to download - Baton Rouge Bar Association

More documents

Recommendations

Info

How to establish good rapport with insurance claims adjusters BY JOEL K. MURPHY Good rapport with people is essential to success in most, if not all, endeavors. If you accept that statement as true, then why do we, as lawyers, engage in behavior designed to damage our rapport with the people who can help us settle a client’s case before we file suit “The people” to whom I refer are claims adjusters employed by insurance companies and with whom we routinely battle on behalf of our clients. In most cases, failure to communicate with the adjuster is the biggest obstacle to getting your client’s claim resolved. To start, just like us, all insurance companies are concerned with three things when evaluating a claim: (1) liability; (2) medical causation; and (3) value. (For purposes of this article, we’ll assume that liability is not an issue.) The more information you can give the adjuster about the above concerns during the course of the matter, the more quickly you can get your client’s claim settled. As stated above, communication is the key, but the extent of most lawyers’ communication with an adjuster is to send a letter of representation followed several months later, if not longer, by a “pay-my-client-somemoney” demand letter. In between these two is a lot of time and possibly many phone calls from the adjuster that go unreturned. Some will look at this statement and think, “Hey, that is communication!” True, but it is not the type of communication you need to establish a good rapport with the adjuster and to ease the settlement process for not only this case, but also for any future cases you will have. The truth is, at the time you send the demand letter, you have probably lived with the case for at least three months, if not longer, and you and your client are READY TO SETTLE. (Your client, because he or she is ready to move on with life, and you, because you need to move on to other cases.) What we forget, however, is the adjuster has not been living with this claim as you have and does not have nearly the information about it that you have. As you control the flow of information, if there has been no communication with the adjuster other than your two letters, the adjuster knows literally nothing about the second and third concerns listed above, i.e., medical causation and value. Keeping the information spigot closed throughout your client’s treatment and recovery is the main reason we have a damaged, strained or downright bad rapport with adjusters. Further, and more importantly, without that information, the adjuster is not in a position to offer your client any money. To give you a little inside information about the way claims handling is done, you should know that adjusters typically average around 150 or more open claims files at any given time. The bigger the organization for whom the adjuster works, the greater chance there will be specialization among adjusters and the greater the chance the claim will have to be moved or reassigned to someone 14 Around the Bar June 2013
else, depending on the type of injury, the potential value and/or the adjuster’s experience. As with any big thing, though, it takes time to make those changes. Initially, any claim that comes in will be classified as a minor soft-tissue injury unless the crash report or your letter of representation indicates otherwise. In all likelihood, if it is initially classified as a minor injury, your claim will be assigned to a low-level or frontline adjuster who has a limited reserve authority. This adjuster will maintain control of your case until such time as you provide sufficient documentation to support a change in the initial assessment. Once such information is provided, the insurance company can take appropriate action to have the matter reassigned to a new adjuster and to adjust the loss reserve. But remember, it takes time to get these changes made. It will not happen overnight. In fact, it could take anywhere from 30 to 45 days to have your case assigned to an appropriate adjuster, and have that adjuster get up to speed on your client’s injuries and treatment history and complete the reports required to adjust the loss reserve. If the first time the adjuster sees this large amount of information is in conjunction with the demand letter, in all likelihood your case is not going to be in a position, from the insurance company’s standpoint, to be settled for at least six more weeks. Further, if your client completes treatment close to the end of the prescriptive period, then you are looking at having to file suit to preserve your client’s rights, which costs money and affects your client’s total recovery amount. If you have to file suit, at that point the adjuster may say, “Let’s get our lawyer involved and let him deal with this.” If, however, you had chosen to share information with the adjuster as it became available, either via a letter or a phone conversation, then chances are the proper adjuster would be assigned and the appropriate reserves in place before you send your demand letter, which means you could expect a quicker response from the adjuster and a quicker settlement. Speaking of phone conversations, we, as lawyers, routinely ignore calls from adjusters, but keep in mind that phone conversations are a great way to quickly update an adjuster on the status of your client’s injuries and treatment. The adjuster can put that information into his or her claim diary, which is then used to prepare the various reports required by the claims supervisor. These reports can then result in a change in the assigned adjuster, as well as the loss reserves, if necessary. What we gain by sharing information on a given case is more than just one case getting resolved more quickly than it might. We also gain: 1. Good rapport with the initial adjuster. Establishing good will with this adjuster, who you will probably deal with again in the future, is a great thing. This adjuster will likely let his or her coworkers know about dealings with you, which can be to your benefit even if you have not yet dealt with some or many of the other adjusters in the company. By sharing, we have allowed the initial adjuster to also provide pertinent information to a supervisor in a timely manner, which allows the claim to be reviewed and initial determinations revised if necessary. In the last-minute-demand scenario, in most instances the initial adjuster will be called on the carpet for not providing critical information sooner. That adjuster is not likely to think kindly of you and will probably remember you when he or she comes across another of your cases in the future. In addition, that adjuster will spread the bad experience with you to other adjusters. 2. Good rapport with the adjuster reassigned to the case. You will develop good rapport with the new adjuster because he or she is happy to have received this new case with sufficient lead time to become comfortable with it and its issues, as well as to have time to prepare the required reports in support of the reassignment decision and the need to adjust the loss reserves. It also allows this adjuster an opportunity to reach out to you and begin the process of establishing good lines of communication moving forward. Again, these actions will engender good will toward you by this adjuster who has not been placed “behind the eight ball.” In the last-minute-demand scenario, the new adjuster is not going to be pleased to suddenly have a bucket full of information with a demand in a case the adjuster knows nothing about and has not had a chance to review. Plus, depending on the prescription date of the claim, all your work may be for naught if you still have to go ahead and file suit. At that point, the new adjuster is likely going to sit back and let the company’s lawyer put you through your paces before being willing to consider settlement. Adjusters consider it payback, and it is really something adjusters do. Bad will in regard to future dealings is guaranteed with this adjuster. 3. Quicker resolution. By sharing information as the claim progresses, you have allowed the proper adjuster to be assigned to your case and the loss reserves to be adequately established so that when your demand letter reaches the adjuster’s desk, even if it contains some new information, the adjuster can review it quickly and be in a position within days, instead of weeks, to respond and begin settlement talks. By being willing to share information on your claim as you get it, you have made the life of the person controlling the money, i.e., the adjuster, easier. This is an important thing. While you may not end up friends with the adjuster, it can and will create that rapport and good will on which you can rely in the future. June 2013 Around the Bar 15
Page 1 and 2: Inside: Establishing good rapport w
Page 3 and 4: inside JUNE 2013 4 Contributors 5 L
Page 5 and 6: letter from the president BY MICHAE
Page 7 and 8: tales from the bar side BY VINCENT
Page 9 and 10: ar news BY PAMELA LABBE McGlinchey
Page 11 and 12: PHOTO BY PAMELA LABBE PHOTO BY PAME
Page 13: Rubin receives distinguished attorn
Page 17 and 18: June 2013 Around the Bar 17
Page 19 and 20: WHAT I’VE LEARNED: Interview with
Page 21 and 22: New Orleans. He finished Tulane in
Page 23 and 24: Baton Rouge Bar Association 2013 Su
Page 25 and 26: 2 1 June 2013 2 1 2 3 1 2 3 4 5 6 7
Page 27 and 28: UPCOMING BRBA CLE SEMINARS CONSTRUC

to download - Baton Rouge Bar Association

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?