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How an Insurer Can Succeed With Professional Claims Handlers\\n\\nRead the full article here: http://zalma.com/blog/wp-content/uploads/2023/04/EXCELLENCE.pdf.\\n\\nThe Need for Change\\n\\nThe insurance business must change\\u2014this time for the better\\u2014if it is to \\nsurvive. Insurers must rethink the firing of experienced claims staff \\nand reductions in training to save \\u201cexpenses\\u201d recognizing that the \\nexpense to train, educate and maintain a staff of professional claims \\nhandlers, is a small part of the money that flows out of an insurer\\u2019s \\ncoffers. The major expense is the cost to pay claims. When inadequate or\\n inexperienced adjusters pay claims the insurer did not owe, refuse to \\npay claims it did owe, or pays more than is appropriate, the potential \\nfor an insurer to make a profit is reduced much more than is saved by \\nreducing the expense incurred by paying a professional claims staff.\\n\\nInsurers should, if they wish to succeed, adopt a program to promote \\nexcellence in claims handling. Only with a staff of claims handlers \\ndedicated to excellence in claims handling can insurers promptly, fairly\\n and in good faith keep the promises made by the insurance policy and \\navoid charges of breach of contract and the tort of bad faith in both \\nfirst and third party claims.\\n\\nInsurers must understand that they cannot adequately fulfill the \\npromises they make to their insureds and their obligations under fair \\nclaims practices acts without a professional, well trained and \\nexperienced claims staff. An insurer must work vigorously and \\nintelligently to create a professional claims department or recognize it\\n will lose its market and any hope of profit.\\n\\nA Proposal to Create Claims Professionals\\n\\nTo avoid claims of breach of contract, bad faith, punitive damages, \\nunresolved losses, and to make a profit, insurers must, in my opinion, \\nmaintain a claims staff dedicated to excellence in claims handling. They\\n must recognize that they, as representatives of the insurer, are \\nobligated to assist the policyholder and the insurer to fulfill all the \\npromises made by the insurer in the wording of the policy. An insurer \\ncan create a claims staff dedicated to excellence in claims handling by,\\n at least:\\n\\nIf any experienced claims professionals exist on the insurer\\u2019s staff, \\nthe insurer must cherish and nurture them and use their experience and \\nprofessionalism to train new claims people.\\nIf none are available, the insurer has no option but to train its people\\n from scratch using available materials produced by the National \\nAssociation of Insurance Commissioners, the State\\u2019s Department of \\nInsurance, Insurance associations, and professionals who have \\u2013 for a \\nreasonable fee \\u2013 the ability to properly and effectively train claims \\npersonnel.\\n

\\n(C) 2023 Barry Zalma