Develop Best Practices To Stay Ahead, say Claims Experts

An insurance professional—regardless of expertise—must be above reproach.

Professionalism appeared to be the underlying theme that all panelists spoke to at the 43rd Annual CICMA/CIAA Ontario Chapter Joint Conference, held in Toronto from Feb. 3 to 4, 2010.

Whether it is the documentation of a claims investigation, a discussion with a policyholder, or conduct before, during and after litigation, “optics, from a litigation standpoint, must be nothing less than professional,” explained Dan Buch, branch manager and special investigations at Cunningham Lindsey.

The argument by many of these seasoned insurance specialists was that professionalism afforded the adjuster, investigator, litigator (and broker) the opportunity to build relationships within the industry and to maintain the integrity of the industry. This last part is particularly important given the number of different guidelines and the amount of legislation that’s been enacted over the last three decades around privacy and industry ethics.

The good news is that best practices enable the industry to perform at a higher level than what is mandated.

“PIPEDA didn’t really impact the investigative profession,” explained Brian King, president of King Reed & Associates. “Because we were already, for the most part, compliante to the rules and principles set out in the Act.”

However with emerging technologies and trends the industry will have to work hard to maintain their above reproach professionalism.

For example, new ethical and legal questions around obtaining and using information through social network sites, such as Facebook, are prompting the industry and lawmakers to rethink the use of pretext and/or pseudonyms. As a result claims investigators—and those involved in claims litigation—will need to develop best practices regarding the use of social networking sites, King told the packed room at the Metro Toronto Convention Centre.