How to Determine the RIGHT Caseload for Insurance Adjusters

Determining the ideal caseload for adjusters is no easy feat. There are far too many factors that go into identifying both case complexity and adjuster capability.

So where should you start? Take a look at adjuster performance, it’s easy enough to read between the lines.

Are Your Caseloads Too High?

Adjusters who carry a caseload that exceeds their capacity, experience, or training can do more harm than good. It can cause them to make mistakes, force them to take shortcuts or drop the ball on something important.

Do these signs look familiar to you?

• Missed dates
• No action plans
• Poor file documentation
• Insufficient preparation for estimate writing
• Failure to properly prepare for disposition
• Little to no communication with claimants

...and the list goes on.

Need More Reason to Reduce Caseloads?

Okay, let’s break it down a bit further...

Staff Morale: Work-life balance is important and excessive caseloads can lead to burnout, poor work performance, or worse yet, employee turnover. Be sure to check out our article 5 Ways to Prevent Adjuster Burnout and Reduce Employee Turnover for more.

File Quality: As caseloads increase, the quality of case files tends to decrease. In order to close all the cases that come across their desk, adjusters may cut corners, leaving room for error and cause for concern. Speed and efficiency are not the same!

Cost Containment: As the quality of case files goes down, risk and costs go up. Additionally, lost productivity, recruitment, and training costs far outweigh the cost of hiring or outsourcing to cover the extra caseloads.

6 Factors Impacting An Adjuster’s Ability

Ideal caseloads depend on the type of case, the adjuster’s experience, and the time needed to resolve the claim. The ideal caseload can keep an adjuster busy while allowing them to perform a complete and thorough investigation of each claim.

Properly managing and monitoring adjuster caseloads are key duties of office claims management. Here are six factors that impact an adjuster’s ability to close files:

1. Line of Coverage

Depending on the type of claims being covered, the demands on an adjuster’s time can vary greatly. A first-party glass breakage loss to the family minivan is a bit different than a product liability claim against a farm combine that overturned, killing its operator.

2. Case Complexity

No two files are the same, they each seem to have their own quirks and nuances. A number of moving parts, especially when it comes to more complex cases, can slow an adjuster down. The issues presented, witnesses to locate, people to interview, and so much more create a unique case file that can require varying time commitments to close.

3. Experience

As we’d expect, experienced adjusters should be able to handle higher caseloads than when they first got started in the role. For that reason, consider them for more complex cases to ensure both quality and efficiency.

4. Efficiency

Some adjusters learn faster than others. Some have figured out a system that works well for them. Knowing the capabilities of your team beyond their tenure goes a long way in determining an individual’s caseload.

5. Available Support

Claims often require a bit of clerical and administrative work - typing, printing, and file retrieval to name a few. The more support an adjuster has, the more cases they should be able to handle. The ability to delegate work should increase their productivity, allowing them to carry a higher caseload.

6. Service Standards

Customer service is important, but it can come at the cost of adjuster efficiency. Mandatory service standards like 24-hour contact on new claims, returning calls the same day, and writing estimates over the phone for small claims can slow adjusters down. And when caseloads are too high? These standards get thrown out the window anyway.

A Bit of a Balancing Act

Determining your ideal caseload is no easy task, but knowing your adjusters and what they’re capable of will certainly help. The balance lies somewhere between productivity and happiness.

So what can you do when your team gets overburdened and you want to avoid exceeding their caseloads?

US Claim Solutions is here to help! We bring extensive knowledge and expertise in both field and desk adjusting. We’re here to service your claims needs 24 hours a day, 7 days a week.

Email us at [email protected] or give us a call at (888) 701-1153.

Sources:

• https://www.propertycasualty360.com/2013/05/28/6-factors-impacting-the-claims-caseload/
• https://blog.reduceyourworkerscomp.com/2016/08/guidelines-to-determine-right-case-load-for-your-work-comp-adjuster/
• https://blog.reduceyourworkerscomp.com/2017/03/20-common-adjuster-mistakes/