Communication & Negotiation Skills in Claims Handling Flashcards

A claimant accuses the adjuster of bad faith during a phone call. The adjuster should FIRST:

Answer: Acknowledge the concern, remain calm, and explain the claim-handling process clearly

Calmly acknowledging the concern and transparently explaining the process often resolves misunderstandings and demonstrates good faith handling.

Which negotiation style is MOST appropriate when handling a high-severity catastrophic injury claim with significant liability exposure?

Answer: Collaborative/interest-based style focused on long-term resolution

Collaborative negotiation on catastrophic claims builds trust, addresses complex needs (structured settlements, future care), and reduces litigation risk.

An adjuster uses 'mirroring' as a communication technique. This involves:

Answer: Repeating the last few words the claimant said to encourage elaboration

Mirroring in communication means repeating the speaker's last words or phrases, signaling active listening and prompting them to expand on their statement.

A property claimant rejects the adjuster's scope of loss and demands an independent appraisal. The adjuster's communication response should:

Answer: Acknowledge the right to appraisal under the policy and explain the process clearly

Most property policies include an appraisal provision; acknowledging it and explaining the process demonstrates good faith and policy compliance.

During a recorded statement, the adjuster asks: 'You weren't really hurt, were you?' This question is problematic because it is:

Answer: A leading question that suggests the desired answer and undermines statement integrity

Leading questions corrupt recorded statement quality by suggesting answers, making the statement less credible and legally defensible.

When delivering a large settlement check to a represented claimant, the adjuster MUST direct all communication through:

Answer: The claimant's attorney of record

Ethical rules and most state regulations prohibit direct contact with a represented claimant; all communication must go through the attorney.

A useful framework for structuring a difficult claim conversation is the HEAR model. The 'E' in HEAR stands for:

Answer: Empathize with the claimant's perspective

In the HEAR (Hear, Empathize, Acknowledge, Respond) model, Empathize means validating the claimant's feelings before moving to facts or solutions.