Claims: What Makes the Difference?

3 hours ago

4 min read

When people think about successful claim outcomes, they often focus on settlements, verdicts, or claim costs. While those metrics matter, I've learned over the years that one factor consistently influences the success of a claim long before it's resolved:

Communication.

One of the earliest lessons I learned in claims is that people can handle bad news far better than no news. I've seen difficult claims reach successful resolutions because stakeholders understood the process, stayed informed, and knew what to expect. Conversely, I've seen relatively straightforward claims become unnecessarily complicated when communication broke down.

The reality is that communication is not simply a customer service function—it's a core claims management strategy.

The Call That Changed My Perspective

Several years ago, an insured called me and began the conversation with a simple statement:

"Tim, I'm not sure what's going on."

That single sentence revealed a much larger problem.

The claim had been reported promptly. The investigation was progressing appropriately. The adjuster was handling the file professionally. Nothing was technically wrong with the claim itself.

What had failed was communication.

The insured had not received an update in weeks. The broker lacked visibility into the claim's status. Defense counsel was moving forward independently, but no one had connected the information across stakeholders. By the time everyone aligned, confidence in the process had already begun to fade.

The claim hadn't changed.

The perception of the claim had.

That experience reinforced a belief I still hold today: communication isn't something that happens after the work is completed—it is part of the work.

Every Claim Is About People

At its core, claims handling is a people business.

Every claim involves individuals with unique concerns and perspectives:

A driver involved in an accident.
A business owner worried about operational disruption.
An employee reporting an injury.
A broker fielding questions from a client.
An adjuster gathering facts.
Defense counsel evaluating risk.
Executives seeking answers before their next board meeting.

Although their roles differ, they all share the same fundamental need:

They want to know what's happening.

When communication slows down, uncertainty fills the gap. Assumptions replace facts, frustrations increase, and confidence begins to erode. Effective communication prevents those problems before they start.

The Cost of Silence

One of the most common mistakes in claims handling is not making the wrong decision—it's waiting too long to have the conversation.

Stakeholders don't expect perfection. They expect transparency.

If an investigation is taking longer than anticipated, explain why. If medical records are delayed, communicate the delay. If liability remains under evaluation, say so. If you're awaiting an expert report, provide a timeline.

Most people are understanding when they know what's happening.

What they struggle with is silence.

Often, a brief phone call or a short email is enough to reassure everyone that the claim continues to move forward. Small updates can prevent much larger issues later.

Better Communication Leads to Better Decisions

Communication is not only about providing updates—it also improves decision-making.

Throughout my career, I've seen critical insights emerge from conversations that otherwise might never have occurred. An insured shares information that changes our perspective. A broker provides context that reshapes a settlement strategy.

Defense counsel identifies emerging risks not apparent during the initial investigation.

These valuable insights depend on engagement.

Claims are rarely solved by one individual working in isolation. They are resolved through collaboration, shared information, and a willingness to challenge assumptions in pursuit of the best possible outcome.

A Proactive Approach to Communication

At Hartwell Insurance, we believe communication should be proactive rather than reactive. Our goal is to keep insureds, brokers, TPAs, and other partners informed throughout the claims process—not only when significant developments occur.

That means:

Setting expectations early.
Explaining strategy and objectives.
Discussing potential challenges.
Providing periodic updates.
Maintaining visibility even when there hasn't been a major change.

In many cases, the most valuable message isn't dramatic at all.

It's simply: “Here’s where we are today, and here's what we're waiting on."

Those conversations build trust, and trust strengthens partnerships.

Technology Is a Tool—Not a Substitute

Modern claims organizations have access to impressive technology. Claim portals, dashboards, video inspections, AI-assisted document review, and automated updates all help improve efficiency and information flow.

These tools are valuable and should be embraced.

However, technology cannot replace human connection.

Sometimes the most effective action a claims professional can take is simply picking up the phone. A five-minute conversation can answer questions, reduce anxiety, and strengthen relationships in ways that automated communications never will.

Technology should enhance communication—not replace it.

Final Thoughts

If there's one message I'd leave with every claims professional, it's this:

Never let someone wonder what's happening with their claim.

You don't need to have every answer immediately. You don't need every report finalized or every uncertainty resolved.

But you do need to communicate.

Good communication builds confidence.

Great communication builds partnerships.

And strong partnerships almost always lead to better claim outcomes.

Key Takeaways