Previously I didn’t know which was worse – North Korea’s burgeoning nuclear program or its Fearless Leader’s bad haircut. Now we learn that this country is a leader in international insurance fraud. Details and exploits are uncovered in a recent front page issue of The Washington Post (http://www.washingtonpost.com/wp-dyn/content/article/2009/06/17/AR2009061703852.html?hpid=topnews).
Apparently Korea National Insurance Company is renowned for procuring reinsurance and then submitting dubious claims. In fact, insurance fraud is a source of much needed hard currency.
Any anti-fraud or SIU adjusters looking for the ultimate career challenge might consider this one. Of course, taking on Kim Jong Ill might involve risking a stint in a North Korean labor camp. (Any adjuster who has flown Northwest will be well-prepared for this eventuality, however.)
Perhaps we should introduce a motion to the United Nations that it create an international SIU???
Friday, June 19, 2009
Saturday, June 6, 2009
Invest in Your Career Through New CLM Lit Management Training Sessions!
Vince Offer, the ShamWow pitchman, has nothing to worry about from me. You know – the scary dude on late night TV with the headset. (Actually, the economy is so bad now, I hear that some folks are knitting together Sham-Wows to fashion their own makeshift Snuggies!) ShamWows, Snuggies and Garden Weasels. We may laugh and snicker, but the pitchmen laugh too . . . all the way to the bank.
The Claims Coach isn’t given much to making product endorsements, but makes an exception now. I heartily recommend the new slate of litigation management training sessions being launched and offered by the Council on Litigation Management (visit http://www.litmgmt.org/Training.aspx ). The CLM is offering courses in 25 states, approximately 250 times from June to November 2009. Many provide adjuster CE credits.
The curriculum includes:
• “Fundamentals of Litigation Management”
• “Case Assessment and Evaluation”
• “Negotiation Strategies”
• “Structured Settlements”
• “Litigation 102: Pleasing and Motion Practice”
• “Litigation 103: Discovery Practice”
• “Litigation 104: Trial Practice”
Sadly, there has been a dearth of easily accessible training for claim professionals in the discipline of litigation management. This is ironic, as for many claim professionals this activity comprises a huge chunk of their jobs. The CLM helps fill this void.
In tight economic times, one of your best investments is to invest in your career – deepening your skill sets or broadening them. Visit the CLM website and consider registering for one of its sessions. Better still, join the CLM.
Caveat: if the session rooms are drafty, you’ve got to bring your own Snuggie….
The Claims Coach isn’t given much to making product endorsements, but makes an exception now. I heartily recommend the new slate of litigation management training sessions being launched and offered by the Council on Litigation Management (visit http://www.litmgmt.org/Training.aspx ). The CLM is offering courses in 25 states, approximately 250 times from June to November 2009. Many provide adjuster CE credits.
The curriculum includes:
• “Fundamentals of Litigation Management”
• “Case Assessment and Evaluation”
• “Negotiation Strategies”
• “Structured Settlements”
• “Litigation 102: Pleasing and Motion Practice”
• “Litigation 103: Discovery Practice”
• “Litigation 104: Trial Practice”
Sadly, there has been a dearth of easily accessible training for claim professionals in the discipline of litigation management. This is ironic, as for many claim professionals this activity comprises a huge chunk of their jobs. The CLM helps fill this void.
In tight economic times, one of your best investments is to invest in your career – deepening your skill sets or broadening them. Visit the CLM website and consider registering for one of its sessions. Better still, join the CLM.
Caveat: if the session rooms are drafty, you’ve got to bring your own Snuggie….
Saturday, May 16, 2009
Adjusters Have to Guard Kobe Every Day ...
“Defensive specialist.”
In the NBA, a few players are known for taking on the tough assignments of guarding the most prolific scorers and unstoppable hoopsters. If your job is to guard Kobe Bryant or Lebron James, you’re in for a long night and have a thankless task. Despite the challenges, a few players rise to the mission. In current pro basketball circles, Shane Battier of the Houston Rockets is such a defensive specialist, charged with the daunting task of guarding Kobe.
A recent Sports Illustrated profile on Shane Battier (5/18/09, “Guarding Kobe”) and the rare breed of selfless defensive stoppers quoted Michael Cooper, former NBA star, saying that these stoppers are like being a “garbage collector” because “you don’t notice them until they don’t do their job. [They] handle the messes and the stinky stuff.”
“They handle the messes and stinky stuff.”
That quote jumped out at me and made me think of adjusters. You rarely notice adjusters UNTIL they don’t do their job. When they don’t do their jobs, you have irate claimants and policyholders. You have people calling to bitch and complain. You have grievances filed with the Insurance Commission. You have bad faith lawsuits filed against the company.
When claims people do their jobs, you just don’t have this phenomena. I have often said that the best managed claim offices are “boring” – no crises, no fire drills, no hot-to-the-touch complaints, no circling of the wagons due to a client meltdown.
Give me boring any day! If adjusters do their jobs, the function becomes self-effacing and less visible. Maybe that’s why it’s so easy to take it for granted, or assume they aren’t needed.
Yes, and adjusters handle the messes and the stinky stuff. They are at the side of the Interstate at 3:30 AM with the overturned tractor trailer filled to bursting with produce. They go out to investigate the three-car fatality and survey the grisly photos taken by state police. They have to explain to a pushy insured that the policy doesn’t cover all perils or loss. They have to be the lightning rods for the frustrations of consumers who want it done yesterday.
Adjusters handle the messes and the stinky stuff. Like skilled defenders in the NBA, they are the unsung heroes of the insurance world.
In the NBA, a few players are known for taking on the tough assignments of guarding the most prolific scorers and unstoppable hoopsters. If your job is to guard Kobe Bryant or Lebron James, you’re in for a long night and have a thankless task. Despite the challenges, a few players rise to the mission. In current pro basketball circles, Shane Battier of the Houston Rockets is such a defensive specialist, charged with the daunting task of guarding Kobe.
A recent Sports Illustrated profile on Shane Battier (5/18/09, “Guarding Kobe”) and the rare breed of selfless defensive stoppers quoted Michael Cooper, former NBA star, saying that these stoppers are like being a “garbage collector” because “you don’t notice them until they don’t do their job. [They] handle the messes and the stinky stuff.”
“They handle the messes and stinky stuff.”
That quote jumped out at me and made me think of adjusters. You rarely notice adjusters UNTIL they don’t do their job. When they don’t do their jobs, you have irate claimants and policyholders. You have people calling to bitch and complain. You have grievances filed with the Insurance Commission. You have bad faith lawsuits filed against the company.
When claims people do their jobs, you just don’t have this phenomena. I have often said that the best managed claim offices are “boring” – no crises, no fire drills, no hot-to-the-touch complaints, no circling of the wagons due to a client meltdown.
Give me boring any day! If adjusters do their jobs, the function becomes self-effacing and less visible. Maybe that’s why it’s so easy to take it for granted, or assume they aren’t needed.
Yes, and adjusters handle the messes and the stinky stuff. They are at the side of the Interstate at 3:30 AM with the overturned tractor trailer filled to bursting with produce. They go out to investigate the three-car fatality and survey the grisly photos taken by state police. They have to explain to a pushy insured that the policy doesn’t cover all perils or loss. They have to be the lightning rods for the frustrations of consumers who want it done yesterday.
Adjusters handle the messes and the stinky stuff. Like skilled defenders in the NBA, they are the unsung heroes of the insurance world.
Saturday, April 18, 2009
CEO Review of High-Dollar Claims: Best Practice or Pointless Distraction??
I just read an article in Business Week (4/20/09, “One Greenberg’s Pain is Another’s Gain”) about Evan Greenberg, one of the sons of industry titan and former AIG potentate “Hank” Greenberg. Evan is CEO of ACE Insurance Company. What caught my eye was a sentence in the article that states that ACE’s Evan Greenberg still reviews every claim of more than $1 million.
This stopped me in my tracks. I’m not quite sure what to make of this.
On the one hand, it paints a picture of the fully engaged CEO. I’m not sure what kind of claim valuation background, if any, Evan Greenberg possesses. I would imagine that it is extremely rare for an insurance company CEO to exhibit this level of engagement with high ticket claims.
On the other hand, part of me thinks that a CEO is likely under-qualified to make reasoned assessments of claim liability and evaluation. Is this truly the best use of a CEO’s limited time and attention? Can you imagine being the claims adjuster at a mediation 1000 miles away, needing settlement authority above $1 million in having to call back to the Home Office and try to get the CEO of the company on the line?
Good luck!
So there you have the ACE template: the CEO reviews all claims above $1 million.
Is this a best practice or is it a distracting and pointless drain on the time of a chief executive officer who should be more engaged in managing the forest than the individual trees?
This stopped me in my tracks. I’m not quite sure what to make of this.
On the one hand, it paints a picture of the fully engaged CEO. I’m not sure what kind of claim valuation background, if any, Evan Greenberg possesses. I would imagine that it is extremely rare for an insurance company CEO to exhibit this level of engagement with high ticket claims.
On the other hand, part of me thinks that a CEO is likely under-qualified to make reasoned assessments of claim liability and evaluation. Is this truly the best use of a CEO’s limited time and attention? Can you imagine being the claims adjuster at a mediation 1000 miles away, needing settlement authority above $1 million in having to call back to the Home Office and try to get the CEO of the company on the line?
Good luck!
So there you have the ACE template: the CEO reviews all claims above $1 million.
Is this a best practice or is it a distracting and pointless drain on the time of a chief executive officer who should be more engaged in managing the forest than the individual trees?
Wednesday, April 15, 2009
IKEA Gets no Discount on This Jury Award
“You know what the word `IKEA’ really means when translated from Swedish?” asked comedian Jay Leno recently.
The answer: “Cheap particle board.”
Though the audience laughed, it is likely that few IKEA personnel are laughing over a recent jury hit that the retailer just took in the Washington D.C. area.
A Fairfax County (VA) woman was just awarded $3.2 million in damages for injuries she suffered in 2006 when a 350-lb. stack of countertops fell on her in one of IKEA’s Woodbridge, VA stores. The plaintiff, Xiaolie Zeng, suffered four fractures of her pelvis and alleged permanent injuries.
http://www.washingtonpost.com/wp-dyn/content/article/2009/04/14/AR2009041402882.html
Fairfax County, VA -- which happens to be my home – is not known for having excessively liberal juries. From a defendant’s point of view, it is considered a fairly favorable jurisdiction. If you have a choice locally to be a defendant in Washington D.C. or Fairfax County, you definitely want your case in Fairfax County. This is no Robin Hood, “rob the rich to pay the poor” area.
It sounds as though liability here was pretty clear. The customer had been looking for a table, but did not find one that she liked Near the Exit, she stopped at the “As Is” section of leftover or bargain items but did not touch any of them. A stack of four particle-board counter tops and inside door collapsed on Ms. Zeng.
Given the clear liability, it is hard to see why IKEA did not settle the case and let it go to a jury. The article says the special damages were about $150,000. We do not know the plaintiff’s pretrial demand. Perhaps it was so high that IKEA felt that, even with a finding of liability, it stood a good chance of doing better than paying the demand.
That demand may be looking better now.
The answer: “Cheap particle board.”
Though the audience laughed, it is likely that few IKEA personnel are laughing over a recent jury hit that the retailer just took in the Washington D.C. area.
A Fairfax County (VA) woman was just awarded $3.2 million in damages for injuries she suffered in 2006 when a 350-lb. stack of countertops fell on her in one of IKEA’s Woodbridge, VA stores. The plaintiff, Xiaolie Zeng, suffered four fractures of her pelvis and alleged permanent injuries.
http://www.washingtonpost.com/wp-dyn/content/article/2009/04/14/AR2009041402882.html
Fairfax County, VA -- which happens to be my home – is not known for having excessively liberal juries. From a defendant’s point of view, it is considered a fairly favorable jurisdiction. If you have a choice locally to be a defendant in Washington D.C. or Fairfax County, you definitely want your case in Fairfax County. This is no Robin Hood, “rob the rich to pay the poor” area.
It sounds as though liability here was pretty clear. The customer had been looking for a table, but did not find one that she liked Near the Exit, she stopped at the “As Is” section of leftover or bargain items but did not touch any of them. A stack of four particle-board counter tops and inside door collapsed on Ms. Zeng.
Given the clear liability, it is hard to see why IKEA did not settle the case and let it go to a jury. The article says the special damages were about $150,000. We do not know the plaintiff’s pretrial demand. Perhaps it was so high that IKEA felt that, even with a finding of liability, it stood a good chance of doing better than paying the demand.
That demand may be looking better now.
Monday, April 13, 2009
I Guess She Couldn’t Sue God
“Michigan Church Faces Second Trial Over Fall at Altar” reads the headline from the Associated Press. (For the full story, http://www.claimsjournal.com/news/midwest/2009/04/13/99550.htm). Apparently Judith Dadd of Lansing, MI is suing her place of worship, Mount Hope Church. The suit flows from a July 2002 accident when she was overcome by the holy spirit, fell backwards and hit her head on the floor.
Her theory of liability: the church should have had an usher positioned there to catch her fall. That leads to an interesting idea, where churches might engage one “spotter” for each celebrant who is overcome with the holy spirit. The pews and aisles might be packed that way.
As a footnote, Ms. Dadd has added a defamation claim, saying her pastor has been wrongful stating that her injury was faked. Imagine that!
If you are the adjuster assigned to this claim, maybe one red flag would be the list of itemized special damages including a hefty bill from a faith healer …
Her theory of liability: the church should have had an usher positioned there to catch her fall. That leads to an interesting idea, where churches might engage one “spotter” for each celebrant who is overcome with the holy spirit. The pews and aisles might be packed that way.
As a footnote, Ms. Dadd has added a defamation claim, saying her pastor has been wrongful stating that her injury was faked. Imagine that!
If you are the adjuster assigned to this claim, maybe one red flag would be the list of itemized special damages including a hefty bill from a faith healer …
Sunday, April 5, 2009
“Michael Clayton” and the Tao of Claim Defense
OK, so I'll confess don’t get to the movie theaters much.
($11 a ticket PLUS $8 popcorn? Are you kidding?!) But the wife and I watch plenty of movies on DVD, courtesy of Netflix. I know that time-wise I’m behind the curve here but last night I finally got around to watching and enjoying “Michael Clayton.” I had not realized that the movie centered on a product liability case, a class action involving a weed-killer and a mythical Nebraska-based company called U-North.
Some highlights of the plotline which may interest those in the claims realm:
• Bad documents can sink your defense (though how did these stay suppressed and secret so long?)
• Lead defense counsel strips down to his underwear during one plaintiff’s deposition (lending a whole new meaning to the phrase, “legal briefs”). Also, why did the lead defense counsel in this role have to be played by Tom Wilkinson instead of, say, Charleze Theron, just to pick a name at random.
• Defense firm of Kenner, Bach & Ledeen dances a jig when it hits 30,000 billable hours on the defense of the carcinogenic weed-killer. Yippee!
• Product defendant plays hardball on a whole new level.
OK, it’s Hollywood. I get it.
Nevertheless, if you work in the vineyard of liability claims, you may get a hoot out of “Michael Clayton.”
($11 a ticket PLUS $8 popcorn? Are you kidding?!) But the wife and I watch plenty of movies on DVD, courtesy of Netflix. I know that time-wise I’m behind the curve here but last night I finally got around to watching and enjoying “Michael Clayton.” I had not realized that the movie centered on a product liability case, a class action involving a weed-killer and a mythical Nebraska-based company called U-North.
Some highlights of the plotline which may interest those in the claims realm:
• Bad documents can sink your defense (though how did these stay suppressed and secret so long?)
• Lead defense counsel strips down to his underwear during one plaintiff’s deposition (lending a whole new meaning to the phrase, “legal briefs”). Also, why did the lead defense counsel in this role have to be played by Tom Wilkinson instead of, say, Charleze Theron, just to pick a name at random.
• Defense firm of Kenner, Bach & Ledeen dances a jig when it hits 30,000 billable hours on the defense of the carcinogenic weed-killer. Yippee!
• Product defendant plays hardball on a whole new level.
OK, it’s Hollywood. I get it.
Nevertheless, if you work in the vineyard of liability claims, you may get a hoot out of “Michael Clayton.”
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