Listening and learning from others is crucial to bettering oneself in any endeavor. This is especially true when handling property insurance claims where claims techniques are changing with technological change, new laws, and claims handling values varying greatly between property insurance companies. In preparation for my upcoming Windstorm Network Conference presentation, Why Can’t We All Just Get Along? Different Perceptions About The Modern Claims Process Between Policyholder and Insurance Industry Representatives, I spoke last week with three experienced claims managers about our panel presentation, which will take place on January 26, 2022, at the 2022 Windstorm Conference.

The topics we will discuss are important and will include:

  1. How Computerization and Artificial Intelligence is impacting claims handling
  2. Claims Delay
  3. Insurance Fraud
  4. How Claims Managers Work to Ensure Fair, Prompt and Efficient Claims Handling
  5. Perception of Roles of the Policyholder, Public adjusters, Contractor and Policyholder Attorney in the Claims Process
  6. The Need For Changes in Law and Regulations Regarding Property Insurance and Claims Handling
  7. What Public Adjusters and Policyholder Attorneys Do Which Slow Down Claims Payments
  8. What are Common Claims Issues With Restoration Contractors

These are “elephant in the room” topics that many only want to hear from their viewpoint. Facing the reality of how one’s role and actions in claims can be improved and is not already perfect is hard for many to take. However, facing realities and what that means about future plans and actions is often harder than pretending. My hope is that our audience will be better in whatever role they have in the insurance claims industry from this panel presentation. This will not be a boring lecture by a lawyer talking to insurance adjusters about the law. It is also not going to be a debate looking for a winner or trying to embarrass somebody or some entity, which seems to be the goal in some other conferences.

My co-panelists are

Doug Branham

Doug Branham is founder and CEO of Colonial Claims. Doug has been in the P&C and Flood adjusting business for over 40 years. He has worked and supervised over 500,000 flood losses through more than 130 hurricanes and tropical storms. He also has extensive experience in Wind, Wildfire, and General Liability claims, and other major claim events such as the Exxon Valdez oil spill.

In 1982, Doug founded Colonial Claims and has since grown the company by focusing on personal customer service, accuracy, and efficiency through technology. Since then, Colonial Claims has handled over $46 billion in damages from single and multiple assignments to catastrophes.

James L. Kelly, Jr

James L. Kelly, Jr. (“Jim”) was Vice President and Chief Coverage Director Chubb North American Claims in Wilmington, Delaware. While at Chubb, he was responsible for the management of major commercial and personal lines property litigation involving the Chubb affiliated companies. He also provided coverage and adjustment advice on high exposure claims involving commercial property and marine policies. Mr. Kelly also served as Assistant General Counsel in the Corporate Litigation Department of ACE USA. Prior to coming to ACE in 2009, Jim served as Managing Counsel of the First Party Property Coverage Unit in the legal department at Travelers Insurance Company from 2001-2008. His unit provided coverage advice to property claim adjusters on a variety of issues and managed first party property litigation on a global level. Jim also served as Group Counsel of extra-contractual claims in the Claim Legal Department at St. Paul Fire & Marine Insurance Company for eight years. Mr. Kelly came to St. Paul in 1993 after practicing law in the Washington D.C. metropolitan area for 10 years concentrating on insurance defense and coverage litigation. He is admitted to practice law in Maryland and Washington D.C. Mr. Kelly is a graduate of LaSalle University (B.A.), Philadelphia and the Catholic University of America (J.D.), Washington, D.C. Jim retired in June of 2021 and now resides in Bethany Beach, Delaware.

Scott Smith

Scott Smith is the Director of P&C Operations at Colonial Claims. Scott has a B.S. in Political Science and has over 30 years of property claims experience encompassing both carrier and independent claims adjusting. Scott has performed both field adjusting and management roles over his career spending the last 17 years as a Sr. Claims Manager with only two independent firms.

Scott has a passion for claims and believes assisting the policy holder with their claim while properly interpreting the policy is essential to the settlement of any claim. Scott attributes his early success to the training he received as a new staff adjuster and now as a manager oversees a new adjuster training program, teaches utilizing recorded modules, and conducts virtual training with adjusters on a regular basis. Scott strongly believes that all adjusting starts with the policy and basic understanding so each training opportunity involves policy basics.

Regarding artificial intelligence and the role that technology will play in the insurance claims field, I came across a McKinsey and Company paper which indicates a significant change to claims handling. It listed some experts with quotes about these:

Alex Singla: I think there will be automatic payments. So before you even file a claim, the insurer will have a perspective of what the incident was, what the damages were. And you’re going to be getting a check—or not even a check, a direct deposit—immediately as the incident occurs. The customer very often won’t have to talk to anybody. It will be much, much more self-service oriented.

Michael Müssig: We also will have a lot of new digital channels, which will have a much leaner, much faster process for the consumer. He or she will have a lot more transparency. He or she will always know, “What’s the status of my claim?” He or she can always contact the insurer whenever he or she wants, in whichever kind of way and channel he or she wants.

Another important part is prevention. I think that will be a major focus in the next five to ten years for insurance because, obviously, the best claim is the one that doesn’t happen at all. So that will be a big focus, and that will change. We will have sensors that will basically notify the consumer before the water leakage happens.

While all of this may happen, each of the claims managers discussed with me the need for the “human touch.” One of the discussions we had was the ability of the insurance claims community to attract and train new claims adjusters. This is a real issue in the insurance claims industry. McKinsey & Company briefly addressed the issue on its website:

Elizabeth Larrea Tamayo: I believe one of the more fundamental changes in the claims organization will actually be the role of the claims manager. There are three stages, in my view, in that role evolution. The first one is what I call the “firefighter,” the second stage is the coach, and the third stage is the integrator. I believe that many organizations are in that journey. But those that will be really successful to deliver on the aspiration for the 2030 mission will be the ones that are able to do that transition from the firefighter to the integrator in the next five years or so. To be able to provide a better customer experience, a human touch, they’ll be able to integrate technology in their not day-to-day but almost minute-to-minute interactions. And that is not an easy thing to develop, so I do believe there is a challenge that might feel a bit counterintuitive: that in a more technological era, the human element will become even more important.

Michael Müssig: I think the next critical step is that insurers start thinking about their HR strategy and people strategy, and that’s not just the business of HR. If it’s important for my business, I, as a CCO [chief claims officer], need to have a view on that. HR is my business partner to help me get there, but I basically need to weigh in and have a clear strategy on what people I need. And that’s a combination of recruiting and building up the capabilities internally.

Deniz Cultu: For a lot of the newer generation of employees, working someplace where they can help others—where there’s a purpose to what they’re doing—is really important. Insurance careers can offer that. You’re helping people in their greatest time of need.

Make plans to join claims professionals at the Windstorm Conference in Orlando on January 24-27. Here is the event link:

Thought For The Day

Live as if you were to die tomorrow. Learn as if you were to live forever.
—Mahatma Gandhi