Has the Insurance Industry Missed the Recruiting Boat?


All of us in the industry responsible for training and recruiting are working as hard as we can to attract new Millennials to our business. Focusing on colleges, we’re teaching, recruiting, interning and trying our hardest to attract new candidates. Sadly, our insurance classes are lucky if they have ten students.

Maybe our industry has missed the boat.

In 2008 – 09 when the economy tanked, the insurance industry missed a great opportunity. When the economy dissolved, the first thing to crash was the construction industry. What if our recruiters had focused on cherry picking construction managers, loss prevention personnel, estimators and other construction personnel who suddenly found themselves jobless? We wouldn’t be having the claims talent crunch we now face, at least in the property arena.

What about today, when the economy and hiring is at a new high? The industry should be looking at people with good customer service and communication skills stuck in jobs that are jobs, not career paths, recruiting these workers into our industry. As Herb Kelleher of Southwest Airlines says, “We’d rather hire someone without a strong educational background who has a great attitude over someone well-educated with a bad attitude.”

Our industry should be selling our benefits: Good health insurance, stability (we’re virtually recession proof), great career pathing, solid entry level pay, stable schedules, college tuition reimbursement and other benefits, to those stuck in jobs without these strong benefits.

Perhaps instead of colleges we should focus our recruiting on customer service positions such as hospitality and human services positions, “poaching” those with strong customer service skills into a career where, each day, they will make a difference in people’s lives. That’s what today’s workers say they want: To make a difference.

Don’t let’s miss the boat. The industry estimates that by 2020, we will have 400,000 open jobs. As I said a few weeks ago on an Insurance Journal Academy webinar when I spoke with other insurance training professionals, without new talent, our industry will be hamstrung.

Let’s think outside the college box and recruit from other professions. With solid customer service experience, some on-the-job problem-solving experience and a great attitude, we can teach them insurance. Who’s in?

Tops tips to bulletproof your workers’ compensation program

workers compensation
Is your workers’ compensation program for the birds?

Last week I presented on ways employers can improve their workers’ compensation program at the Arizona Small Business Association’s annual meeting. Here are the key takeaways for Arizona businesses who have workers’ compensation insurance.

Don’t treat employees as subcontractors. Many businesses, especially in the trades like plumbing or roofing, make this costly error. This is a priority fix both for your employment tax obligations and for covering your employees under workers’ compensation. In Arizona, all you need is one full- or part-time employee (as defined by the IRS or an administrative law judge) to need workers’ compensation insurance.

Tighten injury reporting protocols. Rapid report to your carrier makes a huge difference in workers’ compensation costs. Back injuries are 35% more expensive if not reported within the first week, for example.

Do you have the best agent for your business needs? Does the brokerage or agency offer tools like Modmaster to help you reevaluate your experience modification factor and pinpoint what each injury costs? If not, maybe it’s time to find a new agent.

How’s your safety culture? Safety begins at the top. Employees can’t push safety uphill. Beginning each meeting with a safety report and forming a safety committee of line employees will make a big difference in your organization’s culture.

Where do you need safety training? Can your agent or insurer provide training resources? Spending a little money for training will save you lots of money (and administrative costs)  in the long run.

Do you need stronger hiring practices? Spend money pre-hire by using thorough pre-employment physicals, background checks and testing to eliminate undesirable candidates before you hire them.

Do you know who your adjusters are? Ask your carrier for an introduction if you haven’t met them. Skype or phone conferences quarterly can help, or better yet, on-site visits to discuss each loss, will help reduce costs.

Hone in on those claims where employees don’t get better. Work with your carrier to manage these long-term claims. Ask your adjuster to specifically outline their plan of action on the claim.

Do you have a return-to-work program? If not, you run the risk of an employment claim and increase the cost of each of your claims. Never tell an employee, “We can’t take you back until you’re 100%.”

Make your workplace a healthier one! Comorbidities like obesity, diabetes and hypertension drive medical and workers’ compensation costs. There are many vendors that can bring resources to your workplace to help manage health, including your health insurance carrier.

If I can help you improve your workers’ compensation program, call me for a no-obligation consultation today at 602.870.3230.

Are We Too Focused on the Goal?

Oakland policeA few years ago, the Oakland Police Department spent hours trying to oust a gunman who had barricaded himself inside his house. After firing tear gas canisters into the house, the officers finally noticed the home owner standing beside them in the police lineup, chanting, “Please come out and give yourself up!”

It’s a great thing to set goals and feel proud of our successes. However, to truly succeed in life as well in business, we should remember there are others beside us, also helping us to succeed. Survey after survey shows employees feel increasingly disenfranchised from their work, which hurts productivity and creates customer service issues galore. Employers complain woefully about a lack of talent, yet fail to do everything in their power to keep the very employees they currently employ.

Take a moment today to listen to and sincerely respond to those who help you to succeed, including your employees.

Expressing Professional Gratitude

Today, though, I urge you to take a moment to contact a person in your career for whom you are grateful, either past or present, and say, “Thank you.”

This year my women’s group, which has been meeting once a month for our third year, is reading and discussing a book by Amanda Gore, The Gospel of Joy. I heard Ms. Gore speak at a teleconference last year and her highly personal presentation really hit my core beliefs.

Her book is perfect for a study group since there are twelve chapters in the book, one for each month. Each chapter explores a different spiritual principle, for example, listening, laughter, hope and gratitude. Gratitude has always been my struggle. I sometimes say, “My glass isn’t only half empty; it has a hole in it.” In other words, I have to work to stay grateful.

One of the questions in her gratitude chapter hit home with me. It asked, “Did your parents’ behavior model gratitude?” I can easily say that, “Yes,” their behavior did. Both my parents were independent insurance agents and both people of strong faith. My father, a Lutheran, served in his church as a council member and all-around fix-it guy. My mother, a more reserved Catholic, quietly put her faith into action by volunteering for years at the Westside Food Bank. Their motto in business was “Service before self” and while they were very successful insurance agents, they never let profit interfere with doing the right thing.

I grew up with three older brothers and one of us, usually me or my brother, Ted, was always wrecking a car. (I was quite sure my father owned an interest in the local body shop he insured.) After our accidents, my father would assess the damage then quietly say, “Everything happens for the best.” Frankly, at the time I thought he was slightly mental.

“Dad,” I finally asked when my brother ran his Mustang into a ditch at the end of our street, “How can a car accident ‘be for the best’?”

“Perhaps this minor accident where no one was hurt saved him from a major collision. After all, cars we can fix. You and the boys are irreplaceable.” Dad could always put things into perspective for me. I am so grateful for the wonderful lessons my parents taught me.

This story leads me to my topic – professional gratitude. There are so many insurance gurus who have mentored me over the years, from one of my first bosses at Commercial Union – who predicted, “Ms. Germond, in five years you will be a claim manager,” and I was – to the many risk managers who helped me when I was a fledgling risk manager, never an easy job.

Over the years I have trained and mentored my share of risk and claims professionals. Rarely do they thank me. I’m not dismayed by this; I rarely think of it because at some level, I am sure they are grateful but unaccustomed to expressing gratitude verbally. Today, though, I urge you to take a moment to contact a person in your career for whom you are grateful, either past or present, and say, “Thank you.” I guarantee you: This will mean a great deal to him or her. 

As many of you know, for years I have alternated between running Insurance Writer full time and working more directly in the insurance industry. I just couldn’t stay away from a challenge. But I also know there is more to life than a paycheck. This year, I’m putting it all on the line to branch out, utilizing my God-given gifts to provide specialized services to the insurance industry.

If you’re interested in learning more about Ms. Gore, here is a link to her YouTube channel. If I can help you, these are some of my areas of specialty:

  • Copywriting, including White Papers, advertising copy, articles, ghostwriting and blog entries
  • Consulting with small-to-medium sized businesses to reduce losses and improve workers’ compensation programs
  • Curriculum development and on-site training, including:
    • Customer service training
    • Workers’ compensation claims management training
    • CGL coverage training
    • Business auto training
    • On-site Associate in Claims training
    • Miscellaneous management training

Please feel free to contact me at (602) 870.3230.

 

Cavalcade of Risk #192 Gallops Into View

Cavalcade of Risk #192 gallops into view with some interesting risk-related posts and great advice from various risk experts in their specific fields, from life insurance to enterprise risk management.

expert

 

Excuse the slightly tongue-in-cheek lead-in, because this week’s Cavalcade of Risk is full of great risk management information. We visit a variety of risk management experts for their take on current events impacting their practices. Take a few minutes, grab a cup of coffee and visit and interact with our contributors.

In this post, Dr. Sidorov looks at a recent scientific study that examined national insurance data to determine what happened to the commercial health insurers in the wake of the Obamacare rule that they spend at least 80 to 85 percent of their income on medical care. It turns out that the most vulnerable part of the health insurance market-individual insurance-saw a decrease in profitability.

Jeff Rose helps us through the maze of medical conditions that can limit your ability to buy health insurance in his post. If you have an aortic valve disorder like aortic stenosis or aortic insufficiency, these conditions will impact you when you apply for life insurance. Insurance companies are very cautious about aortic valve disorders because of their potential to cause serious heart problems. There is hope, however. Jeff informs us you can still get insurance despite your condition. It really depends on a few factors, including the seriousness of your condition. To get a better idea of what to expect, read his guide to insurance underwriting for aortic valve disorders.

Here’s a news flash: If you are uninsured, there is a risk of being overcharged for hospital services. In California, the risk is 0. Jason Shafrin of The Healthcare Economist explains why here.

Recently, there have been some remarkable changes in how life insurance is now underwritten, including the use of social media and new technology. Henry (Hank) Stern of InsureBlog has the details.

Julie Ferguson of Workers’ Comp Insider isn’t talking scratch when she asks: “How much risk do you want to take with your kids’ chicken nuggets?” Chickens are on the front burner on the legislative circuit lately with the USDA seeking to overhaul poultry processing regulations that many see as unsafe for workers. But Julie notes that there is more than just worker safety at stake. Read her fast take on fast food here. I would have said, “Winner winner; chicken dinner.” Except after reading her post, and watching the video, I may go vegan. Soon.

David Williams of Health Business Blog says that a patient advocate tells him that it’s “dangerous” to rely on online doctor ratings and reviews and to rely on the “facts” instead. David argues that the case against reviews is seriously overrated and the proposed alternative paths are not as promising as they sound. Read his comments here. I have to admit, I’m a big believer in Yelp and a frequent Yelper myself. I don’t go out to dinner without checking Yelp, let alone try to find a service provider, doctors and dentists included.

Here are some closing thoughts from yours truly regarding the trends I and other risk management experts throughout the US are currently seeing.

  • Enterprise risk management is becoming increasingly important to organizations.
  • Jury verdicts continue to rise. Check your liability limits and double check your policies to determine if you have defense inside or outside limits. Most professional liability policies provide defense within limits, and defense costs can erode your limits significantly.
  • Workers’ compensation costs have moderated in a few states; however, don’t expect to see rates decrease anytime soon, like never. Medical costs continue to escalate nationwide, outstripping wage loss benefits paid.
  • Cyber risks continue to be the bane of businesses at home and abroad; however, hackers increasingly target small-to-medium sized businesses because they seem to provide the path of least resistance to hackers.
  • Commercial insurance prices increased by six percent in the second quarter of 2013, the 10th consecutive quarter of price increases, according to a recent survey conducted by Towers Watson. Now is the time to bulletproof your risk management practices and consider increasing your deductibles or taking higher self-insured retentions.

This does it for another edition of Cavalcade of Risk.

Take the Associate in Claims Class AIC 37 Online and Earn Your AIC Designation

I’m teaching the revised curriculum for The Institutes Associate in Claims Class, AIC 37, Managing Bodily Injury Claims, for Prepacademy, an on-line learning organization that provides an outstanding way to prepare for and pass your exams.

It’s not too late to join us! I’m teaching the revised curriculum for The Institutes Associate in Claims Class, AIC 37, Managing Bodily Injury Claims, for Prepacademy, an on-line learning organization that provides an outstanding way to prepare for and pass your exams.

We began last night, but have a week breather. Our next AIC 37 class covering Chapter 2 starts on Thursday, September 26. It’s not too late for you to join. You can also listen to the recording from Chapter 1 to catch up before our next class. For more information about this exciting web-based training opportunity, click this link.

We’re just winding up the Workers Compensation portion of the AIC. Prepademy is a convenient and easy way to successfully study for your Associate in Claims and other Institutes designations.

Defining and Achieving Maximum Medical Improvement in Workers’ Compensation Claims

Achieving Maximum Medical improvement in a workers’ compensation claim may not be easy, but it is one of the most important goals in claims management.

Maximum medical improvement (MMI) is a term used frequently in workers’ compensation claims management. Often, your adjuster will explain that a case is not ready to settle because your employee has not “reached MMI.” What is MMI? From the employer’s viewpoint, achieving MMI is one of the most important goals in a workers’ compensation claim. MMI is the point at which treatment options have been exhausted and, generally speaking, temporary total disability payments can be terminated. MMI may also be referred to as “permanent and stationary.”

Case law varies in defining MMI

Case law in various states defines MMI in a variety of manners. In Ohio, for example, MMI is defined statutorily as “a treatment plateau.” In California, the Division of Workers’ Compensation defines MMI this way: “Your condition is well stabilized and unlikely to change substantially in the next year, with or without medical treatment. Once you reach MMI, a doctor can assess how much, if any, permanent disability resulted from your work injury.” Texas defines MMI statutorily as “the earliest date after which, based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated.” MMI will vary depending on the claim’s jurisdiction.

MMI – “As good as it gets”

The common thread of both case law and lengthy discussions attempting to define MMI is this – the employee is at a treatment plateau: his or her medical condition will probably not substantially improve. MMI then, might be described this way: “This person’s medical recovery is as good as it gets.”

Does MMI mean the employee can function at his or her pre-injury status? Not necessarily. Even if the employee has not reached his or her pre-injury status, however, the employee can achieve MMI. Some states such as Texas are very clear in stating that an employee’s recovery need not be equal to or better than the pre-injury state.

Defining MMI may be clearly defined in statute, but getting your doctors to declare an injured employee at MMI is not always straightforward. One way to determine if an employee is MMI is to send a nurse case manager with the employee to the medical provider. The nurse should ask this important question: “Is the employee’s recovery as good as he or she will get?” If the doctor says, “Yes,” then obtain a written opinion to that effect and begin the settlement process.

Lack of cooperation in treatment can be managed

What about the claimant who refuses to cooperate in his or her recovery? All reasonable treatment must have at least been offered to the employee. There are times when further diagnostic testing and evaluation are deemed medically reasonable and necessary. It may later be determined that no further treatment would benefit the claimant, or where further treatment is identified and the claimant refuses the treatment. In that intervening time until the employee refuses treatment, the claimant has, in many states, not reached MMI and the employer still owes benefits. Only when treatment is recommended and refused, or not undertaken within a reasonable time, has an injured worker reached MMI. For example, a consulting surgeon may recommend a back fusion; however, the employee declines surgery. In this case, the claimant has usually reached MMI and your claims administrator can begin to conclude the case.

Pressuring the employee for a quick decision on surgery may push the employee to obtain an operation he or she would otherwise refuse. If may be best to give an employee a few weeks to consider his or her decision to obtain further treatment rather than insist on an immediate answer, even if it means paying a little more in temporary disability.

Chronic pain and MMI

Many injured workers allege chronic pain. Chronic musculoskeletal disorders and diagnoses such as arthritis and fibromyalgia impact workplace injuries. In most cases, if the employee’s pain would be materially improved by participation in a pain clinic or pain program, the injured worker has not reached MMI. A patient with chronic conditions may require continuing treatment to maintain his or her recovery or to avert any further deterioration. However, if further treatment is directed solely to maintenance of the patient’s condition and there is no likelihood of further improvement, the patient is at MMI.

The most difficult situation is when the employee’s symptoms fluctuate dramatically. These employees will complain of “good days” and “bad days.” These types of symptoms are troublesome and often delay MMI; however, fluctuation alone is immaterial to a decision of MMI. When symptoms fluctuate, the time it takes to determine whether the patient is at MMI may increase. However, the underlying reasoning remains the same: if the patient has plateaued or the number of good days is growing, consider the patient MMI and begin the settlement process.

However, before deciding MMI has occurred because the employee has had no continuing substantial improvement, the adjuster must offer all “reasonable treatment.” Reasonable treatment does not include experimental procedures. Reasonable treatment usually means treatment that is based on evidence-based medicine guidelines such as the Official Disability Guidelines. With alternative treatments plentiful, employees may want try therapies with only anecdotal track records of success. Just because there are untried treatments available, this does not make them reasonable. Treatment options should be evaluated on a case-by-case basis. When addressing requests by employees for alternative treatments, solicit the treating physician’s opinion in states where employers can direct medical treatment.

MMI is an often subjective and always an important goal

Reaching MMI is subjective and often a time-consuming and sometimes frustrating process. A great deal of state-specific case law concerning the definition of MMI provides some guidance. If you are in doubt, your claims adjuster or legal counsel should assess the likelihood that your employee’s condition has stabilized to the point of MMI. If so, your adjuster or legal counsel should begin to immediately attempt to settle the claim.

Hoarding Behaviors Cause Landlords Big Problems

Hoarding behaviors are on the rise. Take proactive steps to address problems head-on before they escalate to save you repair costs and potential liability.

Today animal and other hoarding cases are mainstream news and the stuff of television reality shows. Early in my career, I worked for a group of self-insured cities and experienced my first case of animal hoarding, if you consider a rat an animal.

In a small Bay Area apartment complex, fellow tenants walked by an apartment unit and noticed a rat sunning itself once in a while on the windowsill. No biggie, they thought. “Live and let live” is a Bay Area core value. Eventually as they passed, however, they noticed the curtains were chewed at the bottom. Still not a big deal. Until one morning, lots of rats were hanging out on the sill and the neighbors decided to peek under the ever-shortening curtain hem. What they saw freaked them out. There were many, many rats, hundreds in fact, scampering about or chillin’ on the furniture, maybe even watching Animal Planet. Neighbors called the management company which turned to the city for help. As the city’s claims representative, I arrived right after a Hazmat team.

Sure, it started out innocently enough – two rats that bred. Then those rats bred. Then the tenants turned their bedroom into the “rat room” and moved into the living room. Soon, rats were everywhere, hundreds when I arrived, as city workers in respirators caged and counted.

“Domestic squalor” is a term used by professionals to define people who slowly destroy their own living quarters. Those who stockpile may experience extreme loneliness after the death of a partner or may have a mental disorder. However, despite the reasons one begins to hoard, landlords must proactively manage these issues to reduce liability. After all, others have to live near these blighted properties.

If you own a rental unit, you probably have a hoarding story or two of your own. Tenants who store papers, hoard animals or even cook meth may be in your story repertoire. Managing the general factors that encourage or discourage these types of problems and others in housing risks can help you to avoid contending with a big, big mess. Those factors are environmental, biological and equipment-related.

Environmental factors include crowded hallways, inadequate lighting which encourages acts like using dark areas as toilets, overgrown landscaping and floors in poor condition.  

Biological factors include not treating vermin infestations, such as roof rats we harbor in inner city Phoenix. These pesky creatures destroy wiring and bring a host of other problems, including mites, rat waste and odor. Bedbugs, too, have become a national problem.

Equipment factors like leaking boilers and other poorly maintained equipment are frequently the root cause of other injuries and incidents like mold.

Only by frequent condition assessments of your tenant-occupied properties can you hope to discourage hoarding and other problems. Here are some tips to help you reduce the exposure to hoarding losses.

  • Try to develop relationships with repair people. Use them to report on the general condition of that property when making repairs, for example a plumber who replaces a leaking faucet or a heating specialist who repairs the heater. They can tip you off to any problems.
  • Put language in your lease agreements allowing monthly property inspection. Use monthly maintenance calls to replace heater filters as the time to eyeball the property condition. This monthly visit helps you both ensure your equipment is well maintained and that hoarding or filthy conditions are nipped in the bud.
  • Hoarding is a difficult situation. Do not let situation get out of hand. If you never faced this problem as a landlord, visit this URL to see what can happen when hoarding runs wild. Your city or county health department may offer guidance, as the city I represented did in the rat affair. Local social service organizations can often assist with the human element, which may be the hardest piece to manage.
  • If you do run across a case of domestic squalor, you may need to marshal outside resources before safely deploying workers. Many companies now specialize in cleaning up after hoarders. Beware, though, coverage for hoarding-related losses may be dicey under your insurance policy.

Landlording is never simple, but with many living alone without family support, hoarding behaviors are on the rise. Take proactive steps to address problems head-on before they escalate to save you repair costs and potential liability.

Taking the Associate in Claims 30 Class?

Take the AIC 30 virtually.

I’ll be teaching the AIC 30 class for Sandy Masters’ Prepademy beginning next week. This virtual live class takes you through the Associate in Claims 30 introductory claims class and is the basis for sound claims handling.

Visit Sandy’s site for my information.

Cavalcade of Risk #144 is a Turkey!

Nancy Germond hosts the 144th Cavalcade of Risk, and it’s no turkey!

 

Since this is the closest the Cavalcade of Risk will come to Thanksgiving this year, what better topic than “turkey” risk problems? While not all blog entries conform to this juicy topic, here are a few that do. In that tone, let’s begin with my Allbusiness blog post, “Consider the Total Cost of Jerks to Your Organization.” In it I discuss how much one human turkey in the workplace can actually cost your organization.

In “The Truth is Stranger than Fiction” category, Jon Coppelman of Workers’ Comp Insider, presents “Turkey Shoot.” This post discusses a case of an insurance investigator shot by the claimant he was investigating, allegedly after being mistaken for a turkey. The truth is often stranger than fiction, isn’t it?

Next, we move to another big turkey that is making the excess market sit up and notice just a bit on the topic of climate change. Have you ever asked yourself if Mother Nature could disrupt your business? This is an old tale for many companies who make their homes in states that regularly experience extreme weather—but what about the rest of us? Read “GRC Preparedness in a Changing Climate” on the Risk Management Monitor written by Alex Bender here.

We move on to some of the biggest turkeys of them all: mortgage makers. At Insurance Bad Faith Claims Bad Faith Law Blog, Dennis Wall updates “Good Faith: Homeowners Betrayed, Banks Unreal: California Investigates, Refuses Pre-Immunity.” His posting presents a reality-based review of why there should be a settlement in the talks between State Attorneys General and financial institutions which are, at one and the same time, Mortgage Loan servicers and originators. This settlement would include all claims based on anything other than the original conditions of the talks. What reasons do the Attorneys General have for even considering a Release of All Claims including claims not yet made and that they have not yet investigated? Read more to learn how Dennis Wall really feels.

As the Supreme Court announces its intent to ponder the national health care debate and those fortunate enough to have group health ponder high-deductible savings accounts and what that means to their budget, Louise Norris presents an interesting look at opting out of group health for individual coverage. Be sure to read her entry, “More Flexibility With An Individual Health Insurance Plan,” posted at Colorado Health Insurance Insider.

In our next post on Disease Management Care, Dr. Jaan Sidorov examines Medicare’s efforts at reducing costly readmissions. It turns out that it’s not only difficult to identify those patients who are likely to be readmitted, but the math necessary to compare readmission rates across hospitals is in its infancy. Dr. Sidorov argues in “Medicare Hospital Re-Admissions: Bad,” that while Medicare’s program is well meaning, this is another example of policy running out ahead of reality.

Medicare will start paying hospitals more which receive high marks for patient satisfaction. What steps are hospitals taking to avert the risk that they receive low scores? The Healthcare Economist weighs in with “Medicare to Hospitals: The Patient is Always Right.”

And as long as we’re talking about healthcare, Hank Stern asks the timely question: “Have you considered the risk of disability and how it might affect your ability to earn a living?” InsureBlog has some thoughts on how to manage that risk. As someone who became quite ill without disability coverage, I can tell you this is a question we should all consider. Read “Are You Protected” and take heed.

That is all the entries we have this time. Have a safe and secure Thanksgiving.

 

Handle Claims With Scrabble-Like Strategy

I was trained by some great claims managers who taught me the first important lesson of claims handling—make a decision.

Last year, I bought a Scrabble game to entertain my guests at my summer home, which is out in the sticks in a little town called Skull Valley. With no TV, a group activity like Scrabble helps prevent descents into insanity from the silence. Although we hear an occasional elk bugle or coyote howl, Skull Valley is pretty darn quiet.

Although I hadn’t played Scrabble in decades, I figured I would pretty much smoke my opponents, since one speaks Czech as a first language and the other reads mostly romance novels (nothing against romance novels, but, the most complex words are usually “sigh” and “crushed”). I was dead wrong. In the first game, the romance reader smoked us both, indeed so badly that the Czech speaker quit in the first ten minutes of the game when we refused to let him spell phonetically and sat glaring at us, his arms folded across his chest.

I started thinking about Scrabble strategy and in anticipation of facing them on their next visit, I visited Google and typed “Scrabble strategy.” I found a great link that outlined top tips for Scrabble players. Upon reflection and because I think of almost everything in terms of risk management, I realized the same rules that applied to Scrabble could apply to managing claims.

What I figured out after my initial Scrabble trouncing is that I was applying the way I settled claims to my Scrabble game. I was trained by some great claims managers who taught me the first important lesson of claims handling—make a decision. There are plenty more files where the one you are agonizing about came from, so decide and move on. That is precisely how I played Scrabble, and ended up with about one-fifth the points of my opponent.

As I read the tips on Scrabble Pages and a few other sites, I translated many of those tips, using or paraphrasing Scrabble language, to efficient and ethical claims handling. Here are a few tips. However, I’m sure if you’re a claims person you could add a few of your own.

Move your tiles!

A file doesn’t get any better sitting on your desk. Pick it up, develop a plan of action, make a decision, and kick the claim forward!

Maximize your power tiles

Don’t squander the biggest advantages you may have. If you have winning surveillance, determine the best time to disclose it. If your plaintiff has a criminal record or previous injury you discovered that may undermine credibility, decide how and if that factors into the settlement equation. Play your tiles closely until you have a strategy; don’t inadvertently let diamonds fall through your fingers.

Be consistent

Inconsistency is some adjusters biggest failing — don’t fall prey to it. In Scrabble, you need 20 points a play to win. Score 10 and you need to score 30 on the next word to catch up. The same is true with files. You may be wildly successful on one file, but if you let 20 others erode because you are too focused on the one you spotlight, your performance will still be criticized.

Get thee to a claims association or obtain an insurance designation

Did you know there are 126 official Scrabble clubs in the US? If you want to improve your game, which for our purpose is handling claims, join an insurance association or take insurance classes and network with your peers. I teach the Associate in Claims designation classes and it is sometimes difficult to convince adjusters these classes improve their chances of promotion. Do you sit around and moan about who gets promotions? You are only as strong professionally as your education, your experience and your network.

Follow the rules

Study ethical behavior and know the rules your company espouses. When adjusters schmooze too much with vendors, saying “no” or criticizing them becomes difficult. Keep a professional distance between you and your vendors, no matter how much you like them. In addition, don’t take advantage of claimants just because you know more about their coverage than they do. I have sometimes heard adjusters crow about the money they saved the carrier on insignificant charges that in reality should have been paid. Candor should be your mantra, even when it costs a little bit more.

Look for the hooks

To score in Scrabble, words hang on existing words. In claims, we generally settle claims one at a time. However, one of the first rules in claims handling I was taught is that we will work with the same people, including plaintiff attorneys, over and over again, so build relationships. Relationships are our hooks. When I have worked with an attorney on one file, I determined what other files I had with that attorney or that firm. Next, I kept notes on those attorneys. What is his hobby? Where did she go to law school? Is she a Denver Broncos fan? Maybe he is a Civil War buff and I can couch a settlement in terms of a famous Civil War battle. Do they take cases to trial or are they simply geared to settle? Early in my career I was led down the garden path by one plaintiff attorney in the Bay Area on traffic light sequencing. When I wrote the denial letter, I addressed him by saying, “Bernie, Bernie, Bernie.” About four years later, I was working in Los Angeles on a claim and which attorney surfaced? Bernie. I was able to pick up the phone, call him and immediately we had a rapport. Little things stand out and improve your “hook.” Those hooks are our signature as negotiators and make the next claim with that attorney easier to settle, sometimes even enjoyable.

Track your opponent

Before beginning negotiations, I wrote a list of the strengths and weaknesses of my case. This way, I know what my opponent is likely to emphasize and I have either an answer, an admission—“You’ve got a point!”— or a counterargument. In other words, I know what my opponents are going to say almost before they say it. I can usually anticipate what is coming next. One word of caution—do not become so focused on framing a response that you stop listening. If you have outlined your case’s weaknesses on paper before you negotiate, you can frame a response so you don’t have to think too long before you reply.

It’s okay to root for yourself or your company

I have an advanced degree in sociology and sometimes I feel badly when bad things happen to good people. However, at some point early in my career an excellent file auditor told me to “lose the sociology” and just handle the claim. Ultimately, you work for your employer, and are not a social service agency, despite how you may feel personally on a loss. I realize this is not a problem for most claims people, but for some, it is. It is perfectly okay to know that you are, overall, fighting the good fight, even if a particular claim outcome bothers you.

It’s just a game

With claims handling, just like in life, you will win some and you will lose some. Get used to it. Savor the wins, learn from the losses, but most of all, once the claims is closed, forget about it. There are plenty more where that one came from.

I often tell others that despite the bad rap the insurance industry receives, I would recommend it in a heartbeat to young people looking for an exciting career. Each day in my career has been totally different and challenging and on some days, downright fun. Much like Scrabble.