What Makes a Great Professional Liability Insurance Claims Team?

Consider this: You’re in the middle of a busy time at work. Your personal life is also so hectic you barely have time to get the laundry done, pay bills, or catch up on Netflix. And then you get a notice: You’ve been named in a professional liability case. It’s like a punch to the stomach. Someone is suing you?!

How are you going to fight this?

This is only the tip of the “stressful-feelings” iceberg that you’re bound to experience when named in a suit. It’s exactly why feeling confident you’ve chosen the right professional liability insurance company to cover you is imperative to sleeping well at night. They’re the ones who will fight.

Your claims experience should be part of your insurance shopping checklist. Why? Because poor customer service, restrictions that may be listed in “fine print,” and slow claim processing times can add unnecessary stress (and potentially financial hardship) to what is already a difficult time.

This article provides a view of what a claims team should do — and help you determine whether the professional liability insurance policy you have (or are shopping for) will provide you with the quality claims team you deserve.

What Does an Insurance Claims Team Do?

But first, what does a claims team do? The claims department at an insurance company helps policyholders in the event of a loss or claim against them (such as an accusation of negligence or malpractice). This article focuses specifically on professional liability claims because these are the types of experiences our claims team at Berxi handle every day.

Here are the steps a claim professional should take when a professional liability claim is made against you, the insured customer:

1. Contact you and let you know that they’re your dedicated claim professional.
2. Connect you with the attorney who will be representing you in that case.
3. Work as the point person for you with your insurance company if you have any questions.
4. Provide you with regular updates to keep you informed, along with your legal counsel.
5. Investigate the allegations against you thoroughly.
   • If you are improperly named, they and your attorney will work with the plaintiff’s attorney to attempt to get you dropped from the case entirely.
   • If you remain in the case, they and your counsel will work to defend you in that case (which may include exploring opportunities to settle, if it’s in your best interest).
6. Help you gather documents and prepare to give testimony in a deposition or trial.
7. Handle paying attorney’s fees and costs associated with your defense, promptly.
8. Finalize all necessary documentation to release you and end the case against you.

Why Is a Claims Team Important to the Insurance Experience?

Claim professionals assist insured customers through a legal case or a licensing board review. If you’re in the unfortunate situation of being named in such a process, you may feel scared, overwhelmed, even alone, especially if it involves something like a wrongful death in a medical malpractice case.

With a world-class claims team working for you, though, you’re never alone. You have someone who understands how you likely feel, listens to your side, and is ready to fight for an outcome that’s in your best interest. Your claims professional should explain the entire process, update you every step of the way, and respond to your questions or concerns in a timely manner. Bonus points if they can help keep you calm through the entire ordeal.

They should also work closely with you and other parties (such as your attorney and expert witnesses) to help ensure a fair and reasonable process and, hopefully, outcome. This is particularly important if you’re a business owner, since a long claim resolution process can negatively impact your company’s financials.

5 Qualities of a Great Insurance Claims Team

Think about the voice you want to hear on the other end of the phone when you’re going through a crisis. That voice represents a company and brand that is now responsible for guiding you through this matter. What qualities do you want in that person and team? Here are a few that we pride ourselves on at Berxi:

1. Empathy

Whether you made a mistake or not, you should be treated with empathy. The claims professional should understand that you may not know what to do or expect, and respond by giving you the personal attention and guidance you need every step of the way. They should also be someone you don’t dread hearing from.

2. Trust

Trust is everything. Trust means knowing that your claims team has your best interest at heart, that the information they give you is accurate and timely, and that the process is transparent. You’ll want someone to give you an honest, objective assessment about your situation, backed up by the specific facts, and their years of experience. For example, if they think it’s in your best interest to attempt to settle a case rather than to fight it, they should tell you that (and help you get there).

3. Responsiveness

You need a claim professional who’s there for you. That involves not just responding to your questions but proactively reaching out to keep you informed. To find out how good a company might be at responding to claims, you can check the insurer’s website for information about the claims process, contact the company directly, or ask friends how their insurance companies have handled their claims.

4. Financial Strength & Reputation

First off, it’s important to choose an insurance company that will have funds to support you. You can check an insurer’s ability to pay claims by looking at its ratings. Independent agencies like AM Best, Fitch Ratings, and Moody’s review the financial strength of insurance companies and issue ratings for them.

But just choosing a financially stable company doesn’t mean they will put you, their customer, first. That’s where their reputation comes in. For example:

• Does the company put customers first?
• Are they available when customers need them?
• Do they have a reputation for doing the right thing?

You’ll want to deal with a company that has a proven track record among professionals in your field.

5. Experience

You know the value of experience in your own field. If a claim is filed against you, don’t you want your professional life and livelihood to be in the hands of an experienced claim professional? You deserve a claims team that can objectively look at the case and use their experience to help you determine the best course of action for you.

What Is the Claims Experience Like at Berxi?

The claims team is an important part of the insurance experience. We know that a claim can be a stressful time in your life. As a Berxi customer, if you were to receive a lawsuit or Board Complaint from a peer or licensing review committee, or if a patient threatens to sue you, you can expect the claim process to include the following steps.

Step 1: Contact Berxi.

Email claims@berxi.com or call Berxi to file your claim.

Step 2: Hear back from the claims adjuster.

Your claims adjuster will contact you within one business day. During the initial communication, they will explain the claims process and ask you more questions.

Step 3: An investigation starts.

The claims team will confirm policy coverage and start looking into the claim.

Step 4: Determine strategy and resolution.

The claims team creates an effective legal strategy. They might resolve the claim early or provide a plan for your defense. If a lawsuit is filed, an attorney from a vetted national panel of lawyers will be assigned to defend you. The goal is to achieve appropriate and timely resolution with your assistance, keeping you informed and involved along the way.

Meet Members of the Berxi/BHSI Claims Team

As part of Berkshire Hathaway Specialty Insurance (BHSI), Berxi offers a team of claims experts that are ready to help you through every step of the process. Meet some of the BHSI/Berxi claims team members and learn why they love helping people in some of their toughest moments.

Ed, Claims Examiner

Years at Berxi/BHSI: Since 2021
Why you love working for the claims team: I love what I do and working with wonderful, knowledgeable, and insightful people makes my job a lot more satisfying.
Favorite claims experience: One of my best experiences here involves a Berxi case involving a physical therapist who was named in a wrongful death suit. When the matter was settled, the PT was cleared and BHSI did not have to contribute to the settlement.

Helena, Claims Examiner

Years at Berxi/BHSI: Since 2021
Why you love working for the claims team: I have been in the insurance industry for 13 years, handling Environmental, Life Sciences, and Casualty claims. I really enjoy the complexity and uniqueness each claim brings. Each one allows me to utilize my analytic abilities.
Favorite claims experience: My favorite claims experiences involve working with both internal and external business partners to provide excellent customer service.

Kait, Former Insurance Defense Attorney and Senior Claims Examiner

Years at BHSI: Since 2022
Why you love working for the claims team: Insurance claims can be stressful and overwhelming for individuals who are dealing with unexpected events, especially when it is their first experience. Being part of the claims team allows me to provide support and assistance to customers during these difficult times, which is incredibly rewarding. Knowing that my work directly contributes to helping people recover from setbacks and move forward gives me a sense of purpose and fulfillment in my role. Claims is our product, after all.
Favorite claims experience: Receiving customer appreciation emails or phone calls when a claim is resolved.

Kristine, Senior Complex Claims Director

Years at Berxi/BHSI: Since 2022
Why you love working for the claims team: It’s a real team environment here. Everyone is willing to listen, lend a helping hand, and support each other. The values of the business are reflected in the team’s attitude towards handling claims.
Favorite claims experience: My favorite claims experiences are getting to work on large, high value claims and to collaborate on strategy in achieving the best outcomes for our customers!

Final Thoughts

As a professional looking for liability insurance, you should always consider the coverage being offered, and at what price. But you shouldn’t overlook an insurer’s service abilities — its key to ensuring any future claims are processed efficiently and effectively.

Whether you’re exploring insurance providers or looking for a new one, choosing an insurer with a strong claims team will help ensure the security and future of your career or business. Contact the provider and ask about policies and processes for filing a claim. Read online reviews and ratings, and talk to professionals in your network. If nothing else, you will hear stories of who not to use, and that can narrow down your list.

And be sure to read about Berxi’s commitment to claims and see how we stack up against the competition.

Gina Gallagher assisted with this article.

 

Image courtesy of istock.com/Tetiana Lazunova

 

Last updated on Jul 24, 2024.
Originally published on May 25, 2023.

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The views expressed in this article are those of the author and do not necessarily reflect those of Berxi™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice. Click here to read our full disclaimer