Every Difficult Claim Is Either a Burden or a Classroom
By Chelsy Bell Carpenter, VP of Business Development, Ampion Group.
Episode 3
One difficult claim can make you cynical.
Or it can make you better.
The difference is not always experience.
It is reflection.
After more than fifteen years in the claims industry, including time spent handling claims directly, I can tell you that the files I remember most are not the easy ones.
They are the ones that challenged my thinking.
The ones that forced me to improve my communication.
The ones that exposed gaps in process.
The ones that taught me when to slow down.
And the ones that reminded me that asking for help sooner is often a sign of good judgment, not weakness.
Those claims shaped the professional I became.
And looking back now, I see something I did not always recognize in the moment:
The most difficult claims were often some of my best teachers.
Every Claim Leaves a Lesson
Claims professionals move fast by necessity.
There is always another file.
Another call.
Another estimate.
Another upset customer.
Another deadline.
That pace makes it easy to treat a difficult claim as something to simply get through.
Close the file.
Document it.
Move on.
But if we move too quickly, we can miss the lesson the claim was trying to teach us.
Maybe communication broke down because expectations were not established early enough.
Maybe a dispute escalated because one party did not feel heard.
Maybe technical expertise should have been brought in sooner.
Maybe documentation was not as clear as it needed to be.
Maybe an adjuster held onto a file too long because asking for help felt like admitting they did not know enough.
Or maybe the organization itself lacked a clear escalation path.
Every challenging claim carries information.
The question is whether we use it.
Experience alone does not make someone better.
Experience combined with reflection does.
Two adjusters can handle the same number of claims over ten years and come away with very different levels of judgment.
One simply accumulates years.
The other accumulates lessons.
That distinction matters.
The Danger of Survival Mode in Claims
There are seasons in claims when the objective becomes simple:
Get through the day.
I understand that reality.
High inventory, severe weather events, staffing shortages, escalations, unhappy customers, competing priorities and constant incoming communication can push even experienced professionals into survival mode.
And survival mode changes how we think.
We become more reactive.
We narrow our focus.
We look for the fastest answer.
We may become more defensive when challenged.
We start treating every interruption as another threat to an already overloaded system.
The question shifts from:
"What is the best way to handle this?"
to:
"How do I get this off my desk?"
That does not mean someone has stopped caring.
It often means their capacity is depleted.
This is where my Built to Last philosophy intersects so closely with claims work.
Burnout is not simply about being busy.
It is often what happens when the nervous system remains in a state of urgency for too long.
When everything feels urgent, thoughtful decision-making becomes harder.
Curiosity disappears.
Patience becomes limited.
Collaboration can start to feel like one more thing that takes time.
Yet ironically, those are often the exact moments when collaboration matters most.
Built to Last Principle: Reflect Before You React
One of the principles I teach through Built to Last is simple:
Create enough space between stimulus and response to choose your next move intentionally.
That principle applies directly to claims.
A difficult email comes in.
A contractor disputes the estimate.
An insured escalates.
An attorney becomes involved.
An expert disagrees with another expert.
The immediate instinct may be to respond.
Defend.
Explain.
Push back.
Close the loop.
But sometimes the most productive thing you can do is pause long enough to ask:
What is actually happening here?
What information am I missing?
What is driving the disagreement?
Is this a communication problem, a technical problem, a coverage problem or a trust problem?
Do I have the expertise necessary to move this forward?
Who else could offer perspective?
Reflection is not indecision.
It is disciplined decision-making.
And in a profession where decisions carry financial, emotional and reputational weight, that distinction matters.
Creating a Culture of Learning Instead of Blame
Organizations also have a role to play.
When something goes wrong on a claim, what happens next?
Do leaders ask:
"Who made the mistake?"
Or do they ask:
"What can we learn from this?"
Those questions create very different cultures.
Blame creates hiding.
Learning creates transparency.
When employees believe mistakes, difficult files or requests for help will be used against them, they become less likely to raise concerns early.
They wait.
They try to solve the problem alone.
They hope the issue resolves itself.
And by the time leadership becomes involved, the situation may be far more complicated.
A learning culture does not remove accountability.
Quite the opposite.
It creates stronger accountability because people are encouraged to identify problems, understand causes and improve future behavior.
The goal becomes:
How do we make the next claim better?
That is a far more useful question than:
Who should we blame for this one?
Why Post-Claim Conversations Matter
One of the most underused tools in claims may be the post-claim conversation.
We spend enormous amounts of time discussing claims while they are open.
Then the moment they close, everyone moves on.
But some of the most valuable learning happens after the pressure is gone.
Imagine taking ten minutes after a particularly difficult claim and asking:
What went well?
Where did the claim stall?
When did communication begin to deteriorate?
Was there a moment we could have brought in another resource sooner?
What would we do differently next time?
What should we repeat?
Those conversations can reveal patterns that individual files hide.
Maybe the same type of dispute keeps occurring.
Maybe adjusters are consistently unclear about when to escalate.
Maybe an outside expert is being brought in too late.
Maybe certain customer conversations need stronger scripting or training.
Maybe managers are unintentionally encouraging employees to handle too much independently.
Reflection turns isolated experiences into organizational intelligence.
Without it, the same problems keep repeating under different claim numbers.
Collaboration Reduces Burnout More Than Perfection Ever Will
Many high-performing claims professionals quietly operate under an impossible standard:
I should know this.
I should be able to handle this.
I should not need help.
That mindset is exhausting.
And organizations can unintentionally reinforce it by celebrating independence without equally celebrating collaboration.
But there is no realistic world in which one adjuster can be an expert in every area a complex claim may touch.
Construction.
Engineering.
Policy language.
Restoration.
Law.
Valuation.
Medical issues.
Negotiation.
Conflict resolution.
Human behavior.
That is not the job.
The job is to make sound decisions with the best information available.
Sometimes that means bringing in someone who knows more about a particular piece of the puzzle.
Organizations reduce burnout when they normalize that behavior.
When managers say:
"Let's get another perspective."
When leaders reward early escalation instead of criticizing it.
When adjusters understand that expertise is a resource, not a referendum on their competence.
Collaboration allows people to carry responsibility without carrying everything alone.
That is sustainable performance.
And that is what Built to Last is ultimately about.
Dispute Resolution Should Be a Learning Opportunity, Not Just a Last Resort
For years, dispute resolution has often been viewed as something that happens at the end.
The claim has stalled.
Positions have hardened.
Communication has deteriorated.
Everyone is frustrated.
Now we need someone to help resolve it.
But I think there is a larger opportunity.
Disputes contain information.
They tell us where expectations separated.
Where communication broke down.
Where technical perspectives differed.
Where trust was lost.
Where assumptions replaced clarity.
When approached thoughtfully, dispute resolution does more than move a claim toward resolution.
It can expose what caused the conflict in the first place.
That makes dispute professionals more than a resource for solving today's problem.
They can become a resource for preventing tomorrow's.
This is one of the things I appreciate most now being part of the team at Ampion.
The value is not simply stepping in when two sides disagree.
It is bringing another perspective to the table.
Helping clarify complexity.
Creating a path forward.
And in many situations, giving claims professionals the additional information and support they need to make confident decisions.
That is not surrendering control of the claim.
It is strengthening the decision-making around it.
The Adjusters Who Thrive for Decades Become Students, Not Superheroes
Claims has a way of rewarding the superhero.
The person who handles the impossible file.
The person everyone calls.
The person who always has the answer.
The person who somehow gets it done.
But superhero culture has a cost.
Because eventually, the person everyone relies on begins to believe they must always be capable of carrying more.
That is not sustainable.
The professionals who thrive over decades learn something different.
They stay students.
They remain curious.
They ask questions.
They seek perspective.
They learn from people with different expertise.
They admit when they need more information.
And they allow difficult claims to sharpen them rather than harden them.
That kind of professional becomes incredibly valuable.
Not because they know everything.
But because they know how to think.
They know how to learn.
And they know when to invite other people into the process.
A Question for Claims Leaders
If you oversee a claims organization, consider asking your team:
What are our difficult claims teaching us right now?
Not simply:
How many are open?
How old are they?
How quickly can we close them?
But:
Where are we repeatedly getting stuck?
Where could we collaborate sooner?
What support are our adjusters missing?
What expertise could help us make stronger decisions?
And what lessons should we carry into the next file?
Those conversations create stronger adjusters.
Stronger leaders.
And ultimately, stronger customer experiences.
That is the kind of claims environment I believe is truly built to last.
And if your organization is exploring how outside expertise or dispute resolution resources can help your team navigate complex claims with greater confidence and clarity, I would welcome the opportunity to have that conversation.
Every difficult claim has something to teach us.
The question is whether we're willing to listen before moving on to the next file.