What is Aggressive Claims Handling ?

Perhaps defining what it is not is the best place to start.  Aggressive Claims
Handling is not the routine and systematic begrudging of benefits to all
claimants.  This style of claims handling only reinforces the reputation of the
insurance community projected by the personal injury attorneys.  Nor is it
passive handling - just paying the claim until it goes away or becomes some other
adjuster's problem.  If Aggressive Claims Handling is not the suspecting of every
claimant, WHAT IS IT ?

Aggressive Claims Handling is pro-active.  It is going all the way to see that
the truly injured and legitimate claimant receives all the help and assistance
at your disposal - quite often more than is necessary.  Critically interweaved
is dealing strongly and often harshly with the malingering or fraudulent
claimant.   Active means conscientiously looking for the various indicators that
a claimant is malingering or fraudulent.  It is also being willing to spend the
necessary funds to investigate claimants who have caused you to doubt their
continued legitimacy.  Malingering and/or fraudulent claimants will eventually
expose themselves to you as you adjust their file.  Moving deftly and swiftly to
investigate and secure the evidence necessary to control the file and the
claimant is critical to developing the proper reputation for claims handling. 
The reputation you are seeking is that of an organization that will go overboard
for the truly injured claimant, but will be nobody's free ride.  A cornerstone
to developing this reputation is not just spending the funds necessary to secure
the evidence, but using the evidence to control and/or end the claim.

Once attained, this reputation will change the way personal injury attorneys deal
with you.  For the most part, personal injury attorneys are businesses more than
barristers.  As such, they deal in volume and the more active, fair and
aggressive your claims handling, the less profitable dealing with you and your
claimants becomes.  The more time claimant's attorneys have to spend to find a
weakness in your claims handling, the less they want to handle your claimants. 
Claimant's attorneys count on and their businesses are built upon passive, path
of least resistance and legal costs claims handling.  Make no mistake this
approach to claims handling must include both sides in order to work. You must
have the reputation for fairness and good claims handling for the legitimate
claimant, as well.  This part of the equation, to all concerned, balances out the
active and aggressive pursuit of the malingerer and fraud.  Your pursuit must be
constant, consistent and vigorous.  In this manner, claimant's attorneys will
know that when you say their client is malingering or fraudulent, that you have
both the knowledge and proof.

It will take time, effort and successes to establish such a reputation.  But once
having done so, controlling claims, claimants, their attorneys and their costs
becomes significantly easier.  You and your organization will no longer be
labeled an easy mark by claimants and their attorneys.  We have frequently seen
where several employees will become claimants after another employee has had a
relatively easy and successful claim.  We are also routinely encountering two and
three generations of claimants within the same family.

It will not be either the legislature or the legal community that cures the ills
of the Worker's Compensation and Personal Injury systems.  It will be done by
you, me and our co-workers thru aggressive and just claims handling.  Passive
claims handling and an opportunistic legal community created the abused system. 
Aggressive claims handling will begin to restore the system to its original
purpose, to assist the injured - Not An Alternative Career.

                Are you going to be Passive or Aggressive ?