Tag Archives: claims managers

The 2 Types of Claims Managers

In an industry buffeted by escalating vehicle complexity, accident severity and repair costs, companies wishing to improve customer satisfaction and their bottom lines must increasingly rely on modern technology to achieve more with less — to be more efficient with a smaller workforce.

Unfortunately, not all claims supervisors and managers recognize this fact. Even those who do sometimes prefer the “path of least resistance” to a journey outside their comfort zones.

Two types of claims managers

Today’s claims managers tend to fall into one of two categories: Innovative Visionary or Status Quo Preserver.

1. Innovative visionaries are forward-thinkers who see the big picture. They focus on process improvement, cost-efficiencies and customer satisfaction. They incorporate and leverage new technologies to optimize workflow processes and drive higher performance. They understand that results are the ultimate benchmark of success. At the same time, they understand that enhancing their companies’ image to acquire and retain good customers is vital to future earnings.

2. By contrast, status quo preservers are driven by the mindset of “this is the way we’ve always done things, so why change?” Though they may not be conscious of it, they encourage fragmentation and inefficiency to promote job security. The more problems they create, the more they position themselves as solution-providers.

See also: Power of ‘Claims Advocacy’  

These managers are fearful of making decisions — even easy decisions — that could improve the company’s performance and processes because they worry they’ll be made obsolete. They also cling to established vendor relationships, even when the companies do a poor job. Whether it’s that safe, “fuzzy” feeling managers get from dealing with “devils they know” or because of the pride they take in “empire building,” such managers always choose what’s best for themselves instead of what’s best for the company and the customers.

Careers are at stake

An orientation toward process improvement is vital for the future. If you’re a “status quo preserver,” you’re not just putting your company’s future in jeopardy, you’re also putting your job and your career in jeopardy — maybe not tomorrow but three or four years from now.

New and Improved

While it’s true that the words “new” and “improved” don’t always go together, much of the legacy software and status quo processes we’ve encountered are grossly inefficient.

Not long ago, for example, we began working with a client that was using so many un-integrated vendors to handle different parts of the claims process (salvage, parts, DRP, etc.) that the adjusters had to keep eight different browsers open on their computers to do their jobs. And many tasks had to be performed manually.

It doesn’t have to be that way.

Forward-thinking carriers are quickly adopting process-improvement strategies and tactics. They realize that in a fast-changing claims environment, doing nothing risks losing customers to more agile, efficient and customer-centric competitors.

Too much hassle?

Some “status quo preservers” do have a valid point when it comes to the hassle of moving to new software. Instead of providing clients with scalable, easy-to-use software that helps managers and employees alleviate stress and become more productive, some vendors sell their products and walk away. IT departments and employees are left to figure out how to integrate and operate the new system. The best tech-solution providers don’t do that. Nor do good service providers, such as ACD.

See also: The One Thing to Do to Innovate on Claims  

Of course, making the transition to new software is never seamless. There’s a learning curve associated with anything new. But in today’s supercharged competitive environment, the risks of doing nothing far outweigh the hassles of adopting more integrated, more efficient tech platforms.

With each passing day, the definition of “status quo” keeps moving forward. So the claims manager who tries to preserve the status quo is actually traveling backward relative to the competition — and that’s a place no insurance company can afford to stay for long.

Why Comp Claims Can Take Forever

Over the years, I’ve had safety directors or claims managers tell me that workers’ compensation claims move slower than a one-legged dog on tranquilizers. I would say the resolution speed of comp claims more closely resembles that of a three-legged dog on mild muscle relaxants – – but I won’t quibble over how far to take the metaphor.

Bottom line: Oftentimes, comp claims do move very slowly. Without dwelling on the obvious, let me suggest three legitimate reasons why comp claims aren’t yet as fast as text-messaging teenagers.

1. Litigation takes time

If you have pro se claims (where the claimant does not have an attorney), you’ve undoubtedly noticed that these claims are usually resolved very quickly. Why? You can insert you own joke, but you might consider the old one about how attorneys make good speed bumps. Having fewer attorneys involved removes obstacles and speeds the process. The absence of attorneys also means that there are likely no real issues to resolve. Everyone agrees on everything, so there is nothing to argue about.

In disputed claims, though, investigation takes time. Discovery takes time. Getting opinions from expert physicians takes time. Courts take time.

Years ago, I had a client tell me: “Brad, I don’t want you to settle any of our comp claims. Take them all to trial.” I did that. . . for a while. After two years of this (and after seeing the defense costs associated with taking every case to trial), the VP of claims called me and said: “Brad, can you start letting me know which claims can be resolved without trial?”

It doesn’t take a high level of skill to take every case to trial. It does, however, require skill to know which claims should be settled and which claims should be disputed.

2.  Movement takes willpower

Apart from falling down, movement takes willpower and initiative. A new client contacted me in June about taking over the defense of a claim that has been litigated since 2002. I entered my appearance, reviewed the medical records, called the claimant’s attorney and worked out a tentative framework for settlement with three or four phone calls.

I am certain that I am not any smarter than the defense attorney I replaced. Some would say he is far smarter – – he was paid to work a file for 12 years, and I was the dope who resolved it with a few phone calls! Self-serving attitudes aside, I had a fresh perspective and wasn’t afraid to throw out ideas to resolve the claim instead of simply throwing out ideas for continued litigation. In an area of the law where the work is often very repetitive, coming up with a new approach is often difficult.

3.  Common sense is mistaken

Common sense would seem to indicate that if the claimant’s attorney knows little about workers’ comp law, this places me (as the defense attorney) in a better position to achieve a favorable result for my client. In this instance, common sense is completely wrong.

I have always found that claimant’s attorneys who actually know what benefits are payable under the workers’ comp law and how to prosecute a workers’ comp claim are far better to work with than the attorneys who handle three comp claims a year and try to handle the claim like a jury trial in circuit court.

Knowledge and experience can bring efficiency to a system that rarely seems efficient.