| Author |
Message |
Dave Dehlinger
Member
Username: Davey
Post Number: 7
Registered: 1-2001
| | Posted on Tuesday, August 20, 2002 - 6:14 am: | |
Ah,Clayton, but will enough US carriers recoginize that what they need is quality adjusters in the trenches and not just a sharper pen in underwriting? In cost cutting times, how do they justify paying for a professional in the field rather than a 90 day wonder at a desk trying to estimate the damage over the phone. |
Clayton Carr
Member
Username: Clayton
Post Number: 94
Registered: 11-2001
| | Posted on Monday, August 19, 2002 - 10:28 pm: | |
".... being rode hard and put away wet ....", isn't that a beautiful phrase? I haven't had the pleasure of reading that or hearing it since I was in my beloved Calgary foothills. A sincere thankyou Cecelia for bringing back the memory.
Jack, you do have thunder in your boots, seems more about the big picture and our role in this changing game.
Kile raised - and answered very well - one of several exceptions I could take to some of your comments - hopefully made only due to the heat of the moment.
The way I see it (I'm on the "tag" part of it now) there is a big desk we all get to sit at. It is about a 60/40 split now over the past 32 years regarding which side of the desk I have hunkered down into. Many, many years ago, and for the past 16, I have been perched on the drawerless side. With my elbows rubbing on the drawerless side it quickly sunk into my head that my sole purpose in the claims world was to investigate and report, or a phrase more to my liking now (from Jim Lakes) - the cause, coverage and cost? Nothing else - other than being punctual, communicative and polite while sticking to that clear role. For the years that I could lean on the side of the desk with drawers that contained the vendor files I chose to keep, I tried to keep things simple and clear to those whose mail came to my desk. The I/A mandate from my desk of an American carrier was to only investigate and report. Nothing else. I became very selective in who I used and for what type of loss, and it became a long, good and trusting relationship.
Well, I'm rambling and was just going to go on and waste everyone's time with the "old days"; but some things remain the same.
It is the carrier's choice on what to do with a loss, how to assign a loss, how to handle a loss, interpret coverage, and how to dispose of a loss.
I think "control" is a good thing - up and down the food chain.
Insurers are approaching a catastrophic level of loss on equity. No longer do most have a sufficient return from investments to offset terrible underwriting results, let alone turn a profit. The short term will see some leave the market or one or more of their marketplaces, as well as a flurry of M&As by the end of Q1/03.
Rate increases can only be a short term fix - they are not the solution. Increases are only gained or approved after statistically showing the depth and history of their bloodbath. Some companies will not be able to sustain themselves between rate increases.
Companies will once again have to rely on underwriting results because the investment well and rate barrel are unsustainable.
Companies are recognizing this - especially the multinationals. Most of the strong willed ones started a momentum early this year to reach u/w returns not previously considered in over 10 years. Of course there are companies lapping up this discarded business of declined renewals and lapsed policies where 35 to 50% increases were not obtained. You have all heard or read about a "tight market" in u/w, well it is here and flourishing, especially in all commercial lines.
This brings with it a need for expertise and experience. Many of todays well educated claims or u/w people have not worked through a steep market cycle in insurance. You will see and feel from this an increased demand for experienced adjusters with depth. A "tight market" in u/w is just their way to express what will happen in claims - a micro managed control system. Any agent can give you their war and horror stories of the ruthlessness of carriers from the u/w side in this tight market. NYC has Firemans Fund to kick around as a good example. Once the claims side grabs the paddle and starts to control the losses and manage claims there will be a lot more than Jack's FIG punching bag today.
The Insurance Journal enews had two interesting stories today. The hypothetical one - if a cat 5 like Andrew were to hit Miami now (the 10th anniversary) it would cause $50.0 Billion in insured losses, roughly twice that of 10 years ago. While you think of that, there was a blurp on the European floods and the expectation of $1.5 Billion in insured losses. No one is going to suggest or convince me that the European continent has sufficient numbers or type of claims people to handle that disaster.
But, here we are, what are we doing about it? |
Ghostbuster
Registered User
Username: Ghostbuster
Post Number: 333
Registered: 12-2000
| | Posted on Monday, August 19, 2002 - 10:10 pm: | |
Thas right, Ms Sharpe, The Almighty Guv and Atty Gen, John Cornyn have indeed filed suit on FIG for a whole bunch of nasty things...
...this is also an election year and Guv Rick is having a nasty time with Democrat Tony Sanchez. (Whew! the mud it is a slingin'.) This suit and the rate freeze imposed on FIG by our Ins. Commish, Mr Montemayor, have put the Big FIG in an awful P.R. light. In fact, both sides are using our noble and good industry as the evil fire breathing dragon and kidnapper of children everywhere.
And...whose fault is it?...None other than our ol' pal Mr Mold! Texans, with the highest homeowner rates in the union, now have the highest rates in the known cosmos, and getting higher each day. Even my super basic HO-A that doesn't cover water damage went up from $600 to $800. That's a 33% increase and to add insult to injury, my barber increased his price 20% from $4.00 to $5.00! I don't think I can afford to be an American any more.
In any event, Joe Lunchbox has woken up and is being enflamed into a lynch mob by the media AND politicians over his policy premium and castrated coverage. In the meantime, FIG has placed lots of billboard help wanted ads for agents around town. Honest to Gawd, it's a great time not to be an adjuster these days around here, cause soon it's agonna get ugly. But, the contractors are running double crews trying to keep up with all the new mold claims coming in before the coverage is dropped during the policy renewal and they are all driving new leathered out Lariat F-250 pickups.
What??? An Okie is going to decypher a Texas lawsuit??? I thought that was against the Laws of Nature... |
Cecelia Sharpe
Registered User
Username: Cecelia
Post Number: 12
Registered: 12-2000
| | Posted on Monday, August 19, 2002 - 9:39 pm: | |
Help me out here Ghost. I was in Oklahoma and my parents read something to me (I was trying to avoid the word "insurance" and was hoping not to hear the word Farmers unless it applied the local farmers in Comanche county) about the governor and someone else in TX filing suit against Farmers and someone in Oklahoma was going to review it. The only reason I have retained ANY of that recollection is because I thought Zurich must be really unhappy with that situation.
Any of you Texans or Oklahomans know enough to give us a brief report?
What will happen to all those "poor,pitiful, downtrodden insureds" when the doors close? They will be legion since one week a claim scenario is deemed covered, the next week it is not, and the next week it is. Darn the luck for those in the middle week!!! |
Kile Anderson
Registered User
Username: Kileanderson
Post Number: 155
Registered: 1-2001
| | Posted on Monday, August 19, 2002 - 8:49 pm: | |
Jack,
Did you really mean it when you wrote:
"Farmers Insurance has no right under the terms of the policy to direct and tell adjusters what they are allowed to pay."?
They have every right to tell you exactly what to pay. You are an independent adjuster meaning that you were hired on an as needed basis to handle the claims volume that can't be handled by staff on a timely basis. It doesn't mean that you are an unbiased third party brought in for your objectivity. You are there to do a job for the company who signs your checks.
If what they tell you to do is illegal or immoral, you are bound by ethics to step aside and inform the company why, but if what they tell you to do is legal and within the bounds of the policy, even if you think they are being cheap, then you have little room to complain.
We all know that policies are open to interpretation and things change every time you turn around. You have to be flexible in this business. What's payable today won't be payable tomorrow and what's strictly verboten will be SOP next week. Just roll with it or suffer the ulcers. |
Ghostbuster
Registered User
Username: Ghostbuster
Post Number: 332
Registered: 12-2000
| | Posted on Monday, August 19, 2002 - 8:22 pm: | |
Jack...we can tell your fired up over this and, I for one, do not doubt the veracity of your allegations. Not because of witnessing this but rather from knowing the basic defects in the Farmers system of corporate survival.
Their basic cheapness is a trait that percolates down from the office of Marty Feinstein and even predates his tenure. They are cheap with their employees, their business equipment, and their vendors. Whatever they buy must be priced some 20 years in the past. This basic corporate character defect is the root cause of all their problems. From massive employee turnover, to computer equipment that was bought at State Farms garage sale, (I've seen the old SF logo on the stickers on Farmers computer monitors), to the cheapest and really dangerous Dodge Neons they used for company cars. ("Where does the ladder go?, I asked, it won't fit in the car. The claim manager said, Use the Insureds ladder.") Folks, the rot starts at the top. You've got kids leading kids because another trait is to hire trainees as management candidates and then run 99% of them off and start over with a new crop. You are then left with the cream of the CRAP rising to the top.
We called them the boozers, the tokers, and the chasers, all a good reason to call in sick whenever they came to town for a press the flesh office meeting.
And, here's the big punchline to the joke. Because each of the 10 independent adjusters that were on that file, each of you will be named defendants in the lawsuit by that poor pitiful downtrodden Insured. Whether you have E&O or not, you WILL be spending alot of time answering depositions, testifying in court, losing sleep worrying about it, doubting the support you might be getting from your vendor, and on, and on, and on. All this years after you have left the scene.
I've heard rumors that some managment types are recommending that FIG just pull up there pants and leave the state of Texas. The Swiss at Zurich are also none to happy to be pumping tens of millions into FIG for it's mold much less the additional tens of millions to bring their computers up to date. I would be none too surprised if Zurich just folds the tarbaby of FIG and locks the doors.
Yes, I realize this would be a catastrophic nightmare, but then, considering the nightmares of the past several years on Wall Street, the planes into the World Trade Center, and the emergence of our Apostle, Clayton Carr, we can't seem to wake up anyway! (Tag, Clayton. You're it!)
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JackCash
Registered User
Username: Jackcash
Post Number: 32
Registered: 6-2002
| | Posted on Monday, August 19, 2002 - 7:16 pm: | |
Kelly, Farmers tells you exactly what to pay...Who are you kidding.. They tell you which plumbers to use, how much they will pay the plumbers and if they do not like it they too are gone. They tell you what you are allowed to bill!! They tell you which claims to deny ect. ect. ect. You are living in a dream world.
It is completly illegal as well as unethical. |
Kelley
Registered User
Username: Kelley
Post Number: 31
Registered: 12-2000
| | Posted on Monday, August 19, 2002 - 6:57 pm: | |
Farmers may say they don't tell you what to pay, they just tell you which estimating program they find acceptable & which data base you must use. It seems this is the normal for carriers/claims services now days. |
JackCash
Registered User
Username: Jackcash
Post Number: 31
Registered: 6-2002
| | Posted on Monday, August 19, 2002 - 6:45 pm: | |
Cecelia, The fact of the matter is we are independent insurance adjusters. The insured trusts us as a result of our independence, we care not whether a claim costs a million or ten dollars.
Farmers is corrupting the process by intimidating the adjuster, thereby skewing the results of the evaluation of the claim. The result is that the policyholder is subject to a corrupt process. Sure everyone wants as you say to put food on the table, I have run into a few criminals that also offered similiar excuses. My integrrity is not for sale and I suspect many other adjusters have decided to bolt when faced with the same moral dilemna.
Farmers Insurance has no right under the terms of the policy to direct and tell adjusters what they are allowed to pay. You are either an independent or a whore working for an un-liscened adjuster. There is no middle ground. |
Cecelia Sharpe
Registered User
Username: Cecelia
Post Number: 11
Registered: 12-2000
| | Posted on Monday, August 19, 2002 - 4:27 pm: | |
Jack,
I agree with almost everything you say (it does get a little rough there in the last sentence; I know many adjusters who are simply trying to feed their families and, although prostitution is not usually one's first choice, it can sometimes appear to be the only option to keep food on the table and the bills paid).
The "Leads" (aka "Examiners") are simply imposing Farmers' policies on the independents. The Leads/Examiners have no more free will or ability to "adjust" than do the independents. I noticed an ad here on CADO which must be for Farmers Mold unit located in Covina CA. The Leads/Examiners are being "rode hard and put away wet". I don't know how they do it. The hours and the requirements (and resultant stress) could kill the best of men/women. All the ones I met were good, honest people who are also trying to pay their bills in a slow storm year. The ones who have an option, however, do not stay. Or so it appeared to ME. |
JackCash
Registered User
Username: Jackcash
Post Number: 30
Registered: 6-2002
| | Posted on Monday, August 19, 2002 - 3:35 pm: | |
Farmers has nothing to lose as they have already decided to take their chances in court and have created policy that adjusters either exercise or depart.
They have forced the independence out of the process and are eliminating the impartiality from the process. The adjuster "leads" are in fact unliscenced and simply adjust the claims by imposing their policies on independents. If independents disagree for any reason they are summarily slandered and their claims are pulled. You either adjust a claim Farmers way or you are gone.
Workers for Farmers have become whores for Farmers in their effort to extricate themselves from the state. |
Clayton Carr
Member
Username: Clayton
Post Number: 93
Registered: 11-2001
| | Posted on Monday, August 19, 2002 - 3:26 pm: | |
Thanks Cecelia for correcting me. Unfortunately, in fact, I didn't have the carrier right at all, after I considered your comments. It was Amfam that my reference was to. However, my thoughts are still valid regarding my response. |
Cecelia Sharpe
Registered User
Username: Cecelia
Post Number: 10
Registered: 12-2000
| | Posted on Monday, August 19, 2002 - 2:21 pm: | |
Perhaps, Clayton, you meant Farmers Mold and not CAT center? It is my understanding that the CAT center (located in Kan City) is closed (for the independents, that is). And the mold group in California uses "Examiners" from out of state to supervise the paper-processing information-gathers (previously employed as adjusters on other assignments).
I wouldn't say that "most" have bailed, but many have resigned or been forced into resigning. |
Clayton Carr
Member
Username: Clayton
Post Number: 92
Registered: 11-2001
| | Posted on Monday, August 19, 2002 - 11:17 am: | |
IF, as you say Jack, ".... most of the good adjusters have bailed ....", what is the natural conclusion of what field quality is left? Would that then not - if it is as you stated - require some form of "mircro management"? I turned down an inquiry by a vendor to be an inside part of the Farmers cat center, due to the vendor and the compensation being offered. Had I not declined it, I would not appreciate being painted with the same "dummy paintbrush"; but in fact would have been unlicenced. Is there a requirement for carrier staff "examiner" licencing? The "kids" do not roll out their own "micro management" techniques, they are undoubtedly mandated and orchestrated by the carrier. |
JackCash
Registered User
Username: Jackcash
Post Number: 29
Registered: 6-2002
| | Posted on Monday, August 19, 2002 - 10:18 am: | |
The new schedule of what adjusters are allowed to charge Farmers is pretty skinny. Most of the good adjusters have bailed, the few that remain are being micro-managed by kids who have little or no experience. The adjusters have become nothing more than paperwork pushers for un-liscenced out of state adjusters that have little or no experience.
The Ballard claim can not be paid as Texas has limitations on punitive damages. I personally think she probably hosed her house via the attic. |
alan jackson
Registered User
Username: Ajackson
Post Number: 125
Registered: 12-2000
| | Posted on Friday, August 09, 2002 - 8:59 am: | |
Jim:
It appears to still be pending. Looks like Farmers appealed but has not yet filed their brief. They requested oral arguments. If it is granted, then it should be a great dog and pony show. If Farmers looses the appeal, then they will just appeal it again.
It might be settled in say the next five years or so. |
Kelley Roberson
Registered User
Username: Kelley
Post Number: 26
Registered: 12-2000
| | Posted on Friday, August 09, 2002 - 12:02 am: | |
I recently renewed my homeowner policy here in TX. I had Farmers... I was asked if I had suffered from a water loss in the last 3 yrs, if so they would not write the policy. I had no water claim. The quote I was given for my policy to be re-written was 30% higher than last years. To add insult to the injury I was told there were no water coverage, I could purchase it for an additional 570.00 a yr. I know how to say "bye bye". |
Todd Summers
Registered User
Username: T4summ
Post Number: 18
Registered: 12-2001
| | Posted on Sunday, August 04, 2002 - 2:24 pm: | |
I have heard that too about no one writing a new policy if there is an "open" mold claim. This person was told that after shopping for a new policy and after her mold claim was closed. |
Jim Flynt
Registered User
Username: Jimflynt
Post Number: 397
Registered: 6-2001
| | Posted on Saturday, August 03, 2002 - 10:28 pm: | |
Memo to Chuck Deaton: Chuck, if I am reading it correctly, the Ballard vs. Famers Insurance Group is still active with the Texas 3rd Court of Appeals. From a review of the website of the 3rd Court of Appeals of Texas, it would appear the information you were given falls far short of veracity.
I am enclosing a link to the 3rd Court of Appeals of Texas which handles those cases appealed from Travis County, and using the Case Information System, you can review the case and status and make your own determination.
Alan Jackson where are you when I need you?
http://www.3rdcoa.courts.state.tx.us/opinions/case.asp?FilingID=8574
(Message edited by jimflynt on August 03, 2002) |
Richard Brooks
Registered User
Username: Rwbrooks
Post Number: 2
Registered: 4-2002
| | Posted on Saturday, August 03, 2002 - 4:45 pm: | |
News media said big three are not writing HO on risk with water loss in last three (3) years. |
Chuck Deaton
Member
Username: Chuckdeaton
Post Number: 41
Registered: 3-2002
| | Posted on Saturday, August 03, 2002 - 10:40 am: | |
Another adjuster emailed me and said that the Ballard case has been heard on appeal and was remanded to a lower court for retrial.
Could someone "in the know" comment on this an bring us up to date.
I also heard "thru the gravevine" that companies are not writing homeowners policies on risks with "open" mold claims. |
Chuck Deaton
Member
Username: Chuckdeaton
Post Number: 40
Registered: 3-2002
| | Posted on Sunday, July 28, 2002 - 3:53 pm: | |
Go back to my orginal posts on this subject.
I predicted that eventually a national recovery firm will start auditing files. On audit requests for return of inappropriate fees are going to be made with forceful followup.
My opinion is that the fur is going to fly. |
Chuck Deaton
Member
Username: Chuckdeaton
Post Number: 39
Registered: 3-2002
| | Posted on Sunday, July 28, 2002 - 3:35 pm: | |
Perhaps someone with current knowledge will correct me, but I don't think Farmer's paid Ms. Ballard 32 million. I suspect that the Ballard claim remains in litigation. |
D Wong Whey
Registered User
Username: Dwongwhey
Post Number: 162
Registered: 10-2001
| | Posted on Sunday, July 28, 2002 - 10:24 am: | |
It is BAD FAITH on the part of the carrier and the stepping stone for REAL Bad Faith actions.
An adjuster knowing he/she is only going to be paid on an AVERAGE claim amount for a T&E file, is only going to do an AVERAGE amount of work and not necessarily what is required to properly handle and conclude the claim.
The 'average' adjuster knowing he/she is only going to be paid for .5 hour(Half An Hour) for Diary is not going to spend extra unpaid time properly documenting activities, conversations, communication, etc. Further, if the adjuster knows he/she will never be paid for more than 2 hours of communication with an insured, may well fall short of accepted thresholds of service necessary for fair claims handling practices.
We remember that it was BAD FAITH and NOT MOLD that cost FARMER'S INSURANCE $32,000,000.00 in the BALLARD case.
Especially in MOLD claim handling, it is important and imperative that insureds and insured claim files not just be handled on an AVERAGE basis.
Each insured, each loss, and each claim is uniquely different. To treat them otherswise or attempt to adjust by template sets in motion actions which will inevitably lead to more and more multi-million dollar lawsuits.
Adjusters should be all the more careful as Bad Faith actions by insureds and plaintiff counsel will draw them into these lawsuits and imperil their own assets and Errors and Omissions Insurance.
Forewarned is forearmed.
Personally, I expect we will all hear more about this story, and much of what we hear (and READ) will ultimately be on 60 Minutes, 48 Hours, and in major newspaper and magazine articles around the country.
This may be a way for the carrier to save money, but in the long run, it is penny wise and pound foolish. |
joseph m lombardo jr
Registered User
Username: Jlombardo
Post Number: 37
Registered: 1-2002
| | Posted on Sunday, July 28, 2002 - 9:17 am: | |
Hey---the time slashing is also common when handling daily claims---they give you a file, tell you to bill it time and expense and then when you submitt a 7 page full formal captioned report with a 27,800 estimate and charge 3.25hrs for the report, you are told "we only allow .4 per page"---Then what the hell is "time and expense?????"--OH--I KNOW--IT IS OUR TIME AND OUR EXPENSE..... |
Sandra Thompson
Registered User
Username: Workingstiff
Post Number: 6
Registered: 1-2001
| | Posted on Friday, July 26, 2002 - 5:33 pm: | |
Wong,
I, too, have heard the same thing. Unfortunately, it is not just a rumor. It is a fact. Someone very close to me is going through this problem right now. It appears that there is an average amount that is being allowed per claim. I am anxiously awaiting the outcome of the exchange between the adjuster and the company. It looks as though he might have to take legal action.
And I've heard rumblings and rumors of a class action lawsuit due to the bills being "slashed" (as you put it and it appears to be an apt description). This is also in one of the larger western states for one of the 3 large carriers in that state. Does anyone know anything about this? |
Gil C. Newton
Member
Username: Newt
Post Number: 15
Registered: 7-2002
| | Posted on Friday, July 26, 2002 - 3:57 pm: | |
There was a lot of comments about the long hours
the adjusters were charging made by Farmers Training Boss , he said they were charging 15 to 16 hrs per claim. Its CYA time, People are shy about working these claims without making sure they got all the I's dotted. I heard this the first week in June. That was just prior to the
appointment of a new mold boss. He was present also at the meeting. As soon as a few claims come in against adjusters the E/O is going to sky rocket. Do not think I want to mess with this mold gold , might end up being fools gold.
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Ghostbuster
Registered User
Username: Ghostbuster
Post Number: 317
Registered: 12-2000
| | Posted on Friday, July 26, 2002 - 3:46 pm: | |
Hmmmmm...when I'z puts my ear to the tracks, is that the ol' Pineapple Express I hearza a rumblin' round the bend? Yep!, and looks like I better pull my head offen the tracks lest it get squashed!
Whooo, Whooo, chugga, chugga! Here come the news train! |
D Wong Whey
Registered User
Username: Dwongwhey
Post Number: 160
Registered: 10-2001
| | Posted on Friday, July 26, 2002 - 11:36 am: | |
I am picking up rumblings and rumors from several adjusters working on a daily mold assignment for one of the larger carriers in one of the larger western states concerning the carrier slashing T&E bills submitted by the vendor and in some instances, refusing to pay some individual bills entirely.
Cat adjusters familiar with the carrier and vendor may want to post here.
For other cat adjusters working mold assignments on Time and Expense, Keep your eyes open and Watch Out!
More details to come....... |
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