New Claims Demands
Brownlee correctly notes that the legal and investigative landscape for the 21st century claims adjuster has changed radically since the book's first edition in 1955. In 2012, adjusters face challenges handling files related to terrorism, cyber risks, computer hacking, global warming, nanotechnology, and environmental impairment liability. New types of coverages offered by insurance companies spawn new types of claims that merit customized, bespoke investigations with specialized investigative templates.  

This is the first update since 2008, and the authors have incorporated many refinements into the book to make it current and relevant to today's claims adjusters charged with investigating losses. For example, Chapter 29 focuses on fraud investigation and is entirely new content. There is a new section on investigating dog- and animal-bite claims. Updated material also includes a chunk on contractor liability under general liability policies, day care center claims, and even a section on claims against colleges and universities. The latter seems prescient, given the backdrop of the Penn State Jerry Sandusky litigation, which will keep lawyers—both on the plaintiff and defense sides—busy for years. This is just a smattering of the updated content incorporated into the eighth edition of CF&MIC.  

Today's stretched-thin-but-enterprising adjusters must investigate these claims. Some of these losses will be litigated. Discovery will train the spotlight on what adjusters did and did not do. One could easily see CF&MIC becoming used as a “standard of care” referenced by those attempting to compare what an adjuster did versus what an adjuster should have done on a given claim file.

Checklists: Cookbooks and Caveats
Of course, CF&MIC is only a guide; it is not a cookbook. Sensible claims handling involves knowing when to occasionally deviate from the guide. Checklists may reflect a complete “soup to nuts” approach in getting all ducks in a row and leaving no stone unturned.

The field claim adjuster's mission and challenge is to use this book and any checklist as a guide—but not necessarily follow it in a robotic fashion. Good judgment means that, in some cases, not every item on the checklist needs to be ticked off. In other cases, there may be investigative steps warranted that are not necessarily reflected in the checklist. One must always be careful in approaching claims with a checklist mentality. Checklists provide useful templates, but good judgment can and should enter in as well, depending upon the exigencies of an individual claim. 

If a checklist embodies best practice in claims investigation, then the adjuster must be careful in deviating from the template. In those situations, the adjuster should clearly document in the claim file the reason for omitting or deviating from the checklist. Failure to provide such rationale in the claim file notes may come back to haunt the adjuster and his or her employer. Here, it may be appropriate to abide by the maxim: “If it isn't documented in the claim file, then it was not done (or considered).”

For a more thorough discussion on the rationale and utility of checklists in professional settings, I highly recommend another book, The Checklist Manifesto: How to Get Things Right, by Atul Gawande. While his focus is in the medical realm, the book has implications for other professions as well, including but not limited to insurance claims adjusters.

Some may balk at CF&MIC's price tag, but this would be unfortunate. First, trade books often command a higher price. Secondly, the book would be a sound investment. If CF&MIC helps avoid an overpayment on one claim or averts a bad-faith claim because of investigative thoroughness, the book would have repaid its investment cost many times over. As a result, managers and companies should view having a reference like this in the claims office as an investment, not an expense.

CF&MIC is a sound investment and resource to have as part of every claim office's adjuster reference library.