claims personnel require perhaps the most diverse skill set in the industry. Claims personnel require perhaps the most diverse skill set in the insurance industry. (iStock)

Whether because of a dispute over policy language, the circumstances surrounding a loss, or the potential for outright fraud, claims professionals have a delicate balancing act to perform. They need to pay legitimate claims in a timely manner, which should keep most customers satisfied. But they also have to hold the line if their investigations justify lower reimbursements than requested, or result in outright rejection — even if that means going to mediation or litigation, which could make the relationship adversarial and raise the reputational and financial stakes even higher.

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