The Insurance Equation: Balancing Claims, Coverage, and Consumer Expectation

38 - The Insurance Equation: Balancing Claims, Coverage, and Consumer Expectation

May 28, 20253 min read

Strengthening the Future of Insurance: Susan Wisbey-Smith on Education, Talent, and Reform

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In this episode of The Claim Hunters Podcast, host Chris Tidball welcomes Susan Wisbey-Smith, President of CLM (Claims and Litigation Management Alliance), for a timely conversation about the challenges and opportunities facing the insurance industry today. From combating consumer misunderstanding and fraud to addressing talent shortages and the impact of third-party litigation funding, Susan offers both clarity and optimism about the path forward. With a mission centered around collaboration, networking, and education, CLM is leading the charge to modernize and strengthen the industry from the inside out.


The Talent Gap, Consumer Sentiment & Rising Pressures on Insurance

One of the most urgent challenges Susan outlines is the aging workforce in insurance, with many experienced claims professionals nearing retirement. To prepare for the future, CLM has launched a litigation management task force focused on recruiting and retaining younger talent. Understanding what drives the next generation—purpose, impact, and opportunity—is key to making insurance roles appealing. That means showing how claims professionals help individuals and businesses in some of their hardest moments.

Equally pressing is the disconnect between consumers and their policies. Many policyholders are unaware of what they’re buying—stacked vs. unstacked coverage, or what exclusions apply—leading to frustration when claims are denied. Susan emphasizes the importance of proactive, transparent communication from insurers and agents, helping people make informed decisions before loss ever occurs. Education isn’t just a value for CLM’s members—it’s a necessity for the public too.

Finally, the rise of third-party litigation funding is intensifying claim volume and complexity. With more cases going to trial, often backed by financial interests, insurers face ballooning costs and the risk of manipulated narratives. Susan notes that nearly 10% of claims are outright fraudulent, and billing abuse—like unbundling or modifier exploitation—is common. These trends highlight the growing need for legislative reform and stronger public understanding of how insurance works.


About Susan Wisbey-Smith

Susan Wisbey-Smith is the President of CLM, where she oversees strategic initiatives to elevate the claims and litigation management professions. With a background in education, association leadership, and marketing, she champions collaboration, development, and ethical practices across the insurance space.

About CLM

The Claims and Litigation Management Alliance (CLM) is the largest professional association in the claims industry. Its mission is to advance the art and science of litigation management through education, training, and professional networking for claims professionals and attorneys nationwide.

Links Mentioned in This Episode


Conclusion

This episode of The Claim Hunters Podcast delivers a clear message: the insurance industry must evolve—through better education, smarter communication, and bold leadership. Susan Wisbey-Smith offers hope through action, showing how organizations like CLM are equipping professionals, informing consumers, and setting the stage for policy reform. The future may be complex, but with collaboration and intention, it can also be bright.


Key Episode Highlights

  • Aging workforce challenge: CLM is actively working to attract and retain younger talent

  • Consumer education gap: Policy misunderstandings often drive claims frustrations

  • Third-party litigation funding: Contributing to higher claim frequency and inflated costs

  • Fraud and billing abuse: About 10% of claims are fraudulent, requiring tighter oversight

  • CLM’s mission in action: Collaboration, networking, and education as industry essentials

To learn how your claims process can benefit from smart recovery strategies and informed litigation management, visit SubroIQ. If you’re an expert in insurance, litigation, or claims management and want to share your perspective, apply to be featured on The Claim Hunters Podcast.


Chris Tidball is a seasoned insurance industry expert, best-selling author, and speaker with a passion for uncovering hidden financial opportunities in claims and subrogation. With decades of experience in claims management, fraud prevention, and recovery strategies, Chris has helped insurers, businesses, and individuals maximize their recoveries and streamline operations.

As the host of the Insurance Claims Innovation Podcast, Chris dives into cutting-edge strategies, expert insights, and real-world case studies that transform the way claims professionals approach subrogation and fraud detection. His work has been featured in leading industry publications, and he continues to drive innovation in the ever-evolving world of insurance and financial recovery.

Chris Tidball

Chris Tidball is a seasoned insurance industry expert, best-selling author, and speaker with a passion for uncovering hidden financial opportunities in claims and subrogation. With decades of experience in claims management, fraud prevention, and recovery strategies, Chris has helped insurers, businesses, and individuals maximize their recoveries and streamline operations. As the host of the Insurance Claims Innovation Podcast, Chris dives into cutting-edge strategies, expert insights, and real-world case studies that transform the way claims professionals approach subrogation and fraud detection. His work has been featured in leading industry publications, and he continues to drive innovation in the ever-evolving world of insurance and financial recovery.

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