Archive for April, 2011

Drafting your way to excellence

Each year, teams in the NFL look to the draft to improve their organization.   Arguably, this is the single most important step any team can take to move from ordinary to extraordinary.   Just as the prior season exposed glaring weaknesses, draft day provides the opportunity for process improvement.  

In many ways, organizational hiring is much like the draft.   Interviews serve as combines where talented individuals can show their stuff.   Managers act as coaches and scouts, keeping a keen eye on talent.    In many instances those with little prior experience become rookies who work to learn the system in a never ending quest to take their organization to the next level. 

Like the draft there are also busts.   Having hired hundreds of people myself, I can attest firsthand to my share of Ryan Leaf’s; prospects with immense talent that never panned out.   Fortunately, I have a greater share of Maurice Jones Drew’s; players that have eclipsed all possible expectations.    

Draft day serves as a chance for organizations to build from the ground up.  These are players that become the functional foundation and can define a team for a decade or longer.    This same philosophy can be used to effectively build an organization.

By recognizing needs, talent can be drawn in and trained to meet those needs.   By establishing a solid training program, calibration process and quality assurance, any organization can become an industry leader, just as any team with a similar philosophy can reach the playoffs. 

So just how does one go about finding the talent necessary to take an organization to the next level?  Often it comes from the least expected places.   During my tenure of running claims organizations and quality assurance processes, some of the best results came from those outside the insurance industry who possessed the skills to execute on basic blocking and tackling.  

From campus recruiting to hiring those with experience in fast paced, goal oriented organizations both within and outside the insurance industry, there is no shortage of talent.   But like the draft, not all players are created equally.   

Rather, it takes a combination of intuition, research, evaluation and a little bit of luck to land the A players of tomorrow.   Far too often a disproportionate amount of emphasis is placed simply on background.   It’s the mindset of, “Hey, he was a great college quarterback so he’ll flourish in the NFL.”  Don’t forget that he played his college ball in a spread offense which may actually become a liability at a higher level.   Rather, focus on what the person brings to the table. 

As John Wooden once said, “I’d rather have a lot of talent and a little experience than a lot of experience and a little talent.”  In reflecting upon hires I have made over the years, this statement rings true more often than not.   Certainly I have hired successfully from within the P&C industry, but the lion’s share of success has come from the outside, more often than not from candidates with no experience whatsoever. 

By focusing more on attitude and ambition, it is possible to dramatically improve results.   As I discuss in Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary, technical skills can be taught, personality and drive cannot.  

Organizational success is built from the ground up.   Just as a GM builds up an organization each April, so to can business leaders use this philosophy to reach the next level.    By effectively utilizing the very concepts behind the draft board, managers can identify their weaknesses and seek out the skills to address this need.   It’s not an overnight process, but then again neither is winning the Super Bowl. 

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Christopher Tidball is an insurance consultant and the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary to Extraordinary.  He spent more than twenty years serving in various claims and leadership capacities for multiple Top 10 P&C carries.   To learn more, please visit www.christidball.com.

April 29, 2011 at 9:09 am Leave a comment

If winning doesn’t matter why do they keep score?

Managing an organization is a lot like managing a football team.   There are defined metrics and goals to achieve, conquer and win.    Like a championship football team, the effective organization blends leadership and talent in a way that sets them apart from the competition.

With a recipe for success, why is it that so many organizations succumb to mediocrity?   From the biggest to the smallest, public and private, there are those who achieve, those to attempt to and those who just seem to get by, satisfied with mediocrity.  

It comes down to people.   From the leadership down to the rank and file employees, building the winning organization takes talent, time and savvy.    A common denominator in many struggling organizations is bureaucracy and complacency.    Far too many have been given tasks in a culture where silos haven’t given way to cross functional cooperation, impeding a companies ability to truly become great.  

To truly understand effective leadership, consider Vince Lombardi, arguably the greatest coach in NFL history.   When he took over the Green Bay Packers in 1959, they were coming off of a 1-10-1 season.  When he departed nine years later, he left behind one of the greatest dynasties in football history.   Lombardi succeeded because he challenged the status quo and had no room for the half hearted.   He had a unique ability to hone in on a players talents, maximizing both their physical and mental abilities. 

The business world is no different, with successful organizations keying in on leaders who have the ability to facilitate change,  like Lombardi, who approach their challenges with a no lose, try hard, old fashioned system.    By identifying A players, motivating B players and removing C players, any leader has the ability to fundamentally transform any organization.  

While this may be easier said than done in an era where pride and hard work have seemingly taken a back seat to entitlements and coddling, it is being accomplished in organizations that stand heads and shoulders above the crowd.  

When Vince Lombardi took over the Packers, he established a military-time system, which later became to be named after Lombardi himself. This meant that “on time” was actually ten minutes early, which was what was demanded of all the players, and is something that true A employees will always adhere to. 

Tee shirts on the road were replaced with blazers and ties.   The team, as the effective workplace, was a cohesive group of “dignified professionals…only winners” and anyone who failed to live up to expectations was “free to get the hell out.”  By establishing a winning culture, the paradigm of this in his organization effectively altered the direction of the team.  

In prior blogs, we have discussed how nothing is ever achieved without passion, which was a critical part of the Lombardi trinity, united with repetition and confidence.    Like many great leaders, he had an affinity for God, family and success, using an uncanny ability to blend all three.    For Vince, there was no distinction between the practice of religion and the game of football, where many of his fundamental principles were learned from the religious ethic of the Jesuits. 

As you look for ways to improve your bottom line results, consider the truly inspirational  leaders that have blazed the path to greatness and paved the way to success.   With the right blend of leadership and talent, it is possible for any organization to exceed expectations which is guaranteed to give them a competitive edge in the marketplace. 

“If it doesn’t matter who wins or loses then why do they keep score?”  – Vince Lombardi

____________________

Christopher Tidball is an insurance consultant and the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary.  He utilizes his experience with multiple Top 10 P&C carriers to assist claims organizations in maximizing productivity, optimizing workflows and improving profitability.   To learn more please visit www.christidball.com

April 28, 2011 at 8:35 am Leave a comment

How to pursue judgments against Chinese manufacturers of defective products

One of the benefits that the legal process provides in our society is a series of checks and balances against manufacturers of defective products.   The courts have been used for years to ensure that goods reaching consumers are safe, and when they are not, actions have been taken to ensure remedies.  Of course, there is also the downside to due process in that it has served to chase jobs and production overseas, making judgments harder to pursue.

Companies in search of cheaper labor have flocked to places such as India, Mexico and in particular, China.   What may cost a dollar to produce in the United States can cost pennies to produce in China.   While this has served to benefit the consumer and company profit margins, it has brought with it an entirely new dynamic in terms of product safety and accountability. 

Many consumers, insurers and attorney’s in the United States are under the impression that pursuing the makers of faulty products can result in obtaining judgments against Chinese manufacturers that will be legally binding.   While China did join the Hague Convention in 1991, it is important to understand that they only did so for the Service Abroad of Judicial and Extrajudicial Documents in Civil or Commercial Matters.  Unfortunately, this does not bind any Chinese manufacturer to a judgment obtained abroad.

In speaking with my counsel in Shanghai, there are steps that can be taken by those who have obtained judgments abroad, but they must be taken in the People’s Republic of China.   A party, or a company, who has suffered damages is entitled to bring their action in a Chinese court and the evidence, excluding the foreign judgment, will be considered and damages can be awarded.   As is the case in many foreign countries, finding competent counsel to handle these types of cases can be difficult.  

Currently, we are one of the only organizations with counsel in Mainland China.   We also remain one of the few businesses outside of the People’s Republic with clientele on the inside.   This means that we are one step ahead of all others when it comes to securing judgments against Chinese manufacturers of defective products.   While this can be a daunting task, it is one that must be pursued, to ensure that the goods being imported both safe and of sound quality.   

If you are pursuing the manufacturer of a product from China that caused damages, it is imperative to understand the risks and pitfalls associated with obtaining both a judgment and a recovery.   It is also important to understand the law that would govern both, which will be Chinese law, not American law as many mistakenly believe.   If you have a pending case or an existing judgment, utilizing our services and connections in mainland China could be very beneficial to your bottom line. 

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Christopher Tidball is the author of Re-Adjusted: 20 Essential Rules to take your Claims Organization from Ordinary to Extraordinary!   He currently works with American and Chinese insurers to provide a streamlined end to end claims workflow, including pursuit of judgments against negligent manufacturers.  To learn more, please visit www.christidball or e-mail chris@christidball.com.

April 26, 2011 at 9:01 am Leave a comment

Effectively using speed to gain a competitive advantage

In just about every aspect of life speed wins.    Whether it’s racing cars, throwing fastballs, winning a marathon or racing down the field ahead of a defender, speed is the key to success.   The same holds true when it comes to successful enterprise processes.   From faster production, supply chain efficiencies and even insurance claims, speed can be used to create a competitive advantage. 

But why is speed so important?  After all, with speed comes the opportunity for errors.   Or does it?   Simply stated, this is a misnomer.   Certainly speed can cause the potential for errors, but when an effective workflow process is put in place, these risks are minimized.  

Southwest Airlines turns around airplanes faster than any competitor.  They are also on time more frequently, have fewer lost bags, less customer complaints and a better safety record, despite their push for speed.  

What it comes down to is a philosophy where speed is of the essence in an environment where quality will not be forsaken.   Organizations that adhere to such a paradigm have set the bar for both performance and quality, irrespective of industry.  

While speed is often pushed, to be effective, it is incumbent upon the organization to have internal workflows and processes that enable timely and accurate outputs.    When these processes aren’t truly optimized, unintended consequences can wreak havoc on a bottom line. 

In any industry, time equals money.   The same holds true in claims where aging adversely impacts everything from reserves to recoveries.   Long tail injury claims tend to settle for more than quickly resolved claims.   Delayed subrogation results can cut returns in half in as little as 50 days!  Each day that a car remains in a salvage lot, a company can expect to pay $20 dollars or more per day.  

But simply pushing edicts to close claims quicker can also have unintended consequences.   Consider initiatives such as inspecting vehicles within 24 hours, which often result in substantially higher supplement rates when lacking a process to guarantee quality.  

To effectively leverage speed, the focus on quality has to begin on day one.   There also have to be counter measures to ensure that metrics aren’t being skewed due to bad behaviors.   When compressing time at first notice of loss, is there a measure to ensure accurate data compliance?   When pushing quick customer contacts, is there a metric to measure the quality of statements and loss details obtained?  When looking at vehicles, is there a metric to measure excessive rental or upticks in reinspections and supplements?   When pushing timely subrogation referrals, is there a measure of closed with no recovery?  When attacking salvage disposition, is there a measure to ensure title compliance. 

Virtually every metric that can measure speed has the potential to be “gamed” for the simple purpose of “making” a number.    As discussed in Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary, speed can be achieved effectively provided there is a solid quality assurance and benchmarking process in place.   

Speed for the sake of speed won’t win; but speed properly inserted into the process creates a competitive edge.   As with many internal processes, it comes down to execution of basic blocking and tackling. 

Consider the football team blessed with a running back that can run the 40 in 4.3 seconds.   This is tremendous speed that can give a team great advantage.   But what happens if that team lacks the mechanism to create the holes necessary to utilize that talent?

The same holds true in the claims organization.  Certainly it is possible to make prompt contacts, complete prompt inspections and make quick subrogation referrals, but what if important steps in the process were overlooked?

When it comes to subrogation, more than 15% of claims with recovery potential are improperly closed.   More than 80% of all judgments obtained are never collected.  Complicating matters, claims with no collectability are often referred.   While this may drive up referral numbers, it adversely impacts recovery ratios and costs the carrier in terms of resources and expense dollars.   All told, this amounts to billions of dollars in lost revenue annually. 

So how can a carrier effectively improve speed and quality simultaneously?   Arguably the best way is through a proven calibration process that aligns organizational goals, processes and philosophy.    This top to bottom paradigm shift results in improved workflows that leverage economies of scale to maximize efficiencies while decreasing costs.   The best part of this type of process improvement is that it can be implemented with no new money required. 

Christopher Tidball is an insurance claims consultant and the author of Re-Adjusted: 20 Essential Rules For Taking Your Claims Organization From Ordinary to Extraordinary!  His proven calibration program has resulted in dramatic process improvements for a number of insurers, both domestically and internationally.   To learn more, please visit www.christidball.com or e-mail chris@christidball.com

April 20, 2011 at 12:47 pm Leave a comment

Ten questions to answer during your bodily injury claims investigation

Each year billions of dollars are paid by insurers for inflated medical bills, exaggerated or pre-existing conditions and even injuries for accidents that never occurred.   It is often perceived that these types of claims are hard to identify and even harder to prosecute. 

As discussed in my book Re-Adjusted, this level of detail is what separates the ordinary from the extraordinary.   Truth be known, the outcome of an investigation can turn on ten simple questions.  While there are many more questions that should be asked, not asking these 10 often results in claims being overpaid or staged accidents not being proactively identified and prosecuted. 

1)      What is your name, address, date of birth and social security number?   Perhaps this is multiple questions, but the reality is that not having accurate personal information will result in prior injuries and other key personal information available through public records databases not being effectively utilized.   While seemingly intuitive, the frequency of missing information in claim files can’t be understated!

2)      Describe the accident, including the vehicle and driver responsible?  For anyone who has ever been in an accident, you know how traumatic this can be and often recall vivid details.      Yet, many who claim to be accident victims can’t describe anything about the incident, vehicles involved, drivers or location. 

3)      Describe your movement in the vehicle compartment at the time of impact?   A surprising number who rear ended claim to be thrown “violently forward” which simply defies the law of physics. 

4)      Describe the others in the vehicle you were occupying?  Simple question, but one that is tough to answer if the person wasn’t in the car at the time of loss.

5)      Describe the route taken from your home to your treating physician’s office?  Provide them with a map and ask them to draw the route. 

6)      Describe the physician’s office?   In some instances, it is beneficial to snap a photo of various medical facilities and see if they recognize any of them.

7)      Describe the physician?   During my years as an adjuster, I carried a portfolio of several people dressed in medical attire and asked the claimant if any of these people were involved in their treatment process.   Needless to say, many co-workers and neighbors were incorrectly identified as treating physicians or medical personnel. 

8)      Describe your pain, including locations of radiating pain?   It is always interesting to compare allegations of pain with actual dermatomal patterns.  If the pain pattern doesn’t make sense, it probably isn’t there.

9)      Describe any prior medical conditions you had prior to the accident, as well as any prior insurance claims?  Of course, the answer is quite often that they were in perfect health, despite 80% of the population suffering some type of back pain during the course of their life.   Using the answer to this question in conjunction with a detailed medical history search can yield incredible information, which can at times be used to impeach credibility. 

10)   Describe limitations of daily activity as the result of this accident?   When conducting a background check of the claimant, a key aspect is to identify acquaintances, friends and ex-spouses, who can often provide a dramatic picture of limitations before the accident.

Again, these are just a few of the many questions that should be asked during the course of the claims investigation.   Often, the answers will provide many other follow up questions.   By following a logical sequence of questioning, it is possible to elicit information which can raise questions of causation or even the legitimacy of the claim.

*****

Christopher Tidball is the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary and a frequent contributor to Claims Magazine.  He has more than twenty years of insurance experience, in roles ranging from adjusting and management to Six Sigma process improvement and executive leadership.  To learn more about how he can work with your company to dramatically improve bottom line results with no new implementation costs required, please visit www.christidball.com or e-mail chris@christidball.com

April 15, 2011 at 8:45 am Leave a comment

Achieving results through organizational consistency

While consistent outcomes may very well be the foundation for organizational success, achieving them is another story altogether.   Whether it is manufacturing, hospital revenue cycle or insurance claims, managing consistency is a full time job.  

The key to success not only lies in properly conveying expectations but holding all parties accountable for results.   Could Honda achieve record levels of customer satisfaction by simply saying that all cars were to have no defect, or is there an underlying process that drives their high quality outcomes?  The same holds true in a claims organization where accurate settlements are paramount to success, but simply requiring it won’t achieve it. 

We often find ourselves on multiple sides of consistency processes; requiring it, managing to it or achieving it.  The good thing is that consistency is achievable with a few simple concepts:

1)      Identify what is trying to be achieved and then outline specific measurements that are conveyed to staff.

2)      Ensure that there is no ambiguity.   There is nothing more frustrating for rank and file employees than having to guess what communication from above really means.    If the goal is to have all calls returned within 24 hours, communicate “I want all calls returned within 24 hours…no exceptions”.  Good managers will ensure that this is achieved while the specific metric can be used to remove those who don’t meet expectations. 

3)      Have a quality assurance process that can be used to benchmark the entire organization down to the individual level.

4)      Have a calibration process which ensures that every person in the organization understands what the expectations are, what the measurements will be and how to achieve their goals with a uniform approach.

5)      Create a culture of winners rather than whiners, as the latter drag down an organization leaving it mired in mediocrity. 

The key to consistency starts at the top, with executives leading by example.  Communication should be clear, concise, timely and most of all frequent.   Goals and expectations should be established and become a part of the corporate culture.  

Follow the lead of well run organizations and examine the types of people that they hire.  Remember that while goals come from above, consistent results come from below.  Consider Southwest Airlines, both an innovator and an industry leader.   Look at the types of people that they hire and try to find just one “whiner”, as they won’t survive the culture of positive thinking and a results oriented philosophy where everyone is a stakeholder. 

“The secret of success is consistency of purpose.” –Benjamin Disraeli

Christopher Tidball is the author of  Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary!    He provides businesses and individuals with innovative solutions to identify new and consistent streams of revenue.  Learn more at www.christidball.com or email chris@christidball.com.

April 14, 2011 at 8:15 am Leave a comment

Is that injury really related to this claim?

Is that injury related to this claim?   It seems that the answer is often elusive with far too many people willing to do just about anything to score a quick buck.    Of course, as an adjuster, the challenge is to serve as a fiduciary to one’s insured while always seeking to uncover the truth in order to achieve an accurate settlement. 

There is no question that insurance fraud is big business.  In fact, at $85 billion dollars per year it would be in the Fortune 500.  But beyond outright fraud, are the billions spent on inflated settlements, or claims for unrelated injuries.  According to the Insurance Research Council, approximately one in every three claims involves an exaggerated injury costing the insurers and the public billions of dollars annually!   Complicating matters is a survey by the IRC which found nearly one third of U.S. adults saying that it was acceptable to inflate insurance claims in certain instances.   

The challenge for those adjusting and managing the claims process is to have the investigative skills and the technical savvy to sort through piles of evidence and harness the power of the information age in order to argue with facts.    It is also important to recognize that those claiming injuries will often argue based on emotion; after all, they have been wronged and are entitled to a cash settlement.   If you don’t believe me, turn on the television during an episode of Judge Judy and hear what your local attorneys are promising. 

As is so often the case with adjusting, there is a direct correlation between outcomes and basic blocking and tackling skills.   When assessing injuries, it is important to understand four key components of the claim:

1-      Physical evidence – Inspecting vehicles or equipment involved in the claim are of critical importance.   In many instances it may be discovered that there is little or no damage.    While it is theoretically possible that a person can suffer an injury in the absence of physical damage, it is highly unlikely and using clear, crisp photographs to show a potential jury that there was no damage can be an incredibly powerful tool.   Remember the adage “a picture is worth a thousand words.”   In this case, it is worth thousands of dollars.

2-      Causal Connection – Consider the type of impact and whether there was a nexis for injury.   For example, a person may claim whiplash in a sideswipe accident.   The directional force of impact and the g-forces exerted on the occupants have a direct correlation on the type of injury sustained.  

3-      Pre-existing conditions – A staggering 80% of Americans will suffer from back pain at some point during their lifetime.    While accidents may aggravate a condition, they don’t necessarily cause the condition and often don’t even contribute to it.    A key part of the claims investigation necessitates searching for prior injuries or intervening causes.   While many insurers effectively utilize indexing, it barely touches the surface of obtainable information due to limitations associated with reporting and prior claims.  There are a number of additional steps that can blow a case wide open.   These include hospital searches, canvassing neighbors and known associates, speaking with ex-spouses, verifying occupational licenses, assessing financial profiles and credit and other such information that might reflect a financial motive.

4-      Character Assessment – In the day and age of pill mills and staged accidents, it is imperative to sort the real accidents from those that have been staged.   Once this has been accomplished, the next step is to determine if the injuries claimed are related to the accident.   This is best done by speaking to the injured parties, using medical authorizations to obtain information from current and prior medical providers.   During statements, or in the case of litigation, depositions of the injured parties a better picture of their physical state of being can be established.    During the investigation, it is imperative to look for discrepancies.  Consider a few of the following:

  • Claimant is working but claims they can’t perform daily duties;
  • Physical evidence not indicative of g-forces necessary to cause injury claimed;
  • Sanctions against or reputation of attorney and/or medical provider;
  • Physical damage does not match description of accident;
  • Occupant movement within vehicle doesn’t correlate to injury claimed (i.e.-Claimant was rear-ended and claims they were violently thrown forward); 
  • Medical treatment provided doesn’t correlate with standard AMA guidelines;
  • Disability or permanency rating doesn’t correlate with standard AMA guidelines;
  • History of prior claims for similar types of injuries including patterns of only filing claims when not at fault. 

While these are just a few of the many red flags, they are of utmost importance when conducting a claims investigation.    Perhaps more than anything, it is incumbent upon the adjuster to be in a position to effectively negotiate a settlement.   In many audits we have conducted, it was not uncommon to see steps taken only to be for naught as the adjuster ended up overpaying a claim that was entirely defensible.  

When it comes to blocking and tackling, accurate outcomes are entirely dependent upon proper execution during every step of the claims process.  From first notice of loss and liability assessments to investigations, negotiations and settlement, there is a need for consistent quality to drive results. 

***** 

Christopher Tidball is a claims consultant and the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary to Extraordinary!  He has more than twenty years of insurance experience ranging from adjusting and management to auditing and executive roles.   To learn more about steps that your organization can take to improve claim skills, quality and outcomes please contact chris@christidball.com or visit www.christidball.com.

April 12, 2011 at 8:54 am Leave a comment

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Chris Tidball is a claims and revenue management consultant and author of the "20 Essential Rules" series of self and organizational improvement books. You can ask him a question at chris@christidball.com

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