September 30, 2007 by
A key part of the claims investigation is the interview. Good interview techniques will help the loss adjuster obtain information that is sometimes elusive. In this article, we will discuss some techniques for planning the interview and outline an effective model interview system. The following techniques can be modified according to situational needs by accommodating the style and personality of the people being interviewed.
Planning for the interview
Interviewing is the process of obtaining information from someone; that person is usually the insured, but it may also be a witness, a third party, or anyone else who can add to the knowledge concerning the loss.
Adjusters conduct investigative interviews — they do not interrogate. An interrogation is an investigative interview where the known facts are matched to a particular suspect for the purpose of obtaining a confession. Interrogations are the mandate of the police and other agencies.
Preparing for an interview is one of the most important, yet often neglected step in any interview. Good action plans can instill confidence in adjusters. It also enables adjusters to understand when the conversation is losing its focus. Good preparation tends to improve the chances the needed information will be obtained and lessen the number of mistakes made.
Before the interview, adjusters should review all available documentation. This could include background information from police reports, newspaper accounts or a visit to the accident scene to help focus the questioning. A previous statement, any reports, estimates or photographs, may generate new questions and a better understanding of the case.
The adjuster should anticipate any coverage issues and be prepared to answer any questions about deductibles and any other relevant terms and conditions of coverage. The insured’s claim history should be reviewed. How many claims and what type of claims has the insured filed?
The adjuster may just take notes of a conversation, unless a need for a formal written statement is established. There would be less of a need to take a statement for a modest first party claim without any coverage issues. When a written statement is required, the adjuster should first decide what must be included in it. A diagram or sketch may help to remind the party of the location and proximity of relevant items.
Enough time must be scheduled to properly conduct the interview. The interviewee should not feel rushed. The environment should be conducive to a business-like, yet relaxed, conversation.
Many claims are handled over the telephone. When a face-to-face interview is required, a location must be chosen that suits the purpose of the interview. Generally, finding an option that minimizes interruptions to the interview is useful. The adjuster must weigh the pros and cons of available locations.
Arrange a time for the interview as soon as possible following the loss. This will speed up the claims process. The claimant, and anyone else being interviewed, will better remember exactly what, when and how the loss happened.
Using checklists or following prepared lists of questions are methods used to encourage thoroughness. Sticking to a prepared script, however, can lull the adjuster into mechanically recording the facts. Adjusters must be flexible and use their listening skills at all times to identify gaps in information.
Here is an example of why a prepared script doesn’t work: A sailor was injured because his ship crashed into the rocks in the fog. He sued the lighthouse operator for failing to keep the lighthouse operational during foggy conditions. The keeper assigned to the lighthouse was asked the following questions:
* Were you on duty on the night of the crash?
* Were you at the lighthouse when the accident occurred?
* Did you aim your beacon in the right direction as a warning there were rocks ahead?
The lighthouse keeper answered yes to all of the questions in the interview. Later in the day, the keeper shared one of his concerns with a friend, “I was scared they were going to ask if the beacon was lit.”
The Model Interview System
Every claimant has different motivations and different reactions. Some time must be spent to assess personality traits and ease into a comfort zone with the person to be interviewed. An approach that works for one person will not necessarily work for another.
Here are some helpful tips:
* Begin the interview by introducing yourself and explaining what your role is. Then try to set the person to be interviewed at ease. Be pleasant and cordial to build rapport. Humour can be used when appropriate, but do not risk offending the person.
To begin, you might start with an open-ended question, something like, “Please describe for me in as much detail as possible the events leading up to the loss” or, “Tell me what happened when you returned home.” This will encourage the person to begin a narrative.
* Be patient and listen. Learn about what happened from the person being interviewed.
A lull in the interview does not necessarily need to be “fixed.” Do not jump in the moment the person stops talking. Allow the person to answer the question. Often, the latter part of an interview holds the most information, as the person being interviewed develops a comfort level.
* Ask for an explanation when something is not clear or if there is a gap in the information. Do not be concerned with looking foolish. Draw out whatever detail is necessary to get adequate information.
A direct or close-ended question calls for a very specific and usually short response. Such a question is particularly useful towards the end of an interview when details need clarification. For example, “Was the front door open when you returned home?” or, “Was the seatbelt fastened?”
A more general type of question might be more appropriate, “You mentioned ___. Can you tell me more about that?”
Too many questions at once may confuse the person being interviewed. Patiently wait until the person is ready to continue.
Although you may have prepared a list of questions, you should not limit yourself to those questions; by listening to the insured’s answers you might think of new relevant questions. A list is just a guide to help ensure that nothing is missed. Leaving an adequate space after each question will permit you to properly document the insured’s answers. The insurance company may have a general set of questions that must be asked and forms that must be filled out. Companies often require computer checklists. An auto accident checklist, for example, will include a list of all physical damage.
* When you maintain your composure you maintain a measure of control over the encounter even if you believe the person is lying. Sometimes a lie can be more useful than the truth when the credibility of a claimant or witness can be brought into question.
* In a face-to-face interview, body language should be evaluated. When a person is in distress, be sensitive to it. Kindness and compassion for another person’s discomfort will ease any rising tension.
Telephone interviews are somewhat more difficult. They require sensitivity on the part of the adjuster to listen to subtle messages and communicate well even though there are no visual cues to guide the conversation.
* Make notes as needed. Is it necessary to record the information immediately?
Unobtrusive note taking may not be a distraction for the person being interviewed. Be ready to show the person notes taken afterwards. If the person wants to amend certain information, ask them to initial changes. This will make it difficult for the person to change the story later.
Information gained in an interview will help guide any further investigation. Regardless of the m
ethod used to document the interview, it must be accurate and thorough. Use the techniques noted in this article to help you to meet your goals during your next interview.
This article is based on excerpts from the study material in the Claims Professional Series of applied courses — a core of the CIP Program that helps adjusters learn the functional knowledge and skills required of their profession.