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Five Risks to Claims Adjuster Effectiveness

The skills on which claims adjusters rely can deteriorate. New risks emerge, demographic factors shift, laws and statutes change, and caseloads grow as carriers seek to keep overhead contained. To make sure your claims department stays effective, you need to invest continually in your adjusters and your claims-handling operation. Otherwise, the variances in settlements for similar claims will spread, resulting in inconsistent settlements that can alienate your best customers. In particular, there are five key adjuster skills you need to address:

  1. Insufficient knowledge and experience: An adjuster may lack the knowledge to ask immediately relevant follow-up questions based on an involved party’s responses to earlier questions. That can cause the adjuster to miss crucial facts, leading to an unfair or inconsistent settlement.
  2. Overconfidence: A senior adjuster may become less effective over time. Carriers need to monitor changes in risks, loss causes, and evaluations and negotiations to ensure fair settlements. And complacency is always a concern. Senior adjusters start to favor experience-based negotiations over facts and the law.
  3. Case allocation: Senior adjusters tend to get more cases because carriers believe they have the experience to handle the load. That can lead to a significant drop in work quality when trying to balance a best-practices contact strategy and a 100 percent closure rate.
  4. Additional responsibilities: The same senior adjusters handling larger caseloads also often support junior colleagues — an added duty that can distract senior adjusters from their own cases.
  5. Missed opportunities: Everyone needs a reminder to look for key factors in a claim file — even the best adjusters miss something important from time to time.

Training alone isn’t the solution, although it remains an important part of keeping your claims adjusters current with best practices. You also need reliable, repeatable processes that enforce claims handling discipline and keep your adjusters consistent with each other — and with company standards. With the ISO Claims Outcome Advisor® (COA) suite, you can implement technology-driven processes to help your adjusters achieve fairer, faster, and more consistent settlements.

Michael Rivers

Michael Rivers is manager for Claims Consulting and Analytics for ISO Claims Services. He manages the statistical analysis group, which is responsible for data mining and data analysis of millions of data elements from the property/casualty insurance industry. Mike can be reached at or 803-422-9169.

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