Being a claims adjuster means navigating a changing landscape where self-insurance and heightened customer expectations are the new norm.

To stand out in this environment, adopting best-in-class practices is crucial. Here’s a guide to the top practices that set apart exceptional claims adjusters:

1. Quality File Documentation:

Detailed, clear, and meaningful documentation is the cornerstone of effective claims handling. Ensure your files speak for themselves, providing transparency and completeness.

2. Proactive Claims and Resource Management:

Take the lead in managing claims, medical aspects, and litigation activity. Be the catalyst for progress toward resolving claims, showing a proactive stance.

3. Effective Communication:

Clear and timely communication is paramount. Maintain meaningful communication with all involved parties and claimants. Building trust through communication is key.

4. Thorough Investigations:

In property claims, document damage comprehensively. For casualty claims, gather relevant information to support sound evaluations of responsibility and damages.

5. Appropriate Reserve Activity:

Master timely and accurate reserving. Carefully analyze damages and medical data to estimate losses or expenses early and accurately. This helps avoid unexpected financial challenges. Document your reasoning at each stage for transparent financial management.

6. Strategic Planning at All Levels:

Every claim file should reflect a clear plan and strategy. Know where you’re going and ensure each action step contributes to an acceptable result.

7. Recovery Initiatives:

Explore traditional recovery or cost containment avenues, such as subrogation and salvage. Your claim file should show the exploration of these avenues and when one or more of these initiatives are not viable.

8. Timely and Appropriate Actions:

From reporting claims promptly to ensuring timely and meaningful contacts and accurate payments, execute every action with precision.

9. Smart Screening and Assignment:

Incorporate human insight into automated assignment processes. Maximizing effective assignment and coverage determination contributes to superior claim outcomes.

10. Supervisory Involvement and Direction:

Appropriate supervisory involvement is critical and should be driven by the needs of the claim or experience level of the staff. Supervisory involvement should include focused directives, evaluations, and strategic planning that align with the specific needs of each claim.

Embracing Excellence:

Being a best-in-class claims adjuster requires mastering these practices. Your role is not just about processing claims but about becoming a driving force in their resolution. As you adapt to the industry’s evolving standards, these practices will distinguish you and set a high standard for claims management. The path to becoming a true leader in claims adjustment is to excel in these fundamental areas.

At AE21, we are committed to helping you become a best-in-class adjuster through our adjuster licensing training and continuing education courses. Sign up today and be on your way to becoming an exceptional insurance adjuster.

---