The general offensive from land, sea and air allows no surcease, only more torment. No wonder why many claims veterans have the shell-shocked aura of battle fatigue. It's a tough job in a tough industry!
The human reaction to this type of environment may take numerous forms. For example there's the "fight" reflex ("well go ahead and get a lawyer if you don't like they way I'm handling your claim"), the "I'm trying to please all stakeholders" approach ("I'm looking out for you"), the aggressive stance ("so you want to piss me off; now see how quick your benefit checks arrive"), the "conciliator" advocate ("I'm so sorry for anything I have done or will do, as I try to accomplish my job"), the "technical expert" defense ("section 12.296 of the Labor Code stipulates that??"),etc.
One thing should be clear; the human dynamics involved in claims adjusting reflect the most challenging part of the job. But it is far from the only issue. Between high caseloads, erratic claims computer systems, statutory time requirements on certain activities and form filing, demanding supervisors, external and internal auditors, staff decreases through lay-offs and attrition, and the ubiquitous internal office politics, being a claims adjuster certainly requires some rather singular attributes. But how do companies prepare "normal human beings" for a claims desk? What is the over-arching focus in the realm of training? What behavioral tools are given to the claims adjuster by the average company to assist them in becoming a successful claims professional? Well, buckle up because the ride just gets wilder!
A claims position requires some knowledge of the law that forms the environment in which the claims will be adjusted. That's true in all lines of business (workers' comp, general liability, inland marine, etc.) So naturally, the first type of training that is often offered to claims employees involves technical instruction of some type. This approach is readily understandable, and necessary. However, technical training alone does not a competent adjuster make. Far from it.
Adjusters need to know the law, how to investigate a claim, how to take a recorded statement, how to diagram an accident site, the methodology of formulating a full formal report, how to determine exposure and establish timely and accurate reserves, how to negotiate settlements, the navigation of the claims computer system, the best way to complete action items on multiple claims in a timely fashion, etc. But more importantly, an adjuster has to know how to interact with people of all backgrounds and educational levels in a successful way that allows them to proficiently accomplish their job. In other words, "people skill" is an incredibly important part of the job that will not be addressed by technical training. To overlook the human aspect of interaction in a claims job (indeed in any job), is to be a poster child for the word myopic. Yet, most insurance companies, TPAs, self-insured employers, etc. have "technical" heavy educational curriculums. So where does this leave the all-important human interaction aspect of the job?
The Closest Approach
When one thinks about a claims adjusting job, besides breaking into a cold sweat and hyperventilating, you may ruminate about a generic position that employs many of the same skills needed for an adjuster's position. To me there is one position with which everyone is familiar that requires many of the same skills as an adjusting job: sales.
Sales??? That's right, sales! First off, "sales" is people centric, just like claims. If you cannot get along with people, you will be a poor salesperson. Second, some experts will say there are four main elements to person-centric sales training; listening, spontaneity, attitude and communication impact (sounds like what a claims adjuster should know). Third, successful sales training concentrates on training salespeople as simply people (there's that people centric issue again). If they are later supervised as people, they should become skilled in establishing personal relations with their customers (in the adjuster's world the clients are the injured party, treating doctors, attorneys, employers, etc.).
What is an adjuster selling to the various stakeholders? Examples include: the outcome of a completed investigation, reserve establishment amount, the theory of mechanical injury resulting in a particular manifestation of disability, settlement strategy, the ability of the injured person to complete some type of transitional duty, value of the case, and best disposition tactics and strategy.
All of the preceding items are technical in nature, but they intimately involve communication with other human beings. Although this communication must at all times be professional, it can also be such things as sympathetic, empathetic, understanding, reflective and helpful. These represent key challenges on the people side of the ledger to becoming a successful claims professional. If you can properly communicate with people, you will do well, close files quicker and for less money, and be seen as a stellar performer. However, all the technical knowledge in the world will not be of value to you if you do not know how to get along with the plethora of human beings who will be encountered in every claim.
Based on my personal experience, interpersonal people skills is not a standard claims curriculum item on the internal training agenda of many companies. Unfortunately, when budgets are squeezed, the training department is usually the first place that suffers a "direct hit" in the form of downsizing, if not outright vaporization. So then the training may go from a technical heavy program to no program at all. As our 41st President George H.W. Bush used to say, "Not prudent."
Interpersonal skill is an accurate barometer of how well a person will perform in a claims job. Those who lack the ability to authentically communicate (in the real sense of the word) with all manner of people, are not likely to have a sterling career in a claims organization (or in many other jobs for that matter).
Shape the Future or be Shaped By It
It seems obvious that the development of excellent interpersonal skills in each adjuster should be an objective of every organization. Certainly, lip service is constantly paid to this concept. However, the application of resources to effect this type of training is normally sadly lacking.
This dilemma is of the same ilk as the propensity of claims organizations to promote their best adjusters to supervisory positions without giving them any people leadership training. As a result, many new supervisors continue to exhibit the same type of behavioral attributes that got them promoted (do everything themselves), resulting in a less than optimal supervisor, in addition to the fact that the company has now lost a key adjuster due to the promotion. A lose/lose situation.
Perhaps it is simply endemic to the claims and insurance industry to overlook the interpersonal skills aspect of the claims business. There are myriad priorities in any organization, and training people on interpersonal skills is hardly in the top 10. However, ignoring the obvious may be institutional, but it certainly isn't intelligent.
With climbing combined ratios and focus on cutting expenses, I doubt there will be a rush of resources into the training area to address the subject of this article. Be that as it may, those organizations that are cognizant of the skill needs of their claims adjusters in this area will be wise to do something formal to address the deficiencies on an ongoing basis. Otherwise, the technical training regimen will remain incomplete in terms of achieving the end result being sought.
May 4, 2012
Copyright 2012© LRP Publications