United Kingdom · Finance · Senior (5-8 years)

Senior Claims Manager

Here is the whole job, in plain words. What it is, what you decide, how you're judged, how people get here and where they go next. Then the part no course gives you: twelve AI tutors who learn your work.

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Free to start: a plan built for this role, and a Future Fluency module to try first. No card.

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One email: what AI is changing in this job, and where to start free. With a link back here. Nothing else follows unless you confirm your address.

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Experience bandSenior (5-8 years)
Direct reportsNo direct reports
Reports toClaims Supervisor / Unit Manager
UK framework levelUsually a manager, or the deepest specialist in a team

Also advertised as Senior Claims Adjuster · Claims Team Lead · Complex Claims Specialist · Litigation Claims Handler

Built on 43,079 real UK job descriptions we analysed · grounded in qualifications employers recognise

Two short quizzes about you

1From this job to a course

The qualifications matched to this job

City & Guilds Level 3 Certificate In Providing Financial Services City & Guilds Limited · Level 3 · covers 2 of 10 standards

City & Guilds Level 3 Award in Providing Financial Services City & Guilds Limited · Level 3 · covers 1 of 10 standards

City & Guilds Level 2 Certificate In Providing Financial Services City & Guilds Limited · Level 2 · covers 2 of 10 standards

Highfield Level 2 Certificate in Providing Financial Services (RQF) Highfield Qualifications · Level 2 · covers 1 of 10 standards

Matched from the standards this job is measured against: a suggestion, not an official ruling.

The units you would start with

Settling complex insurance claims City & Guilds Level 3 Certificate In Providing Financial Services

Contributing to the delivery and achievement of team and business objectives in a financial services environment City & Guilds Level 2 Certificate In Providing Financial Services

Dealing with straightforward claims for insured losses Highfield Level 2 Certificate in Providing Financial Services (RQF)

The future skills this job leans on

AI Fluency working with AI as a thinking partner

Data Fluency turning numbers into a decision

AI Governance Fluency using AI responsibly

Start my Senior Claims Manager plan, free

Your Plan Illustration

Built for Senior Claims Manager

3 units that map to this job, from the qualifications that cover it.

Settling complex insurance claims City & Guilds Limited · covers 2 of 10 standards Level 3
Contributing to the delivery and achievement of team and business objectives in a financial services environment City & Guilds Limited · covers 2 of 10 standards Level 2
Dealing with straightforward claims for insured losses Highfield Qualifications · covers 1 of 10 standards Level 2

These are the real units behind this job, in the order they rank for it. Nothing here is marked done, because this plan has not been started by anyone yet. Yours would fill in as you go.

2AI and this work

Will AI change your work as a Senior Claims Manager?

Nobody can say exactly how. Here is what this job is being asked for next, and where to start.

The new skills this role is being asked for

Advanced Data Storytelling
Ethical AI Claims Review & Bias Detection

Why each one is rising

The future skills this job leans on

AI Fluencyworking with AI as a thinking partner
Data Fluencyturning numbers into a decision
AI Governance Fluencyusing AI responsibly

We'll only ever tell you what we can actually back up. No hype, no scare tactics.

What happens when you start

Next, a free account. We build your Senior Claims Manager plan as you set up, starting with a Future Fluency module on using AI in your job. No card.

Your first Future Fluency module is free. After that, your AI tutor is £70 a month.

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3What this role really is

A Senior Claims Manager handles complex claims, often involving litigation or significant financial exposure, working to resolve them fairly and efficiently.

4What you'd actually use

The tools this job runs on, and how well you'd need to know each one.

Claims Management System (e.g., Guidewire ClaimCenter, Duck Creek Claims) Advanced

Managing complex claim workflows, overriding system flags with justification, training junior staff on system use, and identifying process bottlenecks within the system to suggest improvements.

Document Management (e.g., OpenText, SharePoint) Advanced

Designing document taxonomies and workflows for specific claim types, conducting quality audits on document handling, and ensuring compliance with our record-retention policies.

Data Analytics & Visualisation (e.g., Power BI, Tableau) Advanced

Building custom reports and dashboards to analyse team performance, identify fraud indicators across your caseload, and track loss development trends for specific lines of business. You'll present these to your manager.

Microsoft Excel Advanced

Employing Power Query for complex data cleaning, building sophisticated financial models for large loss scenarios, and potentially using basic VBA for task automation within your claims analysis.

Microsoft PowerPoint Expert

Creating compelling presentations for senior leadership, explaining complex claim situations, reserve changes, or litigation strategies clearly and concisely. You'll need to defend your assumptions under scrutiny.

Collaboration Suite (e.g., MS Teams, Slack) Advanced

Managing channels for specific claims units (e.g., litigation, subrogation), hosting training sessions for junior staff, and coordinating complex cross-functional projects with Legal, Underwriting, and Finance.

Financial/ERP System (e.g., SAP S/4HANA, Oracle NetSuite) Intermediate

Reconciling claim payments with financial ledgers, assisting the Finance team in setting initial reserves, and troubleshooting any payment discrepancies that arise on your complex files.

Governance, Risk & Compliance (GRC) Platform (e.g., ServiceNow GRC, Archer) Basic

Responding to audit requests by providing specific evidence from your claim files and logging compliance-related incidents as directed by the Compliance team.

5What you get to decide, and how that grows

Power in a job isn't your title. It's what you're allowed to decide. Here's how it grows as you move up.

The choice	Coming in	Where you are now	The step above
Claim Settlement Authority	None; all settlements must be approved by a supervisor.	Up to £25,000 for routine claims, with supervisor approval for exceptions.	Up to £100,000 for complex or litigated claims; recommendations for higher amounts to Claims Supervisor/Unit Manager.
Litigation Strategy	Follow supervisor's instructions on legal actions.	Propose initial legal strategy to supervisor; execute approved plan.	Define and direct litigation strategy with external counsel, consulting Legal Department and Claims Supervisor on major shifts or high-value cases.
Reserve Setting & Adjustment	Suggest reserves to supervisor; supervisor makes final decision.	Set initial reserves within defined guidelines; supervisor reviews and approves.	Independently set and adjust case reserves for complex claims, with regular review and justification to Finance and Actuarial teams.
Vendor Selection (e.g., expert witnesses)	Use pre-approved vendor list as directed by supervisor.	Select from approved vendor list for routine services; seek approval for new vendors.	Select and appoint expert witnesses or independent adjusters for complex cases, ensuring cost-effectiveness and quality, within a £10,000 spend limit per engagement without further approval.

6How you'll be judged

The scoreboard, and what is not on it. The hard targets, how often each is actually looked at, and the quiet signals that never reach a dashboard.

Individual Reserve Accuracy

How close your initial and adjusted case reserves are to the claim's ultimate payout. This shows how well you anticipate future costs.

Target · Within 8% variance of ultimate payout on complex claims

If you reserved £75,000 for a complex property claim, and it eventually settled for £78,000, that's a 4% variance – a good result.

Complex Claim Cycle Time

The average time it takes to resolve high-value or litigated claims from FNOL to final settlement. We want to be efficient, but not at the expense of thoroughness.

Target · Average 90 days for non-litigated complex claims, 180 days for litigated files

You closed a complex liability claim in 85 days, well within the target, showing efficient investigation and negotiation.

Subrogation Recovery Rate

The percentage of money we recover from at-fault third parties on claims where we've paid out. This directly boosts our profitability.

Target · Achieve a 30% recovery rate on all claims with identified subrogation potential

Out of £100,000 paid on claims with subro potential this quarter, you recovered £35,000, exceeding the target.

Litigation Cost Control (ALAE)

Managing the costs associated with legal fees, expert witnesses, and other allocated loss adjustment expenses. It's about getting value for money from our external partners.

Target · Keep ALAE below 15% of total incurred losses for your caseload

On a £200,000 litigated claim, you managed to keep legal and expert fees to £25,000 (12.5%), demonstrating excellent cost control.

Mentee Development & Support

How effectively you guide and support junior adjusters, helping them grow their skills and confidence. This is about building the next generation of talent.

Junior team members consistently meet their file quality targets, seek your advice proactively, and show clear progression in handling more complex tasks. We'd expect positive feedback from them in informal check-ins and performance reviews.

Stakeholder Collaboration & Influence

Your ability to work effectively with internal teams like Legal and Underwriting, and external partners. It's about getting everyone on the same page for the best outcome.

You're regularly consulted by other departments on complex policy interpretations or claim strategies. You get positive feedback from external counsel on your clarity and decisiveness. You can influence decisions without direct authority.

Risk Mitigation & Compliance

Proactively identifying and addressing potential 'bad faith' indicators or compliance breaches before they become major problems. This protects us from serious legal and regulatory headaches.

Zero instances of 'bad faith' complaints or regulatory fines on your managed claims. You consistently adhere to internal governance frameworks and external regulations, evidenced by clean audit trails and proactive issue flagging.

Complex Problem Resolution

Your knack for unravelling highly unusual or ambiguous claims, finding solutions where others might see dead ends. This shows your analytical and creative thinking.

Successfully resolving claims that were previously stuck or deemed unresolvable. Your manager will point to specific examples where you found a novel, compliant way forward for a particularly thorny claim.

7Would you like it

Both sides. What people enjoy, and what grinds them down.

What people enjoy

Solving Complex Puzzles

You'll spend your days unravelling intricate claims, piecing together evidence, and figuring out the 'truth' behind an incident. It's like being a detective, but with bigger financial stakes.

Successfully proving a staged accident after weeks of forensic investigation, saving the company £250,000.

Protecting the Company's Interests

You'll feel a real sense of responsibility for the company's financial health, actively working to prevent claims leakage and ensure we're only paying what's fair and covered by the policy.

Negotiating a settlement £50,000 below the initial demand by presenting a strong legal defence position.

Mentoring and Developing Others

You'll get a kick out of helping junior adjusters navigate their trickier files, sharing your knowledge, and watching them grow into confident claims professionals.

A junior adjuster successfully closes a moderately complex claim after you've guided them through the investigation and negotiation steps.

What frustrates people

The Underwriting-Sales Squeeze: You'll often feel caught between underwriters who want you to be tough on claims to protect loss ratios, and the sales team who pressure you to pay a questionable claim for a major client. It's a constant balancing act, and frankly, it's exhausting.
Justifying Reserve Increases: Get ready for the quarterly pain of explaining to Finance why a handful of claims have developed adversely, requiring you to increase reserves and negatively impact the P&L. It feels like you're always on the defensive.
Legacy System Hell: Yes, we still have some older systems. You might find yourself fighting with a 20-year-old claims system that requires manual data entry into three different places and occasionally crashes during month-end. It's not glamorous, but it's the reality.
The Emotional Grind: Dealing with the human tragedy of catastrophic claims—fatalities, life-altering injuries, destroyed homes—and the constant negativity inherent in the role can lead to significant burnout. You need a thick skin and good coping mechanisms.
Vendor Management Headaches: You'll spend time chasing down independent adjusters for late reports, arguing with body shops over repair costs, and managing external law firms that aren't quite performing to standard. It's a lot of follow-up and negotiation.
The 'Good News, Bad News' Performance Review: You might recover a record amount in subrogation (good news!), but then your claim cycle times increased by 5% (bad news), so your budget is still being cut. It sometimes feels like you can't win.

What this role does not give you

A quiet, predictable routine: Every day is different, and new challenges pop up constantly.
Guaranteed positive customer interactions: You'll often be delivering difficult news.
Complete autonomy on strategy: While you have significant authority, major strategic shifts still need higher-level approval.
A 'set it and forget it' approach: Claims require continuous monitoring and adjustment.

8Who you work with

Your work directly impacts our loss ratio, which is a huge deal for our profitability. You'll be making decisions that can literally save or cost the company hundreds of thousands, sometimes millions, of pounds. Beyond that, how you handle a claim can make or break a customer's trust, affecting our brand and future business. Get it right, and you're a hero. Get it wrong, and it's a very public problem.

Inside the business

Claims Supervisor/Unit Manager (for oversight and escalation)
Underwriting (to understand policy intent and risk appetite)
Legal Department (for litigation strategy and advice)
Finance Team (for reserve adequacy and financial reporting)
Special Investigation Unit (SIU) (for fraud referrals and collaboration)
Product Development (to feedback on policy wording issues)

Outside the business

Claimants and their representatives (solicitors, brokers)
External Legal Counsel (managing their strategy and costs)
Expert Witnesses (medical, engineering, forensic accountants)
Independent Loss Adjusters (directing their investigations)
Third-party providers (repair shops, medical facilities)

9What you need before you start

Not a wish list. The things you would be expected to already have.

Proven experience (at least 2-5 years) as a Claims Adjuster or Examiner, independently managing a diverse caseload of standard to moderately complex claims.
A solid track record of achieving individual claims targets, including cycle times, payment accuracy, and customer satisfaction scores.
Demonstrable ability to interpret complex policy wordings and apply them accurately to claim scenarios.
Experience in negotiating settlements and communicating effectively with claimants and third parties.
Basic understanding of reserving principles and the financial impact of claims.
A strong ethical compass and a commitment to fair claims practices.

10What to practise next

Where the job is going, and what to do about it starting this week.

Advanced Claims System Configuration & Optimisation

While you won't be a developer, understanding how our Claims Management System is configured will allow you to suggest and even prototype improvements to workflows, rules, and data capture. This is critical within 6-12 months to drive efficiency.

Workflow Automation · Business Rules Engines · Data Model Understanding · User Acceptance Testing (UAT)

This month: Ask to sit in on a meeting where new system features are being discussed or configured. Understand the 'why' behind changes.
Month 2: Volunteer to be a super-user or tester for any upcoming system upgrades or new modules.
Month 3: Work with our IT or Business Analyst team to map out a current claims process and identify areas for system-driven automation.
Month 4: Propose one small, actionable system improvement that could save your team 1-2 hours a week.

Quick win: Familiarise yourself with the system's administrative menus (if you have access) and understand what settings can be tweaked without IT intervention. Ask 'how does the system actually do that?' more often.

11Staying current once you are in

What people here do to keep up

Regularly attend industry seminars and webinars on emerging legal trends, regulatory changes, and new fraud techniques in the insurance sector.
Participate in specialist claims forums or networks to share best practices and learn from peers handling similar complex cases.
Undertake continuous professional development (CPD) through the CII or CILA, keeping your knowledge current and relevant.
Seek out opportunities to shadow senior claims leaders or legal counsel on high-profile cases to gain deeper insights into strategic decision-making.

12The rising capability

The rising capability

Zavmo analysis

What's rising in its place

This is where the work is heading, and the higher pay with it. Get fluent here and the shift stops being a threat and starts being your edge.

Advanced Data Storytelling

We're drowning in data, but insights are gold. Senior leaders don't just want numbers; they want a compelling narrative that explains why things are happening and what we should do about it. This is becoming critical within the next 12 months as data volumes explode.

Narrative Structure
Visualisation Best Practices
Audience Tailoring
Impact Framing

Ethical AI Claims Review & Bias Detection

As we use more AI for fraud detection, triage, and even settlement recommendations, there's a real risk of algorithmic bias. Regulators are watching, and we need claims professionals who can scrutinise AI outputs to ensure fair, compliant, and ethical outcomes. This is important within 12-18 months.

Algorithmic Bias
Explainable AI (XAI)
Fairness Metrics
Human-in-the-Loop Processes

13What you’ll use

What you’ll use

Skills this role draws on

Technical

Reserving Methodologies
Litigation Management
Subrogation & Recovery
Fraud Investigation Techniques
Loss Adjustment Expense (LAE) Control

14The pathway

The pathway

How you actually get there, here

How you become one varies far more by country than what one does. This is the UK route. Most people take one of these ways in; the right one depends on where you're starting from.

1
From Claims Adjuster / Examiner (L2)
3-5 years as an L2
Skills to master
- Mastering independent caseload management, consistently accurate reserve setting for routine claims, effective negotiation, and a solid grasp of policy interpretation. You'll also need to show initiative in tackling more complex files.
You're ready to move on when
- Consistently exceeding individual performance metrics (cycle time, quality, accuracy).
- Proactively seeking out and successfully handling moderately complex claims.
- Receiving positive feedback on communication and negotiation skills.
- Demonstrating a strong understanding of regulatory compliance in daily work.
2
From Legal Paralegal or Case Manager (Insurance Law)
4-6 years in a paralegal role with insurance focus
Skills to master
- Translating legal theory into practical claims decisions, understanding insurance policy structures, and developing commercial awareness within an insurer's context. You'll need to learn the 'insurance' side of things, not just the 'legal' side.
You're ready to move on when
- Deep knowledge of civil procedure rules and litigation processes.
- Strong analytical skills for legal documentation review.
- Ability to manage complex case files and deadlines.
- A demonstrable interest in the financial and operational aspects of claims management.
3
From Specialist Underwriter (e.g., Complex Risk)
5-7 years in specialist underwriting
Skills to master
- Shifting from assessing risk to managing its realisation. This means developing strong investigation, negotiation, and dispute resolution skills, and understanding the post-bind implications of policy wording. You'll need to get comfortable with conflict and adverse outcomes.
You're ready to move on when
- Exceptional understanding of complex policy wordings and risk assessment.
- Strong communication skills with brokers and clients.
- A desire to move into a more 'hands-on' problem-solving role.
- Proven ability to analyse and interpret detailed technical information.

15Where this role leads

The long view: This work can lead to director level claims leadership, litigation leadership, a chief claims officer role, or leading fraud and financial crime prevention.

The ten Future Fluencies

Zavmo analysis

The credential is what you can do today. These are what keep you valuable.

A qualification proves you can do the job as it's defined today. These ten are what decide whether you're still the obvious person for it in five years. They're the capabilities employers are now writing into senior roles faster than people are learning them. Zavmo weaves them through whatever you study, so you come out with both: the credential and the fluency.

The highlighted ones are the Fluencies your role leans on hardest, from how Senior Claims Manager is actually changing.

How you would learn this

One to one, on the work you already do

A tutor sets the task against your own job and marks the reasoning, at your pace. There is no cohort to fall behind.

A lesson from Settling complex insurance claims, worked against Senior Claims Manager.

Settling complex insurance claims Level 3

Applied to your work in Senior Claims Manager

The objective of this unit is to provide learners with the knowledge and skills to understand the roles and responsibilities within the insurance industry, interpret insurance policies, and effectively settle complex insurance claims. Learners will be able to obtain and provide information, negotiate settlements, maintain accurate records, and consider appropriate actions for claim resolution. This includes understanding the process, factors, and documentation involved in settling complex claims.

How the thinking builds

1 Remember
2 Understand
3 Apply
4 Analyse
5 Evaluate
6 Create

An illustration of a Zavmo lesson, built from this role’s own route. The unit, its objective and every criterion above are the awarding body’s own words, not an example.

It is £70 a month, billed monthly. Your free first module is Future Fluency, and you can cancel any time.

Start my Senior Claims Manager plan, free

See Your Progress Grow Illustration

Senior Claims Manager

Reserving Methodologies
Litigation Management
Subrogation & Recovery
Fraud Investigation Techniques
Loss Adjustment Expense (LAE) Control

This is your Mind Palace on learn.zavmo.ai. Every skill above comes from this role's own record, not an example borrowed from another job. A node lights up when you evidence it, and what you build stays yours between jobs. That is the part a course cannot do.

16The detail, folded away

Everything else the record holds

The career branches in full, how AI is already showing up in the day-to-day, and the questions people ask about this job. Here when you want them, out of the way while you decide.

Where it leads next, rung by rung

Where it leads

The career path, and where it branches

Senior Claims Manager is a start, not a ceiling. Each step below asks for new skills and hands back more autonomy.

Claims Supervisor / Unit Manager (L4)
2-4 years in the Senior Claims Manager role

This is a step into formal people management, leading a team of 5-10 adjusters. Your focus shifts from individual caseload to team performance and development.
- Team Performance Analytics Analysing team-level metrics (e.g., average cycle time, reserve accuracy) to identify trends and areas for improvement.
- Talent Development Identifying training needs, creating development plans for team members, and succession planning.
- Process Optimisation Leading initiatives to improve claims handling processes across your unit.
- HR & Compliance Understanding HR policies and ensuring team adherence to regulatory compliance.
Principal Claims Specialist / Technical Expert (L4 IC Path)
3-5 years in the Senior Claims Manager role

This is an Individual Contributor (IC) path, focusing on deep technical expertise rather than people management. You'd handle the absolute toughest claims, act as an internal consultant, and shape best practices.
- Specialist Claims Auditing Conducting deep-dive audits on high-risk claims to ensure quality and compliance.
- Policy Interpretation Expert Becoming the go-to person for ambiguous policy wording or complex coverage disputes.
- Litigation Risk Modelling Developing models to assess and quantify the financial risk of specific litigation portfolios.
- Training & Curriculum Development Designing and delivering advanced training programmes for claims professionals.

Working with AI on the job

Working with AI

Where AI is starting to help

Let's be real, claims management is demanding. You're juggling complex investigations, legal strategies, and mountains of documentation. What if you could offload some of the grunt work and focus on the high-value decisions? That's where AI comes in.

We're building an AI-powered hub to help our Claims Managers work smarter, not harder. For a Senior Claims Manager, this means less time sifting through documents and drafting standard letters, and more time strategising, negotiating, and mentoring. It's about giving you superpowers, not replacing your judgment.

Automated Claims Triage & Routing

Imagine AI ingesting every First Notice of Loss (FNOL)—from emails to transcribed calls—extracting key details, classifying the claim type, and instantly routing it to the right specialist. For you, this means less manual sorting and faster access to the claims that genuinely need your senior expertise, cutting down on initial review time.

Predictive Fraud Flagging

Our AI models analyse thousands of historical claims to spot subtle patterns indicative of fraud. New claims with high-risk scores get flagged in real-time, allowing you and the SIU team to focus your investigations where they're most needed. No more relying solely on gut feeling; you'll have data-backed insights to guide your forensic skepticism.

Litigation Outcome Modelling

When a claim goes to court, an AI tool can analyse millions of legal precedents and court records. It'll give you a probabilistic forecast of potential outcomes and settlement ranges based on jurisdiction, case type, and even the assigned legal counsel. This isn't about making the decision for you, but giving you a much stronger hand in settlement negotiations and strategy discussions with external solicitors.

AI-Assisted Communications

Use a generative AI assistant to draft first versions of standard claims correspondence—think reservation of rights letters, detailed status updates for claimants, or even initial denial letters. The AI pulls from policy templates and specific claim file details, giving you a solid draft to review, personalise, and send. This frees up significant time for higher-value investigation and negotiation tasks.

Common questions

How do you become a Senior Claims Manager?

Common routes in include From Claims Adjuster / Examiner (3-5 years as an L2), From Legal Paralegal or Case Manager (Insurance Law) (4-6 years in a paralegal role with insurance focus) and From Specialist Underwriter (e.g., Complex Risk) (5-7 years in specialist underwriting). Times vary with prior experience.

Where can a Senior Claims Manager progress to?

This role can lead on to Claims Supervisor / Unit Manager (2-4 years in the Senior Claims Manager role) and Principal Claims Specialist / Technical Expert (3-5 years in the Senior Claims Manager role), depending on the skills you build.

What new skills matter most for a Senior Claims Manager?

Increasingly, Advanced Data Storytelling and Ethical AI Claims Review & Bias Detection. These are the skills our record of this role lists as growing.

You're not behind. You're right on time. The shift is only just beginning. Your role won't look the same in two years. Be the one who leads the change, not the one it happens to. Start my Senior Claims Manager plan, free What happens next: a free account, then we build your plan as you set up. No card. Build your plan, see your roadmap and meet the twelve tutors matched to you. All free. When you're ready to start learning, it's £70 a month, billed monthly. Cancel any time and billing stops.

Senior Claims Manager

Where should we send it?

Two short quizzes about you

Will AI change your work as a Senior Claims Manager?

What's rising in its place

Advanced Data Storytelling

Ethical AI Claims Review & Bias Detection

Skills this role draws on

Technical

How you actually get there, here

From Claims Adjuster / Examiner (L2)

From Legal Paralegal or Case Manager (Insurance Law)

From Specialist Underwriter (e.g., Complex Risk)

The credential is what you can do today. These are what keep you valuable.

Roles this leads to

One to one, on the work you already do

Everything else the record holds

The career path, and where it branches

Claims Supervisor / Unit Manager (L4)

Principal Claims Specialist / Technical Expert (L4 IC Path)

Where AI is starting to help

Automated Claims Triage & Routing

Predictive Fraud Flagging

Litigation Outcome Modelling

AI-Assisted Communications

Common questions

Want a read on where you stand?