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For the Claims Adjuster Who’s Seen It All

In the claims business, most people see experience as the greatest asset. A seasoned adjuster with decades in the field has seen it all and therefore can reach fairer settlements faster — as well as mentor junior adjusters. But what if the last five years of experience are simply a repeat of the previous five? Or worse, what if the last five years’ experience isn’t as good as the five before because of deterioration in disciplined claims-investigations?

In talking to our customers across the country, we’re hearing that a lot of claims managers, while not doubting the value of experience, are beginning to recognize when adjusters are using it as a crutch. In fact, senior adjusters who claim to have seen it all are most likely to need periodic training to recalibrate. Those adjusters may rely on dated assumptions, apply experiences that aren’t relevant to a particular claim, or simply miss pertinent claim details because the conditions, superficially, look familiar.

So, if we can’t rely only on experience, what can help?

We need to pair experience with structure. A well-planned, efficient claims-handling operation provides a framework for applying judgment to relevant cases. For a claims department, that means making sure adjusters remember to ask the right questions at the right time, capture all information that could affect a settlement, and do so in a manner consistent with the rest of the organization.

The ISO Claims Outcome Advisor® (COA) Product Suite — ISO Liability Advisor®, ISO Injury Advisor™, and ISO Liability Navigator® — delivers such a framework. At crucial points in the claims-handling process, the platform provides the operational discipline to help adjusters who have seen it all before make sure they don’t miss anything today. Key features include:

  • an experience-based assessment tool to determine a range for liability percentages
  • accident-scene diagramming tools
  • importing and storing digital photos and documents to include in the case file
  • indicators of comparative liability and the potential for subrogation
  • state-specific statutes as part of the investigation
  • a wide range of dashboards to facilitate adjuster case management, tracking, and reporting across the entire department

Experience sometimes needs help. With the COA suite, you’ll spend less time recalibrating adjusters, and claimants will get fairer, faster settlements more consistently.

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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