Tejas, I am rejecting your post.

Please make sure that you do not use run on sentences.  You need to capitalize the first letter of the first word in your post.  Please don't use exclamation marks, it does not look professional.  Your last sentence is not a complete sentence.   Please take time out of your day and make these corrections even though the inside adjuster could care less about any of it.

Sorry to nitpick your post and to increase your work load, but my job is to find errors that do nothing but kill productivity.   Have a nice day!

I don't think I've had any free time on my hands since I became a file reviewer. How do I get that job, Peter?

Here's my philosophy. If I disagree with a coverage recommendation sent me by an IA, I don't send the file back to the IA and ask him or her to change their position. I simply note in my file why I disagree, and (usually) call up the IA or email that IA and walk through the policy with them. If I disagree with an estimate, I may ask for a rewrite because I want something to send to the insured. If I had the same software program, I might ask for the archive and change it myself. I'm aware that, in today's market, some file reviewers wouldn't know how to write an estimate if it smacked them in the face. I am not one of those. If I want something changed, there's a good reason for it. Trust me on this. My company pays all files on time and expense. It's not a waste of your time to rewrite the estimate if I ask you to do it. And it doesn't cost you money. Bababooey, remind me not to assign you any claims. I prefer to work with people who like working with me and think I am part of the solution, not part of the problem.

Now...the file reviewer who once asked me to draw a diagram of a rectangular bedroom....that was a waste.  I told her, "the room is rectangular and the measurements are on the estimate."  She told me she needed a diagram.  I drew a rectangle, wrote in the measurements, emailed it to her.  Took less than a minute, but still a waste.

It has many years ago in another century when I was a desk jockey. At times as an examiner, I had fille loads over 700 claims, other times I had lots a free time and could make a pain out of myself. The last 20 years have been in the field and once in a while I realize that I was occassionally a real jerk. Many that could be a topic. I did and said things when I was learning that still make want to hide in a closet and bang my head against the wall.

Actually, my friend, File Reviewers work IS file reviewed. When one is spending Mr Big's money, it's a good bet Mr Big will be checking all up and down the line to ensure the money being squeezed out his bank account is no more and no less than what needs to be spent. And whether those persons are two feet or two thousand miles away, if Mr Big's expert minions smell a dead rat in the file, rest assured everyone who has touched that file will be nitpicked. You are not alone.

As one of our esteemed folks here remarked recently, 'Adjusting ain't what it used to be'. Regardless of what the public image may hold, we no longer have the omniscient power of fiduciary disbursement as in the days of yore. Much like the military, with the advent of intense communication and the internet, those above us micromanage our activities down to the nth degree. For those fortunate few who's employers have yet to spend money on this pervasive trend, I am a bit jealous of your continued semi-independence of actions.

I respectfully suggest that all our sensetive male egos be gently placed in a mayonaise jar on the top shelf of the pantry when we are packing our kit to go on storm duty. Let us all recall the famous adage of that delicate flower of Pilot femininity, Kay Hahn, who constantly intoned, "On this storm that is the way it is and everything is subject to change".

Ol' Ghost



 

Posted By Ol' Ghost on 26 Nov 2009 09:59 AM
Please allow me to restate the obvious. It's a simple matter of economics. The field adjuster is an independent businessman, he/she is a company. When the field adjuster receives the file from the vendor, who is a business, the vendor wants a sellable product from the field adjuster so they can resell it to the carrier, who is the ultimate source for the money to be paid to the vendor and then to the field adjuster. Are we all in agreement so far?

Yes, and it is this point that should create a renewed perspective when it comes to writing up our claims.  As independent businessmen, we have an extra load on our plate to do things that the ordinary staff adjuster or examiner is just not familiar with.  As gracious and diplomatic assistants in facilitating the closure of claims, it is up to us IA's to be extremely careful in how we approach corrections, or we'll not see anymore assignments.

I have one carrier where the guidelines are spelled out with the fee schedule, but each examiner has their own unspoken sub-criteria that after some time, I've finally figured it out.  One examiner fussed at me because I didn't recommend cleaning contractors.  With this one, I learned that my estimates are no longer limited adjustments, but are partial-full adjustments with this examiner.  Another one told me to adjust my agreed price from $105K to $99K so he didn't have to do a large loss report.

This particular carrier has a pretty regular stream of claims.  In an effort to see that it continues, I choose to see corrections as a race and seek out ways to beat the other guy when getting my corrected files turned in.  I also include notes in the file to explain what my corrections are for and/or do.   Yes, you have to swallow your pride- a lot for some carriers, but who said that there was anything noble about being an Adjuster- especially an independent one?  You will be even more successful when you accept and appreciate this role.  It's not glamorous, but it does pay the bills.

From a different point of view.  The examiners only picture of the loss is what you send him/her. Your photos estimate and notes are all he/she has to go on. Now the examiner doesn't know you. So when you cut corners and rush the claim, he/she doesn't get an understanding of what she/he is expected to pay. You may be the must upright skilled and gifted adjuster ever to walk on water, or you may be a three day wonder, 1 week out of 7/11. Unless you file tells the story of what happened and what you are paying why should any examiner just pay it?   

And...here's a nasty little Quality Control secret. After seeing more than a few of a particular adjuster's goofball files, that name begins to be uttered and remembered by the other File Examiners in the room. How often I have sat there ingrossed in a big commercial loss to overhear the grand announcement, " UH-OH! I got another BUFORD file!" For that one poor soul named Buford, he can rightly expect to have to revisit, fix, and justify one whole bunch of line items, diary descriptions, photo captions, grocery lists, lightning affadavits, metal shed dimensions, basic file organization, depreciation, deductible absorption, F9 notes, and all the other little odors stinking up the file. Then, the next Buford file that shows up on another examiners screen is going to be scrutinized more than a little closely. Woe be unto Buford.

Please folks, don't be that Buford. Before hitting the send button, walk away for a few minutes then come back with a freshened mindset and read your file. Edit the goofs, justify why the sun sets in the west with F9 notes, place the captioned Risk photos at the front of that section. Make each file a simple, organized story that explains why the money is being spent the way you think it should be.

You will make more money from not having to rework the file over and over, the Q.C. boys will make less money as we will be laid off sooner, the Insured gets paid quicker so there are fewer phone calls to return. All because the file was fixed before it left your computer. That's the big Quality Control secret.

Ol' Ghost

 

There are good file reviewers and a few lousy ones. 99.9% of my file reviewers have been good and fair.

Then again, I was introduced into adjusting through the hellfire system of Farmers Insurance staff training. I was told they were a hard company to work for and I went into it knowing that - knowing that if I started with one of the "hardest" everything else would be easy. For a year and a half I had every file nitpicked and graded on a 4.0 scale based on accuracy, timeliness, customer service and file control...and everyone's results were posted publicly for all to see. Now not many would take this kind of "abuse" and knowing what I know now I probably wouldn't anymore (especially since the hot girl adjusters could see your scores too and you just KNEW they were judging you based on that) but it made every file reviewer after that look like a kitten.

There was one exception and he was a genuine idiot. I had an agreed scope and price with the carrier and the carrier committed to coverage with the insured and was awaiting my final report (this particular carrier would send their in house adjuster to the site with the IA - go figure). The claim was done and the file reviewer wanted a reinspect because he wanted a photo of a specific type of roof gauge measurement. I explained that the carrier was satisfied and committed to coverage with the insured. He wouldn't budge.  He had to have it his way. I explained to him that by forcing a reinspect after coverage was committed he was pushing the carrier into a position of estoppel. He still wouldn't budge. I resigned my name from their roster and wrote a letter to the VP explaining the legal exposure this file reviewer created for the company and for me. Ego is no place for file review.

Outside of this one idiot I greatly appreciate file reviewers as they have given me a ton of free education on coverage and claim handling. Sounds like you just may be dealing with one too many ego's at the moment Bob.  There's enough good ones out there to spend time on the idjits.

Bobabooey

I am not even sure what are you talking about. From my experience if the QA asks me to change something then I usually just do it and ask for rationale behind their request for my future reference.  In the end they are the ppl that keep me busy and I respect that. I should mention, though, that I have never received any requests that do not make sense, usually, they are all justified. I want to be friends with my branch manager, quality control, and of course, carrier adjusters. More than that, I have one quality control guy, that was one meticulous SOB, he used to send files back to me for little things, like, photographs are not in right order, or some little stuff like that. The way I handled this was not to get bitter and start to exude hubris, like "who are you to tell me" but rather make sure my files are perfect and second I started to call this guy on his phone with all kinds of questions about files. Instead of escalating this thing I tried to use this as an oppotunity to learn and to create a personal tie with one of the people I potentially will be working with. Just lighten up and do what they tell ya.

If given the choice to work with a supervisor who is going to pick at my files or not working at all I will take working 100% of the time.  We all have a job to do, and generally speaking once they have faith in you they will stop with the picking.

Two great post.... I agree 100% you clowns will go back to Home Depot this year or the next... it;s over.

I do not travel on catastrophe storms any longer and will not post in the general section , but will on the Adjusters Den. See you old pro`s over on that site.

They work in the catastrophe circus.

And I thought most of us were on the high wire without a net. Or lion tamers without a chair.  and in the end road kill

Hmmm.  The name on this site is CatAdjuster.org not OldPros.org. 

Maybe it should be changed to ClownsandWorms.org so it better reflects it's true purpose?