Does the Claims World Favor Extroverts?

I just finished reading a recently published book, Quiet: The Power of Introverts in a World that Can’t Stop Talking by Susan Cain. She makes the point that most of the world puts a higher value on extroversion and that subtle or not so subtle pressures exist to handicap quieter types.

Cain’s book prompted me to wonder if the claims profession follows this mold. Does the claims world favor extroverts? Can an introvert survive, or even thrive, in the world of claims?

This transition hit me in the face like a wet towel when I entered the claims world. I attended my grad school commencement ceremony on a Saturday afternoon. On Sunday morning, I flew to Atlanta to attend Crawford & Company’s five-week adjuster boot camp. As a grad student, I had lived a bookish existence.

The last four months in grad school, I spent writing out a 200-page Masters thesis on comparative political theory. (Subsequently read only by my mother and some chronic insomniacs seeking a cure …) After graduation, armed with a freshly minted M.A. in Government, I plummeted into the claims world. I was dealing first-hand with people from all socio-economic strata. Most of them were stressed out by their loss and wary of this new kid who showed to adjust their claim. I got yelled at, chewed out, questioned and second-guessed.

And those were the nice ones …

Handling claims wasn’t anything like grad school. In the halls of academia, introversion served you just fine.

In the claims world, shrinking violets get stomped on. I realized that, if I was going to make claims a career, some adjustment (no pun intended) was needed.

So, the questions remain. How do introverts grab their “air time” and advance their careers? Can introverts put on a persona of extroversion in order to advance their claims career?

I don’t claim to have the answers, though I can hazard a few theories.

Much of what adjusters do relies on traits we commonly associate with extroversion. Forcing yourself to deal with people who have suffered loss is no role for shrinking violets. You need not only the hide of a rhinoceros but also the self-assertiveness to jump into situations that most people would avoid. Selling a settlement figure to a reluctant claimant or policyholder, entering the rough and tumble of a settlement negotiation with claimant’s counsel, presenting the second-quarter claim results to upper management – these roles call upon the extrovert.

On the other hand, there are adjuster roles that require quieter, more reflective approaches. These include traits we more often associate with introverts. Examples include:
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Thoughtfully analyzing a packet of demand documentation to fine tune a reserve and develop a target settlement figure
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Conduct a thoughtful performance review of claim staff
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Listening empathetically to an employee, a claimant or insured who has gone through a traumatic event

In some settings, the claims professional is better off closing the mouth, opening the ears and being on “receive” mode. In other roles and settings, the adjuster will be more effective assuming a take-charge, vocal and assertive approach.

One key to job and career success is to size up which approach works best in different situations. Possessing this situational awareness can separate average adjusters from the extraordinary. I’m not saying it’s easy, but it is doable.

So … what is your take? Is there room in the claims business for introverts? Is being an extrovert ever a liability when performing claims work? For those at one end of the spectrum of extroversion or introversion, do you think it’s possible to re-mold your traits to adapt to job demands and situations?

Please share your thoughts here or reply to claimscoach@gmail.com

Claims Coach Podcast Features Interview with Chantal Roberts of Affirmative Risk Management

This week’s Claims Coach blog is augmented by a podcast interview with Chantal Roberts, Vice President of Claims for Affirmative Risk Management in Little Rock, AR. You won’t want to miss this lively and interactive conversation, part of our “Spotlight on Leaders” series that features leaders in the world of claims and risk.

Chantal is a claims executive who works for a family-owned TPA. Many of the claims she handles arise from accounts underwritten by the London market. In addition to being a claims executive, she is a wife, mother, and an athlete in training. A Toastmasters devotee, she gives speeches in a variety of forums, including career pitches to college students on nearby campuses.

Between preparing for 5K races, 50-mile charity bike ride fundraisers and contemplating tackling a triathlon, Chantal studies guitar. (I do believe she also leaps tall buildings in a single bound.)

How does she do it all? Listen to the podcast! Chantal offers insights on:
• The special challenges of being a TPA in today’s environment

• Why having the hide of a rhinoceros is a handy adjuster trait

• What high-tech and low tech tools help her stay on top of her work

• Achieving work/life balance for busy claim professionals, and

• Why an adjuster’s best stress-reduction tool might just have four legs and fur.

Drop in on the conversation and this FREE podcast at http://bit.ly/IguCSN !

The Importance of a Focused Litigation Plan

[NOTE: “The Claims Coach” welcomes a guest post by friend and CLM Advisor colleague John Conlon. John Conlon is an attorney and former insurance claims officer. He presently consults with insurers on litigation management and fee billing issues and blogs about those issues @ http://legalbillreviewerblog.com/. He can be reached at jconlon@conlonassociates.com or at 317-258-0671. From the time I was a child, I heard the adage, “He who fails to plan, plans to fail.” In this post, John Conlon explains why the maxim is especially true in the realm of litigation management.]


Harking back to my days as a litigation claims manager, manager of in-house staff counsel, and now consultant to insurers on litigation management issues, I probably have reviewed thousands of legal files in cases throughout the United States on a variety of issues. One thing I consistently notice in many files I reviewed is the lack of a focused litigation plan.

Collaborating on the Litigation Plan

One of the first things I note lacking in a focused litigation plan is that the adjuster is not sufficiently engaged in the planning process. This lack of engagement usually contributes to a lack of follow through on the plan. While it is okay for the defense attorney to take the lead in coming up with a proposed litigation plan, the adjuster should maintain active engagement in the planning process. Too often, I have seen “okay” or “proceed” as the only adjuster comments to an attorney’s proposed litigation plan.

I have noted that the more experienced the litigation adjuster is, the more likely it is that probative questions will be asked or meaningful comments or changes proposed to the proposed litigation plan. But, even less experienced adjusters, who have little to offer but questions, can add meaningfully to the planning process. Sometimes simply asking the attorney why certain things need to be done or why will certain things take so long to accomplish may serve to help the attorney re-think the proposed steps.

Changing the Litigation Plan

A focused litigation plan must always be viewed as a living document that will need to be updated as circumstances warrant. As developments do occur in a case, they must be viewed strategically through the prism of the litigation plan. How does a particular new development affect the litigation plan from a strategic standpoint? Do major revisions in the litigation plan need to be made? If no changes need to be made in the plan, do the target dates need to be revised?

If a development is not of strategic importance, why waste time (and the company’s money) on changing the plan or reacting to it in some way? Remember it is not always necessary that the defense attorney research every issue the plaintiff attorney raises or vigorously oppose every motion filed.

Conclusion

It is possible to achieve a good result on a litigated file in an efficient and cost effective manner without a focused litigation plan just as it is possible to walk outside and find a $10 bill on the sidewalk. However, the chances of either happening – at least on a consistent basis – are rare.

Achieving a good result in a litigated file can only be accomplished on a consistent basis through developing a focused litigation plan and careful follow through, monitoring, and where necessary, revision of that plan.

Five Risk Management Lessons from Steve Jobs’ Life .. and Death

Like many other folks, I just finished reading Walter Isaacson’s bestselling biography of Steve Jobs. Jobs was and is a fascinating character, a visionary who changed the paradigm in multiple fields – personal computing, movies, music, cell phones, tablets. He successfully navigated multiple risks and obstacles, leaving Apple as perhaps the world’s most valuable company.

Isaacson’s compelling biography has shot to the top of current non-fiction best-seller lists. Interestingly, Isaacson will be a keynote speaker at the annual RIMS Conference, held this year in Philadelphia. Someone else must also think that Jobs’ story has lessons for risk professionals.

The success of Jobs’ biography has spawned a new generation of CEO’s who are Jobs wannabees – sporting black turtlenecks, turning minimalist and peppering their conversations with the Jobs-ian phrase, “Oh, just one more thing …”

In terms of navigating external risks in the business environment, Jobs was a genius.
In terms of navigating risks in his personal space, though, Jobs’ track record falters. Ultimately, Jobs succumbed to a form of pancreatic cancer which he had dealt with for years. Long before his demise in October of 2011, though, Jobs’ cancer was diagnosed in 2003. According to Isaacson, his doctors did a biopsy and were overjoyed to learn that Jobs had an unusual form of pancreatic cancer that was treatable through surgery. They – and many of Jobs’ friends and confidantes – recommended immediate surgery to stem the disease’s progression. His doctors lobbied for it. His family urged him to have the operation. Friends prevailed upon him.

Jobs refused.

He did not want “his body to be opened up.” Instead, he delayed and dallied. He explored holistic regimens to address his cancer: alternative therapies, including diet and visualization. Throughout his life, Job had experimented with offbeat diets and regimens. He fasted regularly. He was a “fruitarian” for one phase. Perhaps one of these regimens could address his pancreatic cancer.

They did not work.

By the time Jobs was willing to undergo surgery in late July of 2004, the window of opportunity for effective intervention had passed. The cancer had spread. He bought time with a liver transplant and various other treatments, but he failed to heed the advice of doctors and others that could have saved his life or extended it well beyond the span that he lived.

Five risk management lessons emerge here:

1. Weigh the advice and counsel of experts. Here, virtually everyone around Jobs suggested surgery. He discounted the advice, having succeeded in “willing his way” around most every other problem he had faced in his life. His “reality distortion field” did not extend to willing away pancreatic cancer cells. You don’t need to be an oncologist to understand that cancer cells don’t stop metastasizing because you are on a macrobiotic diet. In the realm of risk, if your defense attorney and policyholder are telling you to move to settle the claim, NOW, maybe you should listen.

2. Listen to your gut, but don’t always trust it. Instincts are not unerring. Experts are not infallible, but then neither are your instincts. No one wants to undergo surgery. No one wants to die, either. By undergoing surgery, though, he might have avoided premature death. Is it your gut that’s talking or is it the whisper of wishful thinking?


3. Human will is strong, but you cannot “will away” certain risks. Companies may wish to ignore risks because they resent having to deal with them. The Ostrich Approach of sticking your head in the sand leaves you exposed. Companies targeted in lawsuits may resent finding themselves as defendants. “This is a bogus claim!!” They can become so mentally wrapped around the axle with indignation, they cannot view a claim unemotionally. Around a boardroom or conference room table, they convince themselves that they have no liability exposure. There is boardroom reality, though and there is courtroom reality. Unfortunately for companies, claims are tried in the latter, not the former.

4. Risk mitigation opportunities often have short windows. Seize them. Individuals – and companies – often have to seize the moment. Once passed, the window of opportunity may close and forestall opportunities to change one’s fate for the better. Timing is critical when it comes to mitigating emergent risks. Failing to address an employee unsafe practice on a “near miss” may open the door to more serious accidents down the road. It may also compromise the ability to later deny claims due to violating a safety standard. The toothpaste won’t go back in the tube. Carpe diem!

5. If you neglect personal risks – especially those regarding your health – you won’t be able to address external, macro risks. Put bluntly, you cannot continue to make ”insanely great” products if you are dead. In a sense, personal risk management – starting with managing one’s health – is the bedrock. Neglect that, and everything else that you set out to do can become moot. Before an airplane’s takeoff, flight attendants go through their safety instructions. They tell you that, in case of lost cabin pressure, put your own oxygen mask on first before trying to assist a child. This advice underscores the reality that you cannot help others without first taking care of yourself.

Steve Jobs was undoubtedly a genius. Perhaps it is unfair to expect a person to exhibit genius in all phases of his life. When it came to his own health and weighing medical risks, though, Jobs’ decision to forego rapid and decisive action deprived Apple of his continued leadership and deprived the public of an ongoing stream of innovative products which he might have developed through a longer lifespan and more sensible personal risk management.

Kevin Quinley CPCU is Principal of Quinley Risk Associates in the Washington D.C. area. He is the author of ten books on various aspects of claims and risk management. You can reach him at kquinley@cox.net

Litigation Management: Are Defense Litigation Budgets Billable??

A huge part (maybe too much, but that’s the subject of another post) of litigation management is cost control. One key tool in controlling costs is requiring that outside counsel submit periodic budgets. Some of these budgets may be quite detailed and involved.

Further, budgeting is not a one-time discipline. Ideally, budgeting is a recurring discipline on defense counsel’s part. The adjuster or client should have an initial budget within, say, 90 days of the assignment to counsel, at least. Further, budgets have a limited shelf-life, too. Like potato chips, just one won’t do.

Circumstances change which can render a budget out-dated. Responsive and astute counsel should be attuned to this, reporting not only on the changed circumstances, but the implications that those changes have on (a) case value and (b) cost of defense. Sometimes Budget A is predicated on the Judge ruling one way and Budget B is predicated on the Judge ruling another way. Having both scenarios budgeted for helps the insurer or client make both tactical and strategic decisions regarding defense versus resolution. Further, budgets help insurer and clients fine-tune Expense reserves.

In short, defense counsel may have considerable time wrapped up in preparing budgets. A good budget, done right, requires thought … and time! Attorneys may fully intend to bill for such time.

A potential friction point, though, comes when counsel includes in the bill time charged for budget preparation. Some insurers and clients balk at this line item in a bill, thinking that this is something counsel just ought to do anyway and not bill for. Some may refuse the pay any charges related to bill preparation.

Defense counsel bristles, feeling that this is a justified billable task. The insurer or client feels that the lawyer is over-reaching. It can become a distracting frictional issue, even if the amounts in contention are not huge.

Tip for insurers and clients: If you do not intend to pay for budget prep-time, so note this in advance with your client guidelines.

Suggestion: A fair approach and reasonable middle ground, in my view, is to include in litigation guidelines verbiage to the effect that, “We will pay for reasonable time spent preparing a budget. Generally, though, we do not expect counsel to spend more than one (1.0) hour on this task. If you feel more time will be needed, please discuss with us beforehand.”

Tip for counsel: If the client has given you guidelines, read through them carefully! Don’t assume that all guidelines are created equal. If there is anything that is problematic from your standpoint – such as no billing for budget prep – discuss that up front before accepting the assignment or agreeing to be placed on an approved panel. Either negotiate, in a friendly way of course, some leeway here, agree to absorb this time or respectfully decline the assignment.

Litigation is enough of a battle without distracting side-skirmishes with counsel over billing for budgets. Budgets are meant to curb costs, not hike them! Deal with the issue up-front so it is out of the way at the outset of the assignment and avoid it festering during the life of the case.

Kill Them With Kindness … but Still Deny The Claim

[NOTE: “The Claims Coach” welcomes a guest post by good friend and fellow claims professional Nancy Germond, the founder of Insurance Writer, a Phoenix, AZ risk management and communications consulting firm. A second-generation insurance professional, Nancy has authored scores of risk-management articles and white papers. Nancy holds a Master’s degree in Sociology and the AIC, the ARM, the ITP and the SPHR designations.]


Few claims professionals enjoy disclaiming coverage or denying liability. Our lives as claims handlers would be much easier if our insureds’ policies covered any loss they sustained. There is an art to writing the disclaimer or denial which can make life easier for the writer. This method also helps the recipient understand why your company will not provide coverage or accept liability. We call this approach “Kiss ‘em, kick ‘em, kiss em.”

Begin your letter with a sentence—a “kiss.” This wording thanks the insured for choosing your company or praises the claimant for his or her cooperation. Use language like this:

“We appreciate the confidence you placed in our company when you purchased your coverage and your cooperation throughout our investigation of this matter.” Even if the insured was unhelpful, use language that affirms the insured’s role in the insurance contract, such as, “We appreciate your patience during this process.”

To the claimant, you may say something like this: “Thank you for your assistance during our investigation of this matter. We appreciate your patience while we determined the facts of the incident.” This “kiss ‘em” approach affirms the insured or the claimant and stresses the positive, even though you may deliver bad news.

Next, in two or three sentences, outline the events that occurred. Here is some sample wording. “This loss occurred on February 24, 2012, when your employees moved a piece of merchandise by hand truck from your vehicle into the claimant’s location in Henderson, Nevada. This property was in your care, custody, and control while your employees unloaded this equipment from your truck. You described this merchandise as ‘a late-model Kenmore refrigerator.’”

You may want to explain where you obtained the information you rely upon for your decision. For example, “According to the information you provided to our independent adjuster on June 1, 2011, this loss occurred ….” This allows insureds or claimants to correct any misunderstandings they believe you have about the event.

Next, you must gently “kick” your insured or the claimant. After outlining appropriate language that precludes coverage, write a sentence explaining why you disclaim coverage or deny liability. Try language like this:

“Because you were in control of your customer’s refrigerator and due to the foregoing ‘care, custody and control’ exclusion in your policy, we regret that we cannot extend coverage in this matter.” For a denial, wording like, “Due to the extreme weather conditions at the time, we cannot accept liability for your fall.”

End the letter with a final “kiss.” Try language like this:

“While we regret we are unable to pay this loss, we value your trust in our company. If you have any additional information that you feel may alter our decision, feel free to contact me.” If you are writing to the claimant, try something like this:

“While we cannot extend coverage in this loss, we hope that you make a speedy recovery.”

Always add language inviting the insured or claimant to contact you if they have additional information that may alter your decision. Use wording like “If you have any facts that you feel may change our decision, please feel free to contact me.”

This simple wording helps place the responsibility on the insured or the claimant to take further action if circumstances change or they have not previously provided all the facts. This simple affirmative sentence can help prevent misunderstandings and reduce the risk of a successful bad faith claim. It may also help you if these letters become evidence in trial. A well-written letter speaks volumes about your credibility as a claim professional.

Writing the perfect disclaimer is a delicate balance of clearly outlining what the coverage states and how it does or does not apply to the loss facts. Too much explaining can cloud the issue, which can be problematic if you must defend your coverage decision. Writing the perfect liability denial is a bit simpler, especially when you can help point the claimant toward the appropriate party.

For example, in a sidewalk case, the city may be responsible for maintenance in that area. You can furnish a phone number, mailing address or even a hyperlink to a URL where the claimant can download a municipal claim form. Pointing the claimant in the proper direction can help prevent a lawsuit and prevent legal spend.

The “kiss ‘em, kick ‘em, kiss ‘em” approach respects the ongoing relationship you have with your insureds and can help them accept the disclaimer more positively. For claimants, remaining firm but polite and helpful can reduce the chance of the claimant filing suit.

“Where's my adjuster?!?!” Internalizing Claims for Better Access

[This continues our series examining some of the reasons that clients – risk managers, self-insureds, etc. – bring the claims function in-house. This is not to “bash” TPA’s or insurer claim departments. We are simply recapping various motivations that drive clients to bring the claim function in-house, either totally or partially. In future posts, and in the interest of even-handedness, we will examine the DIS-advantages flowing to these same entities from internalizing the claim function.]

Risk managers often get frustrated in trying to connect with their adjuster handling a file. Phone calls are missed. Phone tag takes the place of genuine communication. Phone tag can even give way to email tag! The adjuster may be on the road, on vacation, at an offsite training session or otherwise inaccessible. With an outside adjusting service (or in dealing with an insurer claim department), all the client can do sometimes is keep on trying and waiting .. and waiting .. and waiting.

With in-house adjusters, however, the client has a greater degree of access to the claim staff when needed. To get an opinion regarding a case, to get a quick update or to make a request, one need only walk down the hall and ask the adjuster. Admittedly, in-house adjusters are not going to be around all of the time. Still, it is one thing if a client needs to get in touch with you, and another thing if your boss needs to talk with you.

To the independent claims adjuster, the client is really the risk manager's entire company. In a sense each operating unit of the company is a client, with its own agenda. A company can benefit when individual managers have direct access to in-house adjusters.

This kind of ready access is less realistic when an outside adjuster is charging by the minute. Cost effective use of outside adjusting services requires that referrals be channeled through one person, rather than having each department make adjusting assignments willy-nilly. Sadly, the lack of direct communication prevents the type of give-and-take dialogue that often resolves problems. Such dialogue is more frequent with in-house adjusters.

Where I live in the Washington DC area, the lobbying industry is big business. Part of what clients get when they hire a lobbyist is “access.” In this context, it is access to the corridors of Congress and the top government decision-makers.

In the realm of risk, clients also seek access. Internalizing the claim function can enhance such access without the need to hire expensive lobbyists!