When working as a casualty claims adjuster for a major insurancecompany, I carried blank drafts to settle claims. While there was alimit, I had the authority to settle the claim up to that dollaramount.

The company's desire was to not “lose control of the claim.” Thegoal was to try and settle the matter with the claimant in a fairand equitable manner, and avoid litigation. This is still thedesire of many insurers today; however, the public sometimes doesnot see it.

An insurance professional is familiar with the policy, but theclaimant often is not. Frequently, the adjuster needs to explainthe terms of the policy to the insureds and why the loss may not becovered. The claimants may not be too happy, but if they understandthe terms of the contract, they can better accept the decision asopposed to a flat denial.

That approach almost always poisons the atmosphere of anydiscussion. When the insured understands the situation, an adjusteris more likely to not only produce a settlement of the claim, butalso receive the claimant's appreciation of the company's concern.A continuing relationship may be created, and a claimant turnedinto a cheerleader for the company who says to others, “You know, XCompany really cared about my problem and they helped. I wouldreally recommend them. They don't just want your money.”

I am not suggesting that all claims be paid. In these cases, theinsureds must accept this fact, but if it is presented to them in amanner that they understand, and if the adjuster expresses asincere concern, it will make an impact.

This is something we all know but may forget under a heavycaseload of claims. Try to remember that the individuals involvedin each of those files are people who work hard and have had aloss, and they are relying on their insurance carriers to helprectify the problem.

Think about how you would feel in this position. What would yourconcerns be? Would you expect your insurance company to help you?If you can look at the claim this way and genuinely express yourconcern, you will go a long way toward settling the claim in a fairmanner. You will also leave a good impression of your company andhopefully create a continuing business relationship.