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Last Post 07/31/2009 11:04 AM by  Ray Hall
giving the insured a copy of the narrative report
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Leland
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06/18/2009 5:35 PM
    I never before  had an insured or attorney ask for copies of my scope notes/narrative report/ etc, recently I've had two requests. In California, depending on who you ask (attorneys, file examiners) the insured may even be entitled to a copy of the narrative report (with some exceptions, and possible redacting of certain details).
     
    If the insured asks for the narrative report you probably have to send it to them, ask your carrier for guidance. You may be able to assert that it is not a "claim related document" as defined in the regulations, but intelligent minds differ on this interpretation. Certain privledged documents, documents relating to fraud etc. are excepted.
     
    And the insured is always entitled to get copies of scope notes, photos, estimates- its in the regulations.
     
    I never had anybody ask before.
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    okclarryd
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    06/18/2009 8:00 PM
    It's been my experience that the estimate, narrative, photos, all the claim file stuff, belong to who hired you or is paying you.

    I have been asked or demanded to produce documents related to a claim and I always referred them to the carrier. Or, if I was a staffy guy at the time, I referred them to my supervisor or claim manager.

    Did I ever send anybody anything without WRITTEN approval?

    Never
    Larry D Hardin
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    Leland
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    06/18/2009 8:15 PM
    the carrier has told me to send my narrative to the insured. California regulations, as the carrier interprets it.
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    Mike Smith
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    07/28/2009 4:01 PM
    I've been adjusting in California for 8 years and have never been asked this. I didn't once have a claims file admitted as evidence in a court case. It was unexpected, the carrier's attorney asked me to bring the file in case we needed to refer to it for any details, but once I got on the stand to testify, the insured's attorney asked if I had the file, then asked that it be taken into evidence. I never saw the file again.

    But, as Larry said, I would just pass that request on to whoever was above me, no way I'm handing that out without having permission in writing.
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    Medulus
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    07/30/2009 9:53 AM
    While I was working Katrina, it came as a surprise to me that ICAT was routinely sending my narrative report with the estimate to the insured. This was a very peculiar practice, but I never put anything in the report I would be embarassed by if it became public. So, it led to the insured calling and wanting to argue details with me once or twice, but really didn't affect much. The only problem it created was when the carrier asked me to change my narrative to state something with which I did not agree so it would be consistent with their final decision. If you read between the lines of statements in those reports like "According to your instructions, I am recommending denial," you could still tell I disagreed with the decision.

    Giving the insured a copy of your narrative report is definitely not something you should do without explicit instruction from the carrier. In fact, the carrier should be the one sending the report. Some carriers are very sensitive about even allowing you to release your estimate directly to the insured and prefer that it go through them.
    Steve Ebner CPCU AIC AMIM

    "With great power comes great responsibility." (Stanley Martin Lieber, Amazing Fantasy # 15 August 1962)
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    dcmarlin
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    07/30/2009 11:28 PM

    Like Steve said, providing a narrative report to the insured is a very peculiar practice.  It is the property of the carrier and usually considered work product.  Regardless, in my reports, I always use "we" instead of "I" and never put anything in the report that is inflammatory.

    Gimme a bottle of anything and a glazed donut ... to go! (DLR)
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    Leland
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    07/31/2009 3:23 AM
    Don't think of it as peculiar anymore- its the law in California:

    California Insurance Code Section 10082.3

    The insurer shall notify every claimant that they may obtain, upon request, copies of claim-related documents. For purposes of this section, "claim-related documents" means all documents that relate to the evaluation of damages, including, but not limited to, repair and replacement estimates and bids, appraisals, scopes of loss,
    drawings, plans, reports, third party findings on the amount of loss, covered damages, and cost of repairs, and all other valuation, measurement, and loss adjustment calculations of the amount of loss, covered damage, and cost of repairs. However, attorney work product and attorney-client privileged documents, and documents that indicate fraud by the insured or that contain medically privileged information, are excluded from the documents an insurer is required to provide pursuant to this section to a claimant. Within 15 calendar days after receiving a request from an insured for claim-related documents, the insurer shall provide the insured with copies of all claim-related documents, except those excluded by this section....

    California insurance companies and the attorneys that work for them consider the narrative report to be a "claim related document" that must be given to the insured upon request. An adjuster who refuses to give his narrative report to the insured could be accused of violating the law. Of course the adjuster should check with the carrier before sending anything to the insured. It may be possible to redact (black out) certain info such as reserves, but this issue is subject to interpretation. When an adjuster writes a narrative report, details such as the cause of loss or reserve amount could be used by the insured to contest the adjustment of the claim.

    The adjuster's narrative report is not "attorney work product". A report prepared by an adjuster for an attorney in anticipation of a lawsuit would be "attorney work product".

    This is a law that many adjusters in California are not yet aware of. I predict that it will become wider known as more and more insured's, PA's, and attorneys learn to ask for copies of the "claim related documents".

    Just an additional reason to be thoughtful about what goes in the report.

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    Ray Hall
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    07/31/2009 11:04 AM
    Its not in law in many states, but all the file can can be discoverd, except work product anticipating litigation. Just keep it to the facts and leave you opine of the parants of the insured out of the reports.
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