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Newt
USA
657 Posts |
Posted - 01/09/2003 : 07:44:33
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I'll do that, I have used it before and knew it was wrong so I will have to watch what I say. Better start now because a bad habbit is harder to stop than it is to start.
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JimF
USA
1014 Posts |
Posted - 01/09/2003 : 07:52:06
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I have always wanted to have my own personal claim for hail damage to the roof on my house, and then have a rookie adjuster say to me: "I am going to pay you for a new roof" after inspecting it.
I am just dying to be able to respond: "Why heck, that's Great. Fantastic Really. You can make your personal check out to me or I will be happy to take cash. And WHEN can I expect the insurance company's check for the roof damage as well?"
Can you imagine the look that adjuster would have on their face after that response?
Or can you imagine what the reaction would be in the carriers office if I then called in to the carrier's claims supervisor after receiving my damage check from the carrier and asked where my 'other' second check from the adjuster was, after telling the story above? (Think the carrier staff might laugh the adjuster right out of the office?)
It would make my day! |
Edited by - JimF on 01/09/2003 08:09:15 |
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Newt
USA
657 Posts |
Posted - 01/09/2003 : 08:25:07
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Hard to reach out and grab the words after they leave your mouth. Measuring out what you say is most important when talking to customers, especially strangers. There have been times when after I said something I wanted to crawl under a rock, I guess most people have had the same experience. Folks that do nothing and say nothing don't have anything to worry about.
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KileAnderson
USA
875 Posts |
Posted - 01/09/2003 : 10:07:04
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Jim, I have to disagree with you slightly. When I'm working, I deny the claim based on the carrier's guidelines. I dictate and sign the denial letter and drop it in the mail myself. When a claim is paid, I write the check, from the carrier's account of course, and I sign the check and I hand the check to the insured. As far as the insured is concerned I paid him, or I denied his claim, on the carriers behalf. |
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olderthendirt
USA
370 Posts |
Posted - 01/09/2003 : 11:49:12
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If you are writing denials and checks are you independant? or are you really a short term staff adjuster? |
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Newt
USA
657 Posts |
Posted - 01/09/2003 : 14:44:41
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I got the meaning to be IAs or people like me. It would be a bad habit for me and I agree. Only thing is, Jim said something he can't take back, how does it feel cuz:>) It gets easier as you get older. It also gets more frequent when you hang out with the likes of me. |
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JimF
USA
1014 Posts |
Posted - 01/09/2003 : 15:33:42
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Kile (and Newt):
I posted a comment under this thread here on a Forum for cat adjusting, wherein I made the statement that adjusters never deny claims. In the context it was intended, I was of course correct; that we as independent adjusters working for a vendor do not deny claims. I stand by that statement in the context it was intended and for this audience as I understand it.
Obviously, adjusters working as staff for a carrier do in fact deny claims. In the sense I intended, those adjusters are in a sense, the carrier (as I intended in meaning).
I do not know the very specifics of Kile's recent assignment, but for all practical purposes, with the carrier giving Kile authority to both write indemnity checks and deny claims and send out denial letters, Kile was either in fact or spirit, an employee of the carrier, which I suggest is quite different from the relationships which most of us here normally find ourselves in with a carrier.
I too have had working relationships with carriers where I was assigned the responsiblity and task of composing, signing and sending out denial letters, so I am quite familiar with that practice.
But I still suggest, it is the exception rather than the rule, for independent adjusters to have denial authority, and I still think it is a bad habit for us as cat and independent adjusters to use or keep such phrases in our day to day vernacular. And I think it still can create confusion, misunderstandings, and scenarios of estoppel where the adjuster (or his E&O carrier) may very well end up paying a claim out of their own pockets when this suggestion is not heeded and an adjuster accidentally says the wrong thing as a result of a bad habit.
Finally Newt, I do think that Kile or I, have been adjusting long enough to be aware and cautious of the distinction between those limited times and assignments where we may have denial authority for some carriers, and the majority of times when we don't.
I especially think a new or rookie adjuster should follow my suggestions at least until such time as they encounter the assignment wherein they gain having denial authority and experience.
I am well aware that there will always be those few hardheaded adjusters who will do it their way, the world and prudence be damned. They are the accidents waiting to happen, in this profession, that I warned about earlier, and they do so at their own peril and the peril of their E&O carriers.
If I misled or hurt anyone in sharing my thoughts, I apologze as it was not my intent. |
Edited by - JimF on 01/09/2003 15:51:28 |
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KileAnderson
USA
875 Posts |
Posted - 01/09/2003 : 15:51:41
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OTD, If I'm a temp staff adjuster, I'd sure like a car and an expense account. I really would hate to be driving my own truck and paying for my own lodging and meals if I did't have to.
:) |
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Newt
USA
657 Posts |
Posted - 01/09/2003 : 16:11:24
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You gotta know, I understood your message, it was taken out of context and not by me. I have that problem all the time and it is because I have a problem expressing my self on this computer. You don't, and I understood what you were refering to.
I don't want you to think I was serious, I was kidding so accept my apology and I will keep my smart remarks to myself. |
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olderthendirt
USA
370 Posts |
Posted - 01/09/2003 : 17:21:27
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Kile the wonders of mordern cat work you get all the liabilities but none of hte benefits. |
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Beckye
2 Posts |
Posted - 01/28/2003 : 20:21:58
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quote: Originally posted by CCarr
Jim, regarding the last paragraph of your 08.10 post. I'll leave it to others regionally in the States to comment on that, but up here there are several regionally specific endoresements; and maybe by touching on them it will make others think of those situations unique to their areas.
In Alberta hail is an annual event in the Calgary - Edmonton corridor; the only puzzle is whether it will occur twice or three items in the same area, in the same 90 day period between June and August. Some years ago, carriers managed to get 'hail' taken out of some of their HO policies and / or the loss settlement wording changed specific to hail claims. The result was endorsements that could be purchased that would basically reinstate the previous standard cover and loss settlement provisions, or a more limiting endorsement with hail cover but a more restrictive loss settlement provision.
In addition, Alberta does not use any kind of 'salt' solution on their streets and highways in the winter - when not blessed with a Chinook, the weather is too cold and dry to allow salt to melt road ice. Therefore, they thickly spread a small pea gravel. Well you guessed it, broken windshields are as common as a fella wearing a ball cap, spitting tobacco and driving a Ford truck, or as common as flyfishing in the Bow River. Ten or more years ago, auto carriers had enough of that and excluded broken winshields from the auto policies, but offered an endorsement at a cost to bring it back in.
Regarding endorsements, although I concede it is difficult to be 'comfortably familiar' with all or most of them; I do strongly believe we must be able to put our hands on any that is noted in an FNOL - and become familiar with it - before we knock on the insured's door.
I have two fairly large 3 ring binders, and unfortunately have to start a 3rd, of Canadian carrier endorsements. There is just more and more of them all the time, and seems more so in commercial; and overall quite an increase in the last 2 or 3 years. I'm lucky, I've got my princess that feeds me all new carrier 'paper' and a few other sources for some specialty writers endorsements or wordings.
But, when we get a claim, or an armful of claims, be it at a distant storm office or at our home office, and one or more FNOL's mention some type of endorsement; the adjuster is lost if he/she doesn't clearly know the wording of that endorsement or can not quickly put their hands on one - prior to attending to the claim. How can anyone adjust a claim otherwise? To not have a copy of that endorsement, but to 'hope or feel' they understand the intent of the endorsement - just doesn't cut it. It is an unforgiving world when the reported on adjustment is turned in and the endorsement was not applied correctly. There is no excuse for that - none. It is bad enough the trouble our community has on agreeing on wordings - be they policy or endorsements - let alone not having the benefit of the 'paper' to study fully.
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Beckye
2 Posts |
Posted - 01/28/2003 : 20:33:31
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I have a question regarding the endorcements to a commercial policy. On the declaration page is states that all endorcements and forms are part of your policy. You find such endorcement which states, *If no entry appears above, (schedule)information required to complete this endorsement will be shown in the Declarations or change endorsement, . However on the declarations page, the following information that is required to complete such form is not listed. I do see two other coverages which stated The following information is required to complete form # of form. Does that in turn mean such endorcement that I do not see is not applicable? |
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JimF
USA
1014 Posts |
Posted - 01/28/2003 : 21:18:25
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I am a little unclear as to your question and would find it helpful if you could advise which commercial policy form 'dec page' you are reading from?
The commercial policies generally 'literally' attach applicable endorsements to the Declarations Page and main Policy Form as separate (paper) numbered forms for each endorsement.
Where applicable endorsements are indicated by showing a check in a check box on the dec page or listing separate locations, coverages, or schedules on the dec page, those coverages and endorsements would either be included or not included by the presence or absence of such information in the applicable areas of the dec page.
I hope this helps but you may want to clarify your question.
By the way, which specific endorsement are you seeking to ascertain enclosure within the applicable commercial policy? |
Edited by - JimF on 01/28/2003 21:20:28 |
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canduss
USA
120 Posts |
Posted - 02/03/2003 : 19:48:16
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Beware....there are far too many commercial endorsements (if applicable) including their revisions to remember at any given loss....the resource/availability for referencing this data is crucial in applying the specifics on behalf of the Insurance....there are times when the Loss Reports/Coverage Verification transmitted from the Insurance fails to identify these coverages wherein the Agents Declarations of purchase become necessary in applying appropriate coverage within Underwriting to reflect these mishaps.... |
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