Empowering Adjusters & Enhancing Claims Efficiency with PLRB

Western National Insurance Group | John Buckley, Sr. Vice President of Claims

The Challenge

With the ongoing “brain drain” in the insurance industry, Western National Insurance Group recognized the need to attract and develop new talent. A strong training program was essential to ensure that employees felt valued, confident, and well-equipped to handle claims efficiently. Additionally, the company needed reliable resources to address complex coverage issues, state regulatory requirements, and weather-related claims.

The Solution

Western National turned to PLRB’s extensive educational offerings to supplement its training program. Through coursework, webinars, and seminars, PLRB provided structured learning paths tailored by line of business, ensuring new employees gained a solid foundation. PLRB’s resources also supported ongoing professional development, helping adjusters stay current with emerging issues in the industry.

Beyond training, Western National leveraged PLRB’s research tools to navigate complex coverage questions and regulatory challenges. One significant case involved a total loss house fire where coverage was in question due to occupancy status. While the policy appeared to exclude coverage since the home had been rented, clarification was needed regarding obligations to the mortgage company. Using PLRB’s research tools, Western National identified case law in their jurisdiction confirming the obligation to pay the mortgage company. This resolution benefited the policyholder, strengthened agent relationships, and saved time and legal costs by eliminating the need for coverage counsel or litigation.

Western National also utilizes PLRB’s tools daily to address coverage issues, state regulatory compliance, and claims related to severe weather events. The intuitive platform provides adjusters with state-specific information, policy form guidance, and case law research, ensuring they work within regulatory frameworks while streamlining claim resolutions.

The Results

• Enhanced Training & Employee Development: PLRB’s learning paths provide structured education, equipping employees with the knowledge and confidence to excel. As a result, Western National has successfully retained approximately 80% of the 32 claim trainees hired over the past 10 years, with many advancing into various roles within the claims department and the broader organization.   
• Improved Claims Handling & Cost Savings: Western National used PLRB’s research tools to resolve coverage questions, reducing reliance on external coverage counsel, saving on legal expenses and shortening claim resolution times. 
• Efficient Coverage Determinations: In the house fire case, PLRB resources helped identify case law confirming the company’s obligation to pay the mortgage company. This resolution benefited the policyholder, strengthened agent relationships, and saved time and legal costs.  
• Daily Use for Compliance & Accuracy: Adjusters rely on PLRB’s intuitive tools to ensure compliance with state regulations, policy forms, and case law, enabling more precise and efficient claim resolutions. The website’s 50-state surveys further streamline research, providing quick access to issue specific information.
• Proactive Management of Weather-Related Claims: PLRB’s weather resources enable adjusters to respond swiftly to catastrophe claims, ensuring timely support for policyholders while maintaining regulatory compliance. By leveraging PLRB’s weather analytics, adjusters have significantly improved response times, leading to faster payouts and greater policyholder satisfaction. Additionally, the weather research tool helps verify dates of loss, ensuring accurate claim coding and proper alignment with named events for reinsurance purposes. 

Conclusion

Western National Insurance Group has found PLRB to be an invaluable partner in both employee development and claims management. By leveraging PLRB’s training programs and research tools, the company enhances operational efficiency, reduces costs, and ensures policyholders receive fair and informed claim resolutions. PLRB’s resources empower adjusters to confidently navigate complex claims, state regulations, and weather-related challenges, making it an essential tool in Western National’s claims strategy.