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Admin
547 Posts |
 Posted - 09/27/2002 : 22:42:41
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Course Outline
Fire Scene Investigations
Tips & Techniques
(A) The Adjuster
(1) get organized
(i) recommended reading (tba when presented)
(2) understanding trauma
(i) recommended reading (tba wp)
(3) be comfortable with negotiations
(i) recommended reading (tba wp)
B) Technical Preparedness
(1) understanding the chemistry of fire
(i) recommended reading (tba wp)
(2) Loss Logistics
(i) recommended reading (tba wp)
(3) NFPA 921, Guide for Fire & Explosion Investigations
(4) Cooking fires
(5) Subrogation
(6) specific recommended readings (tba wp)
(C) Building & Contents Fire Loss Considerations
(1) structural considerations
(i) recommended reading (tba wp)
(2) damaged wall & ceiling systems considerations
(i) recommended reading (tba wp)
(3) what is "clean", can it be saved?
(i) recommended reading (tba wp)
(4) damage to textiles & Fine Arts considerations
(i) recommended reading (tba wp)
(D) Forensic Primer
(1) "Red Flags"
(i) recommended reading (tba wp)
(2) Suspiciousness - and the ability not to stereotype
(i) recommended reading (tba wp)
(3) The statutory authority of the Fire Marshall
(i) recommended reading (tba wp)
(4) Co-operating with Public Authorities
(5) Specific recommended readings (tba wp)
(E) The Claim
(1) Insurer receives the FNOL
(2) Vendor receives the FNOL
(3) Adjuster receives the assigned FNOL
(4) Adjuster's first 1/2 hour at the loss site
(5) Statements
(6) Review - what do we have, what do we need?
(7) The convergence of the carrier preferred contractors
(8) The "extent" of the loss
(9) The "scope" of the loss
(10) Is the site habitable?
(11) Review again - what do we have, what do we need?
(12) What has the adjuster told the carrier?
(13) Is it time for the estimate?
(14) Is the adjuster "managing" the loss?
(15) Is the vendor "supervising" the loss?
(16) What's happening to the file back at the carrier office?
(17) The adjuster's time to "adjust"
(18) The adjuster's time to "report"
(19) What is a closed file?
(20) The fee
(21) The carrier closes (hopefully) and what else happens?
By Clayton Carr |
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Admin
547 Posts |
Posted - 09/27/2002 : 22:51:47
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| Notice: We had a problem with the forum tonight which caused us to temporary lose the post made in this topic. We are working to restore all posts and have install additional safeguards to make sure this does not happen again. Clayton I’m real sorry for about this. I know you have spent a lot of time and effort on the posts included in this thread and other threads. |
Roy Cupps -
CatAdjuster.org :: Contact\Feedback :: Adjuster Roster :: Current Forum |
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CCarr
Canada
1200 Posts |
Posted - 09/29/2002 : 21:49:33
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Fire Scene Investigations - Tips & Techniques
(A) THE ADJUSTER
(1) Get Organized
Here we go, please remember the format I will try and stick to. First, a commentary introducing a topic, concluding with (when stated) some recommended web based reading. I do not have all the "answers", and this is not intended to be a draft textbook. The objective is to provide some foundation, some things to think about, some things to build on; so when we are all done we will have a resource base that may be of some value. In that regard, your participation is crucial - your reflection on my commentary, your elaboration on the developing foundation, your input as we progress to create a value added tool.
Who are we? Simply, we are adjusters. However, I consider the audience and participants are made up of the following contingent, their definition taken from Ruff's Dictionary.
Claim Adjuster - an individual who acts on behalf of, or is employed by, an insurance company to settle claims.
Field Adjuster - a claims adjuster who works outside the office to complete the duties of a claims adjuster.
Independent Adjuster - a person, hired by an insurer, who is paid a fee for settling claims.
The sometimes ghostly echo from a carrier to their adjusters, and sometimes more clearly articulated is; ".... you are now responsible for a few million dollars annually and remember to control indemnity and expenses and keep the customer happy, and don't forget about shareholder value ....".
The front line claims position of a field adjuster are pretty fast paced. Telephone calls to make and receive - each time remembering to listen with patience and empathy while being courteous, notes to take and a file to document; and that call will likely necessitate other pro-active things to be done for file resolution. Then there are other activities - mail, places to go, people to see, things to sort out.
It is time to get organized. Being organized is a learned skill for most. Learn how to "manage" your desk, your workflow and daily activities.
Too often while walking the aisles of a claims department over the years, I became frustrated on Thursdays. Inevitably, there would be a steady chorus of people detailing their plans for the coming weekend. However, those great and detailed plans far surpassed any evident planning to their work week or day. Why do otherwise good adjusters take so much care to plan their personal lives, but fail to put the same planning into their jobs?
Consider some ideas that may help you get better organized. The focus of this is centered around what one wise boss told me years ago, as I stood and listened with my tongue hanging out and drooped; ".... I don't doubt you work hard, learn to work smarter ....".
Do you have a "to do" list - one for each day and one for the week? It can be as informal as on a pad, to the latest technological wizardry designed to help you manage time. Memory can be a wonderful thing, but an adjuster must be capable of multiple multitasking.
Prioritize your tasks. Looking at your "to do" list, recognize the importance of some things to be done over others.
Obstacles will come along (maybe in the form of more new claims) that will adversely affect your otherwise well planned "to do" list. Again, prioritize, but make sure you put required defferals onto tomorrows "to do" list.
One of the last things I do each day, before I lift myself out of my desk chair, is to make sure I know what my plan is for tomorrow.
Once you get involved with any regularity with fire or burglary type claims, your level of mail per file will escalate. Mail is "touched" too many times before it is dealt with. People tend to glance at or read incoming mail when it is received, then they sit it aside to deal with it later. When "later" comes, you have to read it again. You may tend to conclude at that moment that you do not have the time to do the required work associated with properly acting on that piece of mail. So, a third reading will occur when finally that piece of mail is actually dealt with. Try and "touch" mail only once. Mail should be an entry on your "to do" list. Some people like the quietness of early morning for this, while others prefer the solitude of night - either carrying the likelyhood of minimal phone traffic or other contact.
On any given day, you will have a few "piles" of files on your desk; prioritize those piles. That may be - a pile of new claims received and not yet called on, or a pile of new claims called but only a message left with an insured, or a pile of files with appointments set, or a pile of files waiting for reports from outside experts a/o preferred vendors, or a pile of files that require your reporting on. You may only have 5 files with each in a differnt incubation stage, and thus I suggest you need 5 "piles". You will develop your own management of your piles; but know what is on your desk.
Aside from the telephone ringing a/o calls to make, a/o appointments to go to, a/o reports to study or do - learn to have only one file open at a time on your desk.
Try and handle the most potentially confrontational task first. Do not develop a "pile" of "dog files"; they will bite you sooner than later. Difficult situations, calls, meetings, negotiations or other tasks are all a regular part of a claims professionals day. If those "difficult" tasks are left, the pending confrontation grows. The longer the "dog" sits idle, the greater the likeyhood of trouble and stress by all the parties involved - including you.
When you decide to deal with a matter that requires your undivided attention, commit yourself to not being distracted until you finish. Normally, this distraction will come from the phone - either while you are at your desk or in the field amongst the company of others disassociated with the incoming call. While at your desk - let the phone ring. Everybody has voice mail, and everybody is used to connecting to it. The key is to use your VM as a time management tool. Get used to changing your VM daily, or several times a day to suit the situation. If your VM declares, ".... I'm sorry I can not take your call at this time .... I will return it today ...." - do so, without exception. Become known as a reliable call returner. This will be one of your most important steps in your evolution as a professional. With regards to your cell phone ringing in your pocket while you are dealing with others - think of the times you have walked up to a retail counter, customer service line, or pharmacist; to discuss something of importance to you with the attendant. You get nicely started with your comments, and the phone on the counter rings. You know what happens, you know how you feel; you have been selected against - when that phone is answered interrupting your conversation. I develop a negative attitude immediately about how I am being serviced. It is my contention that once you leave your vehicle to enter a meeting or deal with people at a loss site, you either leave your cell in your vehicle or turn it off if you carry it. To answer that call in front of others disinterested in that call is both rude and a breach of confidentiality to the caller whose conversation is now occurring among "strangers" to that situation. Again, use your cell VM to manage your day.
Going back to "your word", now is as good a time as any to emphasis this point. In addition to your telephone reliability, never promise anything you know you can not personally deliver. Staff field adjusters have defined and segmented authorities (by line) for settlement authority and could have a different check signing authority. With an I/A, you know the credo of your measured responsibilities. The example I'll use, is that you may know what you will say in your report and when you will deliver that report; but if you can not carve the check - don't promise it. You are capable of handling all aspects of a file but were required to utilize one or more outside experts - you are not in a position to state to an insured when that report will be available so you can incorporate it into your reporting. The list goes on, do not let your heart rule your brain.
Deadlines - they exist all around the functions of an adjuster. Do you know yours and that of each file in your control, regardless of what "pile" it is in. Remember, receiving fire type claims, you do not get them all at once; you could likely have a handful of varying ages and status. You must learn to "work" deadlines in a pro-active manner. A successful adjuster will learn to avoid "just in time" deadlines and learn to prepare in advance for known deadlines.
Finally, in this segment, we should start to consider the building blocks of our "tool box". Thirty three years ago (actually today) I started with a couple of manuals and a few insurance institute course texts, found on my employers shelf. Today, so much more is available to us all. It is not wrong, nor an admission of inadequacy to say to yourself or anyone else, ".... I don't know the answer ....". However, the successful adjuster will know where to find the answer and have the conviction to search it out.
In that regard, I provide the general core of my web based "technical resource" sources. Web sites I use to my advantage to find things I need to know or get clarified. You should each have one of your own. Please provide us with the "tools" that are of use to you, so we can all share.
www.claimsmag.com - a good commentary on technical and other issues affecting our profession
www.catadjuster.org/links.asp - a vast collection of links pertinent to our profession
www.insurlinks.com - another vast collection of links pertinent to our profession
www.insurance-canada.ca - regionally specific to me, tell us about ones specific to your region
www.cafi.ca - topic specific, but international in flavor
www.nils.com/ruffs - a good claims dictionary
www.construction-cost.com - an interesting site
www.insurancefraud.com - topic specific with good articles
The recommended reading for this segment is found at www.claimsmag.com Go to archives - magazine archives, then 2001.
Please read from May 2001 - "Guidelines for happy adjusting" and from April 2001 - "The 20 deadliest words and phrases in claims writing".
What can we learn from these articles?
I look forward to a discussion on this commentary and the suggested reading.
By the way, when we get to "The Claim", the policy that we will be using is the ISO HO3 (04/91). Hopefully, you have a copy of the wording or will be able to get hold of one before we get to that point.
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CCarr
Canada
1200 Posts |
Posted - 09/29/2002 : 21:51:07
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Fire Scene Investigations - Tips & Techniques
(A) THE ADJUSTER
(2) Understanding Trauma
By understanding trauma and its' repercussions in the life of an insured, the adjuster will be better equipped to effect a timely resolution of the loss and limit the potential for conflict with the insured.
Trauma can either be physical or psychological. It is psychological trauma that you must be able to recognize and deal with as you progress through the claims functions. Psychological trauma is defined as emotional shock that produces an emotion or mental disorder. Another description I found that is clearer to me is; a shock that produces a lasting effect on a person's mind.
We, as adjusters, are used to seeing in our day to day claims activities the devastation of a person's house - their home. We have become "battle toughened" to the misery a loss can cause another. We must be able to recognize that each insured we encounter with a loss to their home, is likely to have been traumatized by the event. We do not walk in and see just another "simple" kitchen fire. These people were scared to death at the time of the event. Their immediate fears at the time and lingering concerns were for the life of their family members, the safety of everyone including all pets, the loss of dear and cherished personal effects, the absolute change in their life that the fire created, and their stereotypical dread of "trying to come out even" with the insurance company. An insured's response to such an event is intense fear, helplessness or horror. These effects will be present - in varying degrees and manifestations - when we show up.
There are five types of responses to traumatic events, the following are examples of each type of reaction that we may encounter.
Emotional - shock, disbelief, anger, terror, grief, fear, helplessness
Cognitive - impaired concentration, confusion, disorientation, instrusive thoughts, avaoidance.
Biological - fatigue, insomnia, nightmares, hyperarousal, startle response, psychosomatic complaints.
Behavioral - avaoidance, alienation, social withdrawal
Characterological - personality changes, dissociation
Two good articles in CADO deal quite well with the adaptability we must have in dealing with people, to be successful. Later, have a look at "View from the Slough", to see the 'summum bonum' of one adjuster; and the interesting adaptability found in "Field experience of a woman cat adjuster".
We will encounter insured's in our field claims work who exhibit their trauma response in many actual ways relative to the types described. I have found that after claims have taken their course to resolution, that an "ordinary insured" first exhibited a strong take charge approach (hyperarousal a/o a personality change), later to be told by them they were fighting a strong sense of failure due to the loss. Conversely, I recall another insured who appeared the first day or two to be the most lost and useless person you would meet in a long time (helplessness, impaired concentration, avoidance), later to be told they as well had an overwhelming sense of perceived failure due to the loss.
Anger is another common emotion encountered. We have all likely been rightly accused of at least once taking our "anger out on someone else". Here, an insured may literally blow up at you, but we must quickly decifier and decide if it is because of us - or are we just the medium that anger flows through. We can not be quick to judge these people as "the person" we first encounter. They may not be - at that time - the person they normally are, because of their response to their trauma.
Perception comes into play in many areas of adjusting, as it does in life. The adjuster is trying to focus on the insured's entitlement under the policy. The insured sees their interests and has a great need for validation after a loss. The insured's are not well versed in their policy, all they quickly recognize is that they have a loss and they have paid for a policy; and from that they have definite expectations. While we are adjusting the claim, we may clearly understand that there are few choices in the decisions we have to make. However, the insured usually does not understand this, and adjusters sometimes do not do a good enough job of explaining the issues and processes to the insured.
If someone that knows little about insurance or claims was to ask you - an adjuster - what is it that you do? Varied answers would follow, but likely along the lines of - go to fire scenes, take statements, determine cause, determine coverage, scope damages, estimate damages, do reports, talk on the phone.
All of these things are aspects of the "job", they are tasks; things we do to accomplish our real "job" - provide a service to a client. We arrange, we facilitate, we make things happen - we provide the service necessary in order for the claim to be resolved. Often people, in many professions, focus solely on the various aspects and tasks of the job; and fail to realize that they are really in a customer service business.
One of the important best characteristics for the job of adjusting claims, is our ability to listen. If we listen carefully to an insured, we will get a clear indication of their "attitude".
Empathy is another best characteristic in adjusting. We must learn to acknowledge an insured's feelings. Once we have established that we understand what the insured is feeling and why, only then will the insured really accept what we have to say on a technical or factual level. The insured will then accept and listen to the adjuster and more likely trust the adjuster to the exact degree that we have demonstrated our knowledge of their feelings.
Winning over the insured, gaining their trust; has little to do with our perceived ability to perform the varied aspects and tasks of our job. It has everything to do with our demonstrated concern for their ultimate well being.
Communication in life occurs in three ways - our spoken words, our written words, our deportment or "body language". The manner in which we communicate adds or detracts from the perception others form about us.
By recognizing the potential complications that arise from trauma and the perceptions of an insured, we will be better equipped to deal effectively with the loss.
We need to ensure that we are prepared to effectively meet the "needs" of an insured. To do this three things are central to our success.
(1) Be a qualified adjuster - we have to be sure we have the requisite people skills, that we can recognize trauma and adapt our dealings accordingly without letting our own reactive responses interfere. We must know the policy well that we are dealing with, and be able to refer to it confidently.
(2) Early intervention - some old movie I saw had a line in it that stuck with me, ".... worrying about something tomorrow never solves today's problem ....". Early response by an adjuster, first shows to an insured a reflection of our care and dedication to our job. Consistent early intervention by a qualified adjuster will build a good and lasting relationship with insurers. Insurers need to know what they are faced with so they can not only set adequate reserves, but deal with problems (actual or perceived) that they envision, so as to reduce their likelyhood of becoming a crisis.
(3) Be flexible - everything we encounter in our adjusting functions is not "black and white". As the responding adjuster we must have the confidence to recognize that. Insurer management are well aware that many aspects of a claim are "gray". Claims managers and astute adjusters alike, recognize that it is best to carefully "pick your battles".
Recommended reading for this segment are two articles from www.claimsmag.com
From July 2001 - "The company we keep". Can you relate to the three forms of fear response that the author mentions? What are your feelings regarding "price" versus "brand qualities"?
From October 2001 - "Are insurance adjusters professional?". Here the comment of a carrier that an adjuster's responsibilities are restricted to "the routine and unimportant", is amplified in the result of the suit discussed. What does the author declare as the "needs" to be a professional adjuster?
Look forward to an open discussion about the issues in this post and the recommended readings. |
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ChuckDeaton
USA
373 Posts |
Posted - 09/29/2002 : 21:52:01
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Hang in there Clayton there are more of us than you think. Several of us are working on such things as a tool list and a forms kit that can be emailed like Cat 101.
If you need me to contribute some money to the effort let me know. I value your advice enough to pay for it. |
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CCarr
Canada
1200 Posts |
Posted - 09/29/2002 : 21:52:54
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Fire Scene Investigations - Tips & Techniques
(A) THE ADJUSTER
(3) Be comfortable with negotiation
A great person in anyone's world once said, ".... let us never negotiate out of fear, but let us never fear to negotiate ...." JFK
Some people fear the possibility of "looking" foolish at the negotiation "table". That "table" can take many forms and stage settings as you progress through your adjusting career. It could be an interview at a desk of a vendor or carrier, concerning your application for a job. It could be at the kitchen table of an insured, as you attempt to settle elements of a claim or convince them of the applicability of certain policy wording. It could be in the front seat of your vehicle, as you debate claim elements with a public adjuster. It could be in a carrier boardroom, where a meeting has been arranged for you to review and explain the specifics of a claim; and your attempt to convince them of the right approach to a proper resolution.
We have to recognize the many faces of negotiation. To negotiate, is to bargain or discuss with others, in order to reach an agreement. Visit your local "chinatown" marketplace, and it is alive with negotiations, at its best. Almost every claims meeting or discussion, regardless of the formality; is a negotiation.
It is normal to feel a certain amount of apprehension before a "negotiating session". Negotiation is always dynamic, and often unpredictable. It demands hard work through preparation and lots of patience.
The following are some tips that should help us with negotiations.
(1) Prepare - this can not be overstated. Negotiating is like an iceberg, only 10% is visible, and 90% is hidden. Much of the invisible part of negotiation is in preparation. We can not "wing it" and save the detailed preparation for litigation. A person will fail as a professional adjuster that does not thoroughly prepare. Preparation will increase your confidence and prove your strength through your knowledge to the opposite party. To prepare, we must at a minimum, know the "make up", style and personality of the "other side". We must identify our interests and goals for the file at hand. We must recognize and identify with the interests of the other side. Remember in a previous segment we mentioned the need for the insured to have his claim acknowledged. We must clarify the issues that need to be resolved, get to the "short list" of things that are clearly understood to require resolution. We must be able to clearly and convincingly refer to the policy involved and be able to substaniate our position when required with applicable wording, and be able to professionaly counter the position of others that may introduce improper interpretation. Finally, we must be aware of legal interpretation, that has been tested in the courts.
(2) Know when to "hold" and when to "fold" - before coming to a negotiating "table", we should assess what we could achieve through processes other than at the "table" we are at. In other words, what would likely happen if the file is not resolved at this "table"? Would the carrier have to pay more or less than the amount under consideration at this "table"? We should not settle for a negotiated result that is inferior to the one we would likely receive through another resolution process (such as arbitration or litigation). But, we and carrier management must always be aware of additional costs involved in alternative methods of resolution. We have to resist the temptation to "get it over with" at the "table" you are at, patience is a hallmark of a good adjuster.
(3) Be open to persuasion - we must learn the "art" of persuading others of the merits we see in the points of our discussion. At the same time we must be open to persuasion by others. You may encounter verified or verifiable facts at the table, that were not in your file. Do not remain committed to outcomes which no longer appear feasible.
(4) Recognize that negotiation is a process - we have all walked into meetings where the other side proclaims "I'm short of time and I'll get right to the point". In doing so, they go right to their bottom line, and normally leave no room for negotiation. The process of negotiation is give and take, to find a win - win solution.
(5) Remember the human side - our success will depend not only on our knowledge of the file, the policy, and our careful preparation; but also on the personal qualities we bring to the "table". Our reputation for trustworthiness, our ability to listen, and our communication skills and style will all contribute to the successful resolution of a file. We have to take the time to know the people we are dealing with and learn to respond to their individual styles. I have always referred to this in my claims life as "bedside manner". I think it is a critical element for success as an adjuster. I have a different deportment, style, manner and vocabulary when I have settlement discussions with a lawyer (or even on this web site), than I do with an insured who (respectfully) lives at RR#2 in the boonies. This is very important for your "message" to be understood, past just being heard.
The fear of negotiating can be overcome and become a stimulating element of your claims life by - preparing your file thoroughly, by assessing the strengths and weaknesses of your issues and those of the other side, by being open minded, by understanding the nature of the negotiating process and recognizing the human dimension.
Recommended reading for this segment is from www.claimsmag.com
From May 2002 - "The death of common sense", a viewpoint by the author of the seemingly increasing lack of common sense in our litigous society.
From August 2002 - "The financial benefits of fast, fair claims settlements", an interesting discussion by the author of a perceived conflict, ".... the carrier responsibility to write checks for valid claims while simultaneously being assigned to create "profit ....", and other interesting issues.
This is the end of the first section - The Adjuster. Hopefully you have been left with some foundation and made you think about being organized, understanding people and trauma, and being more comfortable with negotiation. |
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Linda
USA
127 Posts |
Posted - 09/29/2002 : 21:53:35
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| I do believe you have more than given it "a go". My "Fire" notebook has had life breathed into it. I also have printed out the articles for future reference. I am looking forward to Section II. Thanks! |
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CCarr
Canada
1200 Posts |
Posted - 09/29/2002 : 21:54:48
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Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
(1) Understanding the chemistry of fire
First, lets look at some of the common terms we will encounter doing our fire claims. There are plenty more that you will hear outside experts use; but we will start with this building block of terms to our "tool box" and add more in another relevant segment. I might add that these definitions, taken from several sources, are not the only definition of the particular word or term. That is not to say that another definition will give you a totally different meaning, but that some terms carry "deeper" more scientific definitions, that there is no need to grasp in relation to getting a good understanding of the term.
Fire - a rapid, persistent chemical reaction that releases heat. For coverage purposes, a fire must be "hostile", not "friendly".
Fire triangle - the three ingredients needed for a fire; an ignition source, oxygen and fuel. If any of the three is not present or is removed, a fire can not start or continue to burn.
Friendly fire - a fire or combustion intentionally set for beneficial purposes and remaining within its intended confines.
Hostile fire - an unintended fire, or a fire set intentionally that escapes its intended confinement.
Class 'A' fire - one of 4 categories of fires. Class 'A' fires involve solid combustibles (such as wood or paper) which are best extinguished with water or dry chemicals.
Class 'B' fires - one of 4 categories of fires. Class 'B' fires involve flammable liquids, which are best extinguished using foam, carbon dioxide or dry chemicals.
Class 'C' fires - one of 4 categories of fires. Class 'C' fires involve live electrical equipment which must be extinguished by a nonconductive extinguishing agent such as carbon dioxide or dry chemicals.
Class 'D' fires - one of 4 categories of fires. Class 'D' fires involve combustible metals (such as magnesium or titanium), which must be extinguished by special dry chemical extinguishers.
Construction - from a claims and underwriting perspective, the types of materials used in the building and roof of the insured structure. Construction types include, fire resistive, semi-fire resistive, and combustible; depending on the materials used.
Fireproof - a term historically used to describe a material or structure capable of withstanding damage by fire. It is misleading because no material is totally safe from fire.
Fires are also classified into two groupings; simple and complex. Simple fires result in complete combustion and are usually fuelled by a relatively pure fuel, producing no soot and only small amounts of gases, fumes or smoke. I think my trusty Coleman naptha gas lantern is a good example of this, or an ignited natural gas line - whether "firendly" (a gas fireplace) or "hostile" (a broken line).
Complex fires, are the result of incomplete combustion and are fuelled by synthetic materials; including those found in clothing, carpets, toys and furniture. A complex fire causes the most damage and leaves the most waste.
In a complex fire, the acid gases combine with heat and water vapor and penetrate cracks, crevices and joints in construction. When the surface cools, the gases condense and form highly corrosive solutions. An example of this is many years ago I worked during my senior high school summers as a junior forest ranger in forest fire suppresion. I knew nothing about the science of fire at the time, but did wonder why my new Kodiak boots deteriorated to the point where I had to throw out two pair that rotted (from the outside in) by the end of the summer.
These acidic solutions can permanently etch and stain many sensitive surfaces, including machinery and tools, electrical equipment, appliances, marble, glass and aluminum surfaces.
Another common product of a complex fire is soot. Soot is composed of carbon and other materials, that are incompletely burned or oxidized. Some soot is dry, but most is combined with burnt byproduct greases and oils.
The chemical make up of soot is dependent on what the fuel was - textiles in a couch or clothing, or plastics in toys or kitchen containers. A careful consideration of the materials affected and the materials exposed to the fire, will allow us to better deal with the costly restoration and repair aspects later. Widespread soot damage(smoke residue) can be as expensive a repair / reconstruction element of the claim, as the one only room where the fire was contained.
Once we get past the cause and coverage issues of a fire loss, or in explaining to an insured with regards to how to prevent further damage; the following "Do's" and "Don'ts" may be of assistance.
"Do's"
(1) Dry out the affected areas as soon as possible
(2) Vacuum loose dry soot from upholstery, drapes and carpets
(3) Cover dry carpeted traffic areas
(4) Discard open food packages
(5) Remove smoke damaged clothing to a drycleaner specializing in fire damaged clothing. Often carriers have one or more of these as established PVs
(6) Clean countertops and fixtures to prevent or minimize acid damage
(7) Change the air filters on forced air HVAC systems
(8) Tape filter media over cold air returns and warm registers to capture loose soot
(9) Air out the structure (either naturally or commercially) to reduce smoke odor
"Don'ts"
(1) Do not use electrical appliances or fixtures that have been exposed to water or heavy soot, before an electrician has checked the electrical service and then the affected items for damage
(2) Do not attempt to wash any papered or "flat type" paint on walls or ceilings, until it is clear what "type" of soot is prevalent and then determining the correct solution to use; so as to avoid a lingering soot residue problem. The same concept applies to cleaning carpets and upholstered furniture
(3) Do not let the structure or affected room(s) remain wet or with a high humidity level
The recommended reading for this segment is found at www.claimsmag.com
Go to March 2002 - "Training time: restoration and repair losses". It is a good reference article to keep with your collected information and will guide you to determining the quality of restoration people you may encounter. Has anyone reviewed the text "NIDR Guidelines for Fire & Smoke Damage Repair"? I haven't, and would be interested in knowing your thoughts as to its value as a "tool" and its applicability to what an adjuster would encounter in the field. |
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CCarr
Canada
1200 Posts |
Posted - 09/29/2002 : 21:56:14
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Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
(2) Loss Logistics
I am going to suggest to you a concept, that at first glance many of you may disagree with. In my opinion, the field adjuster must "manage" the loss, within the principals of Project Management (PM). Sometimes what the adjuster is managing is only him/herself, while at others times it will be him/herself and varied group of people involved in the overall field management of all the claims issues you may encounter.
Three parties benefit from the efficiencies an adjuster brings to the loss, when that adjuster utilizes proactive PM principals. First, the insurer has benefited in tangible and intangible ways from the structure PM brings to a loss scenario. Second, the insured has received their indemnity (or otherwise) from the insurer in a strategic and planned manner. Third, the adjuster earns new confidence and respect through focused efficiencies that were utilized.
Successful Project management involves the following.
(1) Establishing and focusing on goals, which will be general at first, but as the claim evolves will become more specific and task oriented.
Lets consider Jim Lakes phrase that I really like - "cause, coverage, cost". This is the essence of the sequenced goals that must be established and focused on. As the claim evolves, some or many more specific task goals will be defined within each of the "3C's".
(2) Establishing an effective management process that will operate in a systematic manner.
I have a pretty definite approach to field adjusted fire claims. I have a "process" that is structured that I like to follow - both before I head the scene, and another starting as soon as I arrive in the neighbourhood of the loss while I am enroute. For example, my systematic manner, whenever possible to utilize, once I arrive on site and get the "hello's" out of the way, is to walk around the exterior perimeter of the property with the named insured, but saying very little; but listening and looking. I want to get a "feel" for the structure / dwelling, regardless if it is a template box, and to get a notion as to what type of "home" (not house) this is. Secondly, I want to tour all rooms in the dwelling - bottom to top, front to back, damaged and undamaged areas. Establishing your "process" as to how you will determine the goals (the 3C's) and approaching them in a systematic and planned manner, is an important aid to both your productivity and effectiveness.
(3) Using the management process or system to make the "best possible" decisions for - additional activities required, utilizing outside resources available to you effectively, co-ordinating your activities. In other words - you are managing the file from a field perspective.
This is a natural progression, look back again at items #1 and #2. Consider establishing "cause" as one of your primary goals. Then in your systematic approach to it you may have determined that a possible cause needs the expertise of an outside resource to substaniate. That outside resource for this example, is likely a C&O expert - called to examine for subrogation potential or loss exclusion possibilities. The result of that exercise, in concert with all your cause investigation material collected to that point, will again allow you to consider the next required best possible decision that has to be made, on your route to finalizing your primary established goal - determining cause.
The proactive approach to PM is aggressive, ensuring that the "job" of providing service by your adjustment of the claim, proceeds as planned.
Distinguish the benefits of proactive PM from reactive job management - which allows circumstances and non-strategic elements to prompt or dictate an unplanned course of action.
In property claims, we are generally dealing with a process, not a product. The adjuster who utilizes PM principals, will consider the four phases of the process development; planning, scheduling, control and feedback.
With any size of an open case load of files, we must diligently plan to "spread" ourselves among all files. I again refer to my post comments on "to do" lists and prioritizing your obligations. Scheduling certainly follows the planning component. It is important to schedule different events in a claims history to the advantage of your purpose. I think one of our most important concepts of our field work is control. I am a firm believer that the field adjuster must manage, and hence control, all aspects of the claim from when assigned to final reporting. This is not to say you will not receive direction from your supervisor or carrier examiner, but simply that you must incorporate any such direction into your processes. However, with our exercise to plan, schedule and control; we must always seek feedback of our actions. This feedback often comes from keeping the insured informed in your processes and establishing a "working relationship" that allows them to respond freely to your course of action.
The recommended reading for this segment comes from www.claimsmag.com
Go to 1999 (last article on the list) - "What do you mean by that? Specific terms in a Q&A produce direct responses". This is an excellent article that should be carefully read, absorbed and kept. Many of the issues and tips in this article are critical to the success of investigations. |
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Linda
USA
127 Posts |
Posted - 09/29/2002 : 21:57:22
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| Clayton, could you expand on the subject of the complex fires? Specifically the damages to be expected from the acidic solution and corrosive soots? Is there perhaps some more extensive reading somewhere? Thanks |
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CCarr
Canada
1200 Posts |
Posted - 09/29/2002 : 21:58:56
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Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
Addendum to: (1) Understanding the chemistry of fire
We will delve into the characteristics of a complex fire more,which will give us a better understanding later when we talk about the damages caused by the acidic solutions and corrosive soots. The following will also serve to clearly illustrate that no two structure fires, or even "kitchen fires" are the same; including their resultant damage.
Again, fire results when the components of the "fire triangle" come together. Chemists use the word "combustion" to refer to the oxidation reaction that produces fire. Combustion generates light, heat, gases, and soot.
Most combustible fuels begin as solids, such as wood, textiles and plastic. Any fuel must be in a gaseous state (so that it can react with oxygen) before a fire can occur. Heat from the fire ignition source, and later the fire itself, decomposes solid and liquid fuels, releasing flammable gases called volatiles. In a wood fire, gases given off by the decomposing wood enter the flame, combine with oxygen from the surrounding air, and ignite. The heat from the flame decomposes more wood, thus adding more flammable gases to the flame and creating a self supporting process.
Most common fuels consist of compounds containing the elements carbon and hydrogen. Fuels often also contain oxygen, nitrogen, chlorine, and sulfur. Cellulose is the main combustible compound in wood, paper and cotton. Cellulose contains carbon, hydrogen and oxygen. Plastics that burn such as PVC, nylon, and polyurethane, are composed mostly of carbon and hydrogen.
You can start to see now, the "chemical soup" being created from the chemical chain reaction involved in a fire.
Different kinds of fires burn at different rates - one fire may smolder, while another may quickly use up its fuel. The rate at which a fire burns depends on the composition of the fuel and its surface area, and the amount of oxygen available. Most plastics burn at twice the rate of cellulose fuels, because of the different chemical reactions involved.
The products that a fire releases, and the rate at which it releases them, depends on the fuel and the fire's burning rate. For example, most plastics have a burning rate of about 2.0 times that of wood and about 2.5 times an effective heat of combustion than wood. Therefore, overall, plastic fires produce heat at about 4.5 times the rate of wood fires, under similar conditions. It is these kinds of synthetic materials that greatly alter the chemistry of fire and adds to the creation of the "soup" that adds to the damage, well beyond that of visible fire damage.
The amount of soot produced by a fire depends on the type of fuel, the fuel's burning rate, and the conditions that are present. Most plastic fuels produce up to three times more soot than wood.
Recommended reading, when this segment was first presented, it did not include the following excellent article. It is a 10 page paper on the "Chemistry and physics of fire behavior". It is a bit technical (for me) in areas, but does have a fascinating history of a fire sequence in a room and its three developmental stages. As well, the toxic and corrosive gases are listed and discussed. I suggest the following article is a useful resource to add to your "tool box".
Go to www.cfmoa.org/members/firearsonmanual/unit2
As you will note in the article, at various times in the fire cycle, gases will accumulate and at other times follow heat flows and air patterns present in the structure.
Therefore, lets consider the presence of a grade level kitchen fire, the toxic gases will spread rapidly both horizontally and vertically. Once these gases cool they condense and dry; that is not to say they "puddle", but they do leave their gas state, condense, and mostly evaporate and dry leaving their chemical residue. They are deadly to life when they are a gas, but become damaging to property when they condense.
You can not look at a painted gyprock wall and call the "smoke stain" you see a corrosive chemical stain. Lets say we are down the hall, four rooms away from the kitchen; all you will see is normally dry but smoke stained gyprock. This area (for example) was not directly affected by the fire's heat or the water used to extinguish it. However, it may be damp, with the effects of the humidity from the volume of water used in extinguishing the fire. You can add any amount of variables to a scenario, but it would soon take us away from directly dealing with the effects of the condensed gases.
I suggest you avoid whenever possible, touching with your bare hand, smoke or fire damaged items. If you were involved in a high value and large dwelling, I would tend to take cotton swab wipes of the smoke damage wall surface - progressively by room and retain them in film canisters or pill bottles. They may or may not be of value for testing later, relative to their composition and reaction with the surface they are on.
Where the fire involved a lot of plastics or synthetics, you will likely be able to easily stick your finger into a section of gyprock (about shoulder height or higher), even in rooms one or two removed from the fire and water, and on gyprock visually only carrying apparent smoke damage that at first glance you thought was okay for a wash and repaint.
When that severity isn't as present in that same room scenario, a step ladder should be used to comfortably reach the general area where the ceiling and wall join. Often, as the heat of the fire dispersed, it was still sufficient one or two rooms away (and certainly most times in the adjacent hall) to breakdown the composition of the paint (more likely "flat" type paint). It will likely not be visibly peeled or blistered, but you may be able to lift it with your swab, like chalk off of the classroom boards.
Please bear in mind that these descriptions are general, but have been encountered. Each fire has its own unique fuels and each structure layout will determine heat and air flow patterns. The severity of the scenarios described will be lessened or intensified depending on so many things unique to what happened.
Dealing with contents, many files are reopened months later. Often electronics, not visibly affected by fire or water, nor laden with soot; are found to malfunction. During the adjustment you may have been satisfied, and in fact tested a number of items after they were "cleaned". But, it was only the exterior that appeared "dirty". The corrosive gases can easily penetrate the joints of component housings or casings and settle on the wiring a/o the actual electronics. This is the invisible and often latent damage that will add to a claim. I encourage adjusters and insureds to have all electronics removed that were in a room that has visible evidence of smoke damage on the walls or a reasonable smearing of soot on the casing of the products; to an authorized manufacturer's repair depot for an internal examination and cleaning.
Clothing is another large concern, more so with other than 100% cotton garments. Again, the synthetics are more prone to reactions with the corrosive elements that have settled after cooling, and can easily deteriorate from those affects. Fire damaged clothing should be discarded as soon as the adjuster is comfortable with the inventory of it, while smoke damaged clothing should be removed from the structure as soon as possible and processed by a drycleaner specializing in handling such garments.
The same considerations and concerns apply to carpets, with equal residue exposure differently affecting wool, wool blend, or pure synthetic floor coverings.
You will get to some rooms , far enough removed from the fire or flow patterns that only minor "smoke residue" is noted higher on the wall, and almost not noticed or noticable down to the floor and mouldings. To avoid angry and frustrated insureds months later, do not forget to consider the removal of the floor mouldings when the wall is washed and repainted. The smoke, soot and carried gases that later condense get into the smallest cracks and joints; only to surface as odor months later on a wet or damp day.
Dependant on your carrier and their instructions, you a/o they should have qualified and experienced restoration people that can be utilized. I do not think it is the adjuster's job to deal from start to finish with the scenarios I have mentioned. You must be aware of what could happen, be able to recognize different types of less obvious damage, and know how it should be properly dealt with. This all involves you "managing" the file, and that involves knowing what proper resources to use or refer to, and be able to discuss it professionaly with that resource source.
I hope this has amplified this topic sufficiently, but as well specifically to the questions raised. More concerning the damage aspects will be explored in the next chapter, "Building and contents fire loss considerations"; once this chapter is concluded. |
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CCarr
Canada
1200 Posts |
Posted - 09/30/2002 : 22:02:47
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Just a note to advise on the status of the situation. As we can see, Roy has now restored from backup about 2/3 of the segments, leaving the last four to yet be restored or re-entered.
When I know from Roy that he has restored all he can from his backup, I will then have to manually re-enter the remainder of the segments from my printed copies.
Then, I will enter the first segment of the next section. |
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CCarr
Canada
1200 Posts |
Posted - 10/01/2002 : 11:24:46
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(* reprinted from the original 09/24/02 text *)
Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
(3) NFPA 921, Guide for Fire and Explosion Investigations
The NFPA is the National Fire Protection Association. This is an international association, with its head office in Massachusetts. It is an international code and standard writing organization. Although the NFPA has no power or authority to enforce compliance with their codes and standards, it is highly respected, and its publications are considered reference sources from my insignificant desk up to and including national and international theaters of law.
The first edition of this particular guideline was issued in 1992. Numerous updates over the years have led to the current 2001 edition. I don't have my own copy at home, but source it at a local library in the reference section or from a colleague active in this field. Amazon.com sells the 1998 edition for $33.25. It is a copyrighted publication, and doesn't seem to be on the web for public reading.
NFPA 921 is designed to assist anyone who is directly or indirectly involved or responsible for investigating and analyzing fire and explosion incidents, and rendering opinions as to the origin, cause, responsibility, or prevention of such incidents.
This guide is comprehensive, covering the methodology of investigations, fire science, fire pattern interpretations, planning the investigations, recording data from the scene, handling of physical evidence, determining origin of the fire and the cause of the fire; and more.
The basic methodology recommended in chapter 2 is the use of the scientific method, which is a systematic approach to investigating the fire. The scientific method (a degree in fire science is not required) requires that after collecting data, analyzing the data, and developing an ignition hypothesis, then testing of the hypothesis is required prior to selecting the final cause of the fire.
Testing a hypothesis can take many forms. The most common is deductive reasoning. Using this approach all other reasonable origins and causes for the fire should be eliminated. The investigator compares their hypothesis to all known facts, and if the hypothesis can not withstand an examination by deductive reasoning, it should be discarded as not provable, and a new hypothesis tested.
If the hypothesis being tested can not withstand the test of deductive reasoning, and other reasonable origins and causes remain, but none of which are provable; then the fire cause should be listed as "undetermined". Chapter 2 - Basic Methodology - is a fundamental chapter of the guide, and adjusters involved with fire investigations should read and become familiar with it.
Another key chapter is #16 - Cause Determination - the cause of all fires should fall within one of these classifications - accidental, natural, incendiary, undetermined. Use of the term "suspicious" is not an acceptable level of proof for making a determination of cause.
This guide has such an importance to all those exposed to fire losses - field adjusters, carrier claims management, investigative authorities, C&O experts, and lawyers; that I feel a listing of the chapters is warranted to give you another perspective of the depth of this guide.
The 25 chapters of the NFPA are as follows; introduction, basic methodology, basic fire science, fire patterns, building systems, electricity and fire, building fuel gas systems, fire related human behavior, legal considerations, safety, sources of information, planning the investigation, recording the scene, physical evidence, origin determination, cause determination, failure analysis and analytical tools, explosions, incendiary fires, fire and explosion deaths and injuries, appliances, motor vehicle fires, wildfire investigations, management of major investigations, reference publications.
In summary, this book / guide contains a lot of excellent information, and recommended techniques for documentation of the fire scene. Lawyers use it extensively to cross examine the investigations of both adjusters and experts, to determine if all the steps in the guide have been followed.
Adjusters involved in adjusting fire claims, would be well served to be familiar with this guide, and then at least have ready access to it thereafter as required. You can count on a litigator having one and being well versed with its contents.
An adjuster should ensure that when retaining a C&O expert, that the person being retained is familiar with this guide, and will conduct a systematic fire investigation within the parameters of this guide, that will withstand a challenge under cross examination.
Recommended reading for this segment is found at your local library in the reference section. A good first step would be to find a library that has the NFPA 921, that you can access as required. Reviewing the guide and measuring its contents against your goals as a fire adjuster, you can then decide on the importance of owning a copy. |
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CCarr
Canada
1200 Posts |
Posted - 10/01/2002 : 16:31:51
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(* reprinted from the original 09/24/02 text *)
Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
(4) Cooking fires
NFPA reports indicate that cooking equipment fires remained the leading cause of dwelling fires, and ranked 5th in all home fire deaths, and property damage. According to their latest available statistics, there was $419.1M USD in direct property damage from USA residential cooking fires, in 1998.
Unattended cooking was by far the leading cause of residential cooking equipment fires and associated losses. Other human errors, such as falling asleep, inadequate control of open flame, failing to turn off the equipment, and placing combustibles too close to the heat source; also played a significant role in these fires.
Equipment related mechanical or electrical failures (part failures, leak or break) followed in quantum of causes.
NFPA advises that stove fires continue to dominate the home cooking fire point of origin.
It is time to add some more terms that an adjuster handling fire losses, will either hear being used or will be required to use.
Accident - an unplanned event, that interrupts an activity, and creates an unexpected result
Cause - the circumstances, conditions, or agencies that bring together a fuel, ignition source, and oxidizer (such as air or oxygen), resulting in a fire or a combustion explosion
Proximate cause - the cause that directly produces the effect, without the intervention of any other cause
Area of origin - the room or area where a fire begins
Point of origin - the exact physical location where a heat source and a fuel come in contact with each other and a fire begins
First degree arson - willful and malicious burning of a dwelling by another. The dwelling is occupied at the time of burning. This is a class'D' felony
Second degree arson - willful and malicious burning of a dwelling by another. The dwelling is unoccupied at the time of burning. This is a class'G' felony
Exposed surface - the side of a structural assembly or object, that is directly exposed to a fire
Char - carbonaceous material that has been burned and has a blackened appearance
Accelerant - an agent, often an ignitable liquid, used to initiate or speed the spreading of fire
Combustible liquid - a liquid having a flash point at or above 100 degrees F
Flammable liquid - a liquid having a flash point below 100 degrees F
Ignitable liquid - any liquid or the liquid phase of any material that is capable of fueling a fire
BLEVE - boiling liquid expanding vapor explosion
Flash point of a liquid - the lowest temperature of a liquid, as determined by specific labratory tests, at which the liquid gives off vapors at a sufficient rate to support a momentary flame across its surface
Fire spread - the movement of fire from one place to another
Failure - distortion, breakage, deterioration, or other fault in an item, component, system, assembly or structure; that results in unsatisfactory performance of the function for which it was designed
Failure analysis - a logical systematic examination of an item, component, system, assembly or structure, and its place and function in a system; to identify and analyze the probability, causes and consequences of potential and real failures
Fire analysis - the process of determining the origin, cause, development and responsibility, as well as the failure analysis; of a fire or explosion
Fire Investigation - the process of determining the origin, cause and development of a fire or explosion
The investigation of cooking fires (a.k.a. the kitchen fire) has three fundamental steps. First, the process of examining the burn patterns to determine if the fire originated at the cooking appliance. Refer again to the article recommended in the addendum to "understanding the chemistry of fire" for a good explanation of basic fire patterns. Second, examining the switches of the appliance to determine their status at the time of the accident. Third, examining the adjacent debris to determine whether the remains of any pots or pans may be present relative to the appliance usage. This last step is required to help you determine if in fact careless cooking was a cause of the fire.
Now, each of these three fundamental steps when undertaken may lead you in other directions, and is dependent on the specifics of the circumstances and conditions present at the time of loss, and those factors at the time of your attendance. However, they are the core steps in a reported cooking fire investigation, the results of which could / will take you down other avenues of pursuit.
If the results of your investigation are not clear, or if you fail to find the appropriate conclusions following the second a/o third fundamental step, a parallel route of investigation should be pursued concerning the cooking appliance / equipment. This could include your investigation of the equipment history, installation, maintenance and "housekeeping" practices. An adjuster is always concerned about subrogation potential on any loss, but at this point you should have a greater focus of that issue, as you pursue the above items.
Subrogation will be dealt with in the next segment in more detail, however as an example, the rise in home renovation projects, has resulted in an increase of issues relative to subrogation. A built in wall oven, if not installed in compliance with applicable codes and manufacturer's instructions, can cause a fire almost as easily as a "zero clearance" fireplace installation not installed in compliance with applicable codes. This type of example may be an instance where the use of public authorities or the retaining of an outside expert is warranted. This type of example, where possible code infractions and installation deficiencies occur, can lead to subrogation against equipment suppliers and installers.
Another example of cooking fires, that tend to result in a much greater devastation and loss, is from "outdoor" cooking appliances; and in particular the propane fired BBQ.
The cause of this type of fire is often a failure, due to a deterioration of the burner, or the improper assembly of the item - in particular the hose and fittings connecting the tank to the burner. Add to that a set of circumstances and conditions at the area of origin, that normally allows a serious fire to result. Too often this cooking appliance is not only unattended while on, but out of sight. Also, my exposures to these fires has usually found the appliance adjacent to an exposed combustible surface, that allows for easy spread of a fire from the point of origin.
In regards to the above paragraph, it was "worded" purposely as you see it; splashed with an abundance of the terms set out earlier in this segment. During your investigations, you will have conversations with FD and PD officials, other public and regulatory authorities, and retained outside experts. They will not tend to say, " .... what happened here was the BBQ was worn out or old or broke .... and it was sitting beside the wall ....". They will use the language of their profession, " .... cause, deterioration, failure, exposed surface ....". That is the point of introducing terms that are commonly used in this venue.
Finally, it is important to act quickly on such claims, in order to document the evidence in its early stages, prior to it being disturbed. This will allow you to chart your own course of action and the direction that you take on resolving the evolving issues of your investigation and the claim.
Recommended reading for this segment is at www.claimsmag.com
Go to August 2001 - "The first 48 hours". This is a good article worthy of study, with the seeds of its content found in its first two sentences; " .... when a claim ends up in appraisal or litigation, the seeds may have been planted early in the claim. The first 48 hours following a loss are unique ...." |
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CCarr
Canada
1200 Posts |
Posted - 10/01/2002 : 19:05:42
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(* reprinted from the original 09/25/02 text *)
Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
(5) Subrogation
The most common application of the doctrine of subrogation occurs when an insurer pursues a claim against a third party for their negligence that caused the insured damage, for which the insurer has provided indemnity. The insurer has no right of subrogation, until they have paid the insured loss.
Lets first begin with some more terms that are usual to communications, both verbal and written; when negligence and subrogation are pertinent issues.
Subrogation - the right of a person or entity to assume a legal claim of another
Subrogee - a person or entity who assumes the rights or claims of another, against a third party
Subrogor - a person or entity who transfers their rights or claims against a third party, to another
Tortfeasor - a person or entity who commits a tort (a wrong)
Negligence - the failure to exercise the care of a reasonably prudent or ordinarily careful person or entity in the circumstances; a breach of duty to act with care appropriate to the situation and the relationship of the parties, so as not to cause harm or loss
Contributory negligence - a wronged person's (normally a plaintiff) failure to exercise due care, along with another person's (normally a defendant / tortfeasor) negligence contributing to the wrong
Comparative negligence - the apportionment of the fault when both the plaintiff and the defendant contributed to a loss, by failing to exercise the required degree of care
Gross negligence - negligence beyond the ordinary; a reckless or wanton disregard of the duty of care towards others
Civil law - the legal principals, rights and remedies that apply to the private relations between people, as opposed to criminal law. A private wrong is a tort, while a public wrong is a felony or misdemeanor
Common law - the legal principals, rights and remedies that are based on Anglo - American custom and prior court decisions
Res ipsa loquitur - a legal doctrine, that given the circumstances and the undisputed facts, the tortfeasor's negligence is presumed. It is latin for, "the thing speaks for itself".
Statute of limitations - a law limiting the time within which a claim may be asserted in court
Insurable interest - any interest a person has in property that is the subject of insurance, so that the damage to the property would cause the insured a financial loss or other tangible deprivation
As has been previously stated, a fundamental goal - and in fact principal - of any loss investigation, is to determine the cause. A collateral goal within the effort to determine cause, must be to establish if any third party is in any way or degree at fault for the damage. This certainly is paramount in any fire investigation, but in my opinion is equally important; regardless of the peril.
The right of subrogation is derived from the insurer's payment of indemnity. The insurer can then enforce the rights of the insured. The insurer has no direct rights of its own to enforce. The insurer must advance any subrogated claim in the insured's name unless the rights of action has been assigned to the insurer, or a statute permits the insurer to bring an action in its own name. Again, since the rights are derived, they would come with any "baggage" found in the insured's activities relative to the accident. That is, any defense that is available to the third party as against the insured, is generally also available to the third party as against the insurer's subrogated claim. That is, any contributory negligence the insured had to the loss, can and will be used by the third party to establish a comparative negligence.
Insureds may suffer losses for which they receive a complete or partial indemnity from the insurer. Many of the rights of an insured and the insurer depend on whether the indemnity is complete or partial (exclusive of any deductible). In many cases, where the indemnity paid by the insurer is not a complete one, controversies arise over the rights of the insurer and insured, to the proceeds of any recovery from a third party.
Normally, two things happen with claims at this point in their history. Many carriers have established subrogation units within their claims departments, where the file is referred to once indemnity has been paid and there is sufficient investigation revealing a possibility of negligence by a third party. Often these units are staffed with intermediate to senior adjusters, with more focused paralegal training; and their direct supervision comes from the inhouse claims legal department if such exists. Secondly, most carriers apply "common sense" to apportionment of recovered monies and apply a pro rata distribution. However, you should not only be aware of what goes on after you report and how your report is utilized; but should become familiar with subrogation provisions contained in the subject policy of your loss.
Perhaps of interest, but its only application that I have seen is after an insurer denial of a total loss claim - HO3 Section I, Conditions, #12 Mortgage Clause - (a similar wording for this aspect, as I am used to in my area) where the insurer states their assertion of their rights of subrogation once they have paid the mortgagee; in fact then giving the insurer the right of action against the insured for the covenants found in the mortgage. The first time I was exposed to this, I found it quite an unusual position to be in; with so many possible apparent contradictions surrounding the file. The investigation revealed that the insured (most likely) set fire to and destroyed his home. The crown attorney did not feel the evidence was sufficient enough to support a criminal charge that would withstand the test of "reasonable doubt". Not having paid the claim following the submission of the insured's Proof of Loss, we waited to be sued in a civil action by the insured, which we felt we could successfully defend under a different burden of proof than that of criminal law and would in fact counterclaim with our newly acquired subrogated claim. The mortgagee carried a mortgage clause on the policy and could care less about the civil or criminal actions brought by or defended by the insured. The mortgagee still had a valid claim for their interest regardless of the insurer denial of the claim to the insured. Paying out the mortgage, allowed the insurer to assume all rights of the mortgage, so now the insurer was going after the insured for the mortgage payments a/o principal and interest.
Anyway, back to subrogation and its "normal" address in the policy. In the HO3, Section I&II Conditions, #8 Subrogation, is where the insurer asserts its rights, and demands an insured to sign an assignment if requested. My experience with subrogated rights and those claims advanced against a third party has been solely in Canada. However, I believe there is a continuity of practice in most aspects. As I recall, well over 90% of subrogated claims advanced by an insurer were against third parties that were insured, whether that be auto PD, pure casualty via a CGL, or personal liability under a homeowners policy; I will leave the more complex E&O and D&O out of this explanation. As a matter of practice, responding liability adjusters did not ask for nor were they sent any assignment papers; simply both insurers knew from where the right of the demand came from. Often, as part of the subrogation papers (substaniation of the paid loss) from the subrogated insurer to the adjuster representing the third party, a completed Proof of Loss was attached, and the Canadian version contains an assignment clause. The point here, is be aware of any specific language relating to subrogation in the policy you are dealing with.
This is an appropriate time to advise that even though you may have indemnified your insured with replacement cost values, you will only receive actual cash value from the third party or their insurer on reimbursement of your indemnity payment. You have paid RC due to a contract wording; but due to principals in law you are only entitled to ACV from a negligent party. You will find a worthy third party liability adjuster will scrutinize your claim quite closely with a "hardened" or "strict" application of all the principals of depreciation. They have no obligation or interest that you may have exercised a "liberal" adjustment in determining ACV, they will strive to determine the "true" ACV.
When you are considering subrogation possibilities - the collateral goal to determining cause - you want to "identify" the root of the possible negligent party as detailed as possible.
Consider the generic and inadequate phrase found too often, when otherwise good effort has been made by the adjuster and he/she reports on subro as follows; " .... the insured's GE wall oven, purchased at Sears and installed by a handyman likely was the cause of the fire ....".
Again, think what happens to this file after you are "done" with it. Someone will inherit it to pursue subrogation, because you identified a potential (leave out of this example the "how" and by "whom") issue of negligence. The above generic and inadequate statement will cause the file to be sent back to the handling unit, out of the subro unit, with a terse note advising that the information is useless to pursue. Now, I only want to address "identity" here, not elaboration of cause theory and other critical components of your investigation that allowed you to make the above conclusion.
It is not my intent or wish to turn this segment into a primer on liability or a study of negligence. Those two issues, even in basic form, would require a lot of discussion and study.
In the example provided above, the subro exercise can not commence, then have any likelyhood for success; unless you provide the following.
The wall oven - was it there when the insured bought the home, or purchased since their ownership (it is the insured's either way, isn't it)? What type, model, serial number - all data available from the rear label on the oven? These numbers and data will pin point for the subro people and the third party a lot of critical data regarding where, when and by whom manufactured. Purchased at Sears, where? Who is the handyman, is he part of a company, is there a bill for the oven or the services, where can the handyman by found today? You can cut this pie in more pieces yet, but the point is clear - identify your product, service or person / entity, with as much detail as you can acquire. It will pay back in dividends.
Finally, you will note I have "Satute of limitations" as one of the terms for this segment. You should prepare a sheet of paper for the area you do your claims in that notes the time limitations for actions to be brought for various types of claims. This will not likely directly affect your efforts as the file is likely out of your hands by the time any applicable limitation approaches. But you should be aware, and I always thought it was a positive step to mention as a concluding remark in the subro section of the reporting (when subro was identified) what the applicable statute was limiting the time for an action to commence against the particular third party you may have identified.
One thing adjusters tend to loose sight of during an investigation, or anywhere in the first week of the claim, is "notice period". It certainly can add a bad taste to your otherwise good efforts, if not considered and acted upon, where appropriate. There are not a lot of instances that I can recall where "notice period" was a critical factor in residential fire claims. I do recall one, a total loss fire, where the applicable rural municipality had a volunteer fire department to respond to fires in its catchment area. In that particular case, it was difficult to prove and even more of an exercise to quantify, but we started to question why the response time was 2.5 times longer than "average". We soon determined causes of the response delay were unattended radio calls for help, inaccessible equipment and improperly maintained equipment. Under the Fire Protection Act for the applicable province, certain requirements and duty is placed on a municipal fire service. That is all well and good, but, under municipal liability in that jurisdiction the "notice period" for claims that are going to be advanced is 6 days. I recognize I am speaking outside of your jurisdictions, but, you should be aware of "notice periods" for different entities you may wish to later claim against in your work areas. The insurer could not later proceed with a subrogated action, if appropriate and required notice was not accomplished in the time period stipulated. |
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CCarr
Canada
1200 Posts |
Posted - 10/01/2002 : 21:02:15
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(* reprinted from the original 09/26/02 text *)
Fire Scene Investigations - Tips & Techniques
(B) TECHNICAL PREPAREDNESS
(6) Specific recommended reading
This segment brings the end to another section. I hope I have laid some ground work, some foundation, and have caused you to think about how you approach your handling of any claim.
I hoped in the first section, to put some ideas on the table that might help your productivity; with some thoughts on getting organized, by suggesting that the tasks we do in our function is all part of our job or providing customer service, and how we could be more effective at that by recognizing the "mind set" of the insured when we arrive at their door. Finally, to understand that negotiation takes many forms in life and work; but that in both those venues if we have both an open and a prepared mind, with a focused approach including a knowledge of our adversaries and customers, we will have a greater confidence to accomplish our goals.
In the second section we explored the basic science of fire. It is truly a dangerous and devastating peril, but its scar leaves a story that is part of the puzzle we will solve. There is one more article concerning a fire's "fingerprints" that I would recommend you review and add to your "tool box". Go to www.claimsmag.com, June 2000 (about 1/2 way down the list) - "Thermal pattern analysis". I also hope that on your additional review, we will see how the structured process of Project Management will contribute to your effectiveness and productivity on all your files. I can not overstate that the NFPA 921 Guide is a critical tool for those that want to succeed with the handling of fire claims. The segments on cooking fires and subrogation, were intended to blend with each other to a certain extent, so I could establish the importance of the collateral goal to cause - was some third party negligent for what happened?
In concluding this segment and section, I would suggest that you review all the terms that have been brought forward to this point. It is the language of this niche, of this profession; you will both hear others you encounter use these terms and in time you will come to use them in your written and verbal communications.
The articles I have mentioned for recommended reading in each segment, for the most part, are suggested for their reference value; and perhaps they should be printed and kept in your "fire" binder for review as required.
Finally, but again, the NFPA 921. Please take the time to review one at your local library, get familiar with how it is laid out and deals with its material. It is the universally accepted "bible" for fire investigation. Your comfort level with this guide is a fundamental key to your success as a fire adjuster.
As I said in another forum, on another day, to achieve a sustainable competitive advantage in your market niche, you must have a plan that is focused on providing consistent service and expertise to support it. These superior strategies are generally based on strengths or towering competence in one or more functions that represent a unique source of value to a client.
If property claims are your niche, fire claims can be a rewarding and stimulating function, once you develop strength and competence with this type of claim. A competent fire adjuster is, without doubt, a unique source of value to a client or employer. |
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Fire Scene Investigations ~ Tips & Techniques
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