Daniel Kelly and the Challenges and Rewards of Providing Claims Services

Daniel Kelly is an AGL Senior Claims Representative for ESIS Claims Inc., which is owned by Chubb Insurance. He has worked on a wide variety of claims and situations throughout his career, ranging from the typical slip & falls, assaults, catastrophic fires, sexual and/or racial discrimination cases, even disasters such as the fallout from the […]

Daniel Kelly is an AGL Senior Claims Representative for ESIS Claims Inc., which is owned by Chubb Insurance. He has worked on a wide variety of claims and situations throughout his career, ranging from the typical slip & falls, assaults, catastrophic fires, sexual and/or racial discrimination cases, even disasters such as the fallout from the 2011 tsunami in Asia. He has handled DRAM shop, professional liability, property, auto, E&O, D&O, etc. and has worked for carriers and third party claims administrators alike. Here he tells Finance Monthly more about his work, the key challenges that claims professionals are faced with and the motivation that drives him.

It has been my experience that the most challenging claims are those that involve unrepresented claimants. It seems as though most claimants approach their claim with a cynical point of view, and they look at you as the enemy. They feel that you are “out to get them,” so to speak, and fail to consider that we are professionals who are in a highly regulated field and are expected and required to practice fair claim techniques. “Pay what you owe” is a philosophy that I have seen adopted by multiple carriers, and has most likely been shaped and molded through the influence of the state insurance commissions. The most important thing is to find a way to relate to your claimant, be it on a personal level or some sort of shared experience, or with the ultimate amount of empathy.

As a claims professional, I have found that the toughest challenges are developing and nurturing the functional relationships with the numerous clients that we service. For example, I am on the East Coast, so I am typically in the office for 3-4 hours before I can call an insured in Arizona. Another issue is that fact that we are often times dealing with clients who do not sit in an office at a desk all day. They are running their business, on the road, or working in some other capacity that does not allow frequent email response. As such, I find myself sending requests for information followed by several follow up emails before receiving appropriate responses. On the other hand, when you call or email these clients enough, they begin to recognize your character and work ethic, and it helps in developing that positive relationship.

For me, personally, one of the motivating factors with working in this field of insurance and litigated claims, is that I truly feel that most people are not cut out for this line of work. You cannot take any person off of the street and thrust them into a role in which they are managing 200 or so files, most of which are in litigation, covering all 50 states and then some. Even college grads entering the workplace for the first time could struggle. It takes a temperament in which you need to have the highest degree of organization, patience, and skill. You need to be able to deal with all walks of life. Understand that if you are dealing with an elderly injured individual that you may need to speak a little slower. If you have an unruly and uncooperative person, let them speak their mind and tell you what they think before you explain the claims process to them. It’s the little things, like paying attention to detail, that make the difference. The claims industry is one that never slows down. You close 4 or 5 files, rest assured there are another 7-8 coming in. Long hours are a must and bathroom breaks are kept at a minimum. You don’t want to miss that call from defense counsel seeking settlement authority at a mediation because you had to heat up your lunch!

The claims world is a rewarding challenge that brings something new with every matter that comes in. There are never ending learning opportunities in this field and wherever you go the resources are plentiful. I compare claims handling to the game of golf. No matter how long you play, no swing of the club is exactly the same and there is always room for improvement!

 

Website: http://www2.esis.com/esis-en/

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