Sunny's portfolio      

Insurance claims adjusters must complete their work in an efficient manner in order to ensure timely payment on insurance claims. In October 2006, a major insurance company realized its adjusters were not performing as desired. Comments from claims management staff and anecdotal evidence from the field suggested that for some adjusters completing their required duties and responding to customer needs was becoming much more difficult to accomplish within a forty hour work week. The change of adjuster employee status from salaried to hourly had contributed significantly to this sense of pressure on adjusters.

In an effort to understand and address this performance problem, a needs analysis was conducted. The findings of this analysis are included in this report. Rather than approach the concerns from a purely training need focus, this report documents a holistic analysis which attempts to look at all the possible factors which are contributing to the less than optimum performance of claims adjusters in managing work and tasks. The Performance Pyramid model (illustrated below) formed the framework of the analysis.

To gain an accurate understanding of the situation, data were collected by observing, interviewing and surveying claims adjusters and supervisors and across branches and across areas of specialization.

Data highlighted three areas of need: adjuster planning and organizing skills; consistent and effective tools and procedures for managing tasks; and consistent incentives for completing work in a time efficient manner.

While the implementation of Electronic Claims Handling (ECH) will do much to implement a consistent and systematic approach to managing claims, the intent of this report is to share further insights and recommendations for achieving greater claims adjuster performance.