West Publishing Company has just issued its eighthedition of Casualty, Fire and Marine InvestigationChecklists (CF&MIC). It is co-authored by PatMagarick (posthumously) and Ken Brownlee, our residenticonoclast.

This is a book that no one—not even the most conscientiousadjuster or insurance claims geek—would curl up with and read fromcover to cover. Nor is it meant to be digested that way. It will not give the latest hot seller, Fifty Shades ofGrey, a run for its money on the bestseller list. I doubt thatanyone will load this book on the Kindle and take it to the beachfor escapist summer reading. 

For starters, the book weighs in at almost 900 gut-bustingpages. Nevertheless, CF&MIC is a useful andauthoritative resource guide for claims professionals tasked withhandling a multitude of claims. The book's updated 29 chaptersprovide handy checklists on myriad property and casualty (P&C)claims investigations. For adjusters seeking blueprints to guideinvestigative efforts, this book is an invaluable resource. Itshould be part of the claim office library in any insurance companyor third-party administrator (TPA) branch.

Pat Magarick was once a dean and guru of claims handling. When Ibegan my claims career in the late 1970s in Norfolk, Va., theadjusting industry viewed him as a towering figure. After a careeras a claims executive at AIU, Magarick died in 1998. Nevertheless,his impact reverberates through textbooks he authored and whichstill enjoy multiple printings. Co-author Ken Brownlee, still verymuch alive, sustains Magarick's impressive legacy and builds uponit. Brownlee is or should be well known to those within the claimscommunity. A seasoned claims professional, he is a former corporaterisk manager for Crawford & Company and is a prolific author.Among other things, Brownlee has written a monthly column forClaims Magazine for many years.

New Claims Demands
Brownlee correctlynotes that the legal and investigative landscape for the 21stcentury claims adjuster has changed radically since the book'sfirst edition in 1955. In 2012, adjusters face challenges handlingfiles related to terrorism, cyber risks, computer hacking, globalwarming, nanotechnology, and environmental impairment liability.New types of coverages offered by insurance companies spawn newtypes of claims that merit customized, bespoke investigations withspecialized investigative templates.  

This is the first update since 2008, and the authors haveincorporated many refinements into the book to make it current andrelevant to today's claims adjusters charged with investigatinglosses. For example, Chapter 29 focuses on fraud investigation andis entirely new content. There is a new section on investigatingdog- and animal-bite claims. Updated material also includes a chunkon contractor liability under general liability policies, day carecenter claims, and even a section on claims against colleges anduniversities. The latter seems prescient, given the backdrop of thePenn State Jerry Sandusky litigation, which will keep lawyers—bothon the plaintiff and defense sides—busy for years. This is just asmattering of the updated content incorporated into the eighthedition of CF&MIC.  

Today's stretched-thin-but-enterprising adjusters mustinvestigate these claims. Some of these losses will be litigated.Discovery will train the spotlight on what adjusters did and didnot do. One could easily see CF&MIC becoming used as a“standard of care” referenced by those attempting to compare whatan adjuster did versus what an adjuster shouldhave done on a given claim file.

Checklists: Cookbooks and Caveats
Ofcourse, CF&MIC is only a guide; it is not a cookbook.Sensible claims handling involves knowing when to occasionallydeviate from the guide. Checklists may reflect a complete “soup tonuts” approach in getting all ducks in a row and leaving no stoneunturned.

The field claim adjuster's mission and challenge is to use thisbook and any checklist as a guide—but not necessarily follow it ina robotic fashion. Good judgment means that, in some cases, notevery item on the checklist needs to be ticked off. In other cases,there may be investigative steps warranted that are not necessarilyreflected in the checklist. One must always be careful inapproaching claims with a checklist mentality. Checklists provideuseful templates, but good judgment can and should enter in aswell, depending upon the exigencies of an individualclaim. 

If a checklist embodies best practice in claims investigation,then the adjuster must be careful in deviating from the template.In those situations, the adjuster should clearly document in theclaim file the reason for omitting or deviating from the checklist.Failure to provide such rationale in the claim file notes may comeback to haunt the adjuster and his or her employer. Here, it may beappropriate to abide by the maxim: “If it isn't documented in theclaim file, then it was not done (or considered).”

For a more thorough discussion on the rationale and utility ofchecklists in professional settings, I highly recommend anotherbook, The Checklist Manifesto: How to Get Things Right, byAtul Gawande. While his focus is in the medical realm, the book hasimplications for other professions as well, including but notlimited to insurance claims adjusters.

Some may balk at CF&MIC's price tag, but this wouldbe unfortunate. First, trade books often command a higher price.Secondly, the book would be a sound investment. IfCF&MIC helps avoid an overpayment on one claim oraverts a bad-faith claim because of investigative thoroughness, thebook would have repaid its investment cost many times over. As aresult, managers and companies should view having a reference likethis in the claims office as an investment, not an expense.

CF&MIC is a sound investment and resource to haveas part of every claim office's adjuster reference library.