Claims Adjusting: Critical Thinking Required

Insurance carriers today are focusing on reducing claim cycle times and increasing claim closing ratios while maintaining a high degree of accuracy.

Therefore, our industry is now in an age where companies are utilizing automation and internal intelligence to accelerate the claims adjudication process.

One of the key fundamentals in this process is investigating, documenting and communicating coverage to the insured. However, adjusters must still apply their critical thinking skills, along with using the automation and internal intelligence available to them, while completing this important claims activity.

How can an adjuster’s critical thinking skills be applied and how do they promote conducting a reasonable coverage investigation, making a timely coverage decision and increasing the ability to accurately apply the policy language to the merits of the claim?

Before answering this question, let’s define critical thinking.