| Author |
 Topic  |
|
|
JimF
USA
1014 Posts |
 Posted - 01/08/2003 : 08:49:29
|
I have been accused of stirring the pot, opening cans of worms, and shaking up the tree at times, and this is one time, I honestly hope that happens with this discussion.
If this discussion makes some folks a little uncomfortable then the thread will have the desired effect. It if causes some concerns or consternation within the ranks it's long overdue. If I step on a toe or two, they likely needed to be stepped on anyway.
Taken by the forthright comments posted by 'Inside Man' about the poor Quality of work product that carrier examiners and inside carrier reviewers are seeing, as well as reports from the field from some of the clean up crews (as well as my own long experiences with the same), it does make a lot of insurance managers wonder if there is in fact such a thing as Quality Control supervision, Quality Control management, and Quality Control concern within the ranks of cat adjusters and cat adjuster vendors.
So for starters, here are a few questions I would like to pose:
(1) Are the vendors who cat adjusters are working for stressing Quality in claims knowledge and Quality in claims reporting? If so, how and through what techniques?
(2) Are vendors stressing 'speed' of closing files as opposed to Quality of service and Quality of product to the insureds and carriers? If so, how? If not, please explain.
(3) Do vendors routinely send incompetent adjusters home or try to 'save' them through some increased level of training and supervision? How does this impact claims process Quality?
(4) If vendors are in fact stressing Quality in their marketing pitches to carriers and potential carriers and to and within their adjuster roster, then why and how is it that incompetent adjusters are being sent out to storm assignments in the first place?
(5) What do you do as an individual cat adjuster to increase your insurance knowledge and the Quality of your completed work product?
(6) How important do you as a cat adjuster (and for vendors) feel that Quality Control should be stressed in the claims environment?
(7) As a cat adjuster, is your vendor providing file review prior to submission of your finished claim reports to the carrier to insure Quality?
(8) As a cat adjuster, does your vendor have a 'dedicated' individual on staff with the task of evaluating and supervising Quality Control?
(9) Do we as an adjusting community have any obligation or responsibility to police our own and weed out those adjusters who are dragging down the Quality Control aspects and reputation of this profession?
(10) For those who work as staff adjusters, inside claims examiners, and on cat storm clean-up crews, please share your stories of what you see as regards Quality in the cat claims handling process? How bad is this problem? Is the problem getting better or worse?
(11) Finally, what steps are carriers initiating to improve Quality Control? And what steps are carriers initiating to eliminate or reduce Quality Control deficits?
I look forward to a lively discussion of a topic which is of grave concern to carriers and one of the great embarassments to this profession through a lack of any consistent measurable emphasis, evaluation and monitoring of Quality and Quality Control in the clams process.
So having said all of that, let's air out the laundry and clear the air. |
Edited by - JimF on 01/08/2003 09:36:09 |
|
|
CCarr
Canada
1200 Posts |
Posted - 01/08/2003 : 12:02:13
|
I think this will be the 'can of worms' for the month. However, I doubt there will be a lot of wiggle, as the topic will be ice cold due to the lack of people willing to provide their frank comments.
But, the issues / questions you raise are those that in one forum or another I have already given my thoughts and rants on, so I can collect them here again; and perhaps give the thread some impetus.
(1) In general no, but I do know of one or two vendors that pound this home. Those that I have seen that do this, have dedicated and seasoned storm bosses that set the parameters for what they want, communicate effectively, and return work whenever required that they feel needs elaboration and / or correction. I have spoken with others vendors who do not in my view stress Q in either knowledge or quality of the reporting. I measure this with comments I have received while with a carrier, by storm bosses, who have related to me remarks like - he is a young adjuster, he will be a good one after a few more storms, or - I didn't think it was worth sending the report back to correct that, it won't make a big difference, or - you change it if you want, the adjuster is too busy to deal with handed in files, or - we did it that way because carrier XCV allows us to do that, etc etc.
(2) Most yes, but I do know of one or two vendors that although they define and stress the importance of each 'deadline' - initial contact, site visit, report deadline - they do qualify it with saying don't allow that pressure to make you submit substandard work. These vendors, and a couple of others I have been exposed to, know the value to their survival and quality issues, is to have enough adjusters on site so as those present are not loaded down with a volume that would prevent realistic accomplishment of the stated time goals. However conversely, I have heard vendors really push 'speed' without qualifying the Q element, with comments like we want to impress this carrier by closing all our files in 30 days - do whatever is required.
(3) No, not routinely, but I do know of one or two vendors who will not hesitate to do this. However, most will try and salvage the incompetency situation, because when it surfaces 2 to 5 days after that incompetent person is recognized, the vendor is in a poor position to reassign those files and / or try and find a replacement and get those files on track and current. Training is not the route I have normally seen result from this, but instead copious notes attached to the incompetent's files by the storm boss trying to make a 'silk purse out of a sow's ear'.
(4) There is quite a difference in looking at a person's resume with some certifications, as opposed to being actually aware of what that person's real capabilities are. Even if that resume quotes previous claims or cat experience, if that actually was the case, it may have been for a vendor where the storm boss did not impose or enforce strong Q measures; and therefore the current conscientious vendor or storm boss inherits an idiot, who on 'paper' appeared capable. Yea - for my chance to once again chant on the need for 'Standardized Levels of Proficiency'.
(5) That has been flogged constantly in CADO, to little avail or apparent interest.
(6) It is paramount for the survival of the traditional cat claims niche that QC be stressed in any claims environment.
(7) Yes, in all my experiences as an independent contractor doing any type of claims, including cat. However, from my experiences with carriers, with claims coming in, including cat work, the vendors in those instances gave little indication of actual file reviews of adjuster work before it arrived for the carrier's consideration. However, strangely all this work was initialed by the vendor storm boss, and it was evident from what I saw that it appeared to be initialed without any actual review - if otherwise, those vendor storm bosses were as equally incompetent as the adjuster who supplied the unsatisfactory work. I would like to think it was 'initialed' because it was a 'requirement' (vendor/carrier) and that the intent of the requirement was ignored, as opposed to a measure of their actual skills. I questioned this once with a hand full of garbage files, and I got the sad 'time story' - a humbling explanation of how the storm boss had a huge pile of files on his desk to get rid of, to get 'in' so they could get paid (the emphasis was on the fees being paid) so he 'trusted' that most would 'get through' okay.
(8) What does 'dedicated' mean? That's all he is supposed to do, that is his sole function? Or, that plus he cares, regardless of the piles that hit his desk with equally imposing time lines?
(9) Yes, yes, yes! Start doing it soon, or you will have no one to blame but yourself. Claims is a small industry with a big memory, and the cat niche is even smaller. We are all measured by the actions of each other. No point whinning later, if you did not choose to do something about it when you had the chance.
(10) I think I have touched on that with my current thoughts through the other questions. However, to summarize and deal with your last two points; the problem is real, and the problem is bad, and the problem is getting worse.
(11) This as well has been bounced around CADO to some length. The word 'control' is the operative one. The carrier trend towards these steps is more of avoidance of it now, as opposed to real time control issues. Cat claims call centers will continue to expand and mature, and carriers will also try and utilize more of their own staff wherever and whenever possible. One real time control issue I hear being implemented is to have a vendor storm boss situated at the carrier claims office to work with carrier review staff, or I know of several carriers who dispatch senior people to the vendor storm office to work with vendor storm bosses to try and reduce the things I have mentioned; before they hit a desk for review and hopeful payment. |
 |
|
|
Newt
USA
657 Posts |
Posted - 01/08/2003 : 12:26:09
|
I have little knowledge of how vendors, storm managers, or lead supervisors do their jobs, other than that knowledge I have gained here. From my point of view more are doing their job than given credit. First, if you have an incompetant on the job he will gain fame as such and will reflect on others. If someone is doing a good job, you hear little of them.
I don't doubt there is pressure to burn and turn these claims, it means money, and where there is money there is some greed.
Quality is our most important product with the goal of zero defects.
You owe quality work to the vendor, it is a relection on them. It also reflects on your co-workers as well as yourself.
The first line of quality control starts with the individual, then up the line to the carrier.
Controling the quality of work should be a team effort,it must be taught and being independant doesn't mean always doing it your way. There have to be guide lines and standards to go by.
Supervisors should be training and motivating personnel, checking work, and issuing orders is not the only purpose of his/her being in that position.
All the top hands should be looking out for the lower four. Starters, trainees, apprintices, and those just joining the ranks of the pros. The work of the lower four will reflect on the whole profession.
An important aspect of quality control is customer retention, the quality of your work will have a direct reflection on customer retention. How you do your job is measured by two factors how well you please the customer and the carrier. The vendor will be pleased or displeased automaticly.
We have a balancing act, how do you maintain quality work with so many different directions, we just try harder and hope to be right with our claims.
My motto is, "WORK SMARTER NOT HARDER", meaninig you gotta keep on digging for answers to questions you haven't asked yet. |
|
|
| |
Topic |
|
|
|
How We Handle Quality Control In Cat Claims?
Forum Locked
