from objective third parties that confirms
what they need and why (e.g., SCHIP
111 rules for the claimant’s social security
number, WC statutes regarding benefits
and administrative requirements).
• Respond to phone calls or e-mails within one working day of my receipt.
• Keep the claimants informed of my
progress throughout the claim and of
any additional information they need
to provide based on changes in their
condition or treatment.
• Evaluate all settlement components and
make a verbal offer promptly upon receipt of the necessary documentation.
While many will look at this list and
think there is nothing new here, I fully
agree. However, a review of claims audits over the last several years reveals that
claims handling has become more of a
process-driven function with little communication and relationship-building.
This results in increased uncertainty by
the claimant, leading to more representation and eventually, more litigation.
How the “I wills” reduce
The following chart includes actions or
omissions that feed claimants’ fears and
how the “I wills” help reduce those fears.
This requires returning to a more communicative approach that helps develop
rapport with the claimants and reach resolutions that may be more satisfactory for
everyone. Since dealing honestly and ethically with all parties and treating them with
respect should be core values in all claims
operations, those particular “I wills” are
not specifically included in this table. The
actions or inactions described in this table
that increase the claimant’s fears have been
observed or inferred from claims audits.
Following the “I wills” may have an even
greater impact on improving the outcomes
of liability claims managed by or on behalf
of public entities. Most public entities have
a code or statutory requirement that automobile liability or various types of general liability claims must be filed within a
specified time from the loss on a particular
form and/or with specific information.
In some cases public entities or their
claims administrators delay taking any action even when there is significant injury
and exposure and they have knowledge of
the incident. They wait until the required
form has been received by the legal department or the department identified
in the code and the form and content are
confirmed by the legal department.
While they have met the letter of the
statute, they have delayed working on the
claim, increasing the claimant’s fears. This
delay may lead to attorney involvement
and increased costs.
The “I wills” are not new, but are becoming harder to incorporate into claims
management because of industry automation. While these activities are useful
tools in managing claims, they do not
take the place of the effective communication and relationship building that often create better outcomes.
Gary Jennings, CPCU, ARM, is the principal
consultant at Strategic Claims Direction
LLC. He may be reached at Gary.Jennings@
Claimants’ state of
Adjusters’ actions or inactions
that feed claimants’ fears The “I wills” Why the “I wills” reduce claimants’ fears
• I’m hurt. How will this
injury affect me?
• What happens now?
• What should I
do and when?
• Should I trust the
adjuster? Will I be
• What should or
should not be signed
and provided to
• What financial impact
will this have on me
and my family?
• I saw several attorney
ads that say it won’t
cost me anything
unless I win. Do I
need an attorney?
• I won’t call the claimant until
I talk with the client / insured
(even if it takes several days).
• I will send a form letter to
the claimant and wait for
the claimant to call me.
• I will wait for the police report
before I start investigating.
• I will diary the file for every
60 to 90 days and will then
follow up with the claimant.
• I will send the claimant an
e-mail when I follow up.
• I will wait to tell the claimant
what he needs to provide after
he has finished treatment.
• I will evaluate the claim for
settlement when I have time to
sit down with my supervisor.
• I will e-mail an offer to
the claimant & see how
she responds when
she e-mails back.
• Promptly contact all parties • I know the claim has
• I finally have someone
to talk to.
• I hope we can get this
• I have someone to tell
me what I need to do to
get paid for this claim.
• The adjuster sounds
honest and sincere.
• The adjuster sounds
like he knows what
he is talking about.
• The adjuster sends me
information that supports
what he is saying.
• The adjuster keeps in
touch and is quick to
respond when I call.
• This adjuster seems to be
focused on my needs and
is trying to resolve this
as quickly as possible.
• Initiate and complete the
• Notify the claimant as soon as
I have made a decision about
claim acceptance or denial
• Inform the claimant of the
information and proof needed
• Send independent
documentation so the claimant
can confirm what I am saying.
• Keep the claimant informed of
progress and any additional
• Respond to phone calls or
e-mails within one working day
• Promptly evaluate the claim,
obtain any required approval,
and call the claimant with
a verbal offer upon receipt
of the required information.
Be prepared then to
negotiate during that call.