As complex as P&C claims can be, at their root are three simple factors: coverage, liability, and damages.

Coverage: Is this a covered loss? Who is responsible to afford the coverage? Are there multiple responsible parties?

Liability: Who is at fault for the loss, and to what degree?

Damages: Were economic damages sustained? Are they related? Are general damages owed?

At the most basic level, even the most complex claims can be broken down to nothing more than a tight rope and a good fitting pair of shoes. But, alas, claims aren't always that simple. At times, it can seem as if we are a quarter mile above the Grand Canyon, teetering to the right or left.

Herein lies the key to success, where focus and determination can drive consistency and accuracy. Like Wallenda, we cannot afford to falter. While the result for a mistep in our organizations isn't a quarter mile plunge to a certain death, it can result in costly errors that adversely impact our careers and our companies. The key to success, and avoiding such errors, is to ensure that there are solid processes, procedures and workflows in place. The result of such attention to detail is a consistent output in a calibrated organization where claims are handled in a uniform manner. Coverage, liability, and damage investigations are conducted concurrently with the understanding that we are acting as the fiduciary for our insured, looking to properly and accurately indemnify those that have been wronged.

Five Points To Consider

When optimizing claims management, remember to consider the following:

Procedures should be well thought out, well-documented, and highly defensible.

Processes are critical to quality, as they define how your procedures are executed. In the optimal state, the claims organization works as a fine tuned assembly line whereby low touch claims are moved quickly to closure. More complex claims involving coverage or liability decisions are moved to a well trained group of adjusters who are armed with the best tools in the business to make liability and damage decisions.

People should be the best and the brightest. Don't equate tenure with success; while it can mean success, there is no guarantee. Rather, equate quality with success. The single largest spend in most organizations are people. It is this investment that largely differentiates the ordinary from the extraordinary!

Calibration involves leveraging the right people with the right processes and procedures in order to provide for consistent and uniform outcomes. It is this measurable differentiator that gives one an competitive advantage in an increasingly difficult marketplace.

Technology has come a long way since I began handling claims in the days of dictaphones, polaroids and cell phones the size of small TV. There are incredible claim systems and document management systems, and any number of tools that can be integrated to drive outcomes, such as ClaimIQ for liability decisions and a framework to optimize negotiations.

However, success doesn't happen overnight. Nik Wallenda, for example, started walking tightropes at the age of 2. He also trained for weeks to succeed in his quest to conquer the Grand Canyon. Each day, month and year, he got a little bit better, one step at a time. He didn't flinch while executing on the most basic of skills—walking. His focus and determination let him take one step at a time to achieve a desired outcome. This is exactly what we must do in our claims organizations, and for that matter, in all aspects of life.

Chris Tidball is a claims consultant with Mitchell International, as well as an author and speaker. He has more than 20 years of claims adjusting, management and leadership experience with multiple top 10 P&C carriers. To learn more, visit www.christidball.com or e-mail him at [email protected].