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SKILLS & Click here for detailed information about PRISMS for Claims Adjusters. |
 From Claims Magazine  People
Skills Speed and Streamline Settlements By Russell H. Granger It seemed like an open-and-shut case. The insured said she understood that the policy covered the depreciated value of the equipment lost in the fire, not the replacement cost. The adjuster believed he made that clear. The file seemed to be making a bee-line for the back room. Suddenly, a letter arrives from a lawyer representing the insured threatening a suit and a complaint if the company doesn't up the ante substantially. What went wrong? Right Question Asked? A good possibility is that the adjuster simply didn't ask the right questions. With probing, he might have discovered that the policy holder didn't really understand the settlement. Further explanation might have avoided the whole mess. Settling claims successfully requires a good understanding of how the process of communication works. Although the claim-settlement process is guided by the insurance contract and the facts of the claim, dealing with policyholders as individuals, meeting their emotional as well as financial needs, is key to closing claims fairly and quickly. If the customer feels he or she is getting less than fair treatment-no matter how unfounded that feeling is-problems are inevitable. A few people, of course, are going to complain no matter how carefully they-re handled. But in most instances, a breakdown in communication between the adjuster and customer is the root cause of complaints and unnecessary involvement by counsel. Fortunately, good communicators are trained, not born. With proper training, adjusters can improve their communication and human-relation skills. The result: fewer complaints, more files closed routinely and quickly, and lower stacks of mail from lawyers. Several skills are imperative for good communications. One of the most important parts of that process is how to ask the right questions. First requirement, though, is a good understanding of the communication process. Communicating The adjuster may believe he or she has explained a settlement situation in clear, precise, rational language. Because the message was important, the customer paid attention-even asked a few questions to clarify-and understood. On the surface, that sounds like a reasonable assumption. But the assumption is not only unreasonable, it's irrational; importance does not automatically motivate understanding. Ironically, the problem grows worse when the adjuster asks the customer," Did you understand that?" "Yes, I did," replies the claimant confidently. But just because the right message was sent, it doesn't mean the wrong idea wasn't received. Each party goes away from the discussion with a very clear understanding -- of completely different ideas. Because the adjuster lacks the skills necessary to objectively evaluate the clarity of the message, he or she doesn't even realize that both parties are actually in a fog of misperception. Like two ships without radar in a fog, they're bound to collide. Communication can be defined as what the listener perceives a message to be. Communication psychologists have developed an entire system based on this concept. It's called neurolinguistic programming. But even good old common sense tells us that the receiver's perception is the barometer of good communication. In the process of settling claims, the burden is on the adjuster to evaluate what has been communicated, how well, and whether everything has been understood. Given the complexity of insurance and the emotions that swirl around a loss, it isn't surprising that communication so frequently goes awry. What is surprising is how rarely adjusters receive training in effective communication skills, skills that directly affect the adjuster's ability to close files. Only by asking the right questions, and actively listening to evaluate understanding, can an adjuster ascertain that the message sent and received are the same. Questioning Techniques To get the facts straight and deal with emotions effectively, the adjuster must question the claimant in a thorough, disciplined way. No competent lawyer would simply "wing it" when questioning a witness, even though it might look that way on The Practice. The best lawyers are almost obsessive about preparing questions. To remain competitive, adjusters must do the same. Unfortunately, adjusters too often rely on their hunches and launch headlong into a settlement negotiation unprepared. This haphazard approach is bound to result in more misses than hits. If the initial report is inaccurate, loss reserves may be set too high or too low. If information is not received or is misunderstood, files will have to be opened again and again. To be truly productive, adjusters must do more than ask the prescribed set of technical questions they are required to ask. The adjuster must master different questioning skills that will enable him or her to devise a "needs profile" of the claimant. A needs profile uncovers the claimant's needs, emotional as well as financial. The adjuster will then know how to tailor the presentation of the settlement to meet those needs. This technique also enables adjusters to clarify claimant responses to make sure that true communication is taking place. Proper questioning enables claim specialists to find out what sort of person a claimant is, assess wants and needs more quickly, and guide discussions along a logical path. Questions can also be used to counter objections; they very effectively deflate the emotional aspects of an objection and clarify the claimant's real concern. Skillful questioning techniques reveal unrealistic demands or expectations-which can then be nipped in the bud to avoid future roadblocks to the settlement. The "Needs Profile" Approach The needs profile approach to claims settling requires knowledge of three types of questions: open-ended, close-ended and special-purpose. Each type has its own best use. Open-ended questions are probing tools. They typically begin with words like Why, How and What. Open-ended questions help establish rapport, uncover general information, and reveal basic needs and wants. This is a prerequisite for building the needs profile. An open-ended question at the start of the conversation can pay enormous dividends. "Well, Mrs. Smith, why don't we begin with you telling me all about the how the accident happened?" may be a common open-ended question for an adjuster, but when it is used as part of a complete series of questioning techniques, the answers are more valuable. While it is crucial to get claimants to disclose their needs, typing up loose ends is just as important. This is where closed-ended questions come in to play. Closed-ended questions begin with words like Who, When, and Which. They are used to gather specific facts, and information. For example, "When did you first notice the water damage?" Closed-ended questions nail down admissions and evidence, and they enable the adjuster to direct and control the interview. While open-ended and closed-ended questions are the primary tools, special-purpose questions are ideal when situation demand clarification or commitment. "Learning and using questioning skills isn't just a matter of instinct, experience, or even knowledge. For maximum results, the adjuster must be formally trained to use these techniques." Reverse Question The reverse question is one such special tool. A reverse question is used to clarify a claimant's response or question by rephrasing the claimant's statement in the form of a question. For instance, when a claimant seems unhappy with a settlement, but can't or won't explain why, the adjuster might say: "You said the terms of the settlement offer are not quite what you have expected. Are you saying that you have a problem with the estimate itself or the time allotted for repairs?" In this case, the reverse question narrows down possibilities. The claimant can no longer be "generally" displeased; he or she is guided toward a more specific response. This is also an example of how to handle objections with questions; the reverse technique can be used to clarify an objection before answering it. Another helpful specialty question is the tie-down question. It's a kind of verbal judo. In an effort to gain agreement on issues, or guide the other party into a commitment, a statement is followed by a question like "doesn't it?, "wouldn't you?" or "isn't that right? Tie-down questions are effective when dealing with attorneys, for example, who are often masters of verbal judo themselves. An adjuster who is having difficulty closing a file might use the following tie-down question: "Counselor, you did say you were interested in using a structured settlement if we can finalize the case this month, isn't that correct?" The attorney is then forced to agree, or else admit that he's changed his tactics. If this is the case, the adjuster will know to employ other questioning techniques to uncover reasons for the change. There are other special-purpose questions, such as the pedestal question (getting the claimant talking about him or herself) or the contrast/compare technique (guiding an answer toward a pre-arranged choice). Adjusters who master all these will find that files close smoother and faster. Learning and using questioning skills isn't just a matter of instinct, experience, or even knowledge. For maximum results, the adjuster must be formally trained to use these techniques. A workshop like PRISMS For Claims Adjusters addresses the "people-skills" aspect of settling claims, and is among the first of what is sure to be a crop of "non-technical" training programs for adjusters. With a heavy emphasis on communication, business relations and negotiation skills, programs like PRISMS will not only help claims departments speed and streamline settlements, they will produce improved relations with the public and a better image for the industry. |
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