Beyond the Claim
Beyond the Claim

Episode 9 · 3 months ago

There’s No ‘Right Path’ to Claims w/ Simon Camaj


When it comes to a career in claims, you need to be a translator.

You need to clearly articulate complex topics to people who may be unfamiliar — often during stressful times.

And the only way that's possible is when you start with listening.

For today’s guest, Simon Camaj, LAD and Voluntary Benefits National Practice Leader at Mercer, that comes naturally. Simon’s non-traditional career journey to claims has taught him the universal value of making sure one’s mission — no matter what the role — is never lost in translation.

Join us as we discuss:

  • The universal lessons Simon has learned across his storied career
  • The power of empathy and communication in claims
  • Why alignment is more important than technology   

Need more claims strategy in your life? Check us out on Apple Podcasts, Spotify, or on our website.

Listening on a desktop & can’t see the links? Just search for Beyond the Claim on your favorite podcast player.

Is. If you're too much in the future, you're going to really miss the commitments and the agreements of today. If you're too much in today, you can be left behind for tomorrow. You're listening to beyond the claim, the show for forward thinking risk and claims professionals curious about the latest industry trends, winning strategies and stories from influential leaders. Let's dive in. Well, everyone, and welcome to this episode of beyond the claim. I'm your host, Mark Cunningham, chief sales and marketing officer was broad spire. Today have the pleasure of joining me a friend, the colleague Mr Simon semi of mercer. Simon is practice leader and partner. Simon. Welcome, Hey mark. How are you glad to be on? I'm fantastic, great to see you. I know it's been a while. With this pandemic we don't get the facetime like we used to. But, Simon, I know you do quite a bit more than the quick Insro that I gave you, but can you expand it? So, what are you doing today? Sure, so, that's always changing. How about that, based on the day? But I'll tell you what I'm actually doing today. Mark. Run two businesses at Mercer and they're different but they're connected. What is our life, absence and disability practice, which you hear the term lad, and the other is our voluntary benefits practice. And so while they're two different businesses, we worked, you know, diligently over the last few years of really pulling those businesses together. So while they're distinct, there's opportunities to serve our clients with both solutions and within that voluntary benefits practice you could technically call it a third job or responsibilities or executive benefits practice. So those are the two teams, or technically a three teams I lead at Mercer and then an addition, I'm on the United States leadership team for US health. So that's that's a mouthful. So I'm glad you didn't have to say it me as well. So, Simon, we could go in many directions. Clearly responsible for many things, but before we do, your journeys impressive and I, like me, you've got a very you've had a very nonlinear path. I think it's inspiring. So those that are listening that are maybe evaluating with their career path you will look like, and those are thinking that you know I've come into this space and here's what I'll see the endpoint being, and that may not always be the case and sometimes there's so many doors and directions that we can go in. I think your story is a perfect example that. So do you mind sharing with the audience kind of how you've come to this point in your in your career? Sure, maybe I can start the beginning and that dress the audience. And the first part is, if what you're in today is not the endpoint, it doesn't it doesn't define you and and at times I learned that the hard way. You may have have or whoever's listening. And what I started in operations and operations was very distinct and, to be more refined, disability operations, a disability operations turned into leave and then I turned into a leadership role. Leadership role evolved and I did that for a set of period of...

...time and I actually left one organization to go another, and so here was the awakening mark, if you'd say, the crossroads, of how I got here. So about thirteen, twelve years, who knows? In operations, one part doing the work, one part leading the work, one part strategizing and interfacing, facing with other parts of the business. This was on the carrier side. Left one carrier for another, assuming it would be completely different. What I didn't appreciate was a job descriptions of job, description of roles or role. I thought that making a move would be the difference. What the differences is what you do in the job. The second part is the differences where you can impact the organization. So, after that journey and operations, I realized, Hey, it really wasn't the company I was with or the job that I'm doing, it's really my career progression and I had to own that, nobody else. I then decided, hey, let me try my hand and client management, because in essence that's where I think I was leaning towards. But it was again, you're an operation. So whether you're in sales or underwriting or whatever vocation you're in, how you start sometimes as the path you're defined as and you stay in and I fell into that trap. But I realized, let me get out of my comfort zone and let me try something different, but use my background as an opportunity, you know, use the operations background as a foundation, but as a foundation only. And then I said, Hey, let me learn something else. And while I was learning and using the foundation, I think I found some success. I would call it lightning in a bottle, just a different way of looking at things. And then from client management, after a few years, a sales leadership role. Then I built off of a building block operations, client management to distinct perspectives, leveraging them, moving into distribution. Doing that, what happens? You become a translator, a translator for the client, translator for consultants and Brokers, translation for folks internally, bringing it all together. And then that led to a broader sales distribution roll. Had some success there and then the opportunity knocks to come to my current opportunity, where it was consulting. Same Industry, kind of similar, but but different. But I realized that every step of the way there there's some underpinnings and some you know. You know common elements, and common elements are engaging folks, using your background being a translator and, frankly, lifting everybody up and bringing everybody with you. When I when I made the jump again, saying saying, type of situations occurred. Then you take over a team, you listen, you get better, you translate, you bring them with you and your empower them and and you watch them succeed. That led to and coming to mercer and taking on the LAD team and then, about eighteen months after that, the voluntary benefits team and then in it inner and roll would I had my las at VB with me. I also took over the West Coast coret medical as a market business leader and every job was different. But one thing I learned,...

...mark, is every job was the same. You have to engage with folks, you have to be a translator, you have to be a promoter and then you have to focus on the true north of that role, and the true north this results clients. But if you take care of the folks that you work with, they will help you get to that goal. So I'd say different background, nonlinear, but there's common threads with each piece and it's been great. And then the last thing I'll leave you with. To This Day, you know, twenty, twenty five years later, I think of my original role in time, that period of time when you enter the business, it was like getting a PhD in this industry, when you're actually doing the workfrontline of paying a claim, talking to a claimant, sending a letter, getting feedback, reviewing a contract, even though I have a senior role now and I've had many others, it's amazing how that appreciation for that. I'd say that first three years right out of college gives you the foundation of perspective that you can use twenty years later to be successful and influence a team, to have success clients and hopefully the the market in the industry. Look how you positioned that, especially the the foundation and build a box that I find myself making that reference as well. I mean, you know, mine was more on the kind of the business system side of things, but same thing of a and and in very close partnership with operations, and I find myself, you have in my position today, referring back to those insights, referring back to the structure and how organizations are are looking to bring solutions to the market. But in a way that's more than what I would typically expect of a sales pitch type of orientation. It's more around really understanding what you need to solve a what what the recipients the you know that, whether it be claimants or customers or or corporate environments, what are they looking to solve for? What type of experiences they looking to have and I think you just have a different perspective when you've actually been in positions that are either in those positions or adjacent to those positions in a way that is direct line as opposed to maybe even further away from that, and an ansilar capacity. What do you think has been the most challenging along the way? Well, I think there's been a it's all point in time right. So I look, I reflect now and I wish I had the challenges I had a year ago, and you do that look back. But I'd say if you were to say today it's balancing executing today but really planning for tomorrow, and that's I'd say. I have a feeling everybody's is going through that. So it's a balancing act. Today's execution plan is you know it is going to be different than tomorrow, and you in having your foot in each camp and having a plan for each to balancing act, and not just for Your Business Plan, for your colleagues, the folks that you serve, your clients and then your fellow business partners, both internally and ex outside of our firm. And so... me, having that balancing act, because if you're too much in the future, you're going to really miss the commitments and the agreements of today. If you're too much in today, you can be left behind for tomorrow, and I was, you know, actually had a call with a client today and we're laughing that. You know, if you've been this business long enough or if it's just good old fashioned me getting a little bit older, you remember the times when you could plan, then you can implement, you can see how the plan that you implemented work and then you would recover and start all over. Seems like we're doing all those three or four things at once now and just having the discipline to step away and saying those those three or four buckets of planning and serving have to be distinct so you can be successful and everybody around you'd be successful. So it's a different time, but I'd say managing the current in the future, I'd say, is the biggest challenge. Mark you mentioned translate a few times, one of your kind of core focuses on or front it foundational elements. Can you expand on that? What do you what do you mean by being able to translate? Well, so if you think about anybody interact with in business or in life, they're going to come to you with a frame of reference, okay, and if you don't know them and you're just speaking to them on your framework reference, they're going to be responding with their frame of reference. And if we think of a business setting, something about the the space we're in, and we're going to probably get into a little bit more detail. Even saying the word leave management, that means a lot of things to a lot of people and you can have an hour conversation and leave there and thinking you're aligned, but it's completely different because it's just different understand or understanding signals indicators, where what I'd say is translating and taking a step back and hey, what's the motivation for this, for this topic? What issue are you trying to solve? Has Somebody articulated their issue, and what levers can you pull to solve the issues, to solve to move forward? And again, if you're not translating and understanding up front, you're going to have some great dialog, great assumptions, it may might be even further the problem, even though we're all well intentioned. So I'd say that translating, you know, at least in my world, would always try to do is take a step back and say, okay, let's really intensely listen here, and when I listen I'm going to play back to you what we're trying to solve. And it again not perfect at it, but one really try to do that with my team. Definitely try to do that with our clients because again, words matter and words, you know, signal or indicate other things to other people. So I think that's where, like you'll hear me say the word translate a lot, if that makes says and how, hopefully, I'm translating for you what what I'm met by translating you. You have translated it very well. It's not a skill that not that everyone is developed fully, not a muscle that everyone is continue... develop, and I do think there's you mentioned listening. Within that there's a core component to that. You can't translate until you understand and have listened to that individual perspective, have had an opportunity to digest it, maybe even use your points of reference to translate it internally before you communicate externally. So No, I think that's important. So thanks for sharing that. So we're in November of two thousand and twenty one, hopefully the fourth quarter of this pandemic. How has the pandemic treated? You know you mercer. What what is as it changed how you operate as an organization, yours focus the market in general. I know it's a big question, but what do you think of when you think pandemic and Mercer? So let me take a couple pieces. What I say for me personally, is it makes you reflect because naturally you'll have more time to reflect. Can get time, travel time, and then you really look at where, where you were spending time, where you should maybe where you should spend it more or less. And then, naturally, from a business perspective, you know when you have habits and and you know common patterns of meeting with folks. Was it a was it a pattern or was it value add so I think it's a real good value adjustment, or an analysis rather of your time. But you know when you're servying or whether it's a client, interacting with a partner or even your team it I think you have to be a little bit different. I think we took seeing each other for granted and you know now you see it as a gift. I was at a I was just at a regular launch the other day and you would have thought we were celebrating something and all it was as we were celebrating seeing each other. So what I would say is it's been a it's been a journey and really evaluating time, but also keeping yourself motivated, keeping others motivated and then, you know, keeping clients engaged and things of that nature. So, as we're separated from each other, and yes, we have zoom and yes, we have phone calls like we did before, you do need to you know that, the the need to want to see each other is important, but at the same time, because that's been limited, can you be flexible, can you be Nimble, and then can you have an appreciation for what you're trying to accomplish? So again, I think that's another element that's been added, where things that work. Let's just get on a plane, let's just do launch, let's hammer it out during this discussion. You have to be a little bit more mindful of here's what I want to accomplish, but I have different tools to use and it's it takes a little bit of an adjustment. Now my hope is we've learned from this and we come out saying hey, when I do see in person, when have a more valuable discussion and going to be a more appreciative me of your time. Then hopefully we move things forward. So that's I'd say. What what I'd say has been the some of the the challenges, but then the pivot points in the appreciation, but really getting ready for tomorrow. So pivot a...

...little bit, but it connected to what you just stated. So when you look at kind of the market right, they'll be differences in how we engage ultimately those consultant and that environment. You're advocating for your clients to get the best arrangement, deal, pricing, packaging, whatever it might be, to solve for their individual needs. Where do you see, when you look out at the the administrators, to your third party administrators, your carriers, that you will kind of bring into the fold to provide those solutions to your clients? What do you see the best opportunity to to evolve, to bring that relationship for it? What we're as an industry is that are we missing tpas the carriers them yeah, so I and again, as I will always tell everybody else, speak for me, and this is my big disclaimer, speaking for the industry or Mercer. But I'd say where it's really being clear on what you're trying to solve and what roles folks will play. And now let me try to simplified as much as possible. Yes, the technology is important and yes, the features and capabilities and that's all great. And if you think of the RFP process and you think of finalist meetings, they're just so much good energy and the good things coming out. But what matters? What matters is when that effective date happens, everybody's a prepared, everybody's aligned and everybody understands the experience and what you're really trying to accomplish. Why you went out to bid, why you have these conversations, why you have these capabilities and services and and again thinking, taking a step back and saying why are we doing this, and being intentional. It's all for that, when the phone calls or the intake lines go live, what are you executing on? Okay, it's not a series of random events that get you there and OURFP is not an RP to get to the finalist, finalist to get it's all. It's one threat. So what I would say is, what are you trying to solve? Number two is, what role do you play versus the employer and you, meaning you know your organization, will just use you as an example. There's there are certain things that you're trying to solve and let's just say there's a range of ten. Maybe you're offering at best can solve seven of them. You should be clear on that. And then the three are either you can't do it from a capabilities wise or is just something a third party minister can or can't do. It's not a negative, it just declaring what you do what you can't do, versus an assumption. If you don't have that assumption, those three elements that could be crucial to the decision, crucial to the administration if you go on that live date and you can execute on it, they're ars and assumption. Something was left out. So what are the roles? What are you trying to accomplish? And then the value of again, that claim experience with somebody picks up the phone makes a phone call. Is it the experience that everybody was talking about throughout the process?...

And the other part is, is that the experience clear for the person filing the claim? Let's never lose that. That's what it's all about. Yeah, totally agree with you and you know we've got us of how we communicate, whether we technology based, voice to voice, etc. Like. Ever, real relationship gets a foundation what we do and if we can simplify that, if we can, but more importantly, be clear in our communication, I think it solves for much of that experience. As what was the project component of it that you mentioned on the front end? All right, so, Simon, last question for you. I know you're a big sports fan. I think that's a white sox picture behind you, if I'm not mistaken. If you instead of going the the magic wand route, let's go down the path of a GM or your the Dayana white of of the market, what do you see? And maybe it's your the lad vountary benefits connection, but what are you trying to accomplish in the future? What's your ideals? Scenario? was something we can solve for over the next one to three years. So I have two things mark. First, you've offended me greatly because it's Detroit Tigers behind me. I think you were doing that to make sure that audience understands that I'm a tigers fan. I all things Detroit. So let's remind that. You're going to slip for some yeah, let's see. I think mark was wanted to see if I was paying attention. So Tigers all the time. White Sox, not on this podcast, maybe another one, but Detroit Tigers all the way, all Detroit sports for that matter. But what are we trying to solve for? I would say you know, when you enter a situation, you're trying to do a few things, at least this is my impression. You're trying to solve. It goes in the beginning you're trying to solve the clients needs. Today, you know you're dealing with complexity, compliance costs, you know, claim service, experience, communication, coordinating with other strategies. That's a lot to consider and that's a full time job. But how do you take that experience and say, what are the things that we can anticipate to make today's implementation? Today's stewardship? And frankly, the evaluations in are wise to connect it to a broader strategy for their people or for their broader health strategies, because I think sometimes when we think of our our business that were in a lot of acronyms, a lot of product focus, and it really is, if you think about where the market's going it's all about your constituency, whether you know if I'm assuming within broad spire there's a massive focus with your colleagues as there are with Mercer. The colleagues are consumers of benefits. Benefits are connected to an experience. That experience is the further the employer. So what I would say is, while what we're solving today, if you can tie that into a broader employee experience that connects them to their employer for these important choices in employers strategy as well. That I'd say. That's important. The other part is simplifying.

When somebody files a claim, it's usually their first time. It's usually a challenging time. And back to that in the Vein of translation, translating and connecting them to benefits that they're eligible for, plans that they're connected to, showing why their employer made a choice to to, you know, to select a besness, select the partner or a a product set or a solution. Connecting all those dots and having the discipline to do that versus the crisis of the moment, the escalation of the moment. So it's the balancing act today versus tomorrow. But looking around that corner being a step ahead. I'd say that's our true north mark. I think we do a really nice job at it, but I think that's where we're always going to focus. So observing today, planning for tomorrow, looking around the corner and really connecting it to each of our employers, true north, but most most importantly, doing it through the Lens of the consumer of these benefits in these solutions. Excellent. Excellent is always Simon. Thank you appreciate the insights, Simon. If folks want to get a hold of your reach out connect, what's the best way to do that? Like then I think I think Linkedin, but I but I have two phone numbers and it seems like everybody already knows what those phone numbers are. That's what my wife and kids tell me as I'm walking around sports events vacation. So it looks like everybody knows where to reach me. But I'd say if if it's been a while, reach out to me at Linkedin, and Mark knows this and anybody that probably listening. Always make time for folks, always happy to help. Love being a part of this business and, you know, moving moving things forward for our industry and her and this industry as a whole. So and you're doing a fantastic job of that, Simon. You know, I know there's many other directions we can go and I will get you back down the road and we'll go into mercy a little bit more deeply and maybe brought her into the industry. But truly appreciate your time today. So I'm glad to hear everything is going well. Looking forward to connecting in person in a near future and thank you again. Okay, thank you. Thanks for having me. You've been listening to be on the claim a podcast for risk and claims leaders. To ensure you never miss an episode, please subscribe to the show in your favorite podcast player, if you use apple podcast. We'd love for you to give us a quick rating for the show. Just tap the number of stars that you think the podcast deserves. Until next time, stay curious and keep innovating.

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