It's been said that people love to hate insurance companies. Claim handlers have become so familiar with customer complaints that many feel they are unavoidable. That's not necessarily true, though. There are steps adjusters can take to either respond to a complaining customer or to avoid such complaints altogether.

What to Say, How to Say It

Communication breakdowns, which can lead to allegations of unfair claim practices, can often be avoided when claim handlers take the time to communicate with claimants and policyholders alike. But just as important is the way communication takes place. Statistics show that when communication is lacking or when the body language does not match the verbiage, customer service can quickly deteriorate.

Often, simple fixes will satisfy the customer, such as making changes to an estimate, adjusting a medical bill, or modifying a percentage of depreciation when warranted. Such flexibility is important to the claim process and supports good customer service. In short, the adjuster responds to the complaint, makes effective changes or explains her position, and then moves on.

Then there are the other customers. They are angry. They are loud. They think the world revolves around them. Perhaps it does. Their problems may be no different than a more reasonable person's, but nothing seems to appease them. Under the so-called squeaky wheel theory, they call or visit the claim office repeatedly, making unreasonable demands and accusations.

The key to remember is that most irate customers do not start out that way. Irate customers are often made, not born. Here are some of the ways it can occur:

  • Not knowing what to expect, they may be operating under incorrect assumptions.
  • Their calls have not been returned or not returned in a timely fashion.
  • They receive erroneous information.
  • They do not understand certain terminology.

Claim adjusters can be proactive in managing each of these situations with ease. First, they should set expectations early and often. For example, most people expect that they will receive the dollar amount for a claimed scheduled personal property item. In fact, they may receive "up to" that amount or the item may be replaced. If the adjuster explains what the policy covers from the beginning, there will be no unwanted surprises later.

Second, adjusters should contact claimants within a set time frame. Respond even if the status has not changed since the last conversation. Policyholders would rather hear from their claim person than stare at the silent phone or empty inbox.

Third, be sure to give customers accurate information. When such information changes, make sure to inform them. If a witness statement changes the adjuster's view of the claim, the customer needs to be told how it could affect the outcome.

Last, avoid the use of technical insurance language. Speak plainly so the customer understands what is meant. Why not use the word "fault" instead of the word "liability"?

In Their Shoes

Claim departments can plan the handling of complaints. Planning will help underscore a focus on customer service. This can help the claim staff to efficiently respond to all customers consistently.

That said, claim professionals can be empowered to own the situation and the attendant resolution. The customer will respond better when she knows that action will be taken immediately by the person to whom she is complaining. Here are some tips claim adjusters can apply now:

  • When someone is upset and shouting, the first inclination may be to shout back. This will not resolve the conflict. More important than what is said is what is not said in these encounters.
  • A good course of action will usually be the appropriate combination of non-verbal communication and conversation. Understanding how to use the right words at the right time will often lead to a satisfactory resolution.
  • Silence is golden! So let the customer speak.
  • No matter how irate the customer, the claim handler must remain calm. This is often very difficult because the first thing people want to do is to solve the problem. However, solving the problem is the last thing to do, not the first.

Policyholders who are upset want someone to empathize or sympathize with them -- and they want to vent. The best thing one can do is to say something like, "I'd be upset too if I felt someone didn't understand what my car meant to me." After the customer has been acknowledged, the claim adjuster should do nothing but this one thing: Listen.

Hearing is what you do naturally while listening is something else. That's because listening takes effort. Adjusters should pay close attention to the customer and take notes, if necessary. After the customer speaks, it is the adjuster's turn. But how to begin?

Adjusters may say, "Thank you, Ms. Claimant. Now let me make sure I understand the problem." Using an empathetic statement at this point is helpful. Music to anyone's ear is his own name. By using a person's name periodically during the conversation, it personalizes the situation. One caveat: Unless the customer gives permission, adjusters should not use the customer's first name.

Additionally, adjusters should repeat what they have heard to ensure that the situation is understood by both parties. Ask the customer what would remedy the problem. The adjuster may not be able to meet every demand, but it will allow identification of what can be done. This also invites the customer to become part of the solution. When the customer and the claim person can meet on common ground, it's more likely that the customer will agree with the solution. There should be follow-up to ensure that the agreed-upon resolution takes place and within the promised time frame.

Even as claim departments work to enhance their relationships with policyholders, claimants, vendors, and others, a key partner should not be overlooked: The agent.

Interacting with the agent is a good idea for many reasons. Agents can be pivotal in helping adjusters work with the customer. Keeping the agent advised of situations -- good and bad -- can help claim handlers build and solidify good relationships all around.

A customer-focused organization handles all customers with empathy, intelligence, forethought, and skill. In so doing, it enhances the overall customer and employee experience.

Sure, it's been said that people love to hate the insurance company. Perhaps in time, with great customer service, that adage will become a thing of the past.