"The Claims Coach" Podcast with Kevin Quinley

In this episode, Kevin Quinley offers his unvarnished views on the recently published book by claim expert Chantal Roberts CPCU and explains why this resource should be a part of any claim professional's bookshelf.To order your copy from Amazon:https://www.amazon.com/gp/product/1737426803?pf_rd_r=DJQK2VEYXD620HR2RDTP&pf_rd_p=5ae2c7f8-e0c6-4f35-9071-dc3240e894a8&pd_rd_r=c577e9e9-1402-4dd5-9d1f-89535050bb32&pd_rd_w=kPDBK&pd_rd_wg=Veu6o&ref_=pd_gw_unkOr from the Author's Website:  Home | The Art of Adjusting

If Hamlet was a risk manager, Shakespeare would have him ask, "To report or not to report -- that is the question."In the context of incident reporting to insurance companies, that is the risk management conundrum this episode addresses.Why are insureds wary of reporting incidents? Why do insurance companies want to know about incidents? What are the potential perils to policyholders of foregoing incident reporting?These are among the questions addressed in this episode of The Claims Coach!

For years, Donna Popow headed Knowledge Resources for Claims at the Insurance Institute of America, and served as its Ethics Counsel.In this episode of The Claims Coach, Donna reflects on a claims career that spans six decades. Among the topics she discusses:* Whether technology changes in the claims industry have been for the better or worse.* Will adjusters be replaced some day by AI and bots?* The one key to success for advancing within the field of claims.* The most important quality for a successful claims career.* Lessons learned from training canines for athletic dog competitions applicable to training adjusters.* . . . and much more!Tune in or download this episode of The Claims Coach podcast for an insightful and entertaining look at the world of claims!

A (modulated) rant about what drives adjusters and other claim professionals crazy.What pet peeves do you have to add to this list?(Just remember – – consumers, clients and attorneys can doubtlessly have their own rants about adjuster qualities the drive THEM nuts...)

By its very nature, handling or managing claims is extremely stressful.Covid has heightened the stress levels on claim professionals for multiple reasons.Self-care for adjusters and other claim professionals requires attention to managing stress.Stress is not altogether bad, in the right doses and measures.This brief episode of the Claims Coach identifies practical strategies for managing stress in order to boost self-care and optimize the ability to perform the functions of effective claim professionals at peak capacity.

Self-care for claim professionals includes fueling the body with the right nutrients to foster health and optimal performance on the job.GIGO is an acronym signifying, "Garbage In - Garbage Out."Without diving deep into the arcane (and at times controversial) features of nutrition and diet, this podcast episode highlights the importance of fueling the nutritional engine of claim professionals to infuse them/us with the energy, health and stamina that we need to perform our demanding jobs day today.Snickers commercials talk about getting "hangry." A combination of hungry and irritable.What nutrition tips do you embrace in order to fuel your success?

As a claim professional, your greatest ability is . . . your AVAILability!Availability is the opposite of LIABILITY.This short podcast discusses the importance of exercise, movement and fitness in cementing a platform of self-care to optimize your daily performance as a claim professional.

Are you getting enough rest, sleep and downtime?This episode of The Claims Coach argues that claim professionals are the cognitive athletes of the insurance world.Investigating, evaluating and negotiating requires brainpower, mental and physical stamina.While many people begrudge sleep and lionize CEOs who get by with 4 to 5 hours a night, most of us need more than that.Consider these tips to establish an effective sleep regimen that gives you the physical and mental energy necessary to optimize your performance as a claim professional.

In this brief episode kicking off 2021, Kevin Quinley discusses the importance of self-care for claim professionals and why it is the foundation for any productivity and performance system. Adjuster self-care is an often ignored topic and that leads to burnout and deteriorating job performance. In subsequent podcast episodes, we will cover some of the foundations of adjuster self-care that provide the basis for personal and professional productivity.

In this installment #4 four of a series focusing on building a reasonable Covid-19coverage claim investigation, Kevin discusses the vital role of insurance intermediaries in the claim communication process. He gives three reasons why claim handlers should consult with the insurance agent and broker before "going life" with a coverage denial or reservation of rights.Aim to "inoculate" your own claim files from bad faith assertions by embracfing this step!

What one step, if left neglected, may deeply expose an insurance company and its adjuster to a bad-faith claim of deficient investigation? This episode discusses that step in what adjusters can do to bulletproof their claim files from allegations of deficient investigation of Covid-19 coverage claims.

In this episode, Kevin sets the stage for future brief podcasts addressing specific practice tips that adjusters can use to build a framework for reasonable coverage investigations of Covid-coded 19 claims. This investment of time can mitigate the risk of bad faith claims arising from a breach of contract and bad faith, as well as avert allegations of deficient claim handling processes in reaching hair-trigger coverage decisions without an adequate fact-finding process.Tune in for following short podcasts with specific investigating steps to consider incorporating in investigating coverage for Covid-19 claims.

Believe it or not, many members of the bad-faith bar and the claim experts that they retain vehemently argue that adjusters should be exempt from receiving bonuses, because such bonuses service financial incentives to underpay claims. In depositions of claim handlers and corporate representatives, they are keenly interested in the workings of adjuster pay, particularly bonuses and incentives/contingent compensation. This episode of the Claims Coach looks at the myth that bonuses for adjusters are inherently bad for an invitation to institutional bad-faith. Structured intelligently, bonuses further the corporate goals of customer service, retention, growth and profitability. In addition, the aims of talent recruitment and retention are furthered through such sensible arrangements. It would be grossly unfair to thousands of claims people to single them out as being undeserving of bonus compensation if the company profits from their hard work.

The pending holidays provide a perfect opportunity to reach out and connect and reconnect with your clients and sources of business. This is particularly true for independent adjusters but also for claim professionals who work with commercial accounts. Often, the only time customers hear from a claims person is when a calamity has occurred. Break that cycle by reaching out to customers and clients not only during the end of your holidays but other milestones throughout the year. This is part of developing positive relationships with clients and reinforcing the value added dimension of customer focused claim services

In this episode, Kevin concludes this four-part series by focusing on specific risk management tactics that can prevent institutional bad-faith claims or render them more defensible if and when they surface. As in any endeavor, an ounce of prevention is worth a pound of cure. While no foolproof panacea exists to inoculate insurance companies against the risk of institutional bad-faith, there are certain tripwires and landmines to be aware of and to avoid in order to minimize the risk profile of insurance companies and maximize the odds of delivering quality, customer oriented claim service!

Bob Underdown is an insurance consultant and expert witness based in Scottsdale Arizona and who has a nationwide practice for a large array of clients. In this episode of the claims coach, Bob provides a wide ranging perspective on a lengthy career which is still in progress, including . . . * His take on "insurance archaeology"* The wisdom of starting the claims business as a generalist* Why experts working for both plaintiffs and defendants have an adevantage,,,* . . . and MORE!

Last week we discussed four claims management practices that are not inherently bad, but can serve as a magnet for institutional bad-faith claims. This week, we round out the discussion by examining three more common management practices that form the foundation for institutional bad-faith claims: * inadequate claim supervision/management oversight, * corporate cultures that encourage overzealous claim denials and * "goals gone wild." This sets the stage for the next podcast, offering specific risk mitigation strategies to insulate insurers and claim departments from institutional bad faith claims.

This second installment focused on institutional bad-faith begins a discussion of "7 Deadly Sins" in the form of claims management practices that can invite allegations of institutional bad-faith. This episode addresses the first four; the remaining three are featured in the next episode. Learn how adjuster compensation schemes, caseload mis-calibration, lack of training and computerized valuation software can become institutional bad-faith landmines.

"A fish rots from the head down," according to an ancient proverb. In this first installment of a multi-part podcast, Kevin discusses and defines "institutional bad faith" in the context of insurance claims, discusses the significant costs and sets the stage for identifying specific claim management practices which can serve like a red cape to a charging bull before an active bad faith plaintiffs' bar. In a subsequent podcast, the Claims Coach will identify specific risk mitigation strategies to lower the likelihood and enhance the defensibility of any institutional bad faith claims that plaintiffs may try to advance.

It’s becoming increasingly difficult to pretend that global warming is a myth. Weather and climate trends reflect a heating of the atmosphere, accelerated melting of ice caps, projections of rising sea levels and imperiled coastal properties. Extreme and funky weather now seems the norm. This episode of The Claims Coach discusses potential claim- and risk management implications from this phenomenon and closes with five specific tips for managing the risk.

Virtual reality is more than just on the horizon. Its increasing adoption and reduced cost creates opportunities to harness this new technology as an insurance and claims training tool. In this episode of the Claims Coach, we look at three examples of how insurance companies or third-party claim administrators could use virtual reality technology to strengthen the skill sets of claim professionals.

Bravo TV reality star Tamra Judge recently made news due to her coverage lawsuit against Encompass Insurance Company in connection with its refusal to defend a defamation claim made by the husband of the next cast member of the popular show. (*See link below to more reported features of the dispute.) This week, Kevin discusses coverage defense asserted by the insurance carrier and some of the allegations advanced by the Real Housewife. It’s often said, “Life imitates art” but in this case, reality TV intersects with many of the principles claim professionals deal with daily —making coverage decisions, good faith, and the doctrine of coverage due to reasonable expectations. Could there possibly be in the future a reality show, “Real Adjusters of Orange County”?*https://www.yahoo.com/entertainment/rhoc-star-tamra-judge-back-201342968.html

Increasingly, judges with backlogged dockets see themselves as "docket managers," discouraging litigants from taking cases to trial. Recent attempts by defendants to disqualify Judge Aaron Polster from an October opioid trial reflect concerns that judges have made up their minds to pressure settlements in lieu of hearing all the evidence. What implications does this trend have for claim professionals, pondering whether to pay a dubious claim or take it to trial?

What Oprah Winfrey is to talk shows, Elise Farnham is to insurance training. With a rare blend of insight, warmth and wit, Elise delivers value-added presentations to take claim performance to a new level. Elise has held a range of leadership positions within claim organizations and professional groups. She serves as a consultant, expert witness and educator with a particular emphasis on ethics. Elise entered the insurance claims business at a time when being a female adjuster was a rarity. In this conversation with Kevin Quinley, she traces the upward arc of her career and the challenges she faced -- and surmounted -- in forging herself as a thought leader in the insurance industry. For more about Elise: http://www.elisefarnham.com/home.html

In late August, Johnson & Johnson was hit with a $572 million judgment for its role in the opioid crisis following a bench trial in Oklahoma. This week, the ClaimsCoach offers seven “hot takes” with regard to the insurance, risk management and legal strategy implications of this case. What was the surprising reaction of the investment community? As a bellwether case, what does the Oklahoma trial say for J&J’s future defense efforts? How likely is it that insurance coverage will come into play? What does the Oklahoma trial outcome portend with regard to the “deterrence theory” of litigating cases in order to discourage future claims? These and other issues Kevin spotlights, issues that have implications for claim professionals managing other types of repetitive claims — mass tort claims, class actions and multidistrict litigation.

What factors enter into the decision for a claim professional to attend an examination under oath on first-party claims? This episode discusses data points to consider for adjusters and other claim professionals to make that decision. What are the pros and cons of physically attending an EUO? What kinds of cases lend themselves to the adjuster backstopping the coverage attorney doing the questioning?How can claim professionals add value to the EUO process? This episode will help frame the issue in a way to assist making the decision the next time a claim professional has an opportunity to attend in person an EUO.

Time limit demands are one plaintiff attorney strategy for weaponizing the claim process in a way to set up the claim professional and the insurance company for a bad faith claim. Mishandling time limit demands is a prime source of extracontractual liability claims and exposure for insurance companies. Time limit demands can come from third-party plaintiffs, from policyholders or from excess carriers. In this episode of the Claims Coach, Kevin offers six "best practice" tips for navigating the perils of time limit demands to prevent bad faith claims or make them much more defensible if and when they surface!

This week the Claims Coach interviews Jared Lamb, Claims Director at the Meritus Group, a startup TPA. Jared discusses reasons why insurance claims work is rewarding, the value of the CPCU designation, the joys of handling cargo claims and how the claims industry can combat the ongoing "brain drain." He also explains why, had he not become a claims professional, he might've been a theoretical physicist!

Claims Coach concludes a multi-week discussion of counsel selection problems and issues by looking at the importance of process in making defense counsel choice decisions. Why is it important to give policyholders and brokers a fair hearing? How do claim professionals deal with situations when the account or broker is going to go over their heads to appeal to the boss or underwriting department? This 9-minute podcast offers practice tips addressing these challenges.

Seattle-area claim specialist and expert witness Danette Leonhardi chats with Kevin about her journey through the claims industry, why claims work is fascinating, the importance of self-care amongst claim professionals and why Washington state’s bad faith landscape is so challenging.

Like it or not, the phrase “panel counsel” has become a pejorative term in the lexicon of some commercial policyholders and among some brokers. This episode of the Claims Coach podcast offers claim professionals specific tips on selling the advantages of panel counsel when navigating friction points with accounts that want to go “off panel” and choose their own attorney. Although the insurer may have the contractual right to select counsel as part of the duty to defend, especially in the absence of any coverage issue a reservation of rights, forcing counsel choice down the throat of a reluctant policyholder can create lasting hard feelings that can ultimately germinate in a bad-faith claim. Claims people are salespeople. This episode of the Claims Coach discusses features of “panel counsel” to highlight in making the case to reluctant policyholders and brokers.

Claim professionals, commercial policyholders and brokers occasionally butt heads over choice of counsel, even on situations where there are no coverage issues and the insurer is not defending under a reservation of rights. These clashes can quickly become a test of wills to leave a bad taste in the mouth of customers and producers. In this episode of The Claims Coach, Kevin offers 4-5 alternative compromise ideas to consider when a policyholder or the broker has strong feelings about appointing alternative counsel that is "off panel" in the insurance company's eyes. These alternatives can provide win/win solutions, avoid a later bad faith suit and preserve customer goodwill.

Claim professionals occasionally clash with policyholders and brokers over selection of defense counsel. Unfortunately, the term "panel counsel" as often become a pejorative term in the eyes of insureds and brokers. In certain cases, policyholders and brokers might make a strong push to install off panel counsel and override and insurers desire to select the defense attorney, even when there is no coverage question or conflict of interest controversy. This installment of the Claims Coach addresses the situation and ways to remove ego from the equation in order to reach a reasoned, compromise approach.

This podcast offers seven practical strategies for claim professionals to use when they receive a subpoena or summons to testify at a deposition in connection with an insurance dispute or bad faith case. The Claims Coach also offers a list of specific questions to pose to the retaining attorney was representing the adjuster or the adjuster's employer.

It may be the day after St. Patrick's Day, but there is no statute of limitations with regard to Irish blessings. Likely we have heard many through the years. Kevin Quinley offers some that are tailor-made for claim professionals.

Why should risk managers as well as claim professionals embrace "best practices"? How do written service gudelines reinforce such practices?

Many plaintiff attorneys and experts assert that insurance companies maximize profit by denying meritorious claims indiscriminately. In this episode, Kevin offers a perspective on this common but fallacious trope and explains why a policy of reflexive claim denial creates a path, -- not to profitability, but to financial ruin.

Kevin discusses challenges facing claim professional dealing with clients that want to "self-handle" claims within their self-insured retention (SIR).

It's that time of year where insurance defense firms will notify claim departments of the firms new rate structure for the forthcoming year. Invariably, these are higher rates. This episode of the "Claims Coach" offers a half-dozen suggestions and tactics for how to respond to such requests. It also offers specific examples of how law firms receiving fee increases can be constructively challenged to provide enhanced legal services in exchange for higher rates.

The new year is upon us. Whether you believe in New Year’s resolutions or not, goal setting is a key discipline for your personal and professional success, whether you are a claim professional or not. This podcast offers 18 examples of professional goals that claim managers and supervisors could consider for 2019 in order to make this year there best year ever.

Does the Keodalah v. Allstate decision represent a huge threat to adjusters as potential, individually named defendants in bad faith lawsuits? Let's take a deep breath and pump the brakes.

Everybody sends cards and gifts during the holiday season at the end of the year. Think outside the box, however. Think of other reasons to reach out to clients to show thoughtfulness and deepen business relationships throughout the calendar year. Kevin gives over a half dozen examples that can help deepen client relationships, maximize client retention and make those relationships more meaningful.

Chantal Roberts CPCU, ARM on insurance claim issues in medical marijuana, handling claims for the London market, why you should disable your “new email” alerts .. and much more!