Calibration is defined as a set of gradations to show positions or values. It brings into alignment what previously was out of sync. In the world of insurance claims, it accomplishes the elusive goal of organizational consistency.
In an imperfect world, achieving perfection is often the goal. While well intended, the chase often lacks the calibration necessary for success. How is it possible to achieve consistent and accurate outcomes when there isn't a uniform methodology for achieving them?
Most certainly there is an element of subjectivity to the claims process. Consider liability decisions in which 10 different adjusters will quite frequently come up with 10 different assessments. While one may be hard-pressed to challenge the results of a 60/40 decision against one that is 70/30, this often isn't the issue. Rather, organizations are confronted with far too many adjusters simply assessing 100 percent against one party or another in a world where 100 percent liability is often an anomaly.
During my tenure running quality assurance, or QA processes, for a large multi-national insurer, significant amounts of time, energy, and capital were expended to bring a uniform approach to achieving results. Most certainly there are products being marketed to assist in this endeavor, which underlies the concern that many basic liability fundamentals aren't being properly executed.
What we found during a variety of calibration exercises designed to benchmark organizational understanding was a widespread lack of liability knowledge. Adjusters often weren't assessing liability because they didn't understand the basic principles, such as duties owed and duties breached. But this didn't stop at the adjuster level, as we found some opportunities in the ranks of management, as well.
When considering your own organization, what is the level of understanding in this critical aspect of the claims process? What percentage of claims are being assessed with 100 percent liability against a given claim party? Consider the scenarios that intuitively shout out "shared liability," such as claims involving intersection accidents, lane changes, parking lot collisions, or slip and falls.
Establishing liability is one of the crucial foundations to achieving the right claims outcome. However, it is often cast aside in a never-ending quest to achieve other metrics. Compounding matters are a subset of adjusters who may seek to resolve claims by taking the path of least resistance. But is this the right approach, especially when considering the important role that the carrier, as a fiduciary, plays in achieving accurate claims outcomes?
While the laws vary in many states, there are some basic benchmarks against which your results can be measured. For auto carriers, a good starting point is to identify the percentage of claims on which comparative negligence was assessed. Opportunities likely exist if comparative negligence is assessed on fewer than 35 percent of collision claims in pure comparative venues, 25 percent in modified venues, and 10 percent in contributory venues.
While these benchmarks may seem daunting, as they did when I first rolled out calibration initiatives, they are both realistic and attainable. That said, proper calibration of an organization does take time, experience, and effort. But it is a worthwhile endeavor that exposes inadequate knowledge from which training can commence. It should never be designed as a punitive exercise, but rather one that seeks to improve performance that ultimately drives results.
In a sense it is your claims organizations "Oklahoma," a football drill designed to pit players against one another in a never-ending quest to perfect blocking and tackling skills. Just as running Oklahoma's create a winning mindset among football players, calibration drills will do the same.
As former Dallas Cowboys Coach Tom Landry once said, "If you are prepared, you will be confident and will do the job." As coaches, it is incumbent upon us to give the players the knowledge that they need to achieve the level of confidence necessary to get results. Calibration drills will force every level of the organization back to the basics, creating a mindset that will forever transform an organization into one focused on execution with no excuses.
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