Latest / The Art of Adjusting® Podcast / Episode # 104 - Your Claim Notes Aren't Good Enough

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Episode # 104 - Your Claim Notes Aren't Good Enough · The Art of Adjusting® Podcast

• 0:00
  William Auten: I'm Bill Augten of August Claims Management.
• 0:02
  Chantal Roberts: I'm Chantelle Roberts of CMR Consulting, and welcome to the Art of Adjusting Podcast.
• 0:07
  William Auten: Today we're going to talk about life as an insurance adjuster from the perspective of property, auto, liability, or workers' compensation adjusters.
• 0:15
  William Auten: Our goal is to bring interesting topics in the world of claims adjusting to people who are working as an adjuster now and to people who are considering a career as a claims adjuster.
• 0:24
  Chantal Roberts: Hi everyone, it's Chantel Roberts with the Art of Adjusting podcast.
• 0:29
  Chantal Roberts: Bill has been doing some heavy lifting for me since I've had some uh family matters going on, and I haven't been able to uh participate.
• 0:38
  Chantal Roberts: And I really do thank Bill for doing that.
• 0:42
  Chantal Roberts: So, to help him out, I thought I would do a very quick podcast on claim notes, why we make the claim notes that we make and how we make really good claim notes.
• 0:55
  Chantal Roberts: If you are listening online, uh you may want to switch over to YouTube because I'm going to be sharing my screen and going over what we are talking about in general so you can actually see what I'm doing.
• 1:14
  Chantal Roberts: I will try to go ahead and uh describe myself as well when I'm doing this, but we'll go ahead and start now.
• 1:27
  Chantal Roberts: Let me try to share my screen.
• 1:35
  Chantal Roberts: All right.
• 1:36
  Chantal Roberts: So now you can um see my screen, and you are seeing uh what I have dummy up as my file notes, right?
• 1:46
  Chantal Roberts: And we've got this email.
• 1:49
  Chantal Roberts: So many adjusters are doing this thing where they just cut and paste the emails into the file notes, just like uh this.
• 2:03
  Chantal Roberts: So now you can see that we have this complete file note of exactly what Zachary had said in regards to the CPCU ambassador status.
• 2:19
  Chantal Roberts: Unfortunately, that really doesn't cut it because remember, when we're doing our notes, yes, we have to keep track of everything that is being said and what is happening in the file, but we also need to recreate the file, which includes our thinking.
• 2:49
  Chantal Roberts: Okay.
• 2:50
  Chantal Roberts: And you were probably wondering where I would find this information.
• 2:56
  Chantal Roberts: We talked about it very, very briefly.
• 2:58
  Chantal Roberts: We usually, Bill and I usually do this at the beginning of the year, where we go over the good faith claims handling status or practices.
• 3:07
  Chantal Roberts: And I also last year began or this year began mentioning some of the administrative codes that you as an adjuster would need to be aware of.
• 3:21
  Chantal Roberts: And for example, I've just pulled up Oklahoma for you know no other reason than just to pull up Oklahoma.
• 3:29
  Chantal Roberts: And this particular Oklahoma administrative rule, it's it's not the statutory rule, it's the Department of Insurance administrative rule talks about claims files and examination of those claims files and when you get a complaint, how you're supposed to respond.
• 3:50
  Chantal Roberts: First of all, the Oklahoma Department of Insurance says, you know, we have the right to examine your file.
• 4:00
  Chantal Roberts: We already knew that, right?
• 4:02
  Chantal Roberts: But here's the the point that I really want to make to people, which is such files shall contain all notes, work papers, and pertaining claim detail to the pertinent event and dates that can be reconstructed.
• 4:21
  Chantal Roberts: Now you go, but I did that.
• 4:24
  Chantal Roberts: I uploaded the email into the claim notes.
• 4:27
  Chantal Roberts: You know, I just cut and paste.
• 4:29
  Chantal Roberts: That's fine, but remember, you're already doing that.
• 4:32
  Chantal Roberts: You already, you know, drag and drop that email into your claim file under insured email or claimant email or body shop email or whatever division, like you would happen to have that into your claim file.
• 4:50
  Chantal Roberts: What is missing is in such detail as to be able to be reconstructed.
• 4:58
  Chantal Roberts: We don't know what you think about this.
• 5:02
  Chantal Roberts: Zachary has asked us to do something here in his email.
• 5:07
  Chantal Roberts: He's asked us to make a CPCU prompt in this particular event.
• 5:14
  Chantal Roberts: He's given us the task that he wants us to do.
• 5:20
  Chantal Roberts: And so that needs to be the fact that we now need to say that we received email from, let's say, Mr.
• 5:35
  Chantal Roberts: Insured.
• 5:36
  Chantal Roberts: Let's say Zachary is our insured.
• 5:39
  Chantal Roberts: So if we just said insured, by the way, I don't know if it's from Zachary's wife or if it's from him, or maybe it's from another insured.
• 5:49
  Chantal Roberts: And I have seen in my expert witness cases where maybe it'll say named insured or something to that effect.
• 5:59
  Chantal Roberts: I have to tell you, sometimes though, we start seeing this, and it gets a little bit difficult because if you say inbound call from named insured, if you're listening and not looking online on YouTube, this line reads IBC from NI.
• 6:26
  Chantal Roberts: It takes me a minute to recognize that that is inbound call from the named insured.
• 6:35
  Chantal Roberts: Or it could be uh left message call back AI.
• 6:43
  Chantal Roberts: Okay, so left message call back.
• 6:45
  Chantal Roberts: If you're looking online uh with me on YouTube, it's L M C B AI.
• 6:52
  Chantal Roberts: What does that mean?
• 6:54
  Chantal Roberts: Yeah, you know, there's a there's a fine line of of going back and forth between what we have in our initials and really what has uh been able to explain ourselves to recreate the file.
• 7:14
  Chantal Roberts: Okay.
• 7:15
  Chantal Roberts: And you got to remember too that the people who may be reading your file, being the insured if you're getting sued for bad faith, the plaintiff attorney if you're being sued for bad faith, the department of insurance, they may not be insurance adjusters.
• 7:32
  Chantal Roberts: So I know what LMCBAI stands for because I've read plenty of claim notes.
• 7:40
  Chantal Roberts: The Department of Insurance may not be, and so they may fine you or the carrier for not keeping adequate file notes.
• 7:49
  Chantal Roberts: So what you would want to say is maybe um you know left message mes or additional insured.
• 8:04
  Chantal Roberts: And so if you're looking at the file notes, it says left MES for ADD T apostrophe L addition, it actually says edit L insured ISD.
• 8:22
  Chantal Roberts: Um, you know, you could you could do that.
• 8:24
  Chantal Roberts: Most people know what LM stands for, left message, you know, but most people now start thinking AI, they think artificial intelligence, especially, and again, that's another good thing.
• 8:36
  Chantal Roberts: What if we're calling um called Mr.
• 8:41
  Chantal Roberts: Insured or BI?
• 8:45
  Chantal Roberts: Well, are we talking about bodily injury or business interruption?
• 8:49
  Chantal Roberts: Of course, we may be able to figure it out if we're in a property file versus a liability file, but this is something that we definitely want to make sure that we're that we're making abundantly clear.
• 9:06
  Chantal Roberts: Uh, if it's let's say a liability claim, BI for Mrs.
• 9:12
  Chantal Roberts: claimant, that way kind of clues me in for or BI for uh three months of uh store being closed, or something to that effect.
• 9:28
  Chantal Roberts: That way, when I'm saying uh or when I see called Mr.
• 9:33
  Chantal Roberts: Insured for BI, if I see four, three months of store being closed, I'm gonna automatically know even though I am already in a property damage file, right?
• 9:46
  Chantal Roberts: Um, so that is something to be thinking of.
• 9:50
  Chantal Roberts: So when we get this email from Zachary, we're gonna say received and reviewed email from Mr.
• 10:05
  Chantal Roberts: Insured Re C PCU ambassador program.
• 10:15
  Chantal Roberts: And I even spelled out received and reviewed.
• 10:17
  Chantal Roberts: You don't have to.
• 10:18
  Chantal Roberts: I probably would even go R E C apostrophe D and I might leave reviewed out, but you can see if you're watching, and of course I made a mis spelling mistake, um, from Mr.
• 10:32
  Chantal Roberts: Insured Re CPCU embass program, you know, and then I go down to Mr.
• 10:38
  Chantal Roberts: Insured thanked me for sharing August content and has asked me to continue with September.
• 10:52
  Chantal Roberts: He states the subject is fall and pumpkin size goodies.
• 11:04
  Chantal Roberts: I'm going to review the prompt and remit shortly.
• 11:09
  Chantal Roberts: I don't know, something to that effect.
• 11:10
  Chantal Roberts: I uploaded that email into Sitson.
• 11:15
  Chantal Roberts: So you see the difference.
• 11:18
  Chantal Roberts: In the first case, most of you are just simply cutting and pasting Zachary's email into the file notes.
• 11:27
  Chantal Roberts: That doesn't tell me what you think about this and what you are going to do.
• 11:33
  Chantal Roberts: It doesn't tell me that you have read this file or this email.
• 11:38
  Chantal Roberts: You understand what Zachary needs and you are going to do something about what Zachary needs, because that is what the Department of Insurance wants.
• 11:53
  Chantal Roberts: And I'm going to tell you that is also what your attorneys want and what your expert witness wants.
• 11:59
  Chantal Roberts: Because if you put all of this information into the file, what you're going to do about this email, what you think about the email, then you will be better able to defend yourself three years from now, if and when you get sued for bad faith.
• 12:19
  Chantal Roberts: So hopefully, if you're listening to Bill and me, you won't get sued for bad faith because you're doing everything correctly.
• 12:25
  Chantal Roberts: But this is the difference.
• 12:28
  Chantal Roberts: And it's a minor one, but it is almost a line in the sand.
• 12:37
  Chantal Roberts: You can tell the absolute difference between just cutting and pasting the email, which says, This is what I this is the problem I have.
• 12:46
  Chantal Roberts: Here, what I've done is I have summarized the email of what Zachary wants and then stated what I'm going to do.
• 12:57
  Chantal Roberts: Now, of course, when I'm saying put your thoughts down, I don't mean uh Mr.
• 13:05
  Chantal Roberts: Inchard thanked me for sharing August contents and asked me to continue with September.
• 13:11
  Chantal Roberts: He states the subject is fall and pumpkin spice goodies.
• 13:16
  Chantal Roberts: So let's say I I think that's stupid, right?
• 13:20
  Chantal Roberts: And I don't sit there and go, This is the stupidest, as I continue to not be able to type subject matter whatever, and I hate pump and spice.
• 13:37
  Chantal Roberts: Of course, I'm not gonna say that, right?
• 13:41
  Chantal Roberts: I am going to say this.
• 13:46
  Chantal Roberts: There are other things to be considered than pump and spice in regards to fall, and we'll need to discuss with Mr.
• 14:05
  Chantal Roberts: Insured and Manager.
• 14:09
  Chantal Roberts: Okay, so in this particular instance, what I have tried to do is say, okay, so maybe there might be a coverage problem here.
• 14:20
  Chantal Roberts: Uh Mr.
• 14:21
  Chantal Roberts: Insured wants me to talk about pumpkin spice.
• 14:24
  Chantal Roberts: I don't think pumpkin spice is going to do anything.
• 14:27
  Chantal Roberts: Um, you know, I'm gonna need to discuss that with him and also bring it up with my manager, go over things with it, and I've uploaded the email.
• 14:37
  Chantal Roberts: Because remember, you're uploading the email anyway.
• 14:40
  Chantal Roberts: I don't need the email as an expert witness.
• 14:43
  Chantal Roberts: I don't need the email as an expert witness in the file notes.
• 14:48
  Chantal Roberts: It just takes up space.
• 14:50
  Chantal Roberts: So, anyway, that is the quick and dirty version of what we are doing here.
• 15:00
  Chantal Roberts: I hope that that helps out a bit.
• 15:03
  Chantal Roberts: If you have any questions, do feel free to drop them in the comment section or send Bill or me a question online via LinkedIn or send us an email.
• 15:15
  Chantal Roberts: Be sure to like, subscribe, send this off to your friends, and we will uh see you again in two weeks.
• 15:25
  Chantal Roberts: Thanks.
• 15:26
  William Auten: Thanks for joining us on the Art of Adjusting Podcast, where we talk about life as an insurance adjuster.
• 15:32
  Chantal Roberts: If you enjoyed this podcast or this episode, please give us five stars and a review.
• 15:38
  Chantal Roberts: It does help the algorithm pick us up.
• 15:41
  William Auten: Hit that subscribe button real quick and tell all of your adjuster friends to check this out as well.
• 15:45
  William Auten: For independent adjusting services, go to www.autin.claims.
• 15:50
  William Auten: And for anyone interested in working as an independent liability adjuster, go to the Contact Us tab to join our roster.
• 15:58
  Chantal Roberts: In the meantime, you can contact me at theartofadjusting.com for consulting and training purposes.