Claims Coach is …. BACK!

Claims Coach is …. BACK!

In the NFL, coaches live a perilous existence.  If they don’t win, they often need to quickly find a good real estate agent.  In fact, pro football joke that “NFL” stands for “Not For Long.”

I’m happy and excited to report that The Claims Coach is back!

After many years in the corporate world, I have launched Quinley Risk Associates, an insurance/claims consulting practice.  Its focus will be on casualty claims, litigation management, training, writing, speaking, coaching and expert witness services.

Along with that comes the jump-start of “The Claims Coach” blog, dormant for years due to my commitment to a corporate role.  Look for new blog posts to offer tips, tactics and strategies to work productively, smartly and save money (and Maalox) in handling litigation.

Please also look for the resumption of risk management and claims management columns in Claims magazine.

The Claims Coach is “back in the game” and looking forward to sharing ideas with other claim and risk professionals in our vocational community!

 

 

Signing off for now …

The Claims Coach has recently taken a corporate position which I like very much.  After some months of trying to juggle the demands of this role with blogging and tweeting, I have concluded that I cannot honor my commitments to the former by continuing to do the latter.

Therefore, the Claims Coach is (for now) hanging up his whistle .. and blog in order to focus on writing and projects in the life science space.  In that vein, I am proposing and exploring the use of social media tools within the realm of life science risk management.

Thanks to those who have read these posts, and perhaps our paths will cross again in the future!!

Three Ways Adjusters can Maximize their LinkedIn Membership

“OK, now I’m registered on LinkedIn.  Now what?

“OK, I’ve signed up for LinkedIn.  That’s that!  One more item off my To-Do list!”

These are common and understandable reactions by many claim professionals.  These comments reveal, though, a naiveté about the social networking tool LinkedIn and how adjusters and claim professionals can deploy it in powerful ways to . . .

• Strengthen relationships with existing clients
• Expand and build your business by creating relationships with new clients and prospects
• Project their professional “brand” in the competitive claims marketplace

LinkedIn membership is free.  Here are three ways adjusters and claim professionals can extract more value from this social networking tool:

Tip #1.  Learn background on clients for deepening relationships. Zoom in on potential clients and people you want to know or contacts with whom you are already familiar.  LinkedIn will show you where they went to school and where they worked before.  You may be able to see the groups they belong to, which can be a tip-off as to hobbies and interests. Knowing this helps arm you with additional “ice breakers” that you can use to draw other people out in conversation.  It may reveal areas of common interest or background.

“Hey, I see we went to the same school, though at different times.  Did you have Professor So and So?”  The more touch points you have with your network of existing contacts, the more likely it is that you can move your status from being a vendor or service provider to the status of a trusted advisor!  That’s what you want to aim for.

Moral:  closely study the LinkedIn profiles of your existing and prospective clients.  This is valuable “intel” that you can use to deepen relationships.

Tip #2.  Join professional claim groups.  LinkedIn has thousands of special interest professional groups.  Attorneys ought to have no trouble finding a dozen or more that tie into their areas of interest or expertise.  Check them out and sign up!  LinkedIn lets you sign up for as many as fifty.  For example, in my area alone, insurance claims and risk management, I belong to the following LinkedIn groups:

• Council on Litigation Management
• Claims Management
• Medical Malpractice Professionals
• P&C Claim Professionals
• Risk Analysis and Claims Handling

Many claim professionals belong to these groups.

Tip #3.  Pose and respond to questions in the DISCUSSIONS area, especially in groups where you have subject matter expertise. Your participation, input and visibility in these discussion forums helps project your brand as a subject matter expert in a particular niche of the law.  When others see that you can answer questions authoritatively, point them in fruitful directions or lead them to resources, they are more inclined to buy your credibility.

Later they may “buy” your services and seek you out when they have a legal matter in your bailiwick.  Get involved in the discussions.  Get engaged.  Check the discussion areas regularly.  Participate!

(Caveat:  Check with and abide by your corporate policy here.  Some companies frown on employees making public utterances on claims, comments which could conceivably come back to haunt those companies.)

LinkedIn is just one more way that adjusters and other claim professionals can project their brand, solidify themselves as thought leaders in an area of insurance, market their services and make business connections that can culminate in new referrals and assignments.  Just like a web site, a glossy brochure, or an advertisement in a magazine, the LinkedIn profile page is one part of a professional’s integrated marketing strategy.

Those claim operations that ignore it may lose out on business.  Those adjusters and companies who harness and leverage the power of LinkedIn as a business networking site may reap many financial rewards!

Up in the Air” Practices Could Land you Down in the Courthouse

“Up in the Air” is rightly heralded as one of the best movies of the past year.  George Clooney plays Ryan Bingham, a corporate nomad man who flies around the country implementing reductions in force for client corporations.  Bingham is a virtuoso at one-on-one exit sessions with employees that he terminates.  Boosting his peripatetic lifestyle is his personal quest to accumulate ten million frequent-flier miles and all the perks that go with that.  Additionally, he is phobic about the need for deep relationships or commitment to others.  His frequent flier mileage goal is jeopardized when his company adopts the advice of a young MBA-type whippersnapper to conduct termination exchanges remotely via videoconferencing, obviating the need for travel and capturing huge savings.

The movie is highly entertaining, though not necessarily accurate with regard to the rigors and frustrations of business travel.  Not once during the movie does the protagonist suffer any flight delays, cancellations, missed connections or lost luggage.  Viewers are spared the delights of pulling into a Hampton Inn at 2:30 AM prior to an 8:00 AM meeting with a client.  But we must remind ourselves that – like any movie — this is fiction.

“Up in the Air” got the Claims Coach thinking as to what might happen if companies utilize this technique for terminating workers.  Most likely it would result in a crest of employment practices liability claims.

There are at least two reasons for this.  First, outsourcing the job of canning people would certainly be perceived as a gutless gesture.  If a company did not have the fortitude to conduct exit sessions itself, hiring an outsider to come in and do it would be perceived as an entirely chicken#$%^  weasel option.

Second, compounding this insult by adding injury and having the exchange conducted by videoconferencing would come off to terminated employees is being extremely callous.  All these factors would heighten the incentive for employees to file employment practices discrimination and liability claims, alleging wrongful discharge, discrimination, etc.  Even if such claims were groundless, the legal costs and management time involved in addressing such claims would be a drag on the organization.

Another potential liability claim inferred by the movie surfaces when one of the terminated employees makes an offhand remark that she was going to jump off of a bridge.  The comment is made in a jocular fashion.  However, months later, Ryan Bingham learns that the woman did in fact kill herself by jumping off a bridge into a river.  Bingham’s boss probes to see if the terminated employee gave Bingham any verbal indication during the exit interview of this potential suicidal tendency. (He lies and claims that there was no sign.)

One way to prevent employment practices claims is to treat departing employees with dignity and respect.  In one heralded case, employees received a toll-free “800” number and were told to call.  When they phoned, a recording informed them that they had been terminated.  When Commercial Financial Services discharged 1500 employees in 1999, it did so via e-mail.

These are examples of how not to handle layoffs.  Instead, exhibit sensitivity and compassion. Alert Security to be available if needed, but avoid having guards escort people out of the building or plant, unless there is a compelling need.

“Up in the Air” is good entertainment, as well as an instructive example of how NOT to handle layoffs or employee terminations.

Adjusters — Are you ready for your annual performance review?

Most likely, every claims person has one – or is supposed to have one.  At the start of each year – or right after your latest/most recent appraisal, create a folder – both hard copy and electronic.  Here, gather and save all documentation and backup for the job you are doing in the claims department.

DON’T wait until your review time or just before your review time to do this!  The best time to collect your thoughts on specific ways you have helped the company is NOW – or when they occur – not when you are wracking your brain trying to remember.  Capture them while they are fresh in your mind.  When you are under pressure – “Performance evaluation meeting on Thursday!” – you are most likely to have a brain freeze and memory lapse.

Keep regular track and document your accomplishments.  Make it a regular/recurring “Task” to review and capture what you have done over the past few days, weeks or – at most – the past month to help your unit, save money, improve claim quality, boost customer service or expand your skill sets.

In your email system and in a hard-copy file, create a file labeled something like “2010 Accomplishments” or “2010 Kudos.”   Put in as a recurring TASK in Outlook or whatever reminder/tickler system you have the task of “Record/review recent accomplishments.”  This way, you have built into your schedule time to reflect on what you have done before your memory grows dim.  Pick whatever time interval works for you.  I have a recurring monthly reminder in Microsoft Outlook that reminds me on the 15^th of each month, “Update Annual Kudos.”

Now you are ready.  Examples of how you can use this system:

• Every time you participate in a significant claim project, note that as a bullet point in your record.  Include your role on the project, your accomplishment and your unique contribution

• Whenever you get a letter, fax or email complimenting, supporting or recognizing your work on a claim or a project, tuck that away in your KUDOS file or folder.  If someone relates the sentiment over the phone, “Don’t hesitate to ask, “Would you consider putting that in a letter or email to me?”  Testimonials can become tangible and credible evidence of support for the claims work that you do.

• Take out a blank sheet of paper and label it, “TEAMWORK.”  Each month, note who you have been collaborating with and how it has been working.  Every claims unit wants to have team players even if they are also successful individual contributors.  This can help your boss understand how your efforts blend with those of others to fuel the overall success of the company and its claims mission.  Teamwork is very “big” in corporate America nowadays, so it helps to show that you are not a lone cowboy (or cow girl.)  Put this on a monthly “diary” just as you might put a claim file on “tickler” or schedule for an every-30-day review.  Make it a recurring task in your Outlook or whatever calendar management system you use.

• Add to the folder brochures on any and all educational events, seminars, courses, workshops, webinars, etc. that you have attended or spent time in throughout the year.  Again, this helps “build a record” and accumulates documentation that you are striving to hone your skills and take them to the next level.  Examples could be AIC courses, CPCU classes, Claim Association meetings, educational seminars put on by local defense law firms, etc.

Now you are ready for your annual performance review.  Good luck!!

Medical Malpractice Apology Programs Can Save $$$ and Reform Healthcare

 

 

Some commentators are advancing apology programs as one step among many in reforming the current health-care system.  The latest issue of Business Week magazine (11/23/09, p. 39) offers ten steps to fix the current health-care system.  Step number ten is, Apologize to the Patient.  It cites the Sorry Works! Coalition which was started in 2005 and designed to allow hospitals to admit mistakes to patients and their families.  As soon as hospitals learn of a mistake, they inform the patient, investigate the causes, and recommend changes in procedure.  If the healthcare provider deviated from the standard of care, the hospital offers a settlement.

The article states that the University of Michigan Health System adopted the policy eight years ago and reports that medical malpractice claims dropped by 50% by 2006.  It also cites the University of Illinois Medical Center in Chicago instituting an apology program in 2006 and enjoying a 40% decline in medical malpractice claims in the face of a 20% jump in clinical activity.

While the debate rages over medical malpractice tort reform and whether that should or should not have a role in the health-care plan forthcoming, there are steps that healthcare institutions can take and experiment with that may reduce liability costs.  The recurring caveat here is to coordinate the rollout and implementation of such a plan with one’s own liability insurance carrier to avoid coverage problems!

 

BOOK REVIEW: Soft-Selling Adjusters for Fun and Profit

Soft Selling Hardened Claims Adjusters: How to Expand Your Marketing to the Insurance Claims Industry By Peter Crosa, Peter J. Crosa & Company, Atlanta, GA, pp. 119.

If you are an independent adjuster or work for a TPA and are interested in getting more business and referrals, you owe it to yourself to read and heed Peter Crosa’s book, Soft Selling Hardened Claims Adjusters.  This very practical guidebook gives dozens of kernels of wisdom in a highly readable, hands-on style.  Author Peter Crosa has extensive experience in the insurance claims business, operates his own claims company and conducts extensive training for adjusters.  A recent reading of a review copy of the book impressed me with Crosa’s ability to pack a lot of real world insights and tips into a very concise format.  A slim volume that packs a big wallop.

The book tracks very closely with a multi-hour seminar that author Peter Crosa conducts regularly.  Having said that, you need not have attended the seminar to derive genuine value from the book.  The book has five major sections:

Section 1 – How to know Your Market

Section 2 – How to Make Them Know What’s in it for Them

Section 3 – How to get their Business and Keep it

Section 4 – The Fourth Hour

Section 5 –  Closing Remarks

In addition to the five sections, there are nine appendices – including worksheets, checklists, regional/national claim associations — that provide extremely useful and practical resources for independent adjusters looking to gain additional clients and market share.

The target market for Crosa’s book is independent adjusting companies and third-party administrators who seek more referrals both from insurance companies and self insureds such as risk managers.  Crosa’s book is the best and perhaps the only such resource on this topic I have seen.  Any independent adjuster who reads and heeds the advice in soft selling will deliver a double espresso caffeine shot to business development efforts.

What Crosa offers is a hunting guide.  We’ve all heard the expression, “less is more.”  Crosa seems to be embracing that philosophy in suggesting that most claims people, by the time they are in positions of authority to make assignments, are pretty hard-bitten folks. It is going to be difficult to pull one over on them, blow smoke up their proverbial derrieres or bamboozle them.  As a result, a hard sell is not going to work with this kind of audience.

Rather, marketing approaches must instead focus on soft selling and building relationships.  This is difficult and it takes time.  It is labor intensive.  For all of these reasons, it is probably often overlooked.  Those adjusters willing to invest time and honing the skills, however, will competitively positioned themselves and their companies to gain market share in a very competitive environment.  Crosa understands that it’s not about you, it’s about the customer and the more ways you can shut up and listen and be as useful service to prospective clients, the better chance you have of making more money

Crosa’s book is probably more important in a tough economy then and any other time.  More and more companies are looking to internalize claim functions, not outsourced.  Those companies in the independent adjusting business find themselves under of cost pressure on billings and counteracting the hunger for clients to control their own fate by internalizing the claims handling function.  These two parallel trends make for an extremely challenging and competitive business environment for those who try to make a living out of doing independent claims adjusting work.  This is not an easy business, and Peter Crosa does not sugarcoat the challenges.

There may be little in “Soft Selling” that is revelatory or totally unheard of before.  Rather, Crosa’s gift is in extracting insights from his own experience usable tactics and strategies that can turbo-charge an effective marketing and business development  program.

Forget the old soft-shoe-shuffle when it comes to marketing.  Instead, get out there and start soft selling.

It may lead to hard cash!!

Vaunted Risks of Social Networking Must be Put in Context

Those resisting the use of social networking for business purposes are quick to seize on disaster scenarios or trivialize social networking as something largely used by teenagers wanting to track Britney Spears’ activities. Due to the perceived perils of Facebook, Twitter and LinkedIn, management teams have blocked corporate access to these sites and are wary of using them for any legitimate business purpose.

The problems of mistakes, liabilities and embarrassments are not confined to social networking, however. Let’s look at the following examples :

Hand-delivered letters. A Confederate soldier accidentally drops Robert E. Lee’s battle plans, wrapped around cigars, in a Maryland field. Union soldiers accidentally discover these plans just in time for the battle of Antietam, which the Union wins. (1862)

Internet bulletin boards. The Treasury Department, in trying to collect– and thereby prevent– computer viruses, instead makes viruses accessible to the public on its Automated Information System Bulletin Board. (1993)

Land-lines. An IRS worker makes a typo when releasing phone numbers for a free Helpline. Confused callers to the IRS hear, “Hi Sexy!”and are encouraged to express their “phone fantasies” for up to $3.99/minute. (1995)

Package delivery. The Pentagon confesses to accidentally sending four fuses for intercontinental ballistic missiles to Taiwan. (2008).

Online file-sharing. Plans of Marine One, the presidential helicopter, are accidentally made available to the public when, it was speculated, a defense contractor downloaded a file-sharing service to share music. (2009)

Websites. Maps showing the locations of enriched uranium stockpiles for nuclear weapons go public when the Government Printing Office accidentally posts them on its web site. (2009)

FAX. Dozens of medical providers in Tennessee send confidential patient records to an Indiana business after being given the wrong fax number by the Tennessee Department of human Services. Note that we need not cite here the proverbial “smoking guns,” inanities or blunders made by e-mail, cell phones or just regular old telephones. Yet, nobody with a straight face suggests that we ban use of these tools which have become staples of the business environment. The point is that the vaunted perils and risks of social networking are unique to social networking. The problem isn’t social networking. The problem lies in using social networking in dumb ways.

In a sense, the debate over business use of social networking tools evokes an odd sense of déjà vu. It is reminiscent of the “debate” often heard twelve years ago when tussling with corporate IT departments over whether or not to allow external e-mail beyond the office or create a corporate web site.

The perils of social networking are not to be underestimated or flicked away. Still, they may represent no compelling reason for companies to delay or defer harnessing the power of social networking for legitimate business purposes. Is social networking totally risk-free? Absolutely not.

Are FAX machines totally risk free? Are cell-phones totally risk-free? Are computers, PDA’s and smart phones totally risk free? At the close of a business dinner, is it “risk free” to hand your American Express card to a waiter at a restaurant? Rhetorical questions, admittedly.

The point is: Don’t assess social networking by impossibly rigorous standards that would flunk other tools and forms of communication and transactions that we use every day.

 

Does it Pay to say, “I’m Sorry”??

Further to the ongoing dialogue about the wisdom of apology programs, there is an interesting article in the latest issue of Business Week magazine (10/12/09, p. 22) talking about when it pays to apologize.  According to a study done by the British Nottingham School of Economics, the best way to defuse customer complaints is a simple apology.  This even works better than a cash rebate.

The study showed that e-mailed apologies were effective even when they were brief and impersonal.  The study concluded that, apologies trigger a biological instinct to forgive that is hard overcome.” Think of what impact the apology might have if it was more detailed and personalized.

This may have implications for risk management and claims handling, though there will certainly be reservations from the attorneys to avoid such communications.

Is there a way to apologize without acknowledging blame, liability or culpability, though?

What Can Claim Fraud-Fighters Learn from Dwight Schrute and “The Office”?

The latest episode (9/23/09) of the TV sitcom, “The Office” featured a subplot pertaining to workers compensation claim fraud.  Seems like Darryl down in the warehouse reported a back injury after falling off of a ladder while performing work duties.  Human Resources Director Toby accepts the story but Dwight Schrute smells a rat.  Many features of Darryl’s story do not make sense to Dwight, who urges Toby to investigate further.  Their homemade attempts to reenact Darryl’s accident deepen their suspicions and they plan a stake out near Darryl’s home while he convalesces on disability.

I won’t give away the plot at this point, except for the fact that the do-it-yourself attempt at surveillance and insurance claim fraud fighting ends up backfiring on the management team at Dunder-Mifflin.

“The Office” and the episode are pure fiction, but unfortunately workers compensation claim fraud is not.

Nevertheless, the episode of “The Office” illustrates a few valid points.

First, have a healthy dose of skepticism with regard to every report of on-the-job injury.   “Trust but verify” is a sound maxim.

Second, leave things like surveillance for the experts.  Amateurish attempts to undertake surveillance and fraud investigations may create new liabilities in addition to workers compensation costs.

Fighting claim fraud is a legitimate endeavor when there is a reasonable suspicion of dubious activity.  What is not reasonable is trying to shave costs and cut corners by undertaking amateurish DIY efforts at fighting fraud.

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