Although most claim file review is generally conducted internally by management, occasions arise where your documentation will be subject to harsher examination, particularly in the litigation realm. So how do you ensure your claim file will withstand the scrutiny of the most tenacious plaintiff’s counsel or expert? These four rules will guide you to a better claim file.
1. Document early and often.
Every time you communicate in any way with the insured, document it: this includes leaving messages with representatives or by voicemail. If you do speak to the insured by phone or in person at an inspection or meeting, document the content of the conversation as soon as possible while the memories are fresh. This will ensure no detail is overlooked. Each and every email and letter should be documented in the claim notes, and saved to the file.
2. Take photos and caption them.
Any time you perform an inspection of a vehicle or property, take as many photos as you can. Upload them as soon as possible, and include descriptive captions. This will help refresh your memory of the inspection should you need to recall the details years later if the matter proceeds to litigation. It also provides information to other adjusters who may pick up the claim after you. Word usage is critical – see Rule 3.
3. Word choice is more important than you think.
Imagine you are uploading photos from a site inspection. You are phrasing your descriptive captions. You take a photo of a slope of a residential roof that has hail impact marks. Your caption is “hail damaged north slope of the roof”. Perfectly descriptive, right? Wrong. Although use of the word “damage” may seem appropriate, in a litigation context, a plaintiff’s attorney or expert will view that as an admission the property is in fact damaged, when in actuality the hail impact marks may be superficial and not warrant repair or replacement of the roofing materials. Upon reflection, if there is a more specific word to use, use that. Continuing the example here, damage is a very general term. “Condition of north slope” or “hail impact marks on north slope” is more appropriate. Careful word choice is also helpful to experts retained on the claim, who often prefer to not have any suggestion as to what the adjuster thinks of the condition, but rather would prefer to make the determination as objectively as possible.
4. Be objective. B-E Objective!
Often when dealing with insureds and their representatives, personalities will conflict, and difficulties may arise. Refrain from using personalized descriptive words for these interactions. Do not say, “insured called and was a jerk,” the “public adjuster continued to act like an idiot.” Simply report the specifics of the interactions, how you responded, and describe the next steps on the claim. Unnecessary criticism of the insured or representatives will invariably haunt you at any deposition and trial testimony, and may affect credibility, even though it was documented innocently enough. Keep your claim notes as dry and un-colorful as you can while still accurately documenting the activity and interactions on the claim.
While this is certainly not an exhaustive list as to how to best document your claim files, following these simple rules will make the litigation process much simpler with fewer surprises in depositions or at trial. If you are ever faced with a documentation challenge, seek assistance or advice from your managers.
ABOUT THE AUTHOR
J.P. Harrington Bisceglia is senior counsel at Tyson & Mendes, LLP. She specializes in general liability defense, insurance coverage and bad faith litigation. Contact J.P. at 602.386.5644 or firstname.lastname@example.org.
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