When working as a casualty claims adjuster for a major insurance company, I carried blank drafts to settle claims. While there was a limit, I had the authority to settle the claim up to that dollar amount.
The company's desire was to not “lose control of the claim.” The goal was to try and settle the matter with the claimant in a fair and equitable manner, and avoid litigation. This is still the desire of many insurers today; however, the public sometimes does not see it.
An insurance professional is familiar with the policy, but the claimant often is not. Frequently, the adjuster needs to explain the terms of the policy to the insureds and why the loss may not be covered. The claimants may not be too happy, but if they understand the terms of the contract, they can better accept the decision as opposed to a flat denial.
That approach almost always poisons the atmosphere of any discussion. When the insured understands the situation, an adjuster is more likely to not only produce a settlement of the claim, but also receive the claimant's appreciation of the company's concern. A continuing relationship may be created, and a claimant turned into a cheerleader for the company who says to others, “You know, X Company really cared about my problem and they helped. I would really recommend them. They don't just want your money.”
I am not suggesting that all claims be paid. In these cases, the insureds must accept this fact, but if it is presented to them in a manner that they understand, and if the adjuster expresses a sincere concern, it will make an impact.
This is something we all know but may forget under a heavy caseload of claims. Try to remember that the individuals involved in each of those files are people who work hard and have had a loss, and they are relying on their insurance carriers to help rectify the problem.
Think about how you would feel in this position. What would your concerns be? Would you expect your insurance company to help you? If you can look at the claim this way and genuinely express your concern, you will go a long way toward settling the claim in a fair manner. You will also leave a good impression of your company and hopefully create a continuing business relationship.
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