The experts insurers rely on to adjudicate complex claims, quantum assessors, adjusters, forensic investigators, are chosen through a process most clients never see, and the reports those experts produce are almost never shared in full, according to Brian Rosenbaum (pictured), national claims director at Aon, who raised both issues with a group of insurers he described as among the industry's most collaborative, at a recent symposium hosted by the brokerage.
Rosenbaum said one of the recurring pain points insureds encounter is simply not knowing how insurers select the specialists brought in to help resolve a claim, or how those experts are kept on schedule once engaged. That uncertainty matters more than it might first appear, since a client facing delays has little explanation for what's causing them unless their broker understands the process generating those delays in the first place.
"How do they select the experts that they use? How do they discount some experts? How do they keep them on track to make sure that there's a timely resolution?" Rosenbaum said he asked the group directly. The answers matter, he said, because the more specialists involved in a claim, the more a case is exposed to delays from something as ordinary as a vacation or an illness stretching out an already complex investigation, delays that can compound quickly once multiple experts are coordinating on the same file.
A related and thornier issue, Rosenbaum said, is what happens once an expert's report is actually finished. Insurers rely on those reports to determine a coverage position, but clients are typically shown only the portions the insurer chooses to share, not the complete document, even in cases where the policyholder is effectively paying for the report through their own coverage.
"They only excerpt the parts that they want to, but they don't reveal and disclose the entire report," Rosenbaum said. "This irritates many of our clients."
Rosenbaum said it falls to the broker to explain to clients why that limitation exists, so it doesn't read as insurers withholding information without cause. Insurers have legitimate, confidentiality-driven reasons for not disclosing a full report, he said, and part of the broker's job is making sure clients understand that the practice isn't nefarious.
When he pressed insurers on the reasoning behind that practice, Rosenbaum said the responses centered mainly on confidentiality and legal exposure rather than any effort to withhold information for its own sake. That distinction, he said, is worth drawing out clearly for clients who might otherwise assume the worst about why a report is being withheld.
"There are confidentiality issues," Rosenbaum said. "There are other things, but they basically said, tell us what it is you want to know, and we'll do our best to communicate that to you."
That answer, he said, is probably the most realistic outcome brokers can expect given the legal constraints insurers are working within, even if it doesn't fully resolve client frustration in the moment.
"They understood that there is a level of distrust on the part of clients when the report itself is not furnished to them, and in some cases where they actually pay for it because it comes off of their insurance available to them," Rosenbaum said.
That same tension between moving efficiently and being transparent, Rosenbaum said, extends to how insurers communicate a coverage position once one has actually been reached. Insurers face real pressure, from clients, brokers, and often internally, to land on a determination as quickly as possible. But he said there's a real risk in communicating too soon, one that can tip from candid updates into something closer to a premature promise.
"Inadvertently misleading the client by making them think that there might be coverage, and then when further information comes in, backtracking," Rosenbaum said. He said he wanted faster, well-reasoned coverage positions from insurers, but not at the cost of having to reverse course later, since undoing a client's expectations tends to do far more damage than simply taking longer to get there in the first place.
"Backtracking is death," Rosenbaum said. "It is the worst, because then you've got a client who had an expectation, and now you have to undo that expectation, and that is difficult."
Rosenbaum said it's on the broker to help clients understand why a position may shift as more information comes in, so a later correction doesn't read as bad faith on the insurer's part.
Ultimately, Rosenbaum said, nearly every pain point insureds raise with insurers, whether it's how an expert is chosen, how much of a report gets disclosed, or how a coverage position is communicated, comes back to the same underlying issue.
"Communication is most important, always," Rosenbaum said. "We find the best relationships that we have, and therefore our clients have with insurers, are ones where communication is regular, it's transparent, and there's a willingness to speak and negotiate and collaborate."
