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Last Post 11/21/2007 10:36 AM by  moco
Any Different On Your Side Of The Fence?
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moco
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11/18/2007 8:45 PM

    Hi every one, i am new to the world of claims adjusting (1.5 years) and work daily claims only for a small IA. I have yet to work any cats, however i have been doing some marketing lately for other IA's to work for, or better yet, fill the void. My search and exploration of other IA's have revealed several things to me, one being that when it is slow it is slow industry wide, or at least seems that way, and the other thing i have observed is that it appears to me that the handling of cat losses are somewhat different than that of daily claims. I am not sure exactly what is different, but i have viewed some final reports for a cat loss ( unknown vendor) and the final cat reports appear to be substantially smaller in terms of volume of detail and paragraphs. Perhaps this is only this particular vendor's way of finalizing a loss report. The vendor i work for demands a great deal of detail, seemed anal to me at first , but i now understand why  so much detail is important,as the examiners will have lots of questions if detail is not throughout. Again i am new and still have aloooot to learn, i am thankful for the daily work, which is up and down from month to month but for the most part provides steady income. Anyways i am looking for input from those of you who have worked both daily and cat losses and am curious of your experience on both sides, and which ones are preferred by you (with exception of the money being greater with cat claims) and if cat losses are quicker to finalize than daily claims. Another thing i have heard is that the final reports and estimates are not  scrutinized as bad during cats as much as the daily's are because the examiners are so backed up with files to review, and miss or let things through that would normally be questioned or denied with a daily claim. Just curious. Please reply.

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    Adjusterman
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    11/19/2007 10:20 AM
    GW Moco,
    Good morning to you. To answer your questions all IA's are different all examiners are different. With daily claims you are right, the reports and estimates are looked at with a fine tooth comb. The severity with which this is done depends on the IA, which insurance company the report is going to and who the examiner is. Unfortunately in this industry there is no standard for writing reports and estimates. I have found out the hard way that I must tailor my reports and estimates depending on who the IA adjuster reviewing the file is. Who the insurance carrier is and in some cases if I know who the examiner, tailor the report and estimates for them as well. Since you are working for only one IA at this time you may have not run across this yet. I know that I had not back when I was working for only one IA.
    As for the cat losses they were much easier to handle in a report writing scense but much harder in time spent on the loss and amount of losses handled in one day. However since Katrina, Rita, Dennis, Charley and their other friends things have changed. This is mostly due to lawsuits. Insurance Carriers do not like to get sued as most of us don't. This has brought about a change in handling cat losses. I have been to training seminars were Carriers are now setting up their own websites for adjusters to log their daily work. For example if you contacted an insured and set an inspection they want to know. Since at least in Florida there are now statutes which indicate the number of days a Carrier has to responde to a claim and get it settled this gives the carriers a way to keep track of that. However this causes much more work for us. As I see it this will cause us to lower the amount of claims we can inspect in a day. Gone are the days when you could sit down with you stack of claims start calling insured's set up inspections and get those claims closed as quickly as possible. Carriers now want everything you do documented so when the insured's put calls in to them they can tell the insured's exactly what is going on with their claim and when they can expect a payment.
    Hope this answers your questions.

    Adjusterman
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    Leland
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    11/19/2007 11:55 AM
    Things you might have to pay more attention to as a daily claim adjuster vs. CAT adjuster:

    1) Fair market value of the property. You will need to order property appraisals frequently rather than almost never.
    2) Subrogation. What 3rd parties might be liable, and why? What evidence can you gather? Don't throw out that old toilet! Your carrier might want to demand money from the manufacturer and even funnier, they will often get it.
    3) Recorded interviews. On complex claims this can be challenging, to ask all the right questions. Some very important questions can be easily overlooked.
    4) Liability. Even if your assignment is the property, it will often overlap into liability issues. For example if you are scoping a big fire loss, did anyone get hurt? Is there evidence or statements you can gather that will help your carrier avoid a liability settlement that might be much larger than the property damage?
    5) Policy interpretation. As a daily claims adjuster you are more likely to wrestle with these issues rather than have a supervisor decide it for you.
    6) Reaching agreement with contractors and PAs, attorneys. On Katrina I rarely met an contractor and never a PA. Not unusual for a big catastrophe, unless you get cleanup work. I never had to inspect any property twice. On daily claims sometimes I have to inspect several times to resolve disagreements.
    7) Report writing in general, more detailed and voluminous
    8) More interaction in general with other professionals, as mentioned above- appraisers, contractors, attorneys, salvers, forensic engineers, leak detection services, etc etc.
    9) More variety- instead of 100 hail claims you'll get 10 claims; each one different.
    10) Slower file closing. On a CAT its normal to send out a final payment that the insured might not even have reviewed. On daily claims the insured might need to notarize a proof of loss etc., and claims often take months to close.
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    Medulus
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    11/19/2007 12:05 PM

    I have been an adjuster for seventeen years now, and am coming up on my tenth anniversary as an independent.  I've seen considerable change in that time in terms of file requirements.  The first two cat events I worked were on staff in 1994 and 1995.  They had rather minimal file requirements for independents at that time.  In 1995 State Farm would hand you a file folder with a loss notice in it.  You would inspect the loss, draw a roof diagram freehand on the back of the file folder, put a couple minimal log notes on the inside front of the folder, handwrite your estimate and slip it into the folder.  And you were done.  On the cat I'm working now, the only difference between what is expected of me and what is expected of a staff adjuster is that my log notes can be written in MS Word, while the staff adjusters have to struggle with inputting all their log notes into a DOS system necessitated by their 1988 main frame computer.  It has been the trend for several years for the file requirements to get more and more extensive.  This is particularly true of states where the legal climate tends toward the litigious (think California, Florida, New York, and more recently Mississippi and Louisiana).  This is also particularly true when working for the larger vendors and those with extensive daily operations.  The file I hand in these days is not much different than a file I would hand in as a staff adjuster.  The reports are no shorter.  The file inclusions are no less than would be expected of any staff adjuster.  Does it mean that the days of closing ten or twelve claims a day are over?  Or that the whip out an estimate and close the file type of catadjusting are gone?  In many, or even most, cases they are.  There may be cat assignments where they expect an inspection and estimate, and nothing else, but I haven't worked one of those assignments in a long time.

    Steve Ebner CPCU AIC AMIM

    "With great power comes great responsibility." (Stanley Martin Lieber, Amazing Fantasy # 15 August 1962)
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    Ray Hall
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    11/19/2007 5:14 PM

    Think about a photo of the shore line from Florida to Louisiana that could be zoomed down to the bare slab and debris. Then pull all the coverage one carrier has and try to contact all the owners ASAP.

    When contact is made tell the homeowner an inspection will  be made and you will hear from the adjuster's involved in your severe loss within five working days and send these policyholders an advance of $10,000. UPP and $10,000. ALE that day. If they also  insured their auto's  with the same carrier send $3,000 per auto.

    This could be done in Katrina in 2005 and one carrier would have known their exposure and ultimate payout within 10 days from the day the storm struck and not need more than 100 adjuster's on the "wave wash" losses for 6 months. The biggie is only 5-7% would be lawsuits.

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    moco
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    11/19/2007 6:13 PM
    Leland Coontz, sounds like you have been working for the same vendor as me, lol. I have experienced all of these senarios at least once. I must say for me the most irritating thing is to revise a report at an exasminer(s) request, make note of it so that i can remember it the next time (as Jose Gimenez has noted). But i have on more than a dozen files noted a particular loss associated with a particuluar examiner(s), and remembered how they wanted it the last time, completed it with the same detail etc, and still have it sent back with questions of why this and that etc., when at first the questions was why "not" this and that etc. I have come to the conclusion that there is no set standard that examiners go by, and every final report sent to them regardless of similarities in loss (total loss fire, water damage via the roof or what ever) they are likely going to find something to address, or inquire on something(s) that is noted in the report ( as though they dont want it there), but requested it before. And my last complaint is the lack of common sense some of them seem to have( note i stated some, not all), like "why is the content manipulation allowed for in the estimate"? These things i really have to bite my tongue on, AHHHH, what is the insured to do just paint around the furniture, or claen the walls and floors around the furniture. Oh well enough venting, and thanks for the replies so far.
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    BobH
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    11/19/2007 6:58 PM
    and remembered how they wanted it the last time, completed it with the same detail etc,

    You adjust each claim based on exposure. The same examiner may want super detail on a coverage question with large potential claim - but consider that overkill for their next assignment that is a "slam-dunk" small loss.

    or inquire on something(s) that is noted in the report

    Believe it or not, most of the people you report to are too busy to actually read your reports. They will glance at the photos, and sift through the baggage to figure out how much the check needs to be.  Not to minimize the importance of your report - it remains a record of the invest and may need to be reviewed later if things go south.  Occasionally they understand construction and needed sub-products - but don't count on it.

    Bob H
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    JimGary
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    11/19/2007 10:12 PM

    As a staff adjuster for Farmers I was "called on the carpet" for not documenting enough, the explanation was I needed to explain my thought process. So I decided that I needed to document every little item, on my next review, I was told that I was documenting "too much", try and condense my log entries. I figure if a reviewer wants more than I give, they will let me know and I'll add a little to make em happy.

    JWG

    I know the voices aren't real, but sometimes they're right!
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    Jud G.
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    Posts:509


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    11/20/2007 9:10 PM

    You are doing well to notice this very important difference.  In lieu of that, demonstrate your concern for providing the needed detail to complete your assignments.  I have reviewed many claims assignments from pure-bred catadjusters (no prior Daily experience to speak of).  Getting them to provide the necessary detail in a full captioned report has been like pulling teeth from a clumsy and stubborn crocodile.  Most have no clue as to what to do with a full captioned report.  In the end, it becomes too much effort for them to paint a picture with necessary details and funnel the claim down to a single conclusion. 

    A good three to five years of consistent and accurate reporting for a daily claims vendor will launch your resume to the top of any IA Firm out there- whether cat or daily.  Any decent manager knows and appreciates the value of people who able to keep their nose to the ground by complying wholeheartedly (implied is the essence of a good attitude) and consistently with client instructions.  This appreciation is especially keen now that the peak days of high-volume Katrina claims are gone. 

    Now, the cat claims are being viewed under a microscope by hungry plaintiff attorneys poised to strike at their prey.  Currently, they are striking hard and frequently.  If a tough depo or following trial is not at their heels, then the lack of work is now a terrifying reality.

    After your solid three to five years are up, you will be able to comfortably move from cat claims to daily never have to worry about finding work.

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    moco
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    Posts:122


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    11/21/2007 10:36 AM

    Jud Gardener, thanks for your input, as well as everyone else. Its nice to see that i have at least one geographical neighbor (Jud) i noticed you are from Daphne,Al, well i am just to your west in Mobile,Al.

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