About eight months ago, I left my job as an associate attorney in private practice to work for a Fortune 500 insurance company as a claims professional. In my new role, I handle litigation claims against rideshare drivers.
Moving from counsel to counsel’s client has given me a unique view into the particulars of each role in the claims process. My hope is that the following tips and insights for practitioners will foster a better relationship among professionals on each side and allow for more effective and efficient claims handling.
Details, Analysis, and Recommendations Matter
Too often, I receive reports from counsel that just repeat the allegations, incident facts, and medicals. This is information that we already have. Lacking an analysis of the liability issues or recommendations on settlement value and next steps, the reports are not useful. The most helpful reports offer insights into what the known facts mean for the case in this venue, or with this judge, for example.
Likewise, we need to be informed of all details prior to making a decision. I recently received an email from counsel stating something to the effect of, “Plaintiff’s counsel has requested that defense cover court costs, please advise if you approve.” My first question: How much are the court costs? Providing this information upfront would have prevented follow-ups and allowed for quicker closure of the file. I can’t stress this one enough: Please provide details, analysis, and recommendations in your reports to adjusters.
When a claims professional sends a follow-up email to check in on a case, we need a timely response. Period. What is timely? I have found there are two types of attorneys: those who reply within 24 hours, and those who reply after the second or third follow-up, a few weeks after the original request. You can imagine which group is favored by claims professionals.
We are not privy to the “boots on the ground” actions of a case and need timely responses to document and manage our files. This raises the question, should an attorney update the claims professional on every step taken and document received in the case, or wait until there is more substance to report? This is difficult to answer, and likely subject to the preference of the individual adjuster. However, in my opinion, it comes down to what could have an effect on the case. I will simply offer that I appreciate quick notifications regarding any court filing, or impact on a court-imposed deadline or settlement value. Too often, I find myself going through the online docket to find out information about a case before my assigned counsel alerts me of the update.
Furthermore, it is all right to say, “No new updates.” I would prefer that simple reply to either a summary of the whole case with no new information or no reply at all. We understand that litigation takes time and there may not be any news to report. As long as the claims professional knows what he is waiting on or what the hold up is, a simple “no new updates” reply should suffice.
Nothing pains me more than to receive a call from an attorney who says, “I’m about to send you a report, but wanted to call and discuss it with you first.” The attorney then proceeds to read the entire report to me.
Trust me, I can read. I would much prefer to read the report and then have a phone call with you to discuss my questions, concerns, and opinions. If you tell me everything in your report during our call, then there should be no need for me to read your report that you spent hours drafting.
The same goes for when the claim owner changes. There is no need to call the claims professional and give a full case history. We review the entire file upon initial receipt, which should include all of your past reports and communications with the prior adjuster. If we have thoughts, questions, or concerns, we will call you.
Understandably, different companies have different reporting guidelines, and those should all be followed. However, some cases do not need much work on the defense counsel side, while others will need a considerable amount of work. If you are unsure about whether we need an initial case report or a status report, it is all right to check with us before preparing. For a straightforward case, a report may not be necessary.
Likewise, authority for large expenditures and experts should be established upfront. I often get emails from attorneys that read, “We’ve set up the expert medical examination,” when there is no authority and it is not necessary.
Every case does not need an expert. I might need to write that sentence again: Every case does not need an expert.
In addition to the assigned claim owner, there are often many different people from the insurance company who are in a file offering their thoughts and opinions on the case strategy. Counsel should have a meaningful discussion with claims professionals on whether an expert is actually needed prior to engaging their services.
Get to Know Your Claims Professional
Fortunately, both as an attorney and as a claims professional, I have had the opportunity to work with the same handful of people on either side. The professionals who stick out the most are the ones who have taken the time to get to know me.
I am not saying we have to spend 30 minutes discussing the Super Bowl, vacations, or politics, but a little friendly chatter is nice. Getting to know the professional builds trust, which, in turn, fosters a better working relationship and more efficient claims handling.
As the first partner who I worked for straight out of law school used to tell me, “[The cases] are your babies. You have to treat them like that—you have to know everything about them; you have to care for them.” This is our goal, together, and with this in mind, we can accomplish efficient and excellent claims handling.