A Guide to Claim and Risk Management Manuals
By Kevin M. Quinley CPCU, AIC, ARM
Manuals canít cover every contingency that risk managers or claim professionals face. They can, however, provide needed guidelines for operating a busy and productive office. In our last installment, we discussed some of the vital components of risk and claim manuals. Here are some other features which you should consider including in your manual:
Outline Your Manual
Office routine, including opening and closing times, lunch hours, coffee breaks, switchboard coverage, employee time cards and overtime
Standardized claim office procedures, such as style of correspondence, pleadings and other document formats, including use of pre-printed office forms, how to open, close and store claim files; and guidelines for releasing files and information to clients and others.
Bookkeeping procedures, including use and processing of adjuster time-sheets, client expense records and check requests, billing procedures.
Job descriptions for support staff, risk management support staff, adjusters and claim personnel with managerial responsibilities. Have staff people revise their own job descriptions periodically, with their manager's or supervisor's approval. This way, descriptions are kept current and accurately reflect the job's real requirements.
Further, employees remain clear about their duties for purposes of performance evaluation, and claim managers avoid having to reinvent the wheel every time a new adjuster or risk management analyst comes on board.
Summary of benefits, including vacation and sick-leave policies, insurance coverage, retirement plans, parking or public transportation policy, and any other perk or benefit offered by the adjusting company.
Salary review schedules, performance criteria and termination procedures.
An Appendix with all claim forms clearly identified and a description of their use.
As a rule, if it is a claim office policy, procedure, form or recurring routine, put it in the manual.
Using the Manual
Provide each office staff member with a copy of the manual and require that they keep it in their office or work station. Give each new employee ample on-the-job time to read, review and become familiar with the manual (i.e., pay them to do it -- it's well worth the expense, and helps boost morale). Make sure that the branch office manager or administrator is available to answer questions about policies and procedures.
Keep the entire manual on a floppy disc. This helps make changes, updates and revisions easier. When you do update, indicate the date of the last revision. The branch claim manager should retain the master copy.
Policies and procedures set forth in the claim office manual should be followed by all personnel, including adjusters. If matters arise repeatedly which are not covered in the manual, formulate a new policy or procedure and add it. This will keep your manual current, credible and useful. Not all answers can be found in a manual or anticipated by even the most well-though-out booklet. Nevertheless, any claims or risk manager striving to operate at peak efficiency should consider developing a departmental manual, or dusting off and improving their existing one.
Kevin M. Quinley CPCU, AIC is Senior Vice President, MEDMARC Insurance Company, Fairfax, VA. He can be reached at firstname.lastname@example.org.