However, once you complete these steps, you will be armed with everything you need to sit down and draft your new claim and litigation management plan.

Check back in December for part two of my blog that will discuss initial steps in your new claim and litigation management plan and provide an example of a plan that was successful for me.

Claims And The Investigative Journalist And Learning From All The President’s Men

Posted on November 9, 2010 by Marc Lanzkowsky

Digging for the accurate story is a claims person’s goal

The other day I was watching All The President’s Men, the story of Bob Woodward and Carl Bernstein, The Washington Post reporters who broke the Watergate scandal wide open. If you have not seen the film then please accept this as my “two thumbs up.”

What does this have to do with claims you may ask? Keep reading and you will see.

Woodward and Bernstein were investigative journalists. Their job was to uncover facts that would lead to other facts that would lead to a supported conclusion. There was a lot at stake for the Washington Post if the story was wrong, and even more at stake for the country if the story was right. The process was well laid out in the movie with the two journalists following one lead to another and researching and following up to support their eventual conclusion. Given what was at stake, the Publisher made it clear to the two reporters that there was no story if it was only supported by innuendos and accusations and no proof. Once the support was there, the story ran and the rest is history.

Sounds a lot like a claim file to me.

It is the claims professionals responsibility to figure out what happened and then come to a supported conclusion when evaluating and settling a claim. As there was for the Washington Post, there is a lot at stake for an insured, a claimant and a company if decisions are made in haste. Getting the conclusion right or wrong can have significant financial consequences for all parties involved. Prior to spending money on claims, good claims practices dictate that there is support for the decisions to settle and pay claims. Being a claim professional is a lot like being an investigative journalist. Figuring out what happened and why is critical to making the appropriate assessment.

Technology has really helped those investigations

Unlike Woodward and Bernstein back in the early 1970’s, claims professionals have a tremendous amount of technology available to them to help figure out claims problems. There are two great scenes in the movie that truly reflect how times have changed when it comes to conducting even basic investigations. Back in the day, even simple tasks, that we all take for granted today, would have taken hours and multiple resources to complete.

In the movies, the reporters found a name on a check and had no idea who the person was or how to contact them. Imagine that issue today – no big deal – go online, plug in the name to Google, and presto a list of information including addresses, phone numbers, job descriptions and maybe even photographs appears in seconds. Not back in 1973 where Bob Woodward (played by Robert Redford) is seen sitting in a room with phone books from all over the country looking for a name. Another staff person comes into the room and was able to find a photograph in what was called the “clip file.” I can only imagine how long that took and how many resources were needed to find the photograph alone.

In another iconic scene from the film, the two reporters needed to find out what books had been taken out by a White House staff member from the Library of Congress. The two were handed boxes and boxes of slips of paper used to document the check out of books from the library. In a great piece of film making, there is an overhead camera angle of the two reporters going through every slip of paper in what would have taken hours if not days. Of course, they never found what they were looking for. Today the same task would have taken seconds.

Think about the tasks you do as a claims professional and try and imagine not being able to use even basic technology to find a name or locate a witness.

Just remember, technology isn’t everything in claims

I have always been a big proponent of good systems to enhance a claims professional’s ability to get their job done. Regardless, claims technology should allow the claim handler to be a claim handler and free them to be more analytical and less ministerial. Unfortunately, technology has often brought more work with little relief. As more claims can be processed faster, there has been a greater emphasis on dotting I’s and crossing T’s and less on outcomes. While it is important to accept tremendous efficiencies technology has brought to the claims process, do not forget that the true art and skill of claims is in the ability of a claims professional to analyze the information and make an appropriate decision.

Tell us your investigative journalist claims story

Promote Creative Thinking To Get The Most Out Of Your Claims Staff

Posted on August 16, 2010 by Marc Lanzkowsky

So how do you train the next leaders in claims? How about challenging their creativity!

If you do not know about TED, I strongly recommend you take a look. To quote them directly:

TED is a small nonprofit devoted to Ideas Worth Spreading. It started out (in 1984) as a conference bringing together people from three worlds: Technology, Entertainment, Design. Since then its scope has become ever broader.

I recently watched the clip below from the TED archives and was so fascinated by the concepts I just had to relate them to claims. 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 found and rewarded?

I am a big proponent of new ways of looking at claims and trying to get people to think out of the box (see Change Hats With Someone And Free Your Mind To Make Your Claims Operation Better and Is your claims department becoming a bus company?). With increases in technology, more claims specialization and the constant pressures on staffing, the ability to freely think, analyze and resolve claims creatively is being challenged.

Sir Ken Robinson is considered a “Creativity Expert” and led the British government’s 1998 advisory committee on creative and cultural education, a massive inquiry into the significance of creativity in the educational system and the economy, and was knighted in 2003 for his achievements. He has most recently published a book, The Element: How Finding Your Passion Changes Everything, which is a deep look at human creativity and education.

Good workers but not creative thinkers

Take a look at the video below with Sir Ken. He is truly and a dynamic speaker and the will engage you quickly. In this clip, Sir Ken 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?

Two suggestions to help promote creativity

So how do you promote creativity? How do you get the claims staff to try new ideas? It is difficult to encourage creativity when claims have to be regimented and everything is being monitored and standardized. Regardless, there are ways to attack the creative mind to open up new ways to manage claims.

Challenge staff to be more creative when looking at problems. When facing a difficult situation try and put together an old fashioned brain-storming session to allow free flowing ideas no matter how crazy. The idea here is to promote creativity and come up with new ways to solve problems.
Another way to try and teach creativity is to tell war stories. Have a war story lunch and see who has resolved a claim in the most creative way. I am sure you will be surprised at how creative people are and retelling those stories will help stir the imaginations of others.