Obstacles to the bodily injury update: Breaking through the gatekeeper
When you have yet to receive an injury update on your represented claimant, the adversary is often the personal injury receptionist/gatekeeper.
It’s been almost a year now, and you have yet to receive an injury update on your represented claimant. Your bodily injury reserve currently sits at an inadequate (most likely) $2,500.
When the auditing team digs deep into your file it appears as if you simply clicked “copy and paste” for the last 10 claim notes in a row. Is there no new information available? The problem is you’ve been running into that same adversary: The personal injury receptionist/gatekeeper — as the broken record file notes read:
“Called Attorney Smith, not available. Left message with receptionist for injury update, attorney will return call.”
We can be pretty sure that the personal injury attorney here has not taken a sabbatical for half the year and is avoiding your calls. Shocking, I know.
Perhaps he actually has no update, but that in itself would clearly be an update. Maybe he has not checked in with his client or ordered any records. Maybe he can’t even locate his client. But likely there’s information to be gathered so that you can properly adjust your file and post an appropriate reserve.
So how does this conversation go when speaking with the gatekeeper who answers the personal injury attorney’s phone when you ring?
“Hi, this is Joe Claims, and I need to speak with attorney Smith to obtain an injury update on his client?”
“Oh, is this in regard to settlement?” the receptionist says.
“No, just an update please.”
“Oh sorry, he is in court, let me take down a message.”
Diary your file three weeks, rinse and repeat. Six- to nine-months later and this game continues until you make the effort to break it. Or it ends with a lawsuit, and the surprise is that this soft-tissue case now involves multiple back surgeries, and you have a grossly inadequate reserve to explain to your supervisor.
So, let’s look at some different opening lines with the injury gatekeeper that may assist in acquiring the information you need:
“Hello, this is Joe Claims. I was looking to speak with Attorney Smith regarding his client Mr. Miller.”
“He’s in court right now can I take a message,” says the gatekeeper.
“Oh really, that’s bad timing because I wanted to discuss the possible settlement of the case.”
“Oh, wait I just heard him come in, hold please for Mr. Smith.”
(In this scenario an amazing sequence of events has taken place where the attorney is teleported from the courtroom straight to the office to take your call. I know this to be true because it has happened so often!)
“Hey this is Joe Claims looking for an injury update, can I speak with the attorney, paralegal or clerk assigned to this case.”
(Asking for someone else who may have knowledge of the file.)
“Hello, how are you? I was wondering if you could help me out, I’ve been trying for some time to get an update, and I am curious about your client. Can you check the file and let me know if he/she is still treating and if the medicals are ready for review?”
(Going straight to the gatekeeper for the possible update.)
“Hello there, I am calling about resolving a claim for your client. Can I speak to the attorney assigned?”
(You are floating the possibility of a resolution to see if the gatekeeper will take the bait and pass you through to the attorney. It’s true though because you may be able to resolve now if you can obtain the injury specifics finally.)
“I am calling for an update and understand the attorney is not in, can you provide his cell phone number and email so I can reach out to him?”
(Other communication avenues to pursue the attorney for an update.)
“Hello, I am looking to obtain some updated injury information on your client, can I speak to the attorney please as I just needed to confirm the soft tissue injuries alleged in this matter.”
(Sometimes when you make a statement and it may or may not be correct, the other party may feel the need to correct you and spill the beans. This type of question may lead them to tell you there was a surgery or something more serious so they can convey it holds more value.)
“Hello, I’m sorry I’ve left messages now 10 times in the last 5 weeks, can someone there help me? There has to be someone with knowledge of this case if the attorney can’t speak to me?”
(The plea for human decency can also be a good approach depending on the audience.)
But when all else fails, sometimes a certified letter (if not currently in suit) can be very effective.
Dear Mr. Smith,
I have left several messages over the last six months with your receptionist on XYZ (list all dates of attempts). I have yet to receive the courtesy of a response from your firm with regard to an injury update regarding your client.
Please provide me with an update in the next 10 business days, or I will deem your silence as an indication that you no longer wish to pursue a claim, and I will review my file for closure.
Thank you,
Joe Claims
Creativity can go a long way in many facets of claim handling and obtaining injury updates is no different. Whether you try similar approaches or simply just calls at different times of day, your efforts will show that you are being proactive in your attempts. If you try the same call over and over, you can be pretty sure that the same results will follow. I believe Einstein had some thoughts on that topic.
What are your secrets to break through the gatekeeper on your most frustrating files? Feel free to share your thoughts and share the wealth to the industry.
Chris Casaleggio (ccasaleggio@h2m.com) is a former liability claims adjuster and currently serves as forensic services & claims manager for H2M Architects + Engineers. Opinions expressed here are the author’s own.
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