Claims at Its Core

Big on CE

One factor that drives attendance is the abundance of CE credit opportunities at the conference.

"About 20 percent of attendees come for CE," said Powell. "Although this by no means represents a majority, it is convenient for those who need it."

For adjusters, the Florida Department of Financial Services has approved the conference for as many as 16 credit hours. Partial credit can be awarded for attending fewer sessions. In addition, the North Carolina Department of Insurance approved the three separate days of the conference for a maximum of 18 credit hours. Attendees are eligible to accrue six hours each day. To receive credit for an individual day, an adjuster must attend a full day of sessions. An additional stipulation is that credit for Monday is only awarded when the adjuster attends the general session, for which Dr. Robert Hartwig, CPCU, of the Insurance Information Institute (I.I.I.) will serve as keynote.

Another draw to the conference is the chance to garner ethics credits, said Berka. For instance, the Florida Bar has approved the 2010 conference for up to 21 hours Continuing Legal Education Requirements (CLER). To receive full credit, the sessions must directly relate to the study of ethics. The Florida Bar requires that attendees submit hours online. Further rules and filing instructions pertaining to CE and CLER can be found on www.claimsconf.org, along with updates and approved sessions.

A Layered Approach

Along with the usual show staples, the 2010 PLRB/LIRB conference will feature yet another accreditation opportunity and a newly instated educational program that targets a younger demographic. Never veering away from the fundamentals, the committee created, "Core Claim Skills," which aims to educate adjusters with two-to-seven years of experience. The program consists of eight 90-minute classes divided evenly amongst two tracks: property and casualty claims.

"This special program was requested by our membership," Powell explained. "Typically our conference attendees average 20 or more years in the business. We wanted to draw younger adjusters to understand the challenges they face while underscoring the breadth of skills they need to be successful. Class presenters will discuss coverage analysis, investigations, damage evaluation, and claim resolution. Customer service will also be emphasized."

The "core" classes are slated for Tuesday, March 23. Powell notes that there has been a strong response for sign-ups and some unlikely registrants for the program thus far.

"We think we're on to something good," said Berka. "We've noticed that even senior vice presidents and training managers have signed up. They may in fact be gathering ideas about how to approach or modify their own training programs."

Also new on this year's agenda is the opportunity for attendees to earn or renew National Flood Insurance Program (NFIP) certifications. To obtain accreditation, attendees must complete the seven-hour session, which is set for Wednesday, March 24. According to Powell, the committee wanted to build on the success of regional adjuster conferences. "In working with FEMA this past year, we noticed that the regional sessions related to the flood program were particularly well received," he said. "This new course will provide a primer on the NFIP and the federal laws governing coverage and loss adjustment. It will be useful for a lot of independent adjusters and insurance company adjusters handling either flood claims or property claims. Even property adjusters need to know something about the flood program."

Once again, attendees may seek the California Earthquake Claims Handling Accreditation certificate. Introduced in 2009, it continues to be a viable option for adjusters, given the ongoing exposure, particularly in California.

For Your Consideration

Given the sheer magnitude and variety of offerings, it is crucial for attendees to carve their own educational paths, selecting courses with care so as to brush up on the fundamentals while addressing underlying deficiencies. This will help to ensure that concepts are carried past the classroom and into claim departments.

"This is why it's important for us to post learning objectives," said Powell. "There is a vast expanse of claim-handling topics covered, so each person must examine not only what a given class is about, but also what they can demonstrate in the office afterward. As a result, professionals can focus on changing behaviors and changing performance."

Claims editors have plucked two informative sessions from the lineup (pages 38 and 39) and highlighted others to provide you with a gentle push. The rest is up to you.

2010 PLRB/LIRB SESSION PREVIEW
Striking a Mind-Body-Spirit Balance

Some say there are several constants in life: taxes, death, and stress. All of us deal with an array of stressors on a regular basis. Knowing how to cope with emotional stress in a healthy way can be difficult, but some simple strategies are applicable in many situations.

Claim professionals face a unique set of stressors and challenges, as they commonly work on multiple cases at the same time and, to a large extent, help those who have incurred much hardship rebuild their lives and homes. Following catastrophic events, adjusters may be deployed far from their own homes, and thus away from loved ones.

These kinds of stressors—and others specific to the profession—invariably impact health, job performance, and even safety. That's why it is crucial to remain mindful of the caveats of being a first-responder.

"Although we must look at what is happening off the job, we need to weigh the price claim professionals are paying for what they hear, see, and do when working with distressed individuals," said Raymond Shelton, PhD, director of professional development, National Center for Crisis Management/American Academy of Experts in Traumatic Stress, in a pre-show interview. "Stress can alter the person's ability to focus and concentrate; it can block communication and hinder the claim process. For instance, one's ability to maneuver a car accurately can be compromised. A fatigued adjuster may not see an otherwise apparent hazard or can miss clues indicating that a policyholder is becoming frustrated and angry."

Given the obvious toll stress can take on a person's emotional well being at home and work, and in relationships in general, it is imperative to develop an effective action plan. Dr. Shelton, along with Cynthia Dowies, executive general adjuster, CNA Insurance Companies, will guide attendees toward enhanced well being and detail some coping mechanisms at "Managing Stress in the Claims Profession: Achieving Balance In Mind, Body & Spirit."
Dr. Shelton is quick to point out that this year's seminar differs from his presentations at PLRB/LIRB conferences in the past. "This seminar will represent a departure from what I've done in the past six years," he said. "We'll address stress from different perspective in terms of everyday kinds of issues instead of that related directly to trauma or CAT duty."

When asked to explain the shift, Dr. Shelton noted that past attendees ardently embraced the sections of workshop focusing on daily personal stressors. In fact, as of press time, he reported that 70 people had people had already signed up for the morning session, with 25 scheduled to attend the afternoon session.

During the presentation, Shelton and Dowies will discuss possible benefits to adjusters and policyholders alike, along with the basic nature of stress.

"Stress is action-oriented response," Dr. Shelton explained. "It's important to also keep in mind that, like beauty, stress is in the eye of the beholder and affects each person differently.

They will also outline 10 steps to ease stress. Some common tactics include:

• Get physical. The stress response is an action-oriented physical event designed to keep you alive in the presence of a real life threat. If the tiger is chasing you, then run like mad. However, if your stress stems from everyday life issues, then blow off some steam with a walk or bike ride.
• Laugh. Claim professionals often serve people who are undergoing a crisis and are thus not in a good place emotionally. Instead of internalizing negativity, find the humor where possible.
• Set realistic expectations. Frustration, conflict, and pressure arise when you are not reasonable when setting goals you hope to achieve.

To learn more about Dr. Shelton's other seven stress-busting steps, catch the full presentation. You are already one step closer to achieving greater well being in your work and personal life.

2010 PLRB/LIRB SESSION PREVIEW
Medicare Mandatory Reporting: Consequences and Challenges Ahead

The Medicare, Medicaid, and SCHIP Extension Act of 2007 has insurers nervous about upcoming deadlines and implementation later this year — and rightfully so. Potential penalties for non-compliance show the government means business when it says it wants to ensure that Medicare pays last when it comes to claimants who are covered first under an insurance policy. Compliance, however, is a thorny issue that has many insurers worried about how to handle the reporting challenges ahead. That makes the presentation, "Medicare Mandatory Reporting: Consequences and Challenges Ahead," at this month's PLRB/LIRB Claims Conference "must-see CE" for those attending the show.

"Anytime the government puts out an indication that there will be a penalty of a $1,000 a day per claim, per claimant for being out of compliance, it tends to get people's attention," said presenter Todd Witke, who also serves as superintendent for EMC Insurance Companies. "A lot of insurance companies are dealing with this issue. [During our presentation], we'll explore different scenarios and discuss how to protect Medicare's interests, which is what they are requiring. Additionally, we will look at different adjustment strategies in settling claims that involve Medicare."

Although the idea of Medicare being a secondary provider isn't exactly new, the mandated reporting requirement is. Witke and his co-presenter Brad Spicer, associate manager of casualty claims for Cincinnati Insurance Companies will address this issue as well as describe adjustment strategies to protect Medicare's interest in conditional and future medical payments, including the use of MSAs. The duo also will evaluate the impact of Medicare liens on liability cases and an insurer's ability to settle and pay claims.

"The key part to understand is that the change is the mandatory reporting," said Witke. "Medicare is putting the onus on the insurance company to tell them when they have a beneficiary who is involved in a claim. This is the new component, and it creates a need for insurers to pay much more attention and be much more careful with how they interact with Medicare."

Since all of the requirements have yet to be released, insurers still have many questions left unanswered. Witke and Spicer will do their best to explain the challenges and offer advice.

"Until the final user's guide is published, there are some areas that are a little unclear as to exactly what it's going to be like at the start," said Witke. "It's tough enough right now just to put your company in a position to be in compliance for what you need to do from a reporting standpoint and get the training out there for your adjusters to be able to do the right things at the point of settlement. It's an issue that is going to require some on-going maintenance as we look down the road a bit and explore different scenarios."

When asked how prepared he thought insurers were about the new requirements, Witke said that many were already sending test files to the Center for Medicare Services to ensure their electronic reporting is being well received. Others, however, are relying on a third-party solution, which could pose its own set of problems.

"There are companies that are anticipating using a vendor to do a lot of the reporting for them, which is an option," said Witke. "But at some point, someone has to actually collect the data to allow for the reporting to happen. So I think there are some companies that are still at that point, sort of scrambling to make sure they have processes in place to gather the appropriate data. Some of the data—like social security numbers—aren't the easiest things to get."

If the information above leaves a pit in your stomach, it's not too late to book your trip to San Antonio to bone up on the basics.