Regardless of the coverage involved, those analyzing claims files can take two different approaches—either quantitative or qualitative auditing. The best audit involves both, whereas inferior audits involve only one.
Too often, auditors, especially those who do not come from an adjusting background, may tend to look at claims files only quantitatively, and may therefore declare an excellently adjusted file "inferior," simply based on quantitative factors. Let's look at both types of analyses to determine what an auditor must consider when reviewing a claims file.
Of Vital ImportanceUndoubtedly, many claims adjusters have been the victims of auditors who looked solely at quantitative factors. In one of the early Iconoclast columns, I cited the case of Jack. An adjuster for well over 10 years, Jack had expert knowledge of coverage, liability, and damage issues. Even so, he was somewhat lazy and often relied upon this ample knowledge to take shortcuts that often did not appear in his file notes.
Want to continue reading?
Become a Free PropertyCasualty360 Digital Reader
Your access to unlimited PropertyCasualty360 content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking insurance news and analysis, on-site and via our newsletters and custom alerts
- Weekly Insurance Speak podcast featuring exclusive interviews with industry leaders
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the employee benefits and financial advisory markets on our other ALM sites, BenefitsPRO and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
