While performing claims audits it has
become apparent that there are numerous areas claims administrators should
address to improve their service and the
outcomes. A general decline in the quality of supervision in many of the claims
reviewed means that adjusters’ shortcomings are not being appropriately handled.
The areas to address will not only provide adjusters and supervisors with additional expertise, but will also improve
their efficiency so they will spend less
time on administrative work and more
time on critical work. There are four key
areas that training, both formal and informal, can address.
1. Improving adjusters’ general performance. Much of today’s emphasis
by insurers, third-party administrators, and self-administered programs
focuses on “best practices,” the amalgamation of activities that insurers
and third-party administrators have
found can provide a measure of confidence for their clients that they are
on top of these claims. For example,
insurers/TPAs will emphasize timely three-point contact on Workers’
Compensation claims or timely two-point contact on Liability claims that
give clients the sense that claims are
being managed proactively. It can be
measured simply by capturing the
date these contacts were made, calculating the gap between the date
the insurer/TPA received or assigned
the claim to an adjuster, and showing
that they are making timely contact.
Sometimes this initial contact is done
strictly to comply with the contact requirements, and little of substance is
discovered or discussed.
Many adjusters can make high
scores on their internal claims audits
by meeting the requirements of the
best practices guidelines, while their
Practice Makes Perfect —
The Role of Employee Training
The looming talent shortfall as more and more tenured claims professionals retire is affecting all claims administration services, such as the high-level property appraisers who work
for independent adjusters (IAs), litigation specialists, and specialty
claims handlers like those who manage professional liability claims.
Some companies have been more aggressive than others in trying to
backfill these soon-to-be vacant positions, while others seem to have
buried their heads in the sand.