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Last Post 02/06/2009 8:08 AM by  jlombardo
Ethical Question for 1099 Adjusters...
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Jud G.
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01/28/2009 1:56 PM
    As a 1099 Adjuster, you are free to work for whomever you want as long as there is no confilct of interest involved for the companies you serve.  This is different than if you were to work as a Staff Adjuster for a company, since you are theirs and only theirs.
     
    What are your thoughts regarding ethical considerations of working as an Estimate Writer or Insurance Consultant for a General Contractor while working claims as a 1099 Adjuster?
     
    I ask this question, because of two things I've experienced in the past year.  One of the carriers I work for has a large number of contractors running around writing repair estimates free of charge simply because they receive the benefit of potentially getting the job (this arrangement is no secret to the carrier).  Secondly, I've been approached with the opportunity to write estimates for a GC on an occasional basis.
     
    There are lots of 'what-ifs' and 'but-fors' that this question does not address, so I'm sure they will come up down below.  Please, what are your thoughts?
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    JimGary
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    01/28/2009 4:30 PM
    Jud, I am sure this topic will draw some fire, but in my opinion, I do not have a problem with it. It all rests on your own values. Will you write and estimate any differently for a contractor or insurance company? In auto, I have written for carriers, and body shops. My estimates are the same with regard to covered damage. The same goes for property, I have reviewed estimates for friends and helped with their claims settlements. I draw the line at dealing with the adjuster, but I am happy to help guide them if shortfalls exist in the estimate. I have also helped a local newcomer to the roofing biz learn to write estimates, (that was gratis). The problem is, for many this can lead to stepping over the line. So it is a slippery slope.

    JWG
    I know the voices aren't real, but sometimes they're right!
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    BobH
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    01/28/2009 5:12 PM
    Posted By Jud Gardner on 28 Jan 2009  
    What are your thoughts regarding ethical considerations of working as an Estimate Writer or Insurance Consultant for a General Contractor while working claims as a 1099 Adjuster?
    I was given that opportunity last year, and thought about it because I needed the work at the time. 
    I decided not to do it.  I have done claims in the same area that I live for over 15 years, and bump into the same contractors.  I decided that if I "got too friendly" with a contractor, had received payment from that contractor, it would taint my "neutral" position if I was doing claims for an Insurance company and that contractor was called to the site by the Insd from the Yellow Pages ad.
     
    People tend to jump to conclusions, and often not in your favor.  Once I had an Insured who was a really nice guy, he was a developer, and a torrential rainfall caused a "mud-flow" from his large construction site to the road below.  The claim was eventually denied, and he took it like a man, understood the policy didn't cover it, really rare, decent human being.
     
    Years later I get a claim where he is the claimant, and I mention to the claims examiner that this guy was a really nice guy, I had met him before, and was that a problem (she said it was OK).  Well the Insurance company ended up denying this guys claim (long story) and essentially called the claimant a liar, yet their own Insd had changed his story in front of 4 people, but they all worked together so I end up looking like the "bad guy" who is siding with the claimant, who I knew - that grew into accusations and stupid questions like "did I play golf with the guy" etc.  (no).
     
    That claim may still litigate, as the developer did not get treated the way he felt he should have.  I can only imagine going to that deposition, and having to explain if I had worked for the guy in the past (I hadn't) or taken money from him in the past (I hadn't).
     
    So when this other friendly water-fire damage contractor calls and says he is swamped and needs help writing large fire estimates, I just did not want to get involved with anything other than "arms length" negotiations with future claims. 
     
    You want to be able to tell the homeowner that his contractor estimate is out of line (if it is) and if the Insurance company isn't going to pay more than their own estimate, then he may want to shop for another contractor.  No Strings, no baggage, no ammo to be used against you.
    Bob H
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    okclarryd
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    01/28/2009 9:20 PM
    I look at this kinda like being an insurance adjuster and a pubic adjuster at the same time.

    Even if it's in different states, and even if I think I am totally objective, it's probably not so. And, it isn't perceived so, for certain.

    No body wears a grey hat; they're either black or white in this business.
    Larry D Hardin
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    Jud G.
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    01/30/2009 4:33 PM

    Wow, insightful replies all of you.  It appears that based on these responses, I could substitute the issue of 'the role of work' in with the issue of 'accepting gifts'.  Good intentions for justifying the acceptance of a gift (from an insured, GC, etc.) would be that you'd be objective with the estimate anyway.

    What difference do you see between those two?

    Larry, it looks like you hacked into the rough draft for my original post with your comment on the IA and PA at the same time.  I encountered a fellow on a Gustav clean-up claim this past season that is a GC in Louisiana, Adjuster in FL, PA in Texas, and an Environmental Engineer (mold guy) everywhere else.  He used to be a GA with GAB.  He was very polite, talkative, and boy, his water was murky.

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    ChuckDeaton
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    01/31/2009 9:54 AM
    Cobbler stick to your last. Either you is or you ain't. If you are an insurance adjuster, fine, but being an insurance adjuster, a estimate writer and a quasi-PA is going to cause a sticky situation.
    "Prattling on and on about being an ass with experience doesn't make someone experienced. It just makes you an ass." Rod Buvens, Pilot grunt
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    katadj
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    01/31/2009 10:27 PM
    "Unto thine own self, be true" as stated by the immortal bard,Mr Shakespear.

    As Chuck stated, you is what you is.
    "Anyone who has never made a mistake has never tried anything new... Albert Einstein"
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    BobH
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    01/31/2009 10:58 PM

    Posted By Jud Gardner on 30 Jan 2009
    ... I could substitute the issue of 'the role of work' in with the issue of 'accepting gifts'.  Good intentions for justifying the acceptance of a gift (from an insured, GC, etc.) would be that you'd be objective with the estimate anyway.

    What difference do you see between those two?

    I am of the opinion that "working" for a General Contractor (even if limited to 1099 type "piece work" of occasionally assisting with estimate writing) is a bigger deal than accepting gifts.  And accepting gifts is not something I encounter much, but I acknowledge that it is a  huge "no-no" for many carriers and vendors.

    You may recall the Citizens of Florida training (song and dance) that quizzes you if it is OK to accept a Coke from Insd during inspection (no).  One of the training things I did for a large Carrier recently had a similar theme, and it comes up on the "ethics" portion of various CE classes.  They want us all to be saints, and if they told us - then at least it limits their liability if one of the pack goes astray.  At least they told him not to.
     
    I personally worked "across the table" from 2 adjusters during the 2005 storm season that both ended up going to jail.  You may have seen the headlines, they were "poster childs" for anyone's anger toward bad adjusters. 
     
    They had a restoration company out of state, came in as "adjusters" and then brought in workers to do restoration... charged Insureds credit cards before claim amounts were approved my management, portions of the estimate not covered by the policy, etc.  It was an extreme example of the "gray" area turning to "black" on a conflict of interest.  They were not just doing their job they were paid to do. 

    Politicians got away with murder while these 2 got paraded around to show that laws were "being enforced".  Really bad PR for the rest of us doing our jobs without any conflict of interest.


    Posted By Jim Gary on 28 Jan 2009 
    ... I have reviewed estimates for friends and helped with their claims settlements. I draw the line at dealing with the adjuster, but I am happy to help guide them if shortfalls exist in the estimate. I have also helped a local newcomer to the roofing biz learn to write estimates, (that was gratis). The problem is, for many this can lead to stepping over the line. So it is a slippery slope.
    JWG
    I don't have a problem with that, you are just exercising your skills in society to help those around you. 

    The other point about writing fender-bender estimates for the shop, and then for the Insurance companies could get odd.  But then again I know you personally and would trust you to keep it straight.  It's other people's conclusions that can be grief, even if their accusations are unfounded.
    Bob H
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    cowboy26995
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    02/01/2009 4:24 PM
    The ability to stand tall above the fray is important for an independent adjuster. You never know who you will encounter on that next contract. Impartiality beyond reproach is what we need to stive for. Opportunity sometimes seems attractive however the appearance and knowledge that you are unbiased, professional and honest is what we need to accomplish. Not being obligated to anyone is a wonderful thing.
    Marc Dubois
    Executive General Adjuster
    M.G.D. Claim Services Inc.
    "Your Commercial Claims Solution"
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    Jud G.
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    02/02/2009 3:19 PM

    Posted By Marc Dubois on 01 Feb 2009 04:24 PM 

     Not being obligated to anyone is a wonderful thing.



    That is so true.  So is being a 1099 adjuster.  You just can't put a price tag on freedom.
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    jlombardo
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    02/06/2009 8:08 AM
    Jud,
    Or on honesty and integrity and those are common to both the the IA and the Staff Adjuster.....we are all governed by the same Code of Ethics per the Insurance Commissioner's Code of Ethics as well as our own code.....
    Being a Staff Adjuster is no different....we do not adjust losses according the whim of the day, but rather we adjust losses based on the parameters set forth by the applicable policy. Any company that encourages their adjusters, whether they be staff or IA to do otherwise is acting in Bad Faith and should be punished accordingly.....

    Joe L.
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