Seven Basic Guidelines for Talking to Your Adjuster

First, keep in mind, your adjuster, wants you to be happy with the work product. Second, your adjuster is a claims professional with the responsibility to direct and control the claim. A sharp adjuster welcomes your input and information you provide to assist in managing your claims. You can create a strong working relationship by implementing these seven guidelines.

Establish Rapport

Rapport means knowing your adjuster on a level deeper than work. Asking about vacation or a child’s school program shows interest in the adjuster as a person and builds a bond making it easier to discuss difficult issues. Establish rapport, and then be ready to discuss your claim(s).

Be Focused

Before calling the adjuster review your claim(s) file notes; jot down your questions and the reasons for asking. Knowing your reasons allows the adjuster to provide a focused answer. Otherwise the adjuster may draw conclusions and give answers not fully covering what you need to know.

Be Respectful

Do not berate or question the adjuster’s competence. As the claims professional it is the adjuster’s job to be current in claims handling in accordance with best practices described in your insurer/TPA service contract. If you are dissatisfied with the adjuster’s claim handling, ask questions to learn why the adjuster acted (or not) a certain way and mutually resolve any issues. If you have a real problem with the adjuster’s performance, speak to their supervisor and make sure to have examples of the issues you are concerned about.

Ask Open Ended Questions

Asking open-ended questions allows the adjuster to explain the status of a claim and a future course of action. Yes/no questions elicit yes/no answers and come over as an interrogation rather than a request for information. An interrogatory style may put the adjuster on the defensive and close off the flow of information.

Have a Positive Attitude

When approaching your adjuster be positive in both your words and tone of voice. After all, the adjuster is working for you and wants to do a good job. When expectations are met a sincere compliment of appreciation and a “thank you” keep your adjuster motivated to continue to provide good service to your company. Copy the adjuster’s supervisor on your applause for excellent performance.

Be Willing to Listen

If in your opinion the adjuster’s efforts have come up short. Ask about the “failure” using open-ended questions, give your reasons, and then LISTEN carefully to the adjuster’s response. Careful listening allows you to hear any valid reasons as to why the claim is not going as you wish. Together you and the adjuster can identify problems and you can suggest solutions to assist the adjuster in producing a better quality claim product. [WCx]

Cooperate and Plan

Finally, after discussing all your questions and achieving a complete understanding of the claim’s current standing, future activity is planned by asking these type of questions: “Since I want to follow up with you, what is your plan to move the file forward?” “When do you expect to accomplish your action plan?” “Who else do we need to keep in the loop and how will that be done?” and “What suggestions do you have about how our company can reduce our workers comp costs?”

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

WORKERS COMP MANAGEMENT GUIDEBOOK: www.WCManual.com

WORK COMP CALCULATOR: www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.