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CCarr
Canada
1200 Posts |
 Posted - 02/13/2004 : 12:34:29
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A fee schedule has come in for inclusion into the next survey, that has caused me to stare at it for too long.
The carrier / vendor is not important at this time, but it will be in the next survey.
The titles across the top of the fee schedule page read as follows;
"Property Appraisal Free Schedule Effective 2-1-2004"
"DAY-TO-DAY APPRAISAL FEE SCHEDULE"
There is no typo on my part, in that title. But perhaps, part of my staring is due to a subliminal jesture.
However, to the topic. There has been a fair bit of discussion regarding an "appraisal" assignment versus "adjusting a claim".
The following are quotes from this fee schedule sheet, relative to "appraisal". Aside from spelling mistakes and a general grammatical mess, it is the following quoted statements that need to be discussed:
(1) "Property assignments are for appraisal only"
(2) "Appraisal will include estimate, photos, diagram ...."
(3) "If the loss is determined to be not a covered peril, an estimate of the damage seen is needed as well as the Risk Valuation"
(4) "Appraisal only rate includes: .... Subrogation identification .... will homeowner retain any salvage? ...."
Consider those 4 things, that are clearly printed on this fee schedule.
From a quantitative loss standpoint, items I've shown as #1&2, seem logical; if that is the parameters set. Correct me if those items #1&2 have anything to do with determining cause or coverage. Item $2 does not say, ".... will include determining cause and coverage ....".
So, the question is - item #3 - who determines that the loss was not from a covered peril?
Who determined that, and who told the insured that, and what 'story' was the insured given before or while the estimate (or scope) was being done?
Then, in context with items #1&2, we have item #4. The "appraisal" process made no mention of determining cause or coverage, but it did specify what that process was - "include estimate and photos ...." - but now also includes subrogation and salvage determinations. How can a person work on subro or salvage issues, without the prior requirement to determine cause and coverage?
A separate issue, which is the continuation of my item #2 quote, I now quote in its entirety as follows;
"Appraisal will include estimate, photos, diagram if more than one room & Separate Risk Valuation: "footprint" diagram of exterior residence measurements, 2 exterior photos (Front and 1 side + rear and other side and photos of swimming pool, any hazards, trampoline and dog. Breed specified."
That is a verbatim transcription.
It seems clear to me that the "Separate Risk Valuation" component of what this "appraisal" will include, involves more steps than the "appraisal" of damage itself which only involves an estimate and photos; notwithstanding the other noted claims requirements.
This "SRV" requirement, within the "appraisal includes" wording, has nothing to do with quantifying the amount of any damage. These SRV requirements are a loss control function within the carrier's risk management processes of their portfolio of policies.
So, I need someone to explain to me how a person - an "adjuster" doesn't seem to be required - can perform the functional requirements that I have noted from this schedule. I recognize that each specific item is doable, but how can many of the requirements be accomplished within the parameters of an "appraisal"; where there is no stated requirement to determine cause or coverage?
I might point out that the "Wind and Hail" fee component of this schedule carves a new low in comparison to the current survey, placing it 47th of 47 at the $5000 gross loss price point; which is this schedule's first price point. Whereas, its "All other perils" fee component of its schedule lingers very near the bottom of the current survey; at its first price point of $2500.
All that, relative to pricing, could be fine, if the "job" was limited to an "appraisal" that included an estimate and photos; period.
So again, what is or what isn't, an "appraisal" handled claim? |
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fivedaily
USA
258 Posts |
Posted - 02/13/2004 : 13:24:57
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| Is it possible this fee schedule is instead for an underwriting inspection rather than something used in response to a filed claims? Something the agent might normally have done? |
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katadj
USA
315 Posts |
Posted - 02/13/2004 : 13:32:03
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Looks like the FREE (typo) means that we do all of the above and then have to include our costs to do so, the end result being WE PAY the carrier to be graced with their work.
NO THANK YOU, whomever you are. I can stay home and save money. |
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CCarr
Canada
1200 Posts |
Posted - 02/13/2004 : 13:58:53
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Unfortunately no, Jenn. This fee schedule is typical in style and format to any of the other 60 or so that are available for review. It is a typical vendor / carrier fee schedule for day to day claims; sent to me twice actually, by two different claims people.
To illustrate further, or to amplify the item shown as #3 in my opening post; I have another current "appraisal" fee schedule for this same carrier, but through a different vendor.
Review and consider what I previously mentioned in regards to item #3.
Now, this other schedule - same carrier, different vendor - says the following with regards to "Non-covered peril";
"If an assignment is made to any office and at time of assignment it is mentioned that the cause of loss is a non-covered peril, do not write an estimate but secure photos and send report to assigning claim office. The same applies if we inspect a loss and can tell from first observation that the cause is a non-covered peril, contact the office immediately. Do not write an estimate."
Now, that has some logic and some technical merit to it; not a lot but some. But, note how very different that is from the other schedule regarding non-covered peril.
I don't understand how the same carrier can deal with the same issue in two totally different ways. Further, I don't understand how the vendor dealing with this issue on the first schedule (previous post), can operate in that manner.
Although both schedules are for the same carrier, and both are noted as "appraisal" fee schedules; the file requirements are very different (more so than just the previous paragraph), and the pricing is quite different. |
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Gale
USA
231 Posts |
Posted - 02/13/2004 : 18:26:52
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Clayton it appears (and I have been told by one carrier) there is a wide range in the way claims are often handled within the same company but this is not the case with all carriers.
Once I questioned one in management at a large carrier on this issue and he told me if he had a branch claims manager that was getting the claims settled he was was happy even if the claims manager was doing it "his way". The right hand does not always know what the left hand is doing. Regional divisions often operate very differently within the same carrier I have found. |
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CCarr
Canada
1200 Posts |
Posted - 02/13/2004 : 21:23:08
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Gale, I am the former Monkey of a Regional claims division, and I could guild the lilly for the Ivory Tower with the best of them.
However, I still have no input from anyone trying to explain the logistical questions raised in reference to "appraisal" issues in my opening post. |
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Gale
USA
231 Posts |
Posted - 02/13/2004 : 23:06:44
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I bet you could :) A local CAT adjuster told me he was doing "appraisals" during his down time for a company. When I asked him what that was he said it was quite simple. He shows up at the loss address, ask the insured to show him the damage, writes the estimate, takes a few photos thanks the insured for showing him the damage and that someone will be getting back with them concerning their claim. After that he leaves, mails in the estimate and gets paid in a timely manner.
That is much less than what was meant by "appraisal" by the company in your post.
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CCarr
Canada
1200 Posts |
Posted - 02/14/2004 : 09:58:10
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Would I be far off the mark if I suggested I sense a reluctance of independent claims people and independent adjusters to comment on or discuss the questions I have raised? Surely the shroud of a vendor's or carrier's watchful eye - in this your community - is not enough to stiffle your participation?
Anyway, Gale has told us about what one claims person considers as an "appraisal assignment". It is simple, straightforward, and requires no insurance knowledge or no claims adjusting experience or knowledge; seemingly only requiring some skills at organization, time management, and the ability to scope damages and prepare an estimate. That, I would have to agree, seems like a typical "appraisal assignment".
Conversely then, what I brought forward in my opening post, is not a typical "appraisal assignment".
There are preferred contractor vendors, that do a lot of exactly what Gale told us about, for day to day claims, and at no direct cost to the carrier. The business model being, that the PCV will get their fair share of the work they "appraised".
Still, I don't understand how a carrier could enter into a claims logistical snafu, as is suggested in my opening post. Maybe there is no tangible answer for that.
Next is the vendor who negotiated and agreed to the printed fee schedule, that contains what I suggest is both a legal and logistical snafu. Why would they do it? Again, there is probably no tangible answer.
But, what does the vendor tell the claims people they have gathered, that will work within the logistical parameters of this fee schedule? How would a vendor direct that the logistics of this fee schedule be dealt with in the field?
Finally, the claims person, in what manner are they absorbing what they read on this fee schedule, and what they are told about how to accomplish the "job"?
I suppose the new recruit to "claims", the person who has no insurance or claims training or experience; but is proficient at scoping and using an estimating system, will not recognize the issues in question. Therefore, they will proceed, as per the vendor's instructions; and likely thrive.
Conversely, I can not imagine, regardless of fee, a trained "adjuster" allowing themself to enter into this type of work assignment.
Please understand, this thread is not an attempt at "us versus them". I am not trying to ridicule an untrained claims person versus a trained adjuster. Please be clear on that. The ideal or typical "appraisal assignment" that Gale brought forward, is a great place for a new person to start; and likely a good place for that newer person to make a suitable income, measured against the job requirements.
Anyway, I guess if there isn't going to be a discussion or other comments from independent claims people or independent adjusters, or goodness even a vendor's perspective; then that is all I'd have to say on the issues presented. |
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calgaryron
1 Posts |
Posted - 03/05/2004 : 14:15:27
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Clayton, This is my first post on this board.
However as the topic involves "appraising" and mentioned "untrained" in your posting,Having over 21 years of sitting on both sides of the fence (Property Adjusting and Appraising) in Canada.
In reference to Appraising I would remind you of the stautory condition wordings of the policy. "areas of dispute" it mentions the "appraiser" not the "trained" Adjuster who resolves the areas of dispute (quantum only not coverage)
i have acted as appraiser and umpire, in the "appraisal route"
I would like to explain what I include in my reports to my principals.
1 Photograhs of the Risk in question along with age, condition, size,condition and valuation. The appraiser does not need to know the coverage on the property, However it is important to determain the value for the adjuster / examiner to help him/her determine if the coverage complies with the required co-insurance and or optinal loss settlement clause (if applicable)
2 Cause of loss can be determined and confirmed by the appraiser, if not report back and request the cause be determined by the "trained person" in that paticular field. Then the coverage will be confirmend by the Adjuster.
3 Scope of Repairs and resulting damages, DAMAGE APPRAISAL not ESTIMATE (Huge Diffrence)
The damage appraisal should include the value of the damages based on both replacement cost and ACV. or so to mention any building code requirements included in the appraisal and attach photograhs and floor plan
It is my opinion, regardless if the appraiser feels the cause is not from an insurable cause/peril ( i agree the appraiser should not detrimine coverage)if a detailed appraisal can not be completed at least floor plan, rough scope of repairs and the very least measurements
i have trouble shot many files when the "trained" adjuster" (tonge in cheek) has been out to the loss site taken a photo and simply reported back and advised "cause from seepage no coverage.The insured has submitted estimates and proven that the Adjuster was wrong.I was asked to determine if the amount claimed is in line.
Hard to do when there are no measurements on file to confirm the amount and the measurements on file are correct.
4 I also include in my report my recommendations / conclusions and opinion.
Clayton, may be i have gone "left field" with this topic,as you did mention the "appraisal fee" is there a set fee that you are refering to? we normally only have a set fee for "cat" claims.
I hope i have not bored everyone, As mentioned this is my first post and depending on the feed back possibly my last??? LOL
Ron
ps sorry for the spelling mistakes, spell check will not work. |
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CCarr
Canada
1200 Posts |
Posted - 03/05/2004 : 14:39:01
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Wow wee, kippy I aye! A cowboy canuck from my 2nd favorite maple leaf city.
Ron, you have gone off to the 'left field' with your post.
There is the traditional (or what used to be called) cat fee schedule for "adjusting" cat claims. There is now almost as many "appraisal" fee cat claim schedules, where the fee is predicated on the claim damage only being estimated by a 'claims handler' ("adjuster" not required); with all talk and other work associated with "adjusting" the claim (cause & coverage) being removed from the "appraisal" claim handling process. In other words, just a very limited task assignment.
Have a good review of the forums to get up to speed, then make sure that the post you made is not your last.
I think I can beat any chinook you may have today, it is 64 degrees F in the shade here now; quite amazing for the date. |
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sbeau4014
USA
53 Posts |
Posted - 03/06/2004 : 09:37:35
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| if you want to get an idea of what is considered a "appraisal" or an "agreed appraisal" in the property claims end of it, find someone with the old TAS sheets, or similiar sheets that GAB used to have and may still use. I worked for them back in the late 70's and early 80"s and their fees were based on the scope of the assignment from the carrier. They basicall had "no frills" (a real $$ maker that one was.....), 'damage appraisal", "full adjustments", andanother one like limited investigation that I believe was T&E. Don't have any of those sheets around anymore, but they gave "scope" of what fit into each area. One major difference in appraisal and full adjustment was dealing with the coverage issues. Appraisal didn't deal with coverages, the carrier did. Just if something jumped out as possible a non coverage issue during the inspection, you could contact the carrier, discuss it, and convert it to a full adjustment. |
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trader
USA
236 Posts |
Posted - 03/06/2004 : 12:06:09
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| I remember when the "Bureau" (GAB) worked CWP for $4.50. They were trying to break the other IA,s but we all survived. This was about 1966. |
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What is, or what isn't, an "appraisal" claim?
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