The role of claim adjuster has often taken a back seat in perceived importance inside the insurance industry. Yet, claim-adjusting also catches more than its share of flack when it comes to scrutinizing results. Underwriting and policy language decisions made in order stay competitive and "win the business" can result in having to make payments beyond what was surmised when constructing, writing or selling the policy. As a result, perceived or actual underperformance in the claim department can result in pointing fingers back to underwriting and sales.
Still, there is room for improvement on the claims side of the house. Let's move beyond blaming underwriting and sales and acknowledge that there is good claim handling and not-so-good claim handling. Beyond process, technology, training, and oversight, an often overlooked factor that will determine whether claims are well handled has to do with whom is hired and placed in the role of claim adjuster.
Let's explore some critical attributes of successful claim adjusters, and what can be done to increase the probability of placing the right people in these important positions. To start off our discussion, we'll examine the role of the claim adjuster in popular culture. This topic has not been exhausted by any means, but here are two examples:
'The Claims Man'
Edward G. Robinson as Barton Keyes, from the movie "Double Indemnity":
In this scene, Barton is trying to recruit Walter Neff (played by a very smooth Fred MacMurray) to give up his glamorous life in sales and take a position as a claim adjuster.
"The job I'm talking about takes brains and integrity," Keyes said. "It takes more guts than there is in 50 salesmen. It's the hottest job in the business…Desk job? Is that all you can see in it? Just a hard chair to park your pants on from 9 to 5, huh? Just a pile of papers to shuffle around and five sharp pencils and a scratch pad to make figures on. Maybe a little doodling on the side. Well, that's not the way I look at it, Walter. To me, a claims man is a surgeon. That desk is an operating table. And those pencils are scalpels and bone chisels. And those papers are not just forms and statistics and claims for compensation, they're alive, they're packed with drama, with twisted hopes and crooked dreams. A claims man, Walter, is a doctor and a bloodhound… and a cop and a judge and a jury and a father confessor all in one.
And you want to tell me you're not interested. You don't want to work with your brains. All you wanna work is with your finger on the doorbell, for a few bucks more a week…"
This may be the best — and perhaps only — film that features and lionizes a claim adjuster. This was required viewing early in my career at a large carrier working in the claim department. This suggested to me the importance of the position, along with a feeling that not just anyone is fit to do this work.
'Mr. Incredible'
Craig T. Nelson as Robert (Bob) Parr in the Disney/Pixar Movie "The Incredibles":
Working at an insurance company in the claim department, Bob appears to be in a role for which he is not well-suited. He is not a man happy in his work. His past and his destiny involve being a hero in the literal sense of the word. In this example, the whole insurance industry is portrayed as being purposefully bureaucratic and non-heroic in the sense that it does not seem to keep the promises made in the policies it writes and sells.
The only way Mr. Incredible can be "heroic" is by going out of his way to "help" the hapless insured in getting her claim paid, getting chastised by his boss for doing so, and then bringing his frustrations home to the family. He then sneaks out at night to perform "real" hero work. So, what's the lesson here? Employees not well suited for and unhappy in their work cannot be expected to perform well or support the objectives of the company. This employee is costing the company money. It's as simple as that.
In the Real World
In recent work with clients — both on the carrier and the independent loss adjusting side –we have delved deeper into what are the critical attributes of a claim adjuster. What exactly does a person need to bring to the table to succeed in this role and to actually enjoy and be good at it? We have looked at the differences between the desk adjuster and the field adjuster; between what it means to be working as an independent or for a carrier, or even in an outsource relationship where the independent adjuster is being placed in the role of being the carrier's claim representative. There are many facets to this situation, and understanding the differences is important. What follows is a guide for anyone looking to place the right people in these critical roles and increase productivity and effectiveness on the job.
Essential Attributes
After reviewing the list below, how many do you recognize in your own adjusters? Do you disagree with the inclusion of some of them? Are certain attributes not captured? We would be hard-pressed to determine, within an hour's interview time, whether a candidate possesses any or all of these. Thus, we often must make our best guess, look at past experience, and then hire, train, and wait and see. Some hires succeed, whereas others do not. Some ride the ragged edge of mediocrity and present the employer with little choice other than to accept the fact that they'll have to "live with this one" until he or she decides to "move on."
Those that do not thrive are probably missing some of these critical attributes:
- Above-average intelligence and the capability to handle multiple information streams through multiple channels. A natural "multitasker."
- Capability to readily understand the spoken and written word, to understand intent and meaning, and apply in the course of working a file.
- Able to work with and understand numbers; readily estimate without use of calculators; ability to look at numbers and infer meaning.
- Excels at "thinking on their feet." This means responding to inputs in real-time with confidence.
- Ability to speak effectively and confidently to deliver a message.
- Displays empathy in dealing with people, but not at the expense of defending a position.
- Has a moderate to high energy level and works at a quick pace.
- Relatively assertive and not afraid of confrontation, able to hold ground on a position.
- Relatively social in that he or she does not shy away from human interaction. This person, however, does not crave interaction.
- Manageable and willing to take direction from supervisors in a structured environment.
- Naturally skeptical — trust comes from experience and a "show me" mentality.
- Makes decisions based on data and analysis. Not relying on intuition or swayed by emotions.
- Not overly accommodating. Lacks somewhat the "need to be liked," or desire for constant reinforcement.
- Able to act and make determinations independently while accepting of feedback and supervision.
- Can stay motivated and goal-oriented without requiring an undue amount of oversight.
- Ability to work in a fast-paced, stressful environment without degradation of decision-making or work product quality.
Why Does This Matter?
In the simplest of terms, all of these attributes should be taken into consideration because they impact the bottom line.
Imagine a team of claim adjusters well-suited to the position and succeeding in this role. Think about adjusters who are able to juggle an above-average number of open files without letting any balls drop; who can effectively balance the insurer's interests while delivering and maintaining a level of customer service that leaves the policyholder satisfied, acting as a referral source for new business. Upwards of 65 to 70 percent of every premium dollar goes out the door in the form of either Loss Adjustment Expense (LAE) or indemnity payout. Every percentage point counts in trying to achieve an underwriting profit. While it is difficult to compensate for bad product development or poor underwriting decisions, bad claim-handling resulting in "leakage" will certainly not help in achieving desired results.
Poor claim handling can be a result of many things: inadequate training, business process design, technological support, but — most of all — poor staff selection. You have seen it: Some people "get it," while others, no matter how much time and energy is spent on them, do not. Is this a matter of intelligence? Perhaps. Is it a matter of traits and abilities less obvious, more subtle? Probably.
How to Improve Our Chances
It really comes down to this: Assessing fitness for the job, education level, job knowledge and experience, and how well the candidate presents him- or herself. Easily as important is the preparedness of the interviewer – whether in HR or the business unit- with skills and information necessary to make an important and informed decision regarding selection.
As Figure 1 below suggests, there is quite a bit going on, in fact more than most people realize or are prepared to admit. Too often, decisions are made simply based on previous experience, education, and existing job knowledge. These are certainly important considerations. However, leaving out the other factors shown, where we consider the whole person, may cause us to possibly overlook the best candidates. In my experience as a hiring manager, I know that some of my best hires have come from outside a given industry and have abilities and traits to leverage in what is a new industry for them, but represents a great fit.
Often this fresh perspective, combined with core traits and abilities, can have a profoundly positive impact on future job performance, and a benefit to the company that would not be realized if the narrow, one sided approach is maintained. How often, too, have you hired a person with "deep experience" only to find out that his or her level of performance has never been high, and that's likely the reason they are staring you in the face looking for a job? It's possible that this was a job neither they liked nor were suited for in the first place. If we look at the whole person and arm the interviewer/hiring manager with this information, then an insurer is positioned to make a significantly better decision as it looks at people that might not otherwise have been considered.
How to Obtain This "Additional Information"
There are a number of ways to get at the "whole person." By knowing the critical behavioral attributes of those who are your current high performers, correlations can be made between those that are succeeding and those who are seeking employment or promotion. Highly skilled interviewers can divide the information based on training and experience, along with a solid understanding of requirements and established behavioral interview questions. This, however, is a large "if".
Most of the time, business professionals have neither the time nor luxury to painstakingly examine each candidate to determine whether there is a behavioral fit. It's better to use a reliable and valid tool that is designed for the purpose; one that measures, for example, cognitive ability, behavioral traits and occupational interests, benchmarked against high performing, incumbent employees for a given role. These assessments can help companies create a job match/fit pattern that correlates with a tendency to perform well on the job.
An example of one such job match pattern is shown in Figure 2 below. The resulting pattern can then be used to provide a basis of comparison for each current and potential employee as it relates to this given role. Where a current employee differs from the pattern, valuable information is provided to support coaching and development. Where a potential hire either matches or falls out of the pattern, more focused and effective interviewing and more informed decisions can be made based on overall job fit. This is one example of a tool designed to support the selection and hiring process. Moreover, it provides management and employees with valuable information to help develop employees and corporate culture, as well as enhance overall company performance.
People bring different attributes, strengths, weaknesses, and interests to the workplace, so it stands to reason that not everyone is suited to every given job. In fact, some or most jobs would benefit greatly by taking a look at what drives top performance and can also be used as a reasonable predictor of future success in a given position. While no tool or method is foolproof, there are ways to arrive at the information critical to making sound selection and hiring decisions. These methods greatly improve the probability of putting the right person into the right role, which can make for happy, enthusiastic, and engaged adjusters that deliver value for the salary dollar that they earn. The opposite is true: Someone unhappy in or poorly suited for a given position can cost a company dearly in unsatisfactory performance, low morale, damaged customer service, and overall poor execution. The choice is yours.
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