Insurance 
Damages evaluation Training PROGRAM

Executive Overview

An insurance organization needed to retrain claim handlers nationwide on evaluating general damages—a high-risk task requiring consistent judgment across thousands of claims. Existing training was outdated, inconsistent, and misaligned with current legal and operational standards. I led the redesign of the learning ecosystem, creating a blended solution that improved decision confidence while meeting tight regulatory and timeline constraints.

Business Context

• Damages evaluation accuracy directly affected claim outcomes, compliance exposure, and customer trust.

• Training materials had evolved piecemeal and no longer reflected actual workflows.

• Leadership required rapid deployment with minimal operational disruption.

• Stakeholders included legal, operations, frontline managers, and executive sponsors, each with different definitions of success.

• The organization needed consistency in decision-making without slowing claim processing.

Success Criteria Defined at Start

• Standardize evaluation approach across regions

• Improve adjuster confidence applying guidelines

• Reduce reliance on ad hoc SME clarification

• Deliver solution within a compressed rollout window

Analysis and Key Findings

I conducted structured discovery with SMEs, legal reviewers, and frontline claim handlers to understand where breakdowns occurred.

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Findings

• Variability stemmed from interpretation, not lack of information.

• Legacy training emphasized policy review rather than applied decision-making.

• Claim handlers needed guided practice and accessible reference tools at the moment of use.

• Time away from claim processing had to remain limited.

Design Implication

The solution required performance support and scenario-based application rather than knowledge-heavy instruction.

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Design Strategy

I structured the program as a performance-focused learning ecosystem, not a single course.

Principles Used

• Scaffold complex judgment through progressive scenarios

• Shift foundational knowledge to pre-work and reference tools

• Embed just-in-time support aligned to real workflows

• Design for rapid scalability across regions

• Balance cognitive load with operational efficiency

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Modalities Selected

• Interactive eLearning in Rise 360 for applied decision practice

• Desk-side performance support tools

• Facilitated calibration sessions

• Train-the-trainer enablement for local rollout

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Experience Design

Rather than replicating complex and dry policy language, the learning environment simulated real claim decisions:

• Scenario-driven modules requiring learners to evaluate documentation and select actions

• Immediate feedback tied to business rules and risk implications

• Knowledge checks designed as judgment calibration, not recall

• Laminated quick-reference guide mapped to workflow steps

• Structured group discussions to align interpretation across teams

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Measurement and Outcomes

Evaluation focused on behavioral confidence and consistency of application.

Methods Used

• 30–60–90 day stakeholder reviews

• Learner surveys and facilitated focus groups

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  Manager observations of claim evaluation discussions

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  Ongoing calibration sessions to monitor alignment

Observed Results:

Adjusters reported increased confidence applying evaluation criteria

Managers noted more consistent rationale in claim decisions

Teams relied less on informal escalation for routine determinations

Program delivered within required timeframe despite compressed schedule