A Closed Claim is a Good Claim

Written By: Cliff Crosby*
Nov 27, 2023

The saying in the insurance claims business is, “A closed claim is a good claim”. In the race to get to the finish line, we sometimes take shortcuts that can cost costly mistakes. One thing that we typically rush through is the initial statement. The new adjusters have their prepared script, while the seasoned adjuster has the script engrained in their mind. But are we just going through a checklist without actually paying attention to what the person is telling us? I believe that the best interviewers are the ones that truly listen to what a person is telling them. Slow down a little bit when it comes to statements. Do not cut corners on these. This is one of the most important parts of any investigation.

A lot of cases in SIU are made because of the very first statement taken by first notice of loss or the adjuster. We all know that it is very difficult for a deceptive person to remember a lie. So, by the time that claim makes it over to an investigator, that person most likely will have a hard time remembering what they said in the initial statement. And let the person talk. Especially in the narrative or facts of loss section. Do not interrupt the person at this point. If you need clarification on something that the person says, make a note and go back to that section once the person has completed this section of the statement.

Always encourage claims personnel to record those initial statements. They may think that recording the statement takes more time because you have to make sure everything is set up prior to the interview. But does it really? Most phone systems in the office settings these days make it very easy to record a statement. There are even case management systems out there today that will allow statements to go directly to a file. The recorded statement protects you and the person giving the statement. And there have been a few times in the EUO setting, where I actually played that initial statement for the witness when they were disputing what they said early on in the claim. Kind of hard to dispute a recording of your own voice!

In my 22 years working in SIU, I have found that many bad faith suits could have been avoided if the adjuster had just slowed down a little bit. We make mistakes when we rush through the initial part of our investigations. Small things get left out. And it’s those small things that can make or break a case. I know that this is easier said than done, but I encourage you to really spend some time on that initial statement. Listen. You might be surprised what you actually hear.

*Cliff Crosby, CIFI, FCLS

Special Investigations Unit Director, Atlantic Casualty Insurance Company

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