3 Biggest Problems in the Claims Adjusting World

How do independent adjusters work through the digitization process?

Claims management is becoming more and more customer-centric and digital solutions are rapidly being implemented to transform operations across all verticals in the insurance industry. The use of artificial intelligence and virtual technology has ushered in an era of automated business models and workflow systems.

Claims adjusting is not alien to such changes and an influx of remote tools and virtual assist applications that are being implemented by IA firms causes concern over the kind of changes it would bring into how adjusters work.

Claims adjusters are the primary mediators between insurers and policyholders and claims adjusting essentially is a human-oriented work. As mediators, independent claims adjusters ensure that the interests of both the parties are taken into consideration and this requires them to be a people’s person.

The job of a claims adjuster not only includes inspecting damages but also requires them to negotiate settlement amount for a policyholder. This is a tricky business and requires a lot of interaction. With interventions like virtual assist or drone technology, digitization can only help with the inspection process but when it comes to having that connect with an individual to discuss sensitive matters of money, technology falls short.

We at JustEZ had an interview with the veteran claims adjuster, Lee Vorcheimer who has been working as an independent claims adjuster based out of Florida for the last 20 years. Some of the major insights that were derived from the conversation are as follows:

Remote tools are not helping cut down the claims cycle:

Many IA firms are on the lookout for remote tools that bring in policyholders into the process of claims management. In light of the social distancing regulations in place, remote tools are a way to virtually connect the policyholders with the adjusters to inspect damages in a property. Applications like Hover and Matterport are supposed to enable policyholders to draw 3-D renditions of their property to make the adjusting process more efficient.

However, our Lee's experience over the course of the first quarter of 2020 has led to the conclusion that most of the claims that were handled virtually had to be reinspected, with Lee himself being assigned to 57 reinspection claims in the month of February. Given the reinspection trend that has been prevalent in the USA, remote tools are increasing claim cycles and doubling the work instead of making the process more efficient.

Virtual Assistance is detrimental to customer satisfaction:

Claims adjusting does not only mean handling inspections and deriving settlement amounts. As an independent adjuster, you are working towards helping people rebuild their lives after they have suffered a great deal of loss. In such an environment, the ability to be a support system for the insured and offer emotional support is what separates a great adjuster from the rest. With virtual assistance, there is a substantial loss in the human touch that is so essential for claims adjusters. A drone may be more accurate with assessing loss but it falls flat when it comes to understanding the customer and their psychological and emotional condition. This, in turn, leads to low customer satisfaction rates for IA firms.

Lack of communication and informational support for adjusters:

According to our Lee’s experience, the biggest problem that independent claims adjusters face is the problem of not having enough information about the policyholder. Being a mediator has its benefits as well as limitations and the IA firms may sometimes leave out certain necessary details when debriefing independent adjusters about a new assignment. What that essentially does is contribute to the adjuster losing credibility in the eyes of the policyholder. An adjuster who is not provided relevant information regarding an assignment might not be able to do his job efficiently.

Having proper informational support from IA firms is crucial to an independent claims adjuster’s operation. Without it, communicative gaps can prove to be detrimental to the entire workflow.

These are some of the major disconnects that are present in the current claims adjusting environment and as long as there is an absence of a balance between implementing technology and leveraging the mediation provided by claims adjusters, these problems will continue to persist.