Job competency relates to the skills, knowledge, and attitudesrequired to be successful in a specific position within a company.Employers evaluate competencies of prospective employees during theinterview process to ensure they would be suitable for the rolesthey are intended to fill. The ongoing evaluation of competenciesis also important and necessary throughout an employee's career.When job competencies are properly aligned, both the employer andthe employee benefit. This is especially true in the claimsprofession.

To be successful, claims representatives must be able to performjob functions with incredible competence. These functions fall into severaljob-related competencies, including claims administration,investigation, evaluation, negotiation, and litigation.

One challenge for our claims brethren specifically is to keep upwith all of the changes that occur in the insurance profession.There is the invariable daily bombardment of new laws, regulations,and guidelines that affect how they do their job.

Augmenting Aptitudes

Claims representatives must be competent because there arevarious stakeholders to satisfy. Moreover, the adjuster must answerto employer, state regulators, the insured, and the claimant. Theclaims adjuster has a good-faith obligation to conduct a fair andadequate investigation to determine the legitimacy of a loss andwhether coverage exists. Additionally, there is the ever-presentobligation to fairly evaluate and resolve claims after liabilityand coverage have been assessed.

In some cases, a claims representative must become involved inthe negotiation and litigation of a claim. If a claim cannot beresolved through negotiation, then litigation will ensue. When thishappens, it is necessary that the claims pro be aware of litigationmanagement techniques and how to employ them efficiently. It shouldbe noted that litigation management is an ongoing process intendedto control legal expenses while retaining high-quality counsel andlegal services.

Claims representatives can enhance their skills and knowledge in job-related competenciesthrough education. When pursuing further learning, claimsrepresentatives should consider the proficiencies their jobrequires and attempt to align their education accordingly. TheInstitutes can assist claims representatives and other insuranceprofessionals by providing new application-based learning methodsto offer knowledgeable solutions specific to job competencies. Thistype of learning is achieved by providing content that isimmediately usable on the job. The Institutes'application-based courses are designed to convey useful andappropriate knowledge, skills, and attitudes to professionals, whocan thereby apply the techniques learned to real-life scenarios. Insome cases, the application of the knowledge will also requireanalysis and evaluation. With large amounts of insurance-relatedinformation freely available on the Internet, The Institutes striveto differentiate themselves by designing content in a way thathelps learners translate knowledge and enhance on-the-jobperformance. 

Application-Based Models

There are two types of application-based activities that are anessential part of the learning experience and will help claimsrepresentatives enhance their ability to harness new-foundknowledge on the job. The first, “Apply Your Knowledge Activities,”are short, scenario-based activities that enable learners to applyknowledge from a single learning objective.

For example, Joe purchases a personal auto policy in which he isthe named insured. On the way to work in Joe's car, his wife Janeis involved in an accident in which she is liable for thousands indamages. Jane does not have a policy of her own. Based on thepolicy definitions, are Jane's damages eligible for coverage underJoe's policy? 

The correct answer is “yes.” Joe's wife is covered under thepersonal auto policy. On the declarations page, the words “you” and“your” include an unnamed spouse of the named insured—provided thatthe spouse is a resident of the same household. In fact, even whenan unnamed spouse of the named insured moves out of the household,but remains married to the insured, the spouse is considered “you”for another 90 days or until the policy expires—whichever comesfirst. Coverage ceases if the spouse is named on anotherpolicy.

The second group of activities, “Knowledge to ActionActivities,” are extensive case-based exercises that enablelearners to apply knowledge from multiple learning objectives. Aspart of the course work, learners will be required to review therelevant sections of the policy and answer questions pertaining tothe facts of the case.

A New Test-Drive

Previously, The Institutes' case studies illustrated theapplication of knowledge, skills, and attitudes. Now, however,rather than telling the claims professional what to do, they areencouraging the learners to do it. Instead of providing theanswers, the case studies provide a set of facts and resources,prompting the learners to resolve the issue.

The new Associatein Claims (AIC) Personal Auto Track is the first track TheInstitutes created following application-based learning methods.This track was designed to help auto liability adjusters learn howto efficiently and effectively navigate through the ever-changinglandscape of auto liability claims and the entire loss adjustmentprocess. This track is designed to improve employee effectiveness,enhance adeptness at handling coverage disputes, help mitigatecostly lawsuits, and reduce the time and costs associated withdealing with personal auto claims.

The AIC Personal Auto Track illustrates the basics of autoliability and physical damage claims handling, including discussionof the coverage provided in auto policies. Additionally, a portionof the course material will help learners in evaluating bodilyinjury claims.

According to The Institutes, completion of the AIC Personal AutoTrack will benefit the public, the insurer, and the claimsrepresentative. This education will help steer claimsrepresentatives toward more effective and efficient claim resolution. Better claim handlingnot only improves customer satisfaction and retention, but also theinsurer's bottom line. This track is the first of a long line ofclaims-specific job competency education to be provided by TheInstitutes. For more information, refer to the sidebar above.