In criminal law, offenses are judged as infractions, misdemeanors, or felonies. In academia, A, B, C, D, and F are immediately translatable to value judgments such as excellent, good, average, poor, and failing or “unacceptable.”

A New 'Grading' System
For ease of understanding, I have devised “The Blake Scale.” Similar to an academic rating system, this scale uses five broad categories to help claims professionals discern the overall quality of one typical page of a business-related letter—either template or free form—report, e-mail, memo, or guidelines pertaining to best practices.

One caveat is this: Sometimes, because of particular circumstances, a small infraction can mushroom into a full-scale “felony.” A quick example comes to mind. If I, as a writing consultant, have a single typo in an e-mail to a prospect or a client, then I may lose a job. If, however, I had been writing to a stranger, then there would be no unfavorable consequences for my gaffe.

If you feel that one typo could never loom large enough to cause havoc, then allow me to mention a big accounting firm that sent out its new brochure to masses of prospects and clients, only to later discover that, on the brochure's cover, the term “Certified Public Accountants” was rendered “Certified Pubic Accountants.” Now that is a pretty egregious error, the repercussions of which we shall not explore in this article.

What follows is The Blake Scale, giving a general description of the characteristics of a document that is considered “unacceptable” (5) to one that is “Excellent” (1). The scale is broad, and later on I will describe the typical kinds of errors found in each of the five categories on the scale.

Take Note
I would encourage you to make copies of this article to disseminate to the various players in your claims organization. Take a single page of a claims letter, memo, report, e-mail, or best-practices guidelines and assign it a number based on the rating scale below:

5. Unacceptable. Only about one in fifty documents deserves to be rated “unacceptable.” This rating will mean that the document contains inaccuracies, a harsh tone, or an abundance of stylistic and factual errors that could lead to a DOI complaint, a distraction from the claims process, or even a bad faith lawsuit.

In terms of organization and content, style, and level of correctness, a “5” may exhibit the following characteristics:

• Inaccurate
• Harsh or untrusting tone
• Wordy and unclear
• Replete with errors in punctuation and grammar
• Redundant; poorly phrased; may have mistakes involving gaps in logic
• Vague or inadvertent sexism, racism, ageism, or subjectivity regarding a claim's outcome

4. Poor. This document is difficult to read, with substantial problems in phrasing, paragraphing, or lengthy sentences. It may contain many legalistic and old-fashioned phrases, as well as excessive wordiness.

• Confusing
• Few transitions
• Punctuation and grammatical errors
• Wishy-washy tone
• Ideas that lack supporting details
• Quotes are insufficient, excessive, or inaccurate; sounds impersonal

3. Average. While this document gets its point across, it is often careless and filled with clichés or old-fashioned phrases. It may have lengthy sentences and paragraphs and a smattering of grammar and punctuation issues.

• The analysis is superficial
• Errors in word choice, spacing, punctuation, and/or spelling
• The introduction and conclusion may be weak
• Miscellaneous other errors, such as inconsistent capitalization or abbreviations

2. Good. Basically gets the point across. May have minor stylistic flaws, a comma error or two. May require some copyediting.

• Clearly phrased
• Paragraphs are logical
• May have two or three stodgy phrases or clichés
• Sentences are generally concise, varied, and fluent
• Sounds personal

1. Excellent. This document is well-organized, flows well, and has no examples of old-fashioned phrases or punctuation problems. Its sentences and paragraphs are relatively short, readable, and arranged carefully.

• Appropriate tone
• Clear and concise
• Helpful to the reader
• Well-phrased and well-organized
• Appropriate word choice
• Paragraphs are unified and coherent
• Follows standard rules of punctuation, grammar, and spelling
• Clear purpose

Characteristics of Each Rating
No documents are alike. Rating a document will rarely be instantaneous. Yet, after reading thousands of claims documents, I believe a claims professional can quickly rate a document, become more aware of the specific type of writing issues that commonly occur in the field, and judge the relative severity of each problem.

As you work with the scale, you will develop your own way of applying its basic tenets to the particular document you are reviewing. Something about the seriousness and frequency of the issues you notice will guide you to make a determination. Few documents will be awful; few will be free of all writing problems.

Here are the types of issues I notice in each of the five ratings. Some may be present in any of the ratings, occurring once in the best of documents and many times in the worst.

Unacceptable
One out of every fifty or so documents may be incendiary and need immediate intervention. Among these are letters that are discoverable in which ageism, racism, or sexist or demeaning remarks are evident and may be exploited by opposing counsel. Subjective language may demonstrate that the writer has already become biased before all the facts are in. Sometimes a harsh or even belligerent tone makes a document unacceptable. It may alienate a client, top manager, or opposing counsel.

One letter, filled with numerous punctuation and grammar errors, became “Unacceptable” when the reader, an educator, not only took offense to it but also corrected the errors and mailed a copy of the letter to the carrier's CEO.

Examples from unacceptable documents:

“We have very differing opinions about who has been dragging their feet on this claim in terms of bringing it to a conclusion.”

“The policyholder was discussing something with three Mexican-looking guys…”

Lack of objectivity, taken from a claims file: “We have a favorable interview from a neighbor that our insured's driver was not supposed to use the car.”

Even more subjectivity: “We can only hope that the plaintiff's condition continues to deteriorate …We think this person will die of cancer and we will be off the hook.”

Belligerent tone: “Reality has finally set in, and your client, his family, and even you now realize the theories of liability that you have relied upon in the past are not applicable to this claim.”

Embarrassing word choice: “We want to settle your claim as expediently as possible.”

Poor
A combination of poor wording, questionable punctuation and grammar, as well as inappropriate tone.
Examples are as follows:

“Dear Mr. & Mrs. Smith;

We have given careful consideration to your claim arising out of the above-captioned incident.

Our investigation of the facts indicates that there is no afforded coverage for your vehicle from the auto policy of Mr. XXX. The stipulation of the policy is that of an insured using a “non-owned automobile.” The use of the “non-owned automobile” must be under the scope of the owner's permission. This scope is totally absent in this situation, as XXX had not the authority to let anyone drive the auto. The auto was driven without permission from the owners, in this case the two of you. The auto was also driven without your knowledge of the action being permitted. We have a non-permissive driver driving a non-permissive auto.

Therefore it will be necessary we decline the payment of your claim.

If you feel we are in error and can provide proof that coverage should be afforded for the damage please let me know, we will be happy to reconsider our position.

While a decision on our liability for this claim must of course await the completion of the investigation, it appears conceivable that some policy defenses may be applicable with respect to this matter in which case litigation would be a distinct possibility.”

***

Taken from a claims letter: “This letter will follow up yours of March 17 …”

***

Run-on sentence: “According to the last paragraph of your e-mail shown below you confirmed the total audit experience is 7,100 this is the number we based our revised audit on.”

Other issues may include: overuse of parentheses, not putting comma after the full date, unnecessary capitalization, using an ampersand in “Dear Mr. and Mrs. Smith:” or not responding to every issue brought up in a complaint forwarded by the Department of Insurance.

Fair
Examples:

“This is to confirm that XXX Insurance Company has received your notice of loss regarding the theft of your tools, and our conversation of December 29th, 2003.”

***

Just one example, such as the following lengthy paragraph filled with legalese, can put a document into the “Fair” category:

“Inasmuch as the late reporting of this loss may have impaired Acme Insurance Agency's ability to determine the origin and extent of damage and whether coverage exits for the loss, the purpose of this letter is to advise you that any action taken by any representative of Acme Insurance Agency in connection with the investigation of the aforesaid reported wind and water damage claim, including the investigation of all facts pertaining thereto such as the cause, loss or damage resulting therefrom shall in now way change, waive, invalidate or forfeit any of the terms, conditions and requirements of the above captioned policy of insurance.”

Occasional issues with tenses, often associated with people for whom English is a second language: “I have not receive this information.”

Occasional slash constructions: “he/she” “and/or”

May contain the weak and presumptuous: “Thank you in advance for your cooperation”; or the cliché: “If you have any questions, please do not hesitate to call me.”

Good
Example:

September 12, 2011

Ms. Alisa Craig

6 McDermott Street

Seattle, WA 98767

INSURED: Mason Group/Cedar Hill Apartments

POLICY NUMBER: 989898

DATE OF LOSS: May 19, 2011

ABC CLAIM NUMBER: POL09990

Dear Alisa,

Jahn Adjusting was retained by ABC Insurance to investigate the claim for the damage to the building as a result of fire at the loss location of 22 Foothill Road, Bellevue, WA 98678.

This letter serves to inform you that a $100,000 advance was issued and received by you on Thursday, September 7, 2011, toward the building portion of your claim. At your request we are notifying you in writing of the above mentioned payment(s).

The foregoing reservation is predicated upon the facts and circumstances known at this time. ABC Insurance expressly reserves its right to amend this reservation at a later date should it be appropriate.

If you have any questions in regards to your claim, please contact your Public Adjuster, Karen Seider, at (543) 324-5555.

Sincerely,

Copy: _____________________

Note: In the letter just quoted, the “RE” line, salutation, inside address, and closing are all correctly done.

Excellent
To earn a “1” or “Excellent,” a document needs to be free of even the smallest problems. The inside address, RE line, salutation, and closing are perfect. Sentences and paragraphs are not too long and are easy to read. In fact, if you were to read this document aloud, it would sound warm and natural as the human voice.

Here are ten earmarks of an excellent letter:

1. It gets right to the point

2. No old-fashioned phrases (e.g., “enclosed please find,” “as per”)

3. No redundant expressions

4. No wordiness or vagueness

5. Logical flow of ideas

6. Appropriate transitions

7. No spacing, spelling, abbreviation, or capitalization errors

8. Apt word choice

9. Friendly

10. Conversational but not containing slang or colloquialisms

I should mention that only about one in fifty letters I review merit the category of “Excellent.” The Blake Scale and the examples used to illustrate each of its five ratings will help diagnose and solve the types of writing problems that subtly sabotage claims handling.

To be proactive in tackling claims-writing problems will prevent a million- or billion-dollar carrier, TPA, or independent agency from experiencing everything from embarrassment to a bad-faith lawsuit. Clear, precise writing disarms the opposing attorney who might enjoy reading a poor claims letter aloud in court. Effective writing gives you the edge because it demonstrates that you are fluent, organized, and authoritative.