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Newt
USA
657 Posts |
 Posted - 01/28/2003 : 10:47:05
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| CatDaddy, What a great run through. That was a good customer too. Most are, but every once in a while you'll get a hedge hog. I have run across some duffers that can bore you to tears, and that goes with the territory, I always end up liking them also. You gotta make a friend to be satisfied with your product, what ever it is. Customer satisfaction is our most important product, the carrier and/or vendor will appreciate your work.(I hope) |
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CatDaddy
USA
310 Posts |
Posted - 01/28/2003 : 11:02:07
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JimF - great point about including the insured in the walk-around. I have heard many comments from insureds about how thorough their adjuster were completely their inspection and this is usually the result of the insured walking with the adjuster.
What I think we are all saying in our own words is "include" the insured in the process. Dont just have them watch it. You'll win their confidence everytime and that's have the battle. |
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Newt
USA
657 Posts |
Posted - 01/28/2003 : 11:19:24
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I got to get into a program and load some macros , all this good info should be a key click away and would save a lot of time. I'm gonna highjack a good adjusters computer and steal some macros.
I'll bet Tom Toll keeps his vehicle locked up with a big dog laying on the seat.
On a serious note this is one area I do have to get better at. I need to take one of those advanced courses because I am maybe a little less than third grade computer literate. I can fix them and tear them up but I just ain't no operator.
I just had a thought of something to bring before the software folks. Some way to add notes to the help files or edit if you will, thats another subject for software.
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CCarr
Canada
1200 Posts |
Posted - 01/28/2003 : 11:31:52
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One more reconnaissance into this minefield.
Finally, most if not all of the point I had wanted to make, or perhaps subconsciously thought I was making - has surfaced.
Look at Tom Toll's 1/27 23.57 post. If I was to re-write my opinion - relative to the subject matter - I couldn't have said it any better than Tom did, ".... required to inform an insured as to what coverages he is entitled to on that particular claim. Elaboration of the policy content is not necessary ....". As I said before in similar context, that is the spirit of, but not the same as, ".... required to explain to the insured, contents of their policy ....".
Look at Kile's 1/28 00.27 post. That is straightforward, on a straightforward and often occurring claim. That is not the same as, ".... required to explain to the insured, contents of their policy ....".
Even Mr. State Farm, in his script, which is what Joe was looking for as the next chapter following the '58 new claims', does not provide any direct association with, ".... required to explain to the insured, the contents of their policy ....".
That seemingly small 'contrast' between:
".... required to inform an insured as to what coverages he is entitled to on that particular claim ...."
and
".... required to explain to the insured, the contents of their policy ...."
is what I was trying to accomplish.
If a new adjuster grasped onto the latter phrase as a prerequisite and ran with it literally, it would be an impediment to their productivity; among other possible pitfalls.
Everyone who has actually worked as an adjuster for more than a month knows, " .... they are required to inform an insured as to what coverages he is entitled to on that particular claim ....".
In Kile's or Mr. State Farm's examples, why, would I want to mention and start explaining to an insured their "Special Limits of Liability, or Coverage D - Loss of use, etc - the contents of their policy?
Again, that was the point I wanted to, and tried to make. |
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CatDaddy
USA
310 Posts |
Posted - 01/28/2003 : 12:13:53
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You're exactly correct. I do not think to satisfy the language that JimF provided us yesterday from the Arkansas FCPA means you have to recite the policy word for word. Explaining coverage is sometimes as simple as "That tree fell on my house. Will my policy cover that?" and you say "Yep. Your policy provides replacement cost coverage for the total of the repairs, less your policy deductible."
I believe your explanations during any part of the claims process should include all required and relavant information but should be to the point and brief as they can be. Try to maintain control of your conversations and be careful of elaboration and "what if" senarios. Agreeing with Clayton, it takes up useful time and can lead to pitfalls.
Another common mistake I see when reps are going over the scope and estimate with their insureds is just in the language they use. Sound definitive with your answers and explanations.
Say: "Mr. Insured, I did not see any damage to your roof."
Don't say: "Well, I got up there and looked at it and "I" could not find anything. I saw a few spots that might be hail. If you want to get a roofer to look at it, do that and give me a call. If he finds something, I'll come back out and meet with him."
Your insured just lost all confidence in your ability to handle his claim.
Just food for thought. |
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Tom Toll
USA
154 Posts |
Posted - 01/28/2003 : 22:02:24
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Unlike some adjusters, I do not print the estimate and give it to the insured. I have a lap top on a special mount I built out of 1x12 wood. It is two story, with the lap top on top and junk on the bottom. I always suggest to the insured that they come to the truck with me and sit in the passengers seat. I first show the photos I took in Photoadjuster and explain the roof conditions seen and any other photo germaine to the loss. I then ask if I was able to photograph all the damage they told me they had. If this is a simple claim, I have prepared the estimate and show it to them on the screen, cause sure to heck, there may be something that was left off and now is the time to take care of it, not after it has been printed. They love looking at the photos and I always get one with them in it, which is two fold. Shows they were there during the inspection, and people love to see themselves on screen.
On complex losses, I just show them the photos and asked if anything was missed that is significant to their claim. We try to get the insured's as involved in the scope as possible. Makes them feel like you are really trying to be a good claim rep. Many times I ask them to point to a stain on the wall or ceiling or any other damage.
Everybody has their own personalities and each adjuster should use his or her personality to their benefit. The remarks above have worked for Janice and myself for a long long time. We average working approximately 600+ losses per year and have less than 1% re open. Get involved with the insured and get them involved in the claim process. You will be glad you did.
Always, without failure, have a smile on your face and keep a good positive attitude. If you are a grump, they are going to be grumpy. If you are positive, it sets the table for them to eat on. |
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CatDaddy
USA
310 Posts |
Posted - 01/28/2003 : 22:26:51
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Very good points Tom. I want to shove a pencil in my eye to get some relief when I get inside with an insured and get the "Oh yeah, I forgot to tell you about the blah.blah.blah." By that time, I have printed 3 copies of the estimate and written the check and now I get to do it all over again. Luck me.
Sounds like you have a good system to me. |
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ChuckDeaton
USA
373 Posts |
Posted - 02/03/2003 : 21:45:26
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| Newt, my conviction is that most insured's don't read the policies they buy and that most insured's don't voluntarily purchase most policies. They have some other motive for purchasing insurance. After giving a lot of thought to how to explain coverage I decided to stay with a verbal explaination and as often as not the insured, who hasn't read the policy, disagrees with my explanation. In fact I think that most coverage information comes to insured's thru gossip. A neighbor had a claim and they say that their company did such and so. |
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Newt
USA
657 Posts |
Posted - 02/04/2003 : 09:21:47
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Chuck: Never looked at it in that light before, but you are absolutely right. Most insureds are required to purchase insurance because of a mortgage and for some reason they dont consider coverage, price is more important. Then after the occurance they get a shock. I knew most insureds don't know the contents of the policy because if it is difficult for us to read and understand, what are the chances they will.
After I bought my policy several years ago it went in a file and I never looked at it, not till I got involved in studing did I get it out. Lucky, a good friend and agent did a good job of getting just the right coverage. He was a customer of mine and we became pretty close friends. |
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ChuckDeaton
USA
373 Posts |
Posted - 02/04/2003 : 13:55:26
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Newt, most coverage, especially homeowners coverage, is pretty cut and dryed as far as the product that is sold. ISO HO-3 or a proprietary policy that is pretty much the same. It is almost impossible to grossly over insure or grossly under insure. Most agents and companies are so concerned about class action suits that they hardly stray from the norm.
There is a book called Illiteracy in America. It it getting old now, but in 1985 the author thougth that as high as 40% of the residents of Boston and New York could not read a newspaper. In Arkansas, it is said that about 15% of adults can't read. If you know your statistics you know that most anything that can be measured, if plotted, will fall on a bell shaped curve and half of the curve represents points below the mean. That means that you will be trying to explain a multi page contract to people who fall two and three standard diviations below the mean. |
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Newt
USA
657 Posts |
Posted - 02/04/2003 : 14:19:49
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| I spent several days in Boston last year and very few could speak English that I met, the others were begging on the streets or on the "T". I tried to get directions from the first four people I met and they didn't understand or speak english. That would seem strange to most people down here but its common there. |
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inside man
45 Posts |
Posted - 02/04/2003 : 14:49:51
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Sure Kile, take the easy way out. I wish they were all that simple. I could close 5 a day and watch Dr Phil every afternoon if they were.
Now try explaining recoverable deprecition, 180 days to complete repairs, why they can't recover all of the holdback if they don't spend it on repairs, why they can't submit a final bill for $2000.00 more than the original estimate after the work is done and so on....
(Does anyone else think we have been stuck in the house(cubicle) too long???? We are all getting a little testy here.) |
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KileAnderson
USA
875 Posts |
Posted - 02/04/2003 : 17:37:58
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Yeah, It was a just a template on which one could add anything applicable to the specific loss. My point was to always follow Joe Friday's advice. "Just the facts, Ma'am." If you are in a situation that requires you to hold back tear off or depreciation then you would add that explanation as well.
I have to agree with your last statement too. I think we have all been holed up too long. Will spring and it's wonderful storms ever arrive? I hope that tax refund gets here soon. Maybe I can stretch it out until the hail starts falling and not have to flip burgers. |
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Newt
USA
657 Posts |
Posted - 02/04/2003 : 18:02:08
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(edited by admin)
On the subject of imforming the client of policy coverage, I figure this will vary according to extent of damage, multiples of damage and of course how receptive the client is to the information you give him. If you are unbelievable you can't do the job. That is a given fact, this claim will not get closed until they believe someone. |
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fivedaily
USA
258 Posts |
Posted - 02/05/2003 : 17:11:25
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You know, I just had 1 claim today where the insured didn't understand his policy. He kept insisting that his policy was to cover maintenance issues. He just didn't get it; he'd paid premiums for all his life so we would maintain his property.
I eventually got it sorted out with him, but only by showing him the policy and taking the time to go over it with him. He was still a bit out of sorts, but that might have more to do with my "bravery" in gettin gon his 2-story wood roof that the first adjuster wouldn't touch.
Just another example of why we are the professionals...
Jennifer |
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Some State laws require you to explain coverage
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