News and Events

Communicating with Claimants

William D. Hittler
January 11, 2017

The relationship between a claimant seeking insurance benefits and the people involved in reviewing such claims is more than simply two parties operating under the terms of a written contract. It is, fundamentally, a relationship between people that evolves over time and requires communication in many forms. Let’s explore some practical ways to embrace the importance of communicating with claimants:

 

  • The written or spoken word does more than send a message. Otherwise, we would just send images or a list of options with check marks next to them. Rather, the words reflect your integrity and that of the company. Each communication ultimately becomes a story, recording the work you have invested in reviewing a person’s claim for benefits. They can also help calm emotions in a contentious situation.
  • Prioritize your points. All manner of communications – phone, letter, automatic-generated response, or voicemail messages – embody an underlying purpose. Some require more explanation than others, particularly where the company is informing the claimant of his rights or requesting information. In those situations, get to the point quickly. Headings and sub-headings may seem a bit out-of-date but they make it easier for the reader to follow and understand the point of the communication.
  • Think of yourself as an educator. Put yourself in the claimant’s shoes. He may have little experience with insurance policy terms. Include any reasons not to tell the claimant in detail what efforts you made to answer a question, retrieve a document, or review medical information supporting his claim?
  • Communicate complex points in a simple fashion. By doing so, you are showing respect to the claimant and avoiding confusion. That may require re-reading a long letter, or having someone else do so.
  • Resist the urge to use abbreviations. Saving the time to type out three words may suggest to the claimant that the company is more interested in efficiency than thoroughness.
  • Claimants and insureds should be treated like a customer. It’s okay to empathize – “the company expresses its sympathy for your loss.” Respect, professionalism, and objectivity are similar attributes of a meaningful message.
  • Re-state the question or issue and then provide the answer. All claimants want to know if their claim is being deferred or denied, and why the company made that decision. Stating the obvious, the letter or call should aspire to discuss all of the information supporting the decision, as well as the information that did not support it, in plain English.
  • Sometimes how you say something is more important than what you say. It may be helpful to use softer language on matters involving judgment and discretion that expresses your thoughtfulness and sensitivity (compare “it appears as though…“ to “it is obvious that…“)
  • Strive for continual improvement. Does the last sentence in your letter or phone call match the tone and content of everything above it? Offering a claimant the opportunity to contact you is final, thoughtful gesture.

William Hittler