Lost Time Adjuster
The supervisor plays a pivotal role in assuring quality claim management. Supervisors focus on managing, coaching and evaluating the performance of others. A Supervisor should provide technical expertise, recognize improvement opportunities and insure the files are properly documented and provide meaningful feedback that drives a desired claim outcome.
New Losses (14 Day Supervisor Review)
For all new claims assigned to a Lost Time adjuster the supervisor should complete a review within 7 days. Each review should focus on the following items.
Initial Contact/ Investigation –The supervisor will evaluate the timeliness and effectiveness of initial contacts and investigation. The supervisor should provide meaningful direction and provide a …show more content…
(Unless facts require a more timely review).
• Supervisor will establish an ongoing diary for each claim as determined by the experience level of the adjuster and the complexity of the file not to exceed every 90 days.
• All subsequent Supervisor reviews should include direction and comment on:
1. Reserve – Does reserve reflect the value of the case?
2. RTW – Has RTW been addressed and does plan reflect proper use of RTW specialist
3. Resolution and Adjusters POA- Does the adjusters POA reflect an ongoing course of resolution and reflect the facts of the case.
4. Recovery- Has Subrogation been identified and pursued?
5. Litigation- Has litigation outcomes been controlled? Is the adjuster accurately utilizing the Attorney?
• Supervisor will establish a second TTD diary for all open TTD cases to be reviewed at a minimum of every 30 days while on active TTD. ( unless facts warrant a longer diary period)
Other Duties
• In Conjunction with Q/A the supervisor will complete 4 quarterly file reviews of each adjuster (2 open & 2 Closed) to evaluate file quality and outcome. The supervisor will provide feedback to staff and provide developmental opportunities based on identified
New Losses (14 Day Supervisor Review)
For all new claims assigned to a Lost Time adjuster the supervisor should complete a review within 7 days. Each review should focus on the following items.
Initial Contact/ Investigation –The supervisor will evaluate the timeliness and effectiveness of initial contacts and investigation. The supervisor should provide meaningful direction and provide a …show more content…
(Unless facts require a more timely review).
• Supervisor will establish an ongoing diary for each claim as determined by the experience level of the adjuster and the complexity of the file not to exceed every 90 days.
• All subsequent Supervisor reviews should include direction and comment on:
1. Reserve – Does reserve reflect the value of the case?
2. RTW – Has RTW been addressed and does plan reflect proper use of RTW specialist
3. Resolution and Adjusters POA- Does the adjusters POA reflect an ongoing course of resolution and reflect the facts of the case.
4. Recovery- Has Subrogation been identified and pursued?
5. Litigation- Has litigation outcomes been controlled? Is the adjuster accurately utilizing the Attorney?
• Supervisor will establish a second TTD diary for all open TTD cases to be reviewed at a minimum of every 30 days while on active TTD. ( unless facts warrant a longer diary period)
Other Duties
• In Conjunction with Q/A the supervisor will complete 4 quarterly file reviews of each adjuster (2 open & 2 Closed) to evaluate file quality and outcome. The supervisor will provide feedback to staff and provide developmental opportunities based on identified