Episode #73 - When Claims Get Ugly: Mastering the Tough Conversations

Ever had to break bad news to a policyholder already on the verge of tears—or threats? In this episode, Chantal and Sandy share real-world strategies adjusters actually need (no vanilla “just be empathetic!” advice here).

🎙️ You’ll learn:
✅ What to do when a claimant starts crying—or yelling
✅ How to set expectations without sounding cold
✅ Tips for staying calm, professional, and in control
✅ Why role-playing and preparation are your secret weapons

Whether you’re a seasoned adjuster or just starting out, this episode will help you handle high-stakes conversations with clarity and confidence.

👉 Listen now and level up your claims game!

🔗 [Follow the show and get notified about our next episode on bankruptcy, insolvency, and reserves—dropping July 31!]

To reach Sandy, visit RiskInfluencer.org.

For more insights, you might consider a career in liability adjusting or if you're searching for reliable adjusting services, visit Auten Claims Management.

To explore more about Chantal Roberts and her contributions to the industry, visit CMR Consulting.

Promotions:

• Once Upon a Claim: Explore the magical world of claims adjusting through fairy tales. Get your copy now.
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Chapters

• 0:00 Introduction to Tough Conversations
• 3:26 Why Adjusters Procrastinate Difficult Calls
• 8:01 Letting Claimants Vent Technique
• 15:34 Managing Emotional Responses and Threats
• 27:37 Setting Boundaries with Abusive Claimants
• 39:58 Communication Tips and Plain Language
• 49:39 Closing and Next Episode Preview

Transcript

Speaker 1: 0:00

I'm Bill Auten of Auten Claims Management.

Speaker 2: 0:02

I'm Chantel Roberts of CMR Consulting and welcome to the Art of Adjusting podcast.

Speaker 1: 0:07

Today we're gonna talk about life as an insurance adjuster from the perspective of property, auto liability or workers' compensation adjusters. Our goal is to bring interesting topics in the world of claims adjusting to people who are working as an adjuster now and to people who are considering a career as a claims adjuster.

Speaker 2: 0:24

Hey Sandy, how are you doing? I am?

Speaker 3: 0:27

good, how was your fourth?

Speaker 2: 0:28

It was great. I had a very relaxing fourth. The dog did not like it, unfortunately, you know, very scared of the loud noises and everything. But yeah, I had a great one you.

Speaker 3: 0:42

Good, yeah, same thing Fireworks are. You know they're not permitted in my area, but that never seems to stop any of my neighbors. So if I want to see a show, I just open the window and there it is.

Speaker 2: 0:51

Yeah, it's the same here. It's the same here. Yeah, like we don't, we're not allowed to have those fireworks or anything like that, but yet you can hear the kids shooting them off and yeah, so, yeah, whatever. There you go.

Speaker 1: 1:05

There you go.

Speaker 2: 1:07

So we're going to have a great conversation and it's something that Bill and I have talked about a little bit, but I don't think we've ever really taken, you know, given like really kind of concrete advice on it, and it's how to have these really tough conversations, and this was actually something that you had brought up and I'm like yes, so we're going to be talking about kind of like some of the things you can say, both as an adjuster or as a risk manager or an agent or whatever, when we get ready to have those tough conversations. And so, yeah, there we go, that's, that's it Okay great Good conversation.

Speaker 2: 1:50

We're gonna head on out now.

Speaker 3: 1:52

Yeah, I mean I and I and thanks for you know, adding this to the, to the list for the podcast episodes, to kind of touch on this on this subject, because I I think a lot of us unfortunately learned the hard way right, like we have a conversation that went poorly or we put our foot in our mouth or something happened and we're like, oh okay, we won't do that again and it shouldn't have to be that way.

Speaker 3: 2:15

And I think a lot of adjusters especially because sometimes you have to deliver news that is not great and sometimes you have to deliver news to somebody who they're emotional or they're angry, and no one teaches you really how to have those conversations, especially in the higher stakes environment of claims.

Speaker 3: 2:37

I think a lot of people have what we would consider like customer service experience where you earn retail A lot of us have had a retailer, food service jobs when we're younger and A lot of us have had a retail or food service jobs when we're younger and you learn kind of customer service interactions that way where somebody's upset about their order being wrong or something along those lines. Like we've all had those experiences. But it's very different when someone has had, like, a loss there's damage to their home, their vehicle and something isn't covered. That's significantly higher stakes than you know. Your cheeseburger had onions on it and you don't want onions, so people are going to be much more upset and no one really walks adjusters through how to handle this and we kind of and I, what I see a lot, what I would see a lot in training is you would have people again because there's really no training provided. They're going to have a hard conversation and so they procrastinate.

Speaker 2: 3:29

Yes, which is the worst thing you can do, absolutely the worst thing you can do, by by far. I totally agree with you.

Speaker 3: 3:37

Yeah, they wait until like the last possible moment that they have to call the insured or the claimant whoever they have to deliver the news to to deliver that news and it just makes it so much worse because that person had to wait all that time, right?

Speaker 2: 3:54

So and I think the thing is too is that the longer you have your person being the insured or even the third party claimant wait for that bad news, it gets to be worse, because there is this idea that you all are as the adjuster, you have superior knowledge and you are leading these people down the garden rose path, thinking that you know, so they think that there is coverage and so they're doing all of these things, thinking that they're going to get reimbursed, when in fact you know that there's not. And there have been some questions like are we waiving the rights of the insurer for these defenses? And that's why having these conversations are really, really important. And I do think part of the issue is A, it's soft skills. Nobody teaches soft skills anymore. And then B, we're all working from home. So when I was learning how to have these hard conversations, I was sitting in a pod with three more senior adjusters so I could listen to how they worded things, and we just don't have that anymore.

Speaker 3: 5:12

And I think we really haven't adapted to that. Because same same I, you know, started my career in a cubicle world and you did listen to conversations going around you and you learned that way. But there's no, and maybe there are other carriers who are doing this. But we can do the same thing in like a team's environment where you just have somebody listening on a call. And I mean, if you're listening to the podcast, please drop it in the comments and let us know if you have stories of how this is happening in your organization. But there should be, if not recorded calls, calls where the team listens in so that they can learn from that experience, because then you get to hear both sides right, you get to hear the adjuster and the claimant. I remember early in my career I had the only time we had training on communication. It was the first carrier that I worked for and what they did is they had us all in a conference room and they would have us role play.

Speaker 3: 6:06

And so you have one adjuster, be the adjuster and one adjuster be the claimant and then you'd have them in chairs facing away from each other and like, pretend to have a phone call and the adjusters playing the claimant had a blast with like I'm gonna tell you all the worst things I've ever heard.

Speaker 2: 6:30

Oh yeah, listen, guys, I did this when I was at Liberty Mutual and I don't know if it was just because I was fearless or whatever. I mean I was still a baby adjuster. But management somehow recognize that there's a woman right there who can help us out and they would have the newer adjusters call me and I would be the intern and I would deliberately be rude and I do feel bad about this. I tell this story often. I accidentally made one adjuster cry and I did not mean to. Oh no, yeah, I did not mean to to cry and I did not mean to. Oh no, yeah, I did not mean to, I was. But.

Speaker 2: 7:09

But the thinking is, if you have quote unquote the worst kind of phone call where people are yelling at you or refusing to give you information or whatever in that role playing thing, then the real call is pretty much going to be a cakewalk. Yeah, you know, I would. They would do recorded statements of me or whatever. I would refuse to give driver's license number, you know social security numbers. I would deliberately go off on a tangent somewhere. Yeah, I would do all of the things just like what you were talking about and and then I would start yelling at them when they would say Okay, now I'm thinking that there's no coverage here, and what do you mean? And it was never as bad as all of that, because we build it up in our minds, because, again, we're not used to having that and that I love this idea. We need to do it.

Speaker 3: 8:03

Yeah, it really should be happening in more places Because, you're right, it prepares you and the adjusters who get to wear the hat of the insurer, the claimant. They have fun because then they get to give you all these different scenarios. But then in a in a class environment, you also get to hear like oh, I hadn't thought of saying it that way. Or you hear a phrase that's really great. You're like I'm going to put that in my pocket and use that later if this comes up. So it really is beneficial. But again, most that's rare. That's rare to kind of have that kind of training to prepare adjusters and usually they just learn by doing or worse, they, they never learn.

Speaker 1: 8:41

Right.

Speaker 3: 8:42

And then you have, like a very upset, insureds and claimants on the other end of those calls.

Speaker 2: 8:48

Because one of the things that I talked about in my book, the Art of Adjusting, is a lot of times when the insured and the claimant are upset, it's because the emotion fear and the emotion anger are very, very close, very close together. I mean like a hair's breadth apart. And and the insured, the third party, claimant, whomever they're scared I'm point blank here. I you know. Are you going to pay for this? Am I going to have to pay for this out of my own pocket? You know what's going on. Pay for this out of my own pocket. You know what's going on.

Speaker 2: 9:27

I've lost my house. Where do I go to re-get or re-buy all of my stuff? Do you know how much stuff costs nowadays? You know, and saying these empty platitudes like oh, I understand how you feel. No, you don't understand how you feel. No, you don't. Did your house burn down? Did your car get crashed? Did you lose a loved one in a car accident? No, you do not understand how I feel. So it's being able to empathize with them without patronizing them and knowing what to say, when to say it, and how to say it.

Speaker 3: 10:06

Yeah, I think it's a really good point, cause a lot of people will kind of default to the. I understand how you feel and even if you have let's say you have gone through something similar, you never want to use that as a as a, you know, as a response because, you don't know how they're feeling and to them it feels minimizing. To them it's minimizing and it's important to, like you, can empathize with the situation and still validate how they're feeling, without agreeing with what they're feeling or their account of the events right.

Speaker 3: 10:38

So if they're in the anger stage and they're upset at you and you know that you can listen and let them know. I can tell you're really upset about this. It makes sense that you're. I would be upset too. That's a different thing than saying I understand how you feel. The language really really does matter, just to let them vent and then also being able to be comfortable with pauses.

Speaker 2: 11:05

So I see this a lot with adjusters, where they they'll, they're speaking and then they stop for a second and then the adjuster jumps in with the next thing, yes, one of my go-to techniques and and it's no surprise, because we've talked about this before how Bill and I will have notes or whatever to talk about. Oh, let's make sure we mentioned this one thing, but one of the things that again that I talk about in the art of adjusting is when a claimant, first, third party, whatever is mad, shut up, yeah, shut up. And I actually wrote, I said it's actually one of my favorite things to do and it sounds mean, but what I am doing is I am letting that person vent because, remember again, they could be angry or they could be scared, I don't really know, but I've got to let this festering get out. And so I just sit there and I type in everything that they're saying in my claim notes, you know, and eventually they will stop and take a breath, because I haven't, I haven't even said uh-huh, uh-huh, uh-huh, I am silent, okay, and and eventually they will take a breath and they will go. Are you there? And what I do and this is an excellent technique, it's a, it's a psychological technique is you just lower your voice and you say yes, I'm here, I'm listening, I'm writing down what you say, continue.

Speaker 2: 12:52

And they don't know what to do with that, because they're so used to people coming back at them, like you say, like, oh well, I'm going to tell you this and oh, I'm going to tell you that, and no, you, let them vent. Please continue. Well, blah, blah, blah, ok, great, anything more when they get finished, you keep asking anything more, anything more, anything more. You know, just keep telling me, keep telling me, keep telling me, and then you can go. Ok, this is what I've got. I want to make sure that I've got you down correctly. I've got.

Speaker 2: 13:25

And then you kind of read your notes to them You're upset about this. You did it. Blah, blah, blah. You want this, you want that? Da, da, da, da, da. Ok, are you ready? I would like to respond to these points, and sometimes that works. Sometimes they will be quiet and sometimes and I've had this happen to me when I do the very first point like you're upset that water damage isn't covered. Well, you know, I've sent you the reservation of rights letter, I'm going to send you the declination of coverage letter, and they just start going off again being mad Shut up, again, shut up. And if it gets to be the point to where you can't get in a word edgewise what I would say all your notes, you've got all my letters, you know. Let's, let's plan on 15, 30 minutes tomorrow or Wednesday or you know whatever. Schedule that dedicated time to talk with them and overschedule, like you know. Plan an hour, you know, but that is going to be one of my number one tips for anybody right there. I don't know about you.

Speaker 3: 14:55

Yeah, I like that because it also tells them you're not trying to get rid of them, right, if they're upset, it tells. It tells them. I still want to talk to you about this, but I want to give you time to think about. You know what we're going to discuss and one of the things that I used to use as a. You know I would to your point of scheduling more than you tell them. Schedule like an hour for yourself.

Speaker 3: 15:18

And then at the 30 minute mark when they're still going. Tell them give me one moment. I have a meeting after this, but I want to cancel it because I want to make sure I spend time with you and you don't even have to have a meeting to cancel, by the way, but it gives them the message of you're important right now.

Speaker 2: 15:33

I'm listening to you. Yes, I am listening to you, yeah.

Speaker 3: 15:37

Yeah, that makes it. That makes a difference, because that's really what they need to know. They need to know that you're listening, so I would at least tell them you're my focus. It's again, it's setting that expectation. We talked about this at the last episode. Of the expectation settings, there's this book called. It's not even about insurance, but it shapes how I look at customer service. It's called why Men Rebel and it's about rebellions, but essentially there's like a little graph and it tells you you have your expectations and your capabilities and as long as those two things are the same, you're good. It's when the gap occurs that people get frustrated.

Speaker 3: 16:16

And then what happens when that frustration isn't checked. So I think of customer service that way too, that you never want those expectations to be higher than your capabilities. Always make sure that those are aligned. And if you don't communicate that, then people are going to like they get upset. That's where that, that's where a lot of the miscommunication, all of that occurs, and then people get angry.

Speaker 2: 16:37

And again going back to the schedule, the dedicated time when you, as an adjuster, are making that very first phone call, that first contact, even if you have to text them and go. I need to talk to you for 15 minutes to explain the claims process. This is where we're going to be setting up these expectations, and you got to remember these commercials that people are seeing. You know say 15% or more or whatever. I mean they just think that people are getting checks left and right.

Speaker 3: 17:12

Yeah.

Speaker 2: 17:13

And and that is not necessarily the case. So, again, we're setting these expectations and one of the things that I would recommend that we do is like, like, my number two tip, I guess, is, in addition to shutting up, but also have your, have your documents ready, you know, and maybe have already sent it over to the claimant, first or third party, like if you will see on page two of the estimate, blah, blah, blah, blah, blah, or, you know, whatever, at least you have your policy pulled up, your photos, estimates, notes, whatever you need, so that you're able to speak with some kind of authority, when you are able to speak, because, again, we want them to feel heard, and that's the very first thing I would say as to having that tough conversation.

Speaker 3: 18:17

Yeah, and it's really getting adjusters too comfortable with what they feel is awkward.

Speaker 2: 18:23

Yes.

Speaker 3: 18:23

So it's silence is one of them. A lot of people don't feel comfortable with silence, so they feel like they got to fill it in. And the other one is when someone's crying.

Speaker 2: 18:31

Yes.

Speaker 3: 18:32

And if someone is like let them go through their feelings, let them speak to you. It's going to take them more time. But one once I had, we had an adjuster where she came to me and she was like you know, she was a baby adjuster, brand new. And she told me, like the claim started crying and I panicked and I hung up and I need your back. But but I just want to let you know, cause she's probably going to call you angry right now, and I was like oh, my God bless her.

Speaker 3: 19:01

They called me angry, but she panicked and it was. It really spoke and that's the way I went to, like our, our claims director, and I said, like we need to train these adjusters. But if you've never been in that situation before, right, you have somebody who's fresh out of college, they're now in the claims desk, you train them and they've never had an experience where somebody is crying over a loss that impacts their life. Right, it's for someone who's never had an experience like that. For the adjusters it's very scary. Your first time you had that. If you've never been prepared. But I just thought you know it really is something that we learn on the job and it's a disservice to our adjusters to not prepare them for that, to not get them comfortable with things that they may have previously considered awkward and uncomfortable, because then that leads to avoidance, to it's back to that not wanting to call the claimant, waiting until the last minute because you don't want to have those conversations.

Speaker 2: 19:57

You know it's funny, I have for Wednesday, wednesday wisdom for my LinkedIn post this week a. Actually it's not a, it's the, it's the the only thank you letter I have ever received as an adjuster. I mean, like A, adjusters don't get thank you letters. Thank you for denying my claim. I really appreciated it. We just don't get that.

Speaker 2: 20:28

You know, this letter was dated from May 2006, 2006. And it was after Hurricane Katrina and what this insured said was how she actually appreciated the fact that I didn't dance around concepts or ideas or what was going to happen next. You know, we were in the middle of one of the biggest hurricanes that had ever happened and we just didn't have the manpower. I think the whole industry was caught flat footed by Katrina and even though this insured happened to be in Mississippi, she lost both of her businesses. Just the tidal wave knocked them down and I just said, ok, look, here's the deal. I mean, I got some guys out there in Mississippi that I like, but you know as well as I do, all of your neighbors are gone, so those guys have been hired by everybody else. It's probably going to take three weeks for them to even get to you.

Speaker 2: 21:44

You know that is not normal, but this is what we are dealing with and being this honest and open, upfront kind of deal, she actually wrote me a letter saying I appreciate the fact that you didn't dance around. You told me what was going to be the bad parts. You told me what was not going to be paid right then. And there you know my friends and she wrote this because my friends and family actually laughed at me when I said I thought you were a good person, at me when I said I thought you were a good person, you know, because it is so rare for adjusters to be upfront and honest. But you know what, guys? This is what I say. We have licenses in most states. We are white collar professionals, we have licenses, professionals. We have licenses. We need to act like professionals, just like doctors and lawyers and all of that. We need to be having these upfront conversations Upfront, you know, and set those expectations over and over and over and over and over again every single time you call.

Speaker 3: 22:54

Yeah, and it's important for adjusters to remember when people are angry right, you're the messenger.

Speaker 3: 23:00

You're the messenger they're going to express that anger to you, but they're angry with the situation. There's sometimes anger around just the unfairness of life, right, why did this happen to them? How, all the downstream impacts of that loss in all of the other ways that it affects them that are not insurable, right, they're upset at that, but you're the person that they're communicating with. So remember not to take that personally, and sometimes you'll kind of be lumped in together with the concept of like, oh and you know insurance and you guys, you guys don't want to pay. Like, I'm always the part of you guys, you guys don't want to pay my claim, you guys don't want to provide me coverage, and and again, when they're in that state, when they're upset, let them speak. That's not rebuttal time, that's not rebuttal.

Speaker 3: 24:16

Shut up, just shut up. If you take one thing away from this podcast awful things you don't care about them and you're heartless. And you know, because the policyholder didn't read exclusions. But you have to know that that's not about you. It's not about you. So it's just important to remember that. So maybe that's two things to print out and put in your office. It's not about you.

Speaker 2: 24:33

and shut up, print out and put in your office it's not about you and shut up, I would. I would also say another. Another tip, while we're talking about it's not about you, is to go ahead and anticipate those objections that they are going to say when you're shutting up. You know, but this is, this is part of your prep work to do. You know, if they ask about the ensuing loss of this water damage, how the pipe is not going to be covered, but the ensuing loss is, you know. Here's going to be my answer. Here's how I'm going to talk about that. And then, of course, you can always talk with your team leader or whatever, and run through that role play and making sure that you are using the correct language. And one of the things I always loved to do when I know I'm getting ready to have that tough conversation, in addition to setting aside that time, is I tell the person that I'm going to be talking to listen. I'm going to need you to have a pen and paper because I am going to throw a whole bunch of information at you and and there's no way you're going to be able to to sort it all through or remember anything Good news is that I'm also going to send you a letter, you know. So you don't really have to remember it, because I'm going to send you a letter. You can read it and then we can call you can. So you don't really have to remember it, because I'm gonna send you a letter. You can read it and then we can call. You can call me back and we can talk about it again.

Speaker 2: 26:00

But right now I want you to have a piece of paper and a pencil, and I usually do this when I'm explaining settlement figures.

Speaker 2: 26:10

You know, like, okay, so the RCV is $1,000. You have a $5 deductible. You have, you know, recoverable depreciation, which means you're going to get it back once you fix it, and you send me the receipt showing me that that's $10. And so your actual cash value, the amount that I'm going to make payable to you and the lien holder of your house, is, you know, $950 or whatever. And then I'm gonna send you the estimate, I'm gonna send you the proof of loss and blah, blah, blah and da, da, da, da, or, or, and this is, I think, a very big deal. We're hearing a lot about how, in Florida, there were these independent appraisers out there who wrote up an estimate and then the desk adjuster had taken off, like I don't know what, 90 percent of it of their estimate. And so the insured would have this estimate that says, yes, your damage is $70,000, and they're getting a check from the insurance company that is for $4,000.

Speaker 2: 27:21

And they're like wait I can't fix my house for $4,000 if the damage is 70. That's again when you're going to have to get a pen and paper. Ok, look your damage. Your whole damage is $70,000. Okay, look your damage. Your whole damage is $70,000. However, we don't pay for mold remediation, so I'm going to take off, you know, $10,000 right there To be sure you need it, but your policy doesn't cover it. I'm going to send you a letter explaining that, showing you the math, how I took that off, you know, because we've got to be transparent with these people too.

Speaker 3: 28:05

Yeah, I think that the letter is so important because people need a visual, especially when we're talking about numbers, like they need the visual, they need to be able to kind of walk through it. And then it helps to have everything in black and white because otherwise you get into the, you get into the oh, my neighbor had a loss and my neighbor got X amount. Like you'll hear a lot, my brother had a loss and he got this amount. And trying to explain to them I have no idea what happened with that loss, what carrier they had, but it's, it's important to have that documentation in front of them and then speak to them afterwards.

Speaker 3: 28:41

I think the biggest the thing as an adjuster that I it took me a while to learn was you're going to send a lot of letters. You send a lot of documentation. Yeah, they're not reading it. You have to call them and make sure they understand it, like they glance over it, and we talked about this at the last episode too. A lot of the language in those documents is mandated by Department of Insurance and it's not user-friendly at all and it's a lot of jargon. So it's important to make sure that you speak to them, you walk them through it so that they understand, especially when it comes to the appeal process.

Speaker 1: 29:13

Yes.

Speaker 3: 29:14

If they are upset at the outcome. There's an appeal process in every state for multiple lines and you can say you know if here's the appeal process for this, if you'd like to challenge it. If they start accusing you of you know whatever that let them know about in Department of Insurance or however they report it, if they you know, if they feel that they're not being treated fairly, what their recourse is. So again back to your point that we're transparent, but it also focuses on the process. You always kind of want to redirect them to the process and sometimes that deescalates them too, because now they're focused more on not so much the feelings but what are my next steps and what do I do.

Speaker 2: 29:52

I think that's a great thing is focusing on the process, because I think we were talking about when our claimants get emotional and they start crying and we want to give them space. Of course, shut up, which is one of our themes for today, and you had these really great words like I can hear that this is very upsetting. You know, offer to take a break, like hey, you know I can hear that this is upsetting. Why don't we reconvene in two hours or tomorrow or whatever? And, as you have repeatedly said, don't feel the need to keep the silence. But one of the things, as we're focusing back on the process, is you can say I can tell that this is really upsetting you, but I want to make sure that you have all of the information you need when you are ready. You know, because again, and it, and it's scary for adjusters and I don't want to use this generational thing like oh millennials don't want to talk to anybody, and Gen Z doesn't want to talk to anybody.

Speaker 2: 31:07

It's true, we don't. I mean heck, I'm Gen X. I don't want to talk to anybody either, you know. But it does become a little uncomfortable when we're having these conversations and the focus needs to be on the person we are talking to.

Speaker 3: 31:27

Yeah, it's just important for people to know that they're hurt, right, I think that that's 90% of it is. They're frustrated because, you know, perhaps they weren't aware of what was involved in the coverage or what the exclusions were, or what the conditions were for reporting, and they feel that there was already that lack of communication because they didn't know so, as the adjuster, and it shouldn't be this way, but it is this way. You do have to do that heavier lifting once the loss is filed, so that, uh, especially when they're just starting out in insurance and I'm like, okay, so all y'all been in insurance for about a year?

Speaker 2: 32:27

Uh, how many of you have received death threats so far? And they're just like all saucer eyed and everything. And I'm like, geez, I maybe have gotten three, at least you know. I know my husband is an adjuster as well. He was told that he better bring a gun because this ain't going to be a knife fight. My dad is an adjuster. My dad is an adjuster. He has had to have the sheriff escort him onto the insured's property.

Speaker 2: 33:07

Now, remember, the insured has a duty to cooperate, right. But this insured was pretty upset and said you come on my property is not going to work out well for you. So dad said, ok, I'm going to get the sheriff and I'm going to do my job. So when the policyholder or the claimant makes that threat again it's the same thing that you were talking about earlier is they're scared, they're upset, we don't know. But let's stay professional and not take it personally. And it's really hard not to take it personally when someone says I'm gonna beat you to a pulp if you show up here. You know it's hard not to take that personally.

Speaker 3: 33:50

Yeah, and it's important to understand what the protocol is for your organization when that happens.

Speaker 3: 33:55

Right, because you know, way back when everything wasn't centralized the way it is today. So when your letters went out, had the address for your office, somebody knew where to find you if they needed to, and so you had a protocol for your office. I remember we had a couple of those where there was a threat we had to kind of lock it down, advise security, advise law enforcement. But now that things are centralized, it may have your you know headquarter address. You still want to let headquarters know, because that may be where the threat really is physically, because that's what's on the documentation. So, for your organization, if you don't know what that process is, that's time to reach out to your leadership and say what is the process for this, because everyone should know what to do if they have a threat like that, how to report it, how to make sure other people know, so that everybody can be safe, so that if something escalates, they know how to make sure that the rest of the staff that are at that location are safe.

Speaker 2: 34:47

And listen, guys, you also need to record that in our claim file. You know insured made a verbal threat to physically harm me. You don't have to say the insured called me an SOB and MF and blah, blah. I mean you don't have to quote all of what was said, but you do need to memorialize that conversation, that it's gotten a little bit ugly. And, and when the insurance says, oh, I'm gonna, you know, talk about you on TikTok or whatever, and I'll be like, yeah, that is at KCM Roberts. So if you could just, you know, tag me, I would really appreciate that, it'd be great. Thanks, I could just, you know, tag me. I would really appreciate that, it'd be great. Thanks, I get more you know viewers and followers that way.

Speaker 2: 35:40

No you, you go, you know what. You are absolutely within your rights to get an attorney to make a Department of Insurance complaint, to contact the media you are absolutely within your rights to do that. To contact the media, you are absolutely within your rights to do that, you know. And you of course put that in the file and your next phone call will be to your supervisor. Hey, by the way, so-and-so on, such-and-such file is threatening this, this and this, and you might need to bump that up the chain. Boss, you know yeah.

Speaker 3: 36:16

But those are all good things to make sure adjusters know how to handle those Right, and I, like I don't, was never formally trained on that, it was just it happens and then you learn from that experience.

Speaker 2: 36:28

And it is a horribly frightening experience. I can't I won't say that it's less frightening for a man than it is for a woman to be threatened physically. I can tell you that I was very, very scared, and again I was working at this particular point when we were in offices and I would have a man walk me to my car at the end of the day for at least a week, you know, because I was worried about that. A week, you know, because I was worried about that. You need to know, as the adjuster, you need to be able to draw your boundaries. And even though I'm sitting here saying, oh well, it's not really personal, it is totally personal, especially if it becomes abusive, you know you need to draw that boundary and say I am sorry, I'm here to help you understand what the process is, but I can't do that. If threats continue, and again you draw that boundary and if they keep on going, again shut up. This is your default mode, shut up, this is your default mode, shut up, you know. And then, when they stop, again I'm here to help you. Oh, you're not helping me. Blah, blah, blah, shut up. Again, I'm here to help you, but I can't do that if we're going to be speaking in this manner. And listen, I have never known. Well, I know of one insurer that does not let you hang up on your insured or a claimant if they are being abusive. But I always encouraged when I was a claims manager. I'm like, look, if they're being ugly to you. Of course we're in the South and mama, don't let you be ugly to people. Yeah, you say I am sorry and you use again your lower tone of voice, your softer tone of voice. Don't yell at them, don't scream at them, don't try to talk over them. Talk through them, okay, because I'm not going to wait till they shut up.

Speaker 2: 38:39

In this particular instance, if they're threatening me with bodily harm, I'm going to say I am sorry, I cannot continue this conversation at this time and I am not going to be able to continue a conversation with you until we are able to speak in a more professional or business like tone. I say that twice. I say that twice. I am not going to be able to speak to you until we're able to speak in a more professional and business-like tone. I say that twice the third time I go. I am currently going to hang up the phone. Now I will send you a letter recapping our conversation and we will go on from there.

Speaker 2: 39:21

If we need to communicate, you know in a written format, then that's what we need to do, and I hang up the phone and then again I escalate it to the, to the manager. Even if I was a claims manager, I go to the like VP or the assistant claims manager. Hey, you know what they're going to want my boss, you're going to get to be my boss. The assistant claims manager gets to be my boss today. Have fun with that one, but you know, yeah, you need to know your escalation path and document it in your files.

Speaker 3: 39:55

Yeah, and it's crazy to me to just have a blanket policy. A blanket policy If you can't hang up on on an insured, because you do have scenarios where people are aggressive and insulting and inappropriate or just sometimes vulgar, like they're just vulgar for the sake of being vulgar and they're not even angry, they're just. But they know some people know that you can't hang up or that they have control over you because they're the, I think, of the client. But for any organization, please, like, don't create this kind of blanket. You can never hang up, cause I know people at call centers who they have to listen to those calls because they're afraid if they hang up they get dinged like it marks against them and like don't force your people to do that.

Speaker 3: 40:38

Have a pathway for them.

Speaker 2: 40:40

Well, this one we'll talk offline. I'll tell you who it is and I understand why they have done this. Particular insurer has done it. But yeah, I totally agree, it's different, it's very different, but they've got a different mentality.

Speaker 2: 41:00

It's different, it's very different but they've got a different mentality. So, anyway, so we've been given a lot of good techniques, and one of the things that I did want to make sure that we mentioned is that when we're talking to people because, you're right, they don't read our letters. They don't, you know, read our emails, and this is something that I'm I'm constantly concerned with is putting everything in an email, because we all know we don't read our bosses emails. You know, I'm not necessarily sure my husband reads my emails to him. So, um, you know, that's why I'm such a big proponent of putting things in a letter.

Speaker 2: 41:43

To be sure, you can email it, but make it an attachment, you know, because it makes it a little bit more formal, and then I would snail mail it still, because that's when people pay attention, and you need to make sure that you put this information that you are giving people in chunks, because we just can't, as human beings, process a whole bunch of information all at the same time. So when you're talking to someone, again having that tough conversation, okay, let's first talk about this burst pipe which is not going to be covered, and let me tell you why, and then we're going to go, you know. So you kind of start by clarifying the process and using chunks of language or chunks of information.

Speaker 3: 42:36

Yeah, I think it's important to make sure it's not everything all at once, because that's overwhelming to the caller, but it's important. I always tell adjusters it took you X amount of years however many years to have the knowledge you have today. They're going through this process for the first time, so they're not going to remember the majority of what you say. They're not going to remember the majority of what they read and what you're sending them. You are going to have to repeat yourself. You're going to have to kind of schedule that in your conversations with them to allow yourself to repeat yourself so that they retain it. It's just to be fair to the claimant, to be fair to the insured. But I would see a justice who would get frustrated, like oh, I sent them that letter. Like why didn't they just read that letter? And I'm like, okay, well, tell me the last piece of mail that you read. Yeah, yeah, you got mail too.

Speaker 2: 43:33

And you're probably glancing like oh, bill, bill, bill, send money, send money, send money. You know, yeah, absolutely, absolutely. And I know that we specifically talked about this last episode, but again I want to bring out and this is something I'm very, very passionate about, especially when we're talking about reservation of rights letters and letters of declination or coverage. Declination letters is that we've got to use real language in between all of the jargon, Because I had specifically mentioned when I was in the ER, the doctor came in and said oh yeah, we think we have a pulmonary anema and I'm like okay, pulmonary, you know, lungs anema is that like the bruise, what's the, you know?

Speaker 2: 44:18

And then she said water on their fluid in the lungs. And had she come out and just said we think you have fluid in the lungs, or pulmonary anema, as we call it in the medical field? You know, that would have been better than me being all writhing in pain, you know, on a gurney in the hospital and them telling me what a you know? Oh, you've got pulmonary edema. Okay, great, I've got something with my lungs. And I only know pulmonary because I did a lot of bodily injury claims. Okay, so if I was just a strictly property damage claim, I might not know pulmonary, so use real language in between all of our jargon.

Speaker 3: 45:02

Yeah, simple language and no acronyms. Oh, gosh.

Speaker 2: 45:06

No, if you do use an acronym, you've got to define it. First you have replacement cost value policy parentheses RCV, end of parentheses. You have actual cash value on your policy parentheses ACV. End of parentheses. And then I guess you could go ahead and continue to say ACV, rcv, sob, lmop, you know all of that sort of thing. But yes, you do need to make sure that you are defining all of these sorts of things.

Speaker 3: 45:39

Yeah, and I think that's good in the letter, but definitely like on the phone, like I was telling my adjusters no acronyms on the phone, yeah, because even if even if you tell it to them, they're going to confuse it because they're not using it eight hours a day like you are. So if you say you know our CV, they're going to say, oh, that VCR, how much is like? They're gonna, they're gonna switch the letters around because they're not used to, and then when they call somebody else, they're going to be like what are you talking about, vcr? So it's just on the phone, just no acronyms, because it's just confusing for the claimants.

Speaker 2: 46:13

Yeah, and that's a very good point. One of the things that I do, or I did tend to say when I was talking to the insured, is listen, I might slip into insurance ease. Please stop me. I don't mean to. I will try to remember to translate everything, but every once in a while I know that I will do it. Just stop me, interrupt me so that I can explain it. Okay, I don't want you to have any questions and if anything, you know, get the letter, read it, call me back. We're leaving the door open for them to make sure they have no questions. I guarantee you all of this time that you are spending on the front end having these 15, 20, 30 minute conversations per claim and you've got 150, 200 claims. I get it, I totally get it. It's a lot, I know, but it is going to save you so much time in complaints, return phone calls, emails, all of that kind of lawsuits, all of that kind of fun jazz, yeah.

Speaker 3: 47:26

Yeah, I love that. I love that as a as a practice right, because we're all human and even if we try, we might slip up. So it lets them know. If I start to say something and it doesn't make sense or you can't remember or I feel like I haven't explained this before, stop me so I can make sure I address it.

Speaker 2: 47:42

Right, right. Well, I think we have probably gotten over, like all of that kind of stuff. So, essentially, shut up, it's not personal. Send a letter, yeah, things up into chunks, it's not personal. Send a letter, yeah, things up into chunks. And yeah, we said follow up in writing.

Speaker 3: 48:05

Ok, yes, and then for anybody who's listening in there, in the leadership capacity, train your adjusters train your business scenarios.

Speaker 2: 48:17

Yeah, their first lesson shouldn't be an actual call with a claim. No, yeah, yeah, I totally agree with that. Yes, and it can be a lot of fun just having your even if you get your team leaders with their little pod of people it doesn't have to be the whole claims department, you know just five people and having that conversation like how can we say it better? What's another way we can say this? How do we break this down? It is going to be so very helpful, yeah, so very helpful. What is also going to be helpful and this is again actually based off of your idea, or one of your TikToks that I saw is the next episode, and we're going to be talking about something that adjusters we don't necessarily think about a lot, but it's about bankruptcy, insolvency and reserves and, if anything, we always hear as adjusters oh, you got to set right reserves so you know the insurance company would be profitable, blah, blah, blah. That doesn't mean anything to us, we don't care, we're just like dude. As long as you keep paying us our paychecks, that's all we really care about.

Speaker 2: 49:35

You were explaining something that, again, I've been doing this for like 25 years. I understood it intellectually, but you were able to break it down and I love this to go like oh my God, that, oh, that's what it is. Oh, wow, and it was absolutely fabulous. So don't miss our next episode, number 74, where we're going to be talking about bankruptcy and solvency, how they're different and how reserves that the reserves that the adjuster puts in plays into all of this. So that show will air on July 31st. So, anyway, thank you, sandy, for this great, great idea how to have these tough conversations basically shut up kind of have these tough conversations basically shut up.

Speaker 3: 50:21

Oh yeah, it was a, it was a pleasure and I, you know anything we can do to make it a little bit easier for new adjusters who are in the field, who are feeling frustrated, who you know. Just to let you know it's not just you. Every adjuster goes through this. You're all. You're always going to have tough conversations as part of the job, but confidence comes from doing so. The more you have it, the more secure you'll feel in engaging with claimants, even if they're upset.

Speaker 2: 50:47

Yeah, so great. Well, thank you again. We will see you in two weeks. You're welcome, see you soon.

Speaker 1: 50:55

Thanks for joining us on the Art of Adjusting podcast, where we talk about life as an insurance adjuster.

Speaker 2: 51:01

If you enjoyed this podcast or this episode, please give us five stars and a review. It does help the algorithm pick us up.

Speaker 1: 51:09

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Speaker 2: 51:27

In the meantime, you can contact me at theartofadjustingcom for consulting and training purposes.