, Resources for Adjusters from Adjusters

Clean-up, Poor Work Product, Work and Career Info | Training | Locate Adjusters
Vendors | Marketplace

The Adjuster's Forum » Forum Archive » Clean-up, Poor Work Product, « Site Map »

Author Message
Mike Sebastian (Faith)
Posted on Tuesday, August 29, 2000 - 9:01 pm:   

Anybody come up against a carrier that hold tight to the proposition that their "similar materials" clause allows for discontinued original aluminum siding of 3 1/2" to be repaired with 4" siding. Man its ugly! I wouldn't put it on my house. What have you all come across on this item? Thanks.
Gale Hawkins (Gale)
Posted on Monday, August 28, 2000 - 11:23 am:   

Jim you are a great guy! You sense issues at a deeper level than some and have the knowledge to know things can be very different than they are currently. Sometimes a person has to do what you do from time to time to wake up others.

Others may get upset with a person that is both knowledgeable and vocal but at some level they do appreciate the good that can come from issues being aired that they themselves could never bring themselves to openly address. Keep up the good work. You do not need to apology to me because I am the greater offender. Jim a man with his heart in the right place will always self correct, especially if he has true friends.

You are so right about the dragons. This morning I learned about a guy that I was a customer of mind before we got out of the computer hardware and service business last year. He has developed and patented a product that greatly reduces blowouts in truck tires. He closed his tire store and hit the road marketing it and I understand with great success.

He got home this weekend to learn his wife had quit her job, had the dogs, cats and 2 horses put to sleep and left for Texas. Sure would not want him on my claim today if he were an adjuster!

Jim I do think this subject that you have brought so much light to bear on is one of the most important ones ever to hit CADO. Thanks for that.

To abruptly change the subject, if most of the claims reopened are underpaid and assuming not all underpaid claims are reopened then perhaps from an accounting stand point the cost of clean up adjusters is offset by what may would have been originally paid out if all scopes were accurate the first time around. This is not a positive thought I know but it could explain how some low-end vendors keep getting contracts. Not that they prefer this approach but we know the carriers are under great stress to do “something” when a Cat strikes. Any thoughts on this one from anyone?
Jim Flynt (Jim)
Posted on Sunday, August 27, 2000 - 11:47 pm:   

Gale, in response to your questions, I would offer the following answers based on what I am seeing and have seen over the years.

The reopened claim files are generally underpaid but it is usually a function of the adjuster missing items damaged or leaving them off of the estimate. Generally, unit pricing differences can be dealt with by an inside adjuster assuming there are no scope disagreements. When a claim is overpaid however, and the file reopens at the carrier's request, it is generally overpaid in some relatively extreme amount. In my opinion, there is generally some indication of fraud on the part of the adjuster or insured present.

Secondly, while I don't have any statistics to back up my opinion, I would venture to guess that the files are repopened at the request of the homeowner 75-80% of the time, and 10% of the time by the carrier and 10% by the contractor.

Obviously there will always be reopens to release holdbacks and recapture of recoverable depreciation, and these are to be expected by carrier, vendor and adjuster alike. This type of reopen does not fit into the same catagory as the "unexpected reopen."

I am still getting a lot of email on this topic both pro and con, and I will be writing an article, as I know others also plan to do, to suggest some ways to lower the rate of file reopens.

I have long said and advised newer adjusters that they should work "clean-up" as soon as they possibly can. It is the best way that I know to really learn adjusting. Clean up is where you will see all of the policy issues and their implications. Clean-up is where you will see both good files from excellent adjusters and you will also see the way "not to do it" from those with little knowledge or little concern for quality. The smart vendors realize the educational effects of clean up with newer adjusters, and they are the ones who will push them out of the nest early to better their adjusting skills. I think that after an adjuster has worked clean up, they are also more prone to handle a file properly, and they generally do not repeat the mistakes they have seen in other files of lesser quality.

If through the use of this Forum and the discussion of such a "tough" yet sensitive subject, we all become a little more aware of the problem, perhaps we can make progress by each of us raising our adjusting standards and hence, lowering our file reopens. If every single adjuster reading the CADO page just takes a little more time with a little more awareness to properly handle the claim, we can have a substantial effect out there on the next storm. And in so doing, everyone wins: the carrier, the vendor, the adjuster and the insureds.

Finally, I would like to say to our CADO audience, that by no means do I consider myself the "best" adjuster out there and just like all of you, my files reopen too. Sometimes I do a much better job on a storm than I do at other times. I produce a better work product with some vendors as compared to others. Attitude plays a just as important part in the quality of our work product as do our skills and abilities. Lower fee schedules and poor or irregular payment to the adjusters for their service billing by vendors can also play an important part and have a significant role in the frequency of file reopens. Those factors can significantly affect an adjuster and the adjuster's attitude toward the assignment.

It has been said that our attitudes affect our aptitude and I might add, our altitude in how high we can soar! I will continue to believe that it is the progressive vendors who give their adjusters the training and tools to succeed.

From my own studies of TQM (Total Quality Management), I have learned that people never fail when working for another save for the failure of management to provide leadership, bilateral communication processes, the power to make decisions at the lowest levels, and a quality assurance system which not only allows but generates success on the part of employees as well as the corporation. Quality is a process and as such it is a never ceasing process of refinement and continual improvement. Quality companies are those who recognize the changing nature and needs of a dynamic marketplace, and then not only allow but encourage the changes necessary to respond positively.

As my friend Tom Joyce has noted to me in an email, there are sometimes other things going on in the personal life of an adjuster which has effects that we don't always readily see: separation, divorce, death in the family, caring for elderly parents, a sick child back at home, financial worries, health problems, family crises. These are stressors which can affect all of us and affect our work product. Some times, we do not always see the effects ourselves. That is why when I handle a reopen file, I try to see the claim first from the standpoint of the original adjuster. If I can get "inside his head" it makes it easier for me to know how to close the file. This obviously is easier as the file documentation level increases.

I do believe that an adjuster going through a divorce, family crisis, or death in the family should be accorded a greater degree of tolerance and understanding in mistakes made, and like Tom Joyce, I have been blessed at times by generous and compassionate vendors or carriers when the pain of external events affected my own work and work product.

Gale, I posted this topic knowing it was and is sensitive. I knew that it would generate much discussion, and even some strong negative opinions as well. But I also felt that it was and is timely, and it is our responisbility at CADO to take on the issues of the day, even when they are tough and even when they may cause some discomfort to some of our readers.

Like each and every one of you, our CADO readers, I learn something new on each and every claim. The more I learn about insurance, the more I realize how very little I really know. Learning is a lifetime process and none of us will ever have all of the answers. But it is a tribute to CADO, and to each of you, that together, we can probably find someone here amongst us, who has encountered a particular problem and has a solution that perhaps we as individuals had not thought of which could make our life easier. It is always cheaper and easier to learn vicariously from the mistakes of others than to have to learn the old fashioned way: at our own expense.

I do not have all, if any, of the answers to the age old problem of reopens, but I do believe that this issue will become more and not less important in the days ahead. I would rather deal with some personal criticism now than to see all of us bury our heads in the sand and then wake up one day when it is too late for some remedy on our parts. I do believe that the wider use of telephone adjusters, staff, and contractor direct repair programs are on the upswing, and in large part due to this continuous nagging problem.

Gale, as you no doubt are aware, I have done all that is within my power to help other adjusters with education, training and personal development. I will continue with that task as needed and I stand ready to help any of our adjusters to better themselves with knowledge, training and education. Yet even as I am involved in helping to educate and train newer adjusters, I am constantly in classes myself when I am not on assignment in order to hone my own adjusting skills and improve upon my knowledge base.

I am as close to any adjuster needing assistance as an email requesting help in any way that I can provide, and I know that there are many many more capable and qualified adjusters than I here on this page who stand ready to do likewise. Just let any of us know!

Thanks for letting me share this view and may any of you please feel free to disagree with my points of view. Like I said, I do not have all of the answers and like everyone else, I make my own share of mistakes too. We are all human, and as such, it is part of growth that we make mistakes and then learn from them. I hope we can all use this CADO Forum and the CADO organization as we learn together and better our adjuster community while seeking to increase their richly deserved rewards.

We are all on the same team even when we disagree, and I truly believe that most if not all of you also stand ready to do your own part in insuring that this industry not only survives, but flourishes as well. We are all in this together, and as Dave has said, we will all either sink or reach the same shores together. I thank Roy for continuing to bring us CADO, and I thank each of you for your part in making this a truly wonderful and exciting profession to be in together.

Gale finally, if my words in earlier posts to you seemed abrasive or short, please accept my heartfelt apology. There were other dragons in my personal life which I was trying to slay, and those dragons sometimes allow others to see the very human part of me that makes mistakes: whether in word or deed. Some days we slay the dragons, and some days they slay us.

Gale, I value your opinion, even as we may sometimes diagree, and as always, I welcome your input on the many issues of the day here on the CADO Forum. As I am so humbly reminded so many times by Stephen Covey's wonderful book, The 7 Habits of Highly Effective People, in order for us to be understood, we must first understand. That means valuing the advice of others while respecting their views and positions, even when they are at odds with our own. In my earlier post to you, I failed in that endeavour and for that, you have my deepest and most heartfelt apology.

You just don't meet nicer folks than catastrophe adjusters, and, I might add, adjusting software vendors!

I sincerely hope this helps. It was long overdue. Thanks for listening.

Gale Hawkins (Gale)
Posted on Sunday, August 27, 2000 - 2:25 pm:   

Thanks George for taking the time to cover the subject well. Since you maybe be back on the job and cannot reply, I invite all that get involved with clean up work to comment on the questions I have. It is a given that there will always be clean up work regardless of one’s vocation. I had a uncle that worked for Chrysler and he worked in the shop that got the vehicles that would not start after they were built but it seems that much of the clean up being discussed of late is not due to an oversight but the adjuster just did not care or did not know how to adjust the loss.

My questions of the cleanup adjusters and thanks to each reply.

1. Is it a fact that the truly covered loss has usually been underpaid or overpaid?

2. What is three main reasons you see claims reopened as in who asked for the reopening, the carrier, home/business owner, a contractor, etc?
Jim Flynt (Jim)
Posted on Sunday, August 27, 2000 - 10:06 am:   

I received the following email which I am posting here for everyone's benefit. George and Lori not only are "doing it right," but we can all learn from their words and techniques. George, you are a Maestro!. Thanks for sharing your knowledge, wisdom and experience. Many of you may remember George and Lori as they were with Glen Garoutte when he fell to his death earlier this year. This email, is to me priceless, in the lessons George has to share, if we will only open our minds to learning and self-improvement.
Date: 8/27/00 12:20:02 AM Central Daylight Time
From: GHMullett
To: JFlynt0007


My wife, Lori and I are working clean-up for Mid-America Catastrophe from the May 12th storm in Wisconsin involving hail. Unfortunately we are in the Coloma, WI area population 302 counting us so we cannot access the Internet reasonably and I just visited your site after having been on the road since May 15.

We have been working a lot of re-openings for American Family, probably 20 or more a week.

The primary thing an adjuster needs to do is communicate with the insured. I cannot emphasize that enough. We do not know if there is an error, an oversight or what, until we get out there. The adjuster is always supposed to communicate the proposed settlement with an insured and many people tell us they never heard from the adjuster after he was out there. Whether that is true or not is not the issue. If the adjuster is overly clear not only on the amount of the settlement but exactly what he is recommending, it leaves little room for misunderstandings. Further, if he/she is extremely clear, people will not have the tendency to want to say they never heard from the adjuster.

The other thing that I cannot emphasize enough is to be thorough during the inspection. Take the time to look at EVERYTHING!!!!!

This particular storm came out of the North and West. So, 90% of the damage is to the North and West Elevations. But, there are still gutters damaged on the south and east elevations. We have found damage to the siding on the east and south elevations because a vehicle, RV or other structure is in close proximity and baseball size hail will still cause damage to aluminum siding after it bounces off something 3 or 4 feet away. Or they simply don't look at screens, windows, gutters, downspouts or siding. They need to slow down and REALLY look at everything. It takes more time and yes, you may only look at 5 claims in a day instead of 10, but those claims close and will tend to stay closed.

I know talking with Mid-America and Am/Fam, they have marked a few adjusters who appeared to be closing a large number of claims and Lori and I had to basically re-adjust the claim from the beginning. Sure, come a big storm, they'll get called again, because every one needs warm bodies. But, I assure you, they will be the first sent home when the matter starts coming under control. And they will not only not see their holdback, they will see some fees deducted.

Based upon your own experience, tell me the last vendor and company that were not happy with 5 claims closed per day, every day from the second or third day of the storm.

Next, I would recommend the adjuster be very clear and concise with the estimate. We are getting a lot of estimates that even we cannot tell what the adjuster did. The estimate allows 542 s.f. of siding but we do not know if that is the north elevation, west elevation, both or more. Not only does the insured not know if the adjuster allowed only for the north elevation and did not include the west elevation, but we don't know and we have to re-measure everything to try to figure it out.

The adjuster should carry a "SAMPLE" estimate with them. If they meet with the insured and obtain an agreed scope, they can show the sample to the insured and explain it. It helps the insured understand better when they receive theirs in the mail and will stop a lot of call backs because the insured does not know what the heck the estimate says other than the loss is $10,000 and they are only getting $4,000.

Also, be thorough in scoping regarding measurements and what is there. We have been on roofs that we were not sure were the same one looked at by the adjuster. The insured assures us he was present when the adjuster was on the roof. We found the roof to be 12 foot longer than the original scope/estimate/diagram. We found two layers of asphalt and one layer of Wood shingles on the roof. The roof has an intersecting gable, but it is not on the diagram. This is just one example. We are constantly re-inspecting claims because there was more than one layer and a lot where there is three layers of asphalt and one layer of wood. I make a habit of lifting the shingles while I am still on the ladder and determining the number of layers before I get on the roof. I will take a photo showing the number of layers. If there is only one layer, I usually do not turn it in to the company. If there is more than one layer, I turn in the photos necessary to document what I am recommending be torn off. I carry a pry bar, to get to the last layer if necessary and a can of tar to seal the area after I tear the H--- out of it, but no one comes back and says hey, you missed four layers!!!

In hail claims you have to look at a screen and you have to look at the trim around a window.

We are the "experts." People want to be able to call their insurance company and get an inspection that they feel confident identifies the damage. When they have a contractor come out and the contractor finds obvious damage and/or additional layers of roof covering, it throws the entire original inspection into question and erodes that insured's confidence in the adjusting process.

Since this spring, things have been pretty quiet. As you know from the postings, a lot of adjusters are looking and waiting for work.

Lori and I have worked since May 15 with only seven (7) days that we have taken off including this weekend for our granddaughters' fourth birthday.

We like to think it is for a number of reasons:

1. We are prompt in contacting insureds and very clear in our initial contact about who we are, what we are going to do, when we are going to do it and we comply with all those commitments. We also provide the insured with a number where they can reach us for ANY reason and we return all call promptly.

2. We are always, I mean always, courteous to the insured even when they are not courteous to us. We never react to anger, impatience or any other negative response from an insured for any reason. We are continuously polite and seriously act as if they are being polite. When they find that they are not going to get ANY reaction from us, they ALWAYS become friendly.

3. We are thorough in our inspections. We not only look at things once, with both of on site, we look at things twice and sometimes more. I realize that not everyone is a husband/wife/significant other/partner team. If it is just one person it becomes more incumbent upon that one person to be even more thorough. I know Lori is behind me and if I get lazy she'll still catch the damage. The single person does not have that luxury. I compare us to the outfield on a baseball team. If the infielder misses a ground ball he has the outfield backing him up. The outfielder only needs to turn around every once in a while to know there is no one else back there. The adjuster needs to realize that if he misses damage, there is no one else that may find it. The policy says it will pay for direct physical loss. If an adjuster does not find existing damage, than the company has indirectly violated its own policy.

4. Photographs. We take beaucoup photos. I am sure too many in some cases, but we never seem to get any complaints over the number we take. And we are detailed in our description of photos. Our description of a risk is not "Risk." It will say, "Risk. One story, one family, owner occupied, frame dwelling with attached two car garage located at 1600 Pennsylvania Ave, Washington, DC in average maintenance and condition. The dwelling faces south."

It does not say "Roof." It says "North roof elevation looking west. Test area showing 8+ hail hits to 3-tab, composition, asphalt shingles."

And if there are certain things that have been sustaining damage but we are not including it in our estimate we will photo it to show no damage

5. Scope Notes/Sheets. Lori and I utilize two (2) different scope sheets. One for the roof and one for the rest of the exterior. It has areas for diagrams and it has items to be inspected and the quantity, such as roof vents, ridge vents, gutters, downspouts, siding w/ type and size, screens, etc. We check each item visually and then either mark the quantity damaged or indicated it is okay. That way we know it’s been checked when we prepare the estimate. WE ALSO TURN A COPY OF OUR SCOPE SHEETS IN WITH OUR FILE WHEN WE CLOSE IT. If someone has to come behind us, they know what we were looking at and what we found. I do not know what anybody looked at or what they found other than very confusing estimates.

6. Reporting. Everyone, including us hates paperwork. When I started in claims 26 years ago I could spend 7 hours in the field and have 1 hour of paperwork. Well, that's why they're called the "good ole days." We can either waste time moaning about it or we can come to realize that more is required today and it is all part of the professionalism. Some companies don't want/require a lot of paperwork or verbiage on a claim. Well, that’s too bad, they're still going to get at least one full page from us. 26 years ago, my mentor told me, "Tell them what you did, why you did it and what you’re going to do about it." It still applies and it is still pretty easy once the routine is down. We tell them what we found during our scope and what we recommend and propose about it. We also tell them what we did not find in some instances. If there is no damage to the A/C unit, we will comment upon it. If there is no damage to siding, we will comment upon it and maybe tell them it is wood siding with no damage to the finish. It takes us maybe 10 minutes to prepare our one page report. Now, at five claims per day, that’s 50 minutes. But any kind of report will take at least 5 minutes, so we are talking less than 30 minutes to be thorough. And I carry E&O insurance so we are going to make sure we cover ourselves on paper.

6. We get back to most insureds after we are done with our estimate. There are always going to be some insured who never seem to be home and won't return calls, but that is a very few. Most will want to know and if you leave a message saying you have it done and you WANT to talk to them BEFORE you turn it in, believe me, they will call. If they don't then the third time we will leave as much detail as possible on the message. And we have AT&T so we can leave a message even if they don't have an answering machine.

But, when we do reach them, we go over our estimate, line by line and thoroughly explain depreciation/holdback and ACV. This is not rocket science and I find even elderly people can understand it if one takes the time to explain it clearly. If someone can't explain it clearly then I would question whether THEY understand it. And we always invite people to call us back if they have a PROBLEM OR QUESTION. I don't want them calling their agent, company or brother. I want them to call me. The less calls anyone else gets about George or Lori the better we look. So, if a 83 year old woman wants to call me because her contractor told her he wanted 1/3 down when she signs the contract, I am more than happy to talk to her about it and remind her to check the BBB, ask for and check references, etc.

We are first professionals and second in a service industry. If we cannot take the time to be professionals and provide the service then we should get out of this business.

Sometimes we are embarrassed by what other adjusters have said and done. Claims magazine reported that the insurance claim business is just above used car salesman and we have no one to blame but ourselves. Lori and I spend a lot of our time trying to undo the ill-will that some 10 minute adjuster did because he wanted to see 10 or 15 claims that day and could not take the time with any one insured to make them feel like their claim was nothing but something keeping him/her from getting 11 or 16 looked at that day.

Jim, I am sorry that this has gone on. When I saw your note, I thought, "Boy, is he asking for it."

I know adjusters who keep scores and scores of photographs depicting all sorts of things. They seem to think that that is cool or something. I find it despicable. It throws every claim ever handled by them into question. If a photo did not come out or if you did not take a photo of certain damage you are including on your estimate, GO BACK OUT THERE AND FINISH THE JOB, you should have finished your first time. Laziness, errors, or stupidity does not justify falsifying a claim. If you do that get out of my business as you are a reflection on me. (The use of "you" does not imply YOU, it is an abstract noun.)

You can use whatever part of this you so desire. We are thorough in the product we provide clients and while we fear that if everyone were like us, we would no longer stand out above the crowd, I have been doing this long enough to know that will never happen. If one "average" adjuster improves his/her skills and begins to think as a professional, I will be happy that I sent you this.

Again, I am sorry for the length, but I thought it best to be specific.

You may remember Lori and I were with Glen Garoutte when he fell from the roof in Virginia and was killed. We still talk to his wife, Nancy fairly often and she is getting better although she still misses him terribly as you can imagine.

We enjoy your site and we still plan to formally join as soon as we remember to send you money. The problem with working all of the time is you forget to do a lot of things that you very much want to do.

Your pal,
George Mullett
Rj (Rj)
Posted on Saturday, August 26, 2000 - 3:35 pm:   


While you state quite well, what is happening I must disagree as to your conclusion of where to place the blame. If the problems being dealt with by the cleanup adjusters were just isolated incidents, then your conclusions would be right on the money. However, that just is not the case, the many problems cleanup adjusters are finding are wide spread in the industry and as you have so pointed out have carved out a niche in the business for at least 20 years that appears to have been adopted by many carriers as a normal way of doing business. Please refer back in this tread to my previous posting where I discussed cause & effect.

Sometimes it is hard to see the forest for the trees. You have approached the problem by looking at where the problem is showing its ugly head. Sure it is always easier to find a fault with & place the blame on the lowest individual in the chain of command much as you have done. Sure while I agree that those individuals should be weeded out, that does not fix the problem. You see these individuals are symbolically the trees in the forest you are looking at which is preventing you from seeing the forest where the real problem lies.

Like Jim and others I have on occasion conducted re-inspections of other adjusters work products. The following is one such incident that comes to mind. At the end of a storm event we (my wife & I) were requested by a storm manager to help out by doing some cleanup conducting re-inspections of other adjusters completed loss adjustments. During the course of preforming the re-inspections we found many of the same errors that are being discussed on this tread by the majority of the adjusters the firm hired.

Just when we thought we had seen everything we came across a file that, at the time, shocked both of us. This adjuster left off more than 20% of the damage to the risk off his scope of damages and included for replacement many items that did not physically exist on the residence premises. At first we gave the benefit of doubt and considered that he accidentally entered a scope off another loss into this claim. However, after we very carefully examined & compared those items that were there included in his scope of damages we were left with the fact that the adjuster included items for the sole purpose of increasing his service bill.

We documented the actual loss with photos and presented this situation to the claims manager. The claims manager reacted with total surprise and after review of our documentation told us that our documentation in his opinion was enough to have the adjuster convicted of insurance fraud and his opinion was that this individual should go to jail.

Before we were able to complete all of the re-inspections another storm event suddenly occurred and the firm had to recall all adjusters back to work the new storm. Much to our surprise one of the first adjusters called back by the claims manager was the very adjuster that the claims manager stated should be in jail. To further confuse us the claims manager placed this individual in the hardest hit area and assigned us to outlying areas even though we were the top producers in the previous storm event. As a note of irony the claims manager has moved on and is now currently a claims consultant for a major carrier. His current responsibilities include the testing and certification of an adjuster's abilities and to control claim assignments to vendors.

My whole point to my experience is to demonstrate just what I mean by cause & effect. Without any doubt the adjuster committed the infraction for which he should have been held accountable for. But what occurred after exposing his misdeeds to management clearly shifts the blame to management. For it is management that is not only permitting this activity to flourish it actually encourages it. It is on this basis that the poor work product being produced and acts committed by adjusters clearly are as a result of management decisions to hire unqualified adjusters in the first place and the blame for it lies solely with management.

According to what you and everyone are saying these problems have been around for at least 20 years. So these problems are not isolated, therefore, general knowledge throughout the management levels of all the carriers goes without question. Therefore, since management does nothing to stop the problems and accept them as a normal part of doing business the blame (CAUSE) should be clearly attributed to management and the EFFECTS of their management decisions is the continuation and acceptance of the poor work product by unqualified adjusters.

As I previously stated one situation, which is causing most of these decisions by management to hire unqualified adjusters is due to the fact that speed is more important that quality. They have taken away the ability of the IA's to diary files during a major storm event. It does not matter to management that all claims are unique, therefore, varies in the amount of time each individual loss takes to properly investigate and close. Somehow it has been imbedded in most claim manager's minds that the length of time it takes an adjuster to properly investigate a loss and bring a loss to conclusion is only relevant to the dollar size of the claim. They have lost total insight that on the average it actually takes longer to document & make proper recommendations to deny a claim than to pay one. Yet a claim denial pays the adjuster the least amount to complete.

Payment, none payment or denial of a claim requires clear & concise documentation. The adjuster must have a complete understanding of policy provisions for which the adjuster will base his decision on. It is quite obvious most all of the problems the cleanup adjusters are having are primary due to the fact that many individuals that are being hired as independent adjusters do not have a good understanding of policy provisions and this lack of experience and knowledge is at the root of nearly all problems being experienced.

In addition to comprehension & the applications of policy language there are other qualifications an adjuster must have.

1. Construction: An adjuster should know at the least basic construction practices & techniques, the difference in drywall, drywall sizes & application, grades of floor, wall & ceiling finishes, types of construction load bearing vs. Non load-bearing walls, masonry vs. frame vs. steel construction and the list goes on and on and on.

2. Architecture: Just the basics that often are indicative of the quality, therefore, the cost of construction

3. Personal Property: Sense of value & the basic skills required to be able to determine the value of damaged items

4. Cost of Living: The ability to recognize life styles and the costs associated with them

Management knows that the above qualifications and skills are needed by each adjuster if that adjuster is going to be able to adjust a loss properly. They also know that the quantity of adjusters that possess these abilities is very limited. Therefore, management has made a conscious decision to hire under skilled individuals. So now as a direct result a lot of problems are showing up & according to you have been for at least 20 years. Since management made the decision to hire unqualified individuals, the blame must be placed where the decision was made in the first place.

You see if management wants to play the numbers game they have made the only choice they could. So stop blaming the inexperienced adjuster & place the blame where it belongs, with the top management of the carriers. The vendors & carrier claim managers are only players of the game. The game is being played by the carrier's corporate officers and they are the ones making the rules.

There will never be enough qualified independent adjusters. So, the only option at this time that I can see any relief at all for this problem is for management to first realize the rules are flawed then change them. If they want a good work product then several things are going to have to change.

1. Identified qualified independent adjusters

2. Make sure when qualified independent adjusters are used the adjuster is provided a heavy work load. Nothing will turn a qualified adjuster away from working for a firm quicker than if you fail to utilize his or her skills to the fullest

3. Allow the qualified adjuster the time to adjust his files properly. This includes the ability to diary files during a catastrophe event.

4. Once all off the available qualified independent adjusters are employed then & only then should you begin to add on unqualified adjusters. At this stage be very careful not to overload these individuals & conduct quality reviews their work very carefully.

Now I know I haven't touched on ever aspect of this subject and I expect other opinions and recommendations will & should be posted. But just think for a minute, before CABO came along our group did not have a forum platform in which we could freely express over views on what is good and bad about our industry. I believe and hope others will also believe that through our discussions on this web site we can make a difference and make this profession one to be proud of. After all to become a qualified independent adjuster it takes many years of hard work, training and dedication. Placed in the proper perspective we as qualify independent adjusters must posses the knowledge, training and skills of many professions, so in a way that makes our profession quite unique, therefore, at the very least as a professional the qualified independent adjuster should have the respect and admiration that are bestowed on other professions.
Jimlakes (Jimlakes)
Posted on Saturday, August 26, 2000 - 1:10 pm:   

I agree with almost everything you say in your post.

The one thing that I would like to add is that not all vendors are as you say. Yes, a lot of them are interested in the numbers of claims that they can "suck up" and the number of "warm bodies" they can find to handle them. That's why I have said ALWAYS that we are intrested in "quality," not quantity. We will only take the number of claims that I know we have the qualified adjusters to handle and then tell the carrier that we can't handle any more. Believe me, they appreciate it. And I truly believe that we will always have this concept. That's why we constantly say that "quality control" on the part of the vendor is most important.

Jim Lakes
National Catastrophe Director
RAC Adjustments, Inc.
Whitey (Whitey)
Posted on Saturday, August 26, 2000 - 10:11 am:   

Such a hot topic. Suprisingly Jim has only brought out a topic that has been in existance for at least the 20 years I've been in the business. I have been on both sides of the fence. That as a Catastrophe manager and General Adjuster for a major carrier and as an I.A. (Which is where I am at now and prefer the I.A. designation as to a Cat. Adjuster.)

The interesting thing is that the problems Jim has identified with examples are not new to the industry. Maybe they're new to those reading the posts, but believe me, these types of problems have been around for years.

The problem is a double problem. First: you have the adjuster (so called) who takes short cuts, doesn't know what he is doing and or commits fraud. The estimate written by the adjuster is the adjusters work product. No way can you shift the blame from overwrights, fraud and pure incompetence to anyone else. This person knows what he is doing and is fully aware of the potential consequences.

Second: The vendors are at fault. How you ask, very simple, they enlist the services of so called adjusters without having any real knowledge as to their strengths, weaknesses or their ethics. You see, some of the vendors are only counting the dollars and have made outrageous committments as to providing personnel to service a storm.

Now for the consequences: If you really believe that the carriers don't keep a list of adjusters who appear to have committed a fraud, overwrote estimates or as the examples list, wrote estimates without inspections or hired a roofer to do the inspections for them, then you are sadly mistaken. The Catastrophe managers for each carrier do talk to one another. As for who is responsible to the carrier, the vendor is the one with the contract. As a prior Cat. Manger for a carrier I can advise you that the carriers will pursue an E&O claim against the vendor for monies overpaid on files that fall within the examples provided and others. Do the vendors pursue the individual adjuster? You will have to ask them. Should They? Absolutely. You see, the examples provided border on insurance fraud. But it takes time and money to pursue the individual and of course we all know that personal relationships play a part.

Do the carriers ban certain adjusters from doing their work? Absolutely and heaven help a vendor who uses an adjuster that has been banned. Of course there is alway the possibility of a probationary period with strict supervision for the adjuster, so that he can come back to work. This should only apply if the mistakes are truly scoping and honest in nature. Failure to inspect, writing bogus estimates or having a contractor write the estimate for you does not fall into this category.

Should there be a black list among vendors? Absolutely, but the problem is that with some of the vendors personality conflicts rather than work problems end up playing a role in their decisions. You see, I have seen where an adjuster was rejected due to his physical condition and the assumption that he could not climb a roof. I don't believe this is right, unless it is known that the person cannont climb a roof. Unfortunatly, appearance plays a role in the selection of adjusters by some carriers.

Let me finish by saying, we all know that there is not a file that you can't find problems with if you want. The examples given are not honest mistakes from lack of experience but outright fraud. The blame lies with the adjuster first and the vendor 2nd for continuing to use these individuals and 3rdly with those carriers who do not pursue E&O claims against the vendors. If they did, I doubt that these individuals would be in this profession.

As for Gale's comments, well they speak for themselves. He has forgotten that the estimating program does not make a person an estimator or an adjuster.

David Bennett
Paul Bagnato
Posted on Friday, August 25, 2000 - 10:58 am:   

Just for my two Lincoln Heads I gotta say something
First, yes the times are changing, The computer age is amoung us and we will adapt or not work. The choice is for the adjuster to make. I do though believe that if they are not already computer driven then the vendor will make the decisions for them.
Second, the storm troopers, the parttime adjuster that gets the call so he can write some checks and put a quick dollar in hs pocket with the fee schedules. Please note that I don't believe the storm troopers normally stick around for cleanup. They are parttime adjusters I say because their major income is not derieved from insurance adjusting. They are carpenters, carpet layers and cowboys. Not professionals adjusters, the vendors know this, the carriers know this, the CADO adjusting community knows this.
Why then is the thread so long. Folks there is nothing anyone is going to do about the part timers, they are here and the carriers need them, that is the bottom line. They want to learn, then we are here for them.
I for one, like many others that are on board with CADO work the CATS and the local work in my area. This keeps my standard high. The technology up to date and the CAT duty less stressful because I don't have to relearn everything I did last Hurricane season.
Thank for being here
Paul B
Cecelia (Cecelia)
Posted on Friday, August 25, 2000 - 7:27 am:   

Jim, your friend Jack Wilson is not entirely correct. First, I think if an adjuster is trained by a very good and thorough adjuster, that adjuster will average less reopens on the first few assignments. For me, working inside at Farmers National Catastrophe Center taught me invaluable lessons about how to handle and document a file so that anyone at any time can understand what was done and why. I am now utilizing these lessons. Additionally, if the files I'm working here in Minnesota reopen at the NCC my friends (that I worked with for 2 months) will see them and kick my *** if I've done sloppy work or incomplete documentation, etc. Adjusters CAN, in some circumstances, police themselves. Especially since these people work for the same vendor I do.

Jim Flynt and Dave Hood have written several articles (available on this website) regarding this industry and where it is going. They have written about change; the type of work we are doing and how it is to be performed are changing. For many years the idea was to hit it fast and get out fast. Close those files FAST and turn in volume. Rj is right. The carriers wanted volume and fast closures. So vendors, and therefore, adjusters, gave the carriers what they wanted.

But change is again in the air. I believe that (perhaps only some - Farmers, St. Paul, Atlantic Mutual to name a few) carriers realize the value in handling a file properly, closing it and having it stay closed (except for perhaps an RC reimbursement). To do this takes time.

For this Minnesota storm we had a meeting of all independents and staff. This meeting lasted over 2 hours. It was very clear exactly what the carrier wanted and how the carrier wanted it done. We have received, several times, comments from our vendor management to the effect that if we are doing 8 a day of these type claims, we are pushing it. Any more than 8 per day and there is no way we are doing our jobs properly and looking at all the damage to each and every property. Maybe it IS possible for some people (because I know someone will inform me that a "good" adjuster or a "technologically advanced" adjuster can)to run 10 of these per day.

I agree with Tomj as well. There are carriers out there who will have an adjuster change his/her file in pricing, scope, etc to meet whatever rules the carrier has at the time. And he's correct. The adjuster should not be criticized for his work product when instructed to handle files a certain way. When the file reopens, though, it is sometimes hard to tell if the file was handled and "rehandled" before the carrier would accept it, or whether the adjuster did not do his/her job. I am grateful that I haven't had the experience of the adjuster that Tomj is describing.

Those of you who know me know that I am working for Wardlaw. I am as happy with Wardlaw as Jim Flynt is with RAC. I, too, get paid on time. I, too, have the support of the vendor management for any problems or concerns that I have. There ARE good vendors out there who care about quality of the work product put out by their adjusters. The "fast" adjuster used to be the best. Now it's the "most thorough" adjuster. The times they are a changin'.
Rj (Rj)
Posted on Friday, August 25, 2000 - 12:39 am:   


This is one of the truly professional competent adjusters that has never stayed to clean-up the mess and never will. Well maybe if the daily per diem was $3,000.00 a day with no guarantee as to volume of corrected files and a minimum 30 day commitment. It is way harder physically & mentally to straighten out the mess than to do it right in the first place. The stress is unbeliveable.
Jim Flynt
Posted on Thursday, August 24, 2000 - 10:18 pm:   

I received the following email from a CADO reader relative to this topic.
______________________________________________________________________Subj: Re-opens
Date: 8/24/00 8:44:11 PM Central Daylight Time
From: (Jack Wilson; Memphis, Tennessee)
To: JFlynt0007

I have worked clean-up for many years. The faults are obvious to an average adjuster. The best way to produce a decent file is to work clean-up a few years and learn for yourself. All the teaching in the world will not make a hurried adjuster write a thorough file. Get yourself another subject to "hold forth" on.

Companies want files closed and closed fast. This produces "reopens". You are penalized if you wait for all of the details to close the file correctly. Tell 'em the truth.
Jim Flynt
Posted on Thursday, August 24, 2000 - 10:17 pm:   

I received the following email from a CADO reader relative to this topic as a follow up.
_________________________________________________________________________Subj: RAC
Date: 8/24/00 8:48:27 PM Central Daylight Time
From: (Jack Wilson; Memphis, Tennessee)
To: JFlynt0007

a little brown-nosing goes a long way..huh?
Vince Tabor
Posted on Thursday, August 24, 2000 - 10:11 pm:   

Having read all the previous contributions to this thread I'd like to add a thought. Perhaps the cause is in all of us and in most types of business today. It all must be resolved so quickly.. so we can do the things we really care to do. We should really consider the people we serve... the insureds, with each and every file prepared and closed.

One author wrote:

"No one is willing to acknowledge a fault in
himself when a more agreeable motive can be found
in the estrangement of his aquaintances."

Mark Twain in The Guilded Age
Tomj (Tomj)
Posted on Thursday, August 24, 2000 - 2:31 pm:   

Jim and Rj,
Working with major independants on staff, with companies and as an independant I agree with Rj on many points. I have worked cleanup and can match many a story which are better left alone. However, there is one point that hasn't been addressed, if an adjuster is given a price list and uses good adjustment practices and used the list as a guideline instead of gospel, and gets files kicked back, then redoes the estimate accordingly, then it reopens, whose fault is it?(talk about a running on). If the reinspector has the adjuster redo his estimate so tight the file reopenes and the file is subsequently settled on the adjusters original estimate, whose fault is it. Personally, if I settle a loss with fair and accurate pricing or complete a loss with an accurate scope and explain any questions with a report and I am then told to change it, it is not my responsibilty for any future problems with that file. I have handled many reopens that were settled with the original adjusters estimate. Now I am not discussing those files with inflated or defective scopes, or grossly inflated pricing, but attempting to put a bit of perspective on the situation and the fact that there is more than one party involved in some of these situations.
Oh well, wnated to vacation this fall anyway.
Jim Flynt
Posted on Thursday, August 24, 2000 - 2:02 pm:   

RJ, I agree 100% with your comments. I will continue to believe however, that incompetent adjusters themselves must bear some of the responsibility.

You know RJ, the idea strikes me that there may be one other solution to the problem and that is this: if all of the truly professional competent adjusters would simply refuse to stay and do clean-up, this problem would no doubt solve itself within the course of one storm and a matter of a few months.

What would the vendors and carriers do then? Let the incompetents clean up their own incompetency?
Rj (Rj)
Posted on Thursday, August 24, 2000 - 12:30 pm:   


After reading this thread I feel that I just have to make a response as to where the blame really lies as to whom may be responsible for all of this improper adjusting that is being discussed.

As a cleanup adjuster one will readily see most if not all of the improper adjusting that is being done. The first & most written about conclusion places all the blame directly on the shoulders of the adjuster and you may say why not, he or she is the one that committed the adjustment errors.

Now this is an easy solution to the problem and on the surface deflects the blame from where the real blame for these improper adjustments should be placed. To understand what I am referring too, you first have to think about the theories of cause & effect.

Jim, the problems that you are writing about are the effects of poor management decisions. Bad management decisions CAUSE the hiring of unskilled individuals in place of the experienced adjusters THE EFFECTS are the volume of improper adjusting that you are complaining about. The next question is how far back up the line of management should the problem be traced that would allow one to positively identify the source of the problem?

Well lets start with the vendor. As we all know the number ONE major driving force for hiring any adjuster is how fast can the adjuster close files. Everything else is secondary and really doesn't concern the vendor that much. Now it would be easy to stop here and say this is where the problem lies and place the blame for this activity directly on the vendor shoulders.

The answer is NO. The reason becomes very obvious when you understand the driving force behind the vendors decisions. You see the vendor has a working relationship with the carrier. He must comply with the carriers demands (written or verbal) or be faced with loss of assignments.It is the carrier that places the pressures on the vendor for fast & high quantity of closings under threat of pulling all assignments. So the vendor's number ONE priority is to close files as fast as possible in order to continue receiving loss assignments from the carrier. The vendors theory is we have all the time in the world to go back and fix all the problems, however, if they don't turn the initial file closings in super fast time then another vendor will and that vendor may loose his contract or at the very least a reduction in file assignments. It is this system of conducting business that has lead the adjusting profession down this weary path.

Unfortunately, such things as standard adjusting practices go out the window and the primary concerns of the carrier & vendor firms is the numbers game. The carriers & vendors need a volume of adjusters if they are going to play the number games. What everyone fails to recognize or chooses not to recognize is that the number of qualified adjusters that it takes to play the numbers game simply do not exist. But they still insist on playing the game anyway. That is why you have a job as a cleanup adjuster. When the game is played the vendors are financially forced to hire anyone that comes along. Unfortunately, this has become the industry norm instead of the exception.

In our search for where the blame lies is now at the level of the carrier. We are still looking for the CAUSE, so lets us explore in general the corporate ladder in respect to decision making.

Let us start with the claims department. Depending on the number of policies in force the size of the claims department, in terms of manpower, can range from one individual to thousands. With any size at all the property claims department will be divided into three management levels. Beginning with the claims manager then going down the corporate ladder to assistant claims manager then the various levels of adjusters.

Now all three levels in the carriers group can and do influence the vendors so where would you place the blame for hiring unqualified adjusters just to meet the fast turn around time. Would you place the blame on the staff adjuster. No they are only doing their jobs as defined by the assistant claims manager. Now it appears that we maybe getting closer to the problem. Could the problem lie with the assistant claims manager? This could be the source, however, before you could conclude that you would have to know a lot about the assistant claims manager and the amount of authority given to this individual. Lets move onto the claims manager, should we blame him well it appears we maybe getting closer to the CAUSE. But wait a minute he answers to the vice president of claims, a corporate officer of the carrier from which he takes direction. Now we are getting down to the brass tacks as to where the CAUSE originates.

Now it appears that the true CAUSE originates with the carrier management. Unfortunately, the only ones that can effect change in the way business is conducted at that level is the carriers officers.

While we are quick to point out what is wrong with the system and/or individuals there may be a solution to help in relieving the problem (EFFECT). If the claims managers would allow the independent adjusters to diary their files in much the same manner as staff adjusters do, then independent adjusters could handle a larger case load and the pressure to hire warm bodies to close files rapidly would be lowered. This would in turn allow the necessary time for the independent adjuster to properly adjust the files so when they are closed they stay closed. Then maybe the cleanup adjuster would only have to reopen files for legitimate reasons such as hidden damage, RC benefits ect.. It appears that this would eliminate most of the reasons to hire inexperienced & unqualified in the first place. That old saying "Hast makes waste" appears to have fallen on deaf ears at the carrier level.

Since my wife & I have been independent adjusters we have consistently have been in the last group of adjusters to leave an assignment. While we work an average of Sixteen hour days Seven days a week while on assignment we take a little extra time on each file to make sure our recommendations on every file are as accurate & properly organized as possible so anyone reviewing our work product can follow and understand our recommendations. Because we take this small amount of extra time we almost never receive a file back for correction and never have any charge backs on our files and most important of all when we close our files they stay closed.

In closing it appears that most of the problems could be avoided if the carriers would stop having knee jerk reactions every time an event occurs & go back to standard adjusting practices. In the end a timely (not instant adjusting) and fair settlement will build a better base for which to build customer relations on.
Gale (Gale)
Posted on Thursday, August 24, 2000 - 11:28 am:   

Post removed by CADO Staff as not being germane to the thread topic. Posts concerning software should be posted in the CADO Software Forum under the thread for a particular software.
Jf (Jf)
Posted on Thursday, August 24, 2000 - 8:06 am:   

The PowerClaim discussions are already set up over on the CADO Software Forum for those who wish to discuss PowerClaim, it's pricing and features.
J. Rollins
Posted on Thursday, August 24, 2000 - 4:29 am:   

The date in the Sacramento Bee was 8/22. I rechecked and can't seem to find it either. It may have be linked up from another source I don't know. The name of the story was "Northridge Bill Throws Monkey Wrench Into Talks Between State and Insurers". It stated that swift progress of the bill that let Northridge earthquake victim refile claims is thwarting attempts to get insurers to rescind settlements reached with then Insurance Commissioner Quackenbush, a state negotiator said.Clark Kelso asked senate leader Burton to delay action of his bill which would give victims of the 1994 L.A. Earthquake one year to refile damage claims with insurers. Kelso told Burton the bill would create a wave of class action suits taking years to resolve and would frustrate his efforts to convince insurers to voluntarily recind the controversial settlements. Insurers fearing lawsuits, said the Burton bill removes any reason for them to voluntarily recind the settlements. "The enactment of sb1899 is like the kiss of death to potential for resolving these settlements amicably" said Bill Packer a spokeman for the Association of Calif. Insurance Company. The bill is in the senate, which is expected to approve it and send it to the governor Wednesday, Burton spokesperson Dave Sebeck said Tuesday. Sebeck said Burton disagreed with Kelso and that he's going ahead with the bill. The assembly has already approved it. Insurers beleive the bill allows the potential reopening, unfairly, of the more than 600000 claims, most of which they say were settled satisfactorily. These are some things I jotted down from the article. This all stemed from the Quackenbush deal that the insurers made with him. There were some market research reports that were released by a whistle blower within the commissioners office and it came to billions of dollars in violations and the deal was reduced to millions, which did not go to the victims. The whistle blower released them, then they were released to the public by a senator. There were billions of dollars in violations. The Sac Bee and L.A. Times carries alot of this coverage . I guess the politions are pretty peived at what went on with the way the victims were treated.
Posted on Thursday, August 24, 2000 - 1:09 am:   

Well, full of yourself are ye!
Hell, I'm the best there ever was or will be.
Don't believe me?
Just ask.
Legend in my own mind.
Posted on Wednesday, August 23, 2000 - 11:40 pm:   

The sad thing is that as many adjusters that are blacklisted for cause, there are as many blacklisted for the wrong reasons. Watch that eye contact! Is California still part of these United states? 600,000 claims no wonder everyone wants us on standby.
Gale (Gale)
Posted on Thursday, August 24, 2000 - 1:46 am:   

Chuck thanks for clearing up the “white list” thing for Jim (as if he did not understand from the get go) :)

Jim all I was saying was you can do more for the adjusting industry if you will approach things from a positive angle :) instead of a negative angle :( You have gotten all bent out of shape over what you took to be “no good” adjusters when in fact they were not adjusters at all or were out of their element as Chuck clearly pointed out can and does happen.

Your illustrations are not truly of bad adjusting. They are illustrations of bad management at the vendor and/or carrier or maybe just plain greed. It is a fact that IA’s and vendors both get approached by carriers they are working for saying so and so will handle our claims for 25% less, can you match that or do we have to change over to them?

They want high quality and low price (like one gets with PowerClaim :)) but since most IA’s and vendors have not been grossly over priced from the get go then if they, under pressure lower their schedules may often find that a negative feedback loop takes control.

Jim the vendors need a list of adjusters that can meet their current adjusting requirements, not a list of who not to hire because black list does not insure a vendor is hiring quality adjusters but an accurate white list will.

A body needs to be chartered at a state or federal level that is empowered to do such so it is not run by an out of control personality or personalities as others have pointed out could lead to abuse. Perhaps it could be a body similar to the PLRB organization. Of course it would have to prove itself to all parties or else it would go by the wayside.

So that we are kind of abiding by CADO rules of staying on the subject of the original conversation, yesterday I received a call from a vendor using PowerClaim saying a sales person had approached him from DDS stating they were willing to deal to get them to move over to DDS.

Jim this vendor has our 10 adjuster volume discount of $100 which means with he is only paying $379 per year per adjuster but with our current “NEW” customer special of getting 2 years for the price of 1 year this means his average monthly cost is only $15.79 per adjuster for the first 24 months.

We found this to be exciting since this was the first real indication that DDS is suffering from their pricing system but that may lead to additional headaches if some are paying less that $20 per month while others are reportedly paying up to $139 per month.

While I doubt DDS is yet prepared to go all the and match PowerClaim in features, easy-of-use, support and price but at least it is still a step in the right direction by lowering the cost of technology for adjusters, vendors and carriers as PowerClaim as done. Perhaps the users Boeckh, Simsol and Xactimate can expect to see technology cost fall more in line with what other industries are paying for their software tools very soon as well.

Apparently the best way to save $300 - $400 per year on paying for DDS by the month is to sign up with Pilot if their contract limitations are not going to effect any of your future plans accord to DDS users that find they need a software package when working for other firms as well. We do something similar with vendors as well that basically sell PowerClaim for us so their adjusters are more eager to sign on with them. It really is a win-win for all parties.

Jim try not to stress so over the actions of others. Look at it on the bright side. If non adjusters had not been hired to do the work of an adjuster you might be setting in front of the Weather Channel just watching Debbie died instead of make all that money knocking out 10 claims a day :)

P.S. Jim Lakes I see while I was writing you nailed the issue as well that basic problem is not non-qualified adjusters. No issue can be truly dealt with unless the actual source of the problem can be isolated. The adjusters in question are only symptoms of the problem.
Jimlakes (Jimlakes)
Posted on Thursday, August 24, 2000 - 12:47 am:   

Chuck, You slightly speak in both directions concerning the "list." I do not have a "black list" either. But I will tell you that I don't forget an adjuster that does one of those things that Jim mentioned in his message. If anyone thinks that the things that he mentioned don't happen then just call me and I will tell you some just like it and worse. Thats the point that I was making in a prior message. This is still happening today. I think that this is a very serious topic and needs to be discussed in great length and detail.

I sent Jim an e-mail the other night concerning the causes of this type thing and believe it or not I feel that a greater responsibility lies on the head of most vendors for allowing it to happen. Its called "Quality Control" or the lack of by a lot of vendors. I feel these type things would not happen if the vendors paid more attention to the "quality" that they are putting out instead of the quanity, we would not have near as many of these type discussions.
Keep it going and we can all learn by our postings.
Jim Lakes
National Catastrophe Director
RAC Adjustments, Inc.
Chuck Deaton
Posted on Wednesday, August 23, 2000 - 11:09 pm:   

Jim, I have to applaud your efforts. I can't say that I want a "Black List" but anybody that thinks companies don't maintain a "Black List" is fooling themselves. Approved adjuster lists (white list) and being removed from an approved adjuster list (black listed) is a fact of life. In this computer age your deeds will follow you more than ever, black or white.

I dare say that Jim and I both have a list of adjusters we would recommend and adjusters that we would not use under any circumstance. There are also adjusters that I would use for hail but are out of their element with a flood loss.
Jf (Jf)
Posted on Wednesday, August 23, 2000 - 11:20 pm:   

Memo to JRollins: Please provide us with the date of the story in the Sacramento Bee and we will post a hyperlink here to the story. I researched the Bee website and was unable to find the story you mention.
J. Rollins
Posted on Wednesday, August 23, 2000 - 10:33 pm:   

Talk about poor adjusting, California senate just past a bill that will reopen 600000 claims from the big one. Boy that really has to register on the richter scale with the carriers. Imagine 600000 claims. Maybe the big one just hit again. You can see the story in the Sacramento Bee. We better start brushing up on earthquake damage, old, old, damage. I don't know about you but I better start packing for California.
Russ Doe
Posted on Wednesday, August 23, 2000 - 8:03 am:   

I love this site!!Nowhere else can you get the information you need to become a well informed adjuster!To me Jim Flynt is a crusader,telling it like he see's it!I truly believe that posting the garbage that some adjusters turn in can only be helpful to newbies!I also dont thiink a black list is practical!too many times it would be used as a political tool to hurt someone that may not be a bad adjuster.I do trust that storm managers would not employ those adjusters that make the industry look bad!If they do they deserve what they get!I know for a fact that most of the old timers would be glad to answer any question,give guidance,or an opinion to any newbie that needs it!!Email addresses are on the members page!If you dont want to post on a forum or bulletin board,send an email to a member and see what happens.Remember:IF YOUR NOT CONNECTED TO CADO YOUR NOT CONNECTED TO CAT ADJUSTING!!Much thanks and appreciation to Roy Cupps for the efforts in upgrading and keeping the site up and running!Please BE SAFE AND HAVE A GREAT DAY!!
Jim Flynt
Posted on Wednesday, August 23, 2000 - 1:17 am:   

Gale, I gather by your rather flippant and "cute-sy" response that you are obviously not posting here to respond seriously nor to contribute meaningful dialogue to an important discussion with wide ranging impacts to the catastrophe adjusting community.

If I am mistaken in my conclusion, please let us all know, and I will offer a heartfelt apology for my error.

If you would like for CADO to set up a more frivilously inane thread for you to draw colorful "smiley faces" and display other works of art, please let us know, and it will be done.
Gale (Gale)
Posted on Wednesday, August 23, 2000 - 1:08 am:   

:( :) :( :) :( :) :( :) :( :) :( :) Blue=Black Yellow=White
John Mcmennamy
Posted on Tuesday, August 22, 2000 - 11:04 pm:   

Syracuse, NY. Ice Dams 1998.
Adjuster brags about closing over 60 claims in one week and leaves the storm. Two weeks later the insureds call carrier for an explanation to the checks they received. Seems that this Super Adjuster never contacted the insured. Carrier is very upset and contacts vender. All claims are reopened and reinspected. Photos do not match any part of any risk. All photos are from God knows where. Carrier gets very upset at vender and all Independent Adjusters. Clean up was a nightmare for the adjuster that stayed.
I do not claim to be the best adjuster, just the best I can be. I do not try to compete on how many claims I can close. I just try to close them so they will stay closed. I look for help from those with more experience than myself and receive it in most cases. I give help to those with less experience than myself. By doing this we help to teach each other and hopefully our trade by building a better reputation for adjusters. The adjuster mentioned would not and did not help anyone, even the newbees. It was lucky they found out before the adjuster had been paid. I found out later he started his own adjusting company. It was posted on CADO. I pity any adjuster who might have worked for him.
The reason the carriers are turning to contractors is because of adjusters like the one above and the ones Jim mentioned. I do not post very often and maybe should not have posted now. Just my opinion. Johnny Mc
Jim (Jim)
Posted on Tuesday, August 22, 2000 - 9:32 pm:   

Gale, I guess I am a little confused about your idea for a "White List" as compared to a "Black List."

Perhaps you can share your proposed idea of a "White List" with our larger CADO audience and I? I must admit I am intriqued with your idea as I am sure our readers are as well. Please share it with us.

But first, I am going to share a few examples from some of my clean-up assignments and YOU tell me and our CADO readers which "List" you would put these "adjusters" on: what should be an industry wide "Black List" or the Gale Hawkins proposed "White List" (whatever that means):

(1) Adjuster A reports to the carrier fence damage from a Santa Anna windstorm and his estimate shows damage to 1,200 linear feet of rear yard fence @ 14.00 per/lf = $16,400. Carrier asks for a reinspection. Reinspection reveals insured only has 200 feet of wood fence on the entire premises, of which 100 feet is damaged (real value of actual damage is $1,400.00). Which list should this adjuster be placed on?

(2) Adjuster B reports wind damage to 3 garage doors for full replacement at risk. Reinspection requested by carrier reveals insured has a one car garage with one garage door. Which list would you place this adjuster on?

(3) Adjuster C reports ice dam damage to a steel front door. Carrier requests a reinspection, which reveals no damage to a steel door from ice damming. Which list would you place this adjuster on?

(4) Adjuster D reports damage to the carrier for one item in the gross amount of $1,500.00 and does not include any receipts. Reinspection requested by the carrier, reveals that damage was repaired for $1,000.00 and adjuster did not include paid invoice provided to the adjuster by the insured in the amount of $1,000.00. Insured also sent a copy of the paid invoice to the carrier. (Obviously, the adjuster was trying to help the insured with the deductible). Which list would you put this adjuster on?

(5) Adjuster E reports damage to exterior of risk only from ice. Reinspection requested by insured, reveals no exterior ice damage and $10,000 +/- of interior ice dam damage. Insured advises reinspector that first adjuster advised "that he does not do interior damage." Which list would you put this adjuster on?

(6) Adjuster F closes file and recommends payment of claim for a 40 square roof for hail damage. Reinspection reveals roof to be 25 square. Which list would you place Adjuster F on?

(7) Adjuster G reports claim and closes file for interior damage from water infiltration for 6 rooms of damage including large recreation room. Reinspection reveals that risk is a 5 room dwelling with no recreation room. Which list would you put Adjuster G on?

(8) Adjuster H scopes a loss with an Insured, writes an estimate on site, and reaches an agreed settlement with the Insured on the first call. Insured invites adjuster inside for a "drink" and both proceed to drink heavily and then adjuster withdraws offer of settlement. Adjuster and insured get into a fist fight. Which list would you place Adjuster H on Gale? Your "White List" or MY "Black List?"

(9) Adjuster I is assigned to what is expected to be a 21 day storm. Adjuster does not turn in any completed files until his last day on this assignment. It is later discovered that Adjuster I has driven by risks and taken photos of the front door, and has written estimates for interior damage, but has not talked to any insureds nor inspected any risk interiors. Adjuster I has totally fabricated his estimates and then reported closed files with agreed settlements with the Insureds. Which list would you place this adjuster on Gale? YOURS or MINE? Black or White?

(10) Adjuster J leaves storm, and later his files are reinspected. Carrier and vendor discover that Adjuster J has handed 25 claims to a local roofer to measure, diagram, photo, discuss and reach settlement with Insured. Adjuster J does not even visit risk for inspections but does talk to insureds by telephone. Which list should this adjuster be placed on Gale? White or Black?

(11) Adjuster K has an automobile accident while on a storm assignment with resulting damage to his vehicle in the amount of $5,000.00. Adjuster K does not have any insurance for vehicle repair. Adjuster K then handles a claim for an Insured, Mr.Goodwrench, who owns an auto body shop. Total value of Adjuster K's estimate for Goodwrench is $7,500.00. Claim is reinspected at carrier's request, and it is discovered that claim is overpaid by $5,000.00. Adjuster K complains a few days before his accident that he is "broke" and has his car repaired at Insured Goodwrench's body shop. Which list would you place Adjuster K on Gale?

(12) Adjuster L accepts a storm assignment with a vendor to work for a large carrier on a per diem rate or $500.00 per day to handle outside claims. Adjuster L then proceeds to accept claims from two other vendors on the same storm without informing any of the 3 vendors of the work for the other two. Which list would you place this adjuster on Gale?

Gale, I could go on and on, through the alphabet and back dozens if not hundreds of times, providing you with example after example of ineptitude, incompetence, and outright insurance fraud by these so called "adjusters." These are just a few of actual examples I have encountered over the years. There are many many more that I could share of equal or greater import.

As far as I am concerned, most of the examples I have outlined above do not reflect incompetency, they reflect downright flat out insurance fraud. If I am wrong in my thinking in any way, please point out the error in my logic.

Gale, working as a cat adjuster is not some great big Woodstock like "love feast" where we are all part of some "kinder gentler" society. This is the workplace for God's sake, where people have to take responsibility for their own actions and their resulting consequences.

I know that you and PowerClaim make money when adjusters, however incompetent or dishonest or fraudulent they may be, use, rent, or lease your program. I suppose any diminishment in the pool of adjusters and so called adjusters who might use your program may adversely affect your profits or profit potential.

The Insurance carriers, Insureds, Vendors and the rest of the adjusting community are not as fortunate and they all lose as long as this type of unchecked behavior goes unnoticed, unreported, and unremediated.

You have read the examples above, and I am sure others in our audience could tell a few of their own which would make your hair curl. I guess I am bothered that you seem to want to placate, mollycoddle, and excuse such irresponsible, incompetent, and many times ilegal actions.

You can't have it both ways Gale.

I call this incompetency and I argue strongly these so called adjusters should be made known to the carriers and they should be bounced out of this industry on their ears.

Gale, I will not apologize to you nor anyone else for this type of incompetency. It is hurting all of us, and until we police our own industry, we all bear some responsiblity for it's continuation, and we all will pay one hell of a price, either directly or indirectly.

Let us hear from you, and please share with me which list, the above "adjusters" should be placed on: the Industry "Black List" or the Gale Hawkins "White List."

I have said here before, and will argue strongly, that the vendors behind these incompetent adjusters are in and of themselves just as guilty if not more so, than the incompetent adjusters they send out on storm assignments.

You are right Gale, that this is not a "new problem" but it is one which is getting more attention from carriers in this day and era of cost cutting, cost controls, and financial performance. A new day beckons and we can either join the global movement toward quality control and quality service or we can be left behind with some very painful memories of how we all botched it by our inaction. Which way would you have it? To me, the choice is clear. All of our futures depend on the paths we elect to follow.

Frankly, for me Gale, it is a "no brainer." "Adjusters" or "so called adjusters" like the ones outlined above should be placed on everyone's Black List and removed from this industry before they can do any further damage to the collective reputation of all catastrophe adjusters, the vendor accounts, the insurer financial results, and most importantly of all, the satisfaction and quality service which any Insured should expect from the American insurance system of risk protection.
Gale (Gale)
Posted on Monday, August 21, 2000 - 11:24 pm:   

Congratulations Brittanyh1010! You may have set a record for starting a conversation that got the most axes sharpened in the shortest time period and that was not mostly BS.

You seem to have drawn out issues that have been keep in the dark for the most part, they were known but not openly discussed. That is one way CADO is helping to enable the entire industry to move forward.

From the best I can tell only the carriers actually provide education for the adjusting industry. Sure there are courses but all realize they are only starting points for the most part. Yes your Crawford and GAB types provide training for their staff adjusters but again the carriers fund that indirectly because they pay more for their services. So to me it seems like the carriers are really the only ones providing a pool of trained adjusters for IA or Cat work.

This is without question the cause of “cycles” in the industry that we all have seen or heard about along the way. Just as with the tides there are always reasons behind “cycles”.

Carriers go to contractors when they can provide a better product than adjusters are providing. Local contractors overall are more motivated to provide a more accurate product than a cat adjuster or even IA’s for several obvious reasons.

After the staffing up “cycle” by carriers matures a down sizing, cutting loose or what ever you choose to call it follows. Do these highly trained and experienced adjusters just drop of the face of the earth? No, they go out and buy a Frontier Adjusting office, start an adjusting firm, go to work for one or get into Cat adjusting.

All are fat, dumb and happy for the first 5 –10 years and OK for up to 15 years. The carriers save money by farming out the claims. The adjusters make good money. The insured love dealing with those nice adjusters with the personal touch and caring attitude that the carriers practiced when these adjusters were in training.

Low and behold some get rich and retire, some just retire, some die, some get out of the profession because of health reasons, etc. All of this time the carriers had become accustomed to lower overhead and quality claims handling in the field then one day suddenly realized their claims handling cost are up and customer satisfaction is being often botched in the field, causing them to lose premiums as well.

When you are fighting a battle on two fronts and losing both of them actions will take place where they are right or wrong. I work with carriers that are building their adjusting staff both on the inside and outside because Jim Flynt’s public exposure to the decay in the industry is old news to these carriers.

According to a few sources, Allstate has felt it was in their best industry to staff their own 200 members Cat team internally. If this is factual that means if in the pass a certain vendor had called you out perhaps now you are waiting on the “big one” more than in the past. Most everyone knows some carriers, because of increased staffing are declaring fewer Cats these years. Without question in the non-Cat losses the use of contractors are reducing the number of claims farmed out to adjusters.

There is nothing that will be done to break this “cycle” in its current phase. The carriers have to have better adjusters in the field than are currently readily available to them. No carrier will staff a large Cat team unless they cannot find vendors that can provide the services they need.

The use of contractors and the hiring of staff adjusters will continue in the near future but by starting today, CADO or some other group or combination of groups could help “break” the “cycle” next time around by providing a way that new adjusters were being trained at a rate that will insure a continual pool of quality adjusters to meet the carriers on going needs.

The easiest thing will be to let the “cycle” continue.

To Mlb: Thanks for your input. I feel perhaps some misunderstood you intended message. Your three-sided story view is intriguing. Being neither an adjuster, vendor or carrier perhaps I heard things from these three groups that perhaps one group would not freely share with one of the other groups. It is truly amazing how often you are correct about the three-sided story scenario in this industry. No one speaks the facts in personal (emotional) matters, only our interpretations of the facts.

We all know Jim Flynt is a very knowledgeable teacher that can greatly assist in making the adjusting industry a better place for all. Personally I know it is frustrating when you see others in your profession doing things that are so harmful to their own industry and how easy it is to come across in the wrong spirit.

It is easier to put people on a “Black-List” than a “White-List”. Perhaps Jim is a little like a few Independent Baptist ministers I have know that preached a good message but the negative twist they put on a positive subject often drove away the very ones that needed saving the most. I am sure Jim will work on being less of a stumbling block in the adjusting community by personally focusing on what is wrong with the adjusting industry so he can publicly show how by following a more perfect way, both life and retirement can be more fulfilling as did the Master teacher.

In the event someone may have a similar or opposite thought that you do not want to express in a public place just email me,
Red (Red)
Posted on Monday, August 21, 2000 - 11:21 pm:   

I DO know Jim personally. I have worked with Jim many times and am proud to call him a friend. I have worked cleanup with Jim on more than one occasion. I know that he gives the previous adjuster every benefit of the doubt and that he tries to see how, and the process, behind what the previous adjusters has in their estimate. I have also had him say to me "how in the heck" (cleaned up) could they have measured the roof at 37 feet at the ridge when it measures 58 feet in length, and width at 18 feet not 13'. The only way this type of measurement could be achieved is quite obvious, the first adjuster didn't get on the roof and measure it. This type of stuff is what you see on cleanup from some adjusters that are anxious to get in and get out and handle 10 or more claims a day and that is the quality. I am sure this is probably what he is seeing on this cleanup. I personally would like to see ALL the adjusters that are putting out that type of product to be exposed and have them pursue another occupation. They don't belong in this one. We have enough problems trying to handle the claims correctly without having idiots out there that think they are so good they can tell the size roof and roof measurements by just looking at them. I have literally had an suppose to be adjuster tell me "I don't need to measure the rooms, I can tell by looking at them what size they are. I personally would like to see us be more interested in quality first and quanity second. Don't misunderstand, I realize that we have to work lots of claims to break even with the expenses but I think we should be giving the Insured, the Vender, and the Insurance Carrier the quality they deserve and that which we are being paid to do. If we are not being paid well and the scale is to low, we should have said NO when they called you know our saying "know before you go" once we go, we should do the job right not screw it up for someone else to clear up.
John Mcmennamy
Posted on Monday, August 21, 2000 - 8:12 pm:   

Even though I do not know Jim personally, my cousin does and thinks very highly of him and Roy. Over the last few years I have seen Jim share his knowledge and experience with any adjuster, new or old, that asked. Jim does not try to force his views or thoughts on anyone. Knowing from his past post Jim knows more about our trade than most and has probably forgot more than most will ever know. Like most others, including myself, that has pulled clean up and had to rework claims from the gang bangers I feel the same way Jim does. I do not understand how some of these people are still working. Everyone is yelling to expose the bad venders, that is good. The venders should be able to know and expose adjusters that are giving all adjusters bad reputations. I have seen venders that say they will never use one bad adjuster or another and the next storm someone else from that vender without know hires that person while qualified adjusters or promising newbees are at home. Not only is it not fair to the adjusting community, it's not fair to the carrier or insured. Whether you like it or not the insured pays our salary not the carrier. Both the carrier and the insured deserve to have an adjuster that closes the claim correctly and the claim stays closed. Anyone that says they have never had a claim reopen is lying. If an adjusters claims consistently reopen something is wrong and that adjuster needs to find other work. If Jim's post hit a sore spot maybe it's time to look for another job. Nothing personal because I don't know you. Just stating my opinion. Johnny Mc.
Jimlakes (Jimlakes)
Posted on Saturday, August 19, 2000 - 7:19 pm:   

I would like to take the time to try and clear up a few facts that you seem to be unaware of.

Number one, Jim Flynt is working for RAC in Minn at our request. We have had several adjusters up there for the last two years doing "clean up," for a good carrier that is still receiving new claims daily and also requests for re-inspections on a daily basis. Over the past two years we have had many different adjusters there doing just as he is.

I know for a fact, that what he is stating is the "truth" and correct, that prior adjusters did not do their job and had they have done a complete job and a quality job, he and many others would not be there.

As for the adjusters that are getting a "bad rap" that you state, THEY SHOULD. As a matter of fact, they should be exposed for what they did, so that we as independent vendors know who to use and not to use. How else are we to find out unless we all stick together and weed out the bad ones?

If you read my post, you have seen that I stated that I personally have been there on at least three different occasions over the past two years and have seen what type of work was done. It was pitiful and extremly unprofessional.

I don't consider Jim Flynt to be a "hero," just someone that truly cares why our profession is sadly going down hill fast, by the use of undertrained, uninformed, unqualified, and just plain poor adjusting. This is the reason for this site to inform all of us of those that need that training, education and help.

Thats the strangest thing about this business. I have never met a "good quality adjuster" that was unwilling to help train, guide, or discuss claims with another adjuster with less experience. Herein the problem lies. Its the ones that think that they know everything and don't need further training that is hurting all of us. Hell, I've been doing this for 30 years and I'm still learning from other adjusters and claims people and am thankful for it.

Just one more thing, I never knew Jim Flynt until about 4 months ago. All I can say is I believe that he is trying very hard to improve our profession, as are we at RAC, and I might add do a good job where he is now working. This is evidenced by the responses that we have received back from the carrier. And after all, isn't that what we all want, to do a good job and hold the respect of the people that we are working for so that when needed again, they are happy to call on us again?

Jim Lakes
National Catastrophe Director
RAC Adjustments, Inc.
Posted on Saturday, August 19, 2000 - 9:01 am:   

To Jim F.
I have read all your posts with great interest.
Your list of adjusters should be that, your list. I know I am not one of them, as I did not work in the area, however, adjusters are having a bad rap from carriers and vendors as it is without "you" adding fuel to "their" flames.
Why not just accept your job, no matter "HOW" you got it, and "DO" your job, and that is adjust the claims. If the files you are looking at for reinspections,etc, then do just that, properly and fairly pay the insureds and close the file.
Being a "HERO" to vendors and carriers in no way means "YOU" are the best adjuster in the business,it only means that you find fault in other peoples work and use that to "highlight" your achievements in order to be the "CLEAN-UP MAN".I have seen your quotes here, and I believe it has been 3 sides to the story, yours, theirs,and the truth. So try to be a little more kinder and gentler? with your opinions.
I am trying not to critize you or your postings but at least before you pass on "YOUR" "BLACK-LIST" to Mr. Lakes and "ruin" someones career make sure "you" have all sides, yours,theirs,and the truth.
If in doing that we at least try to keep our profession to the carriers and vendors just that
Thank you
Jim (Jim)
Posted on Saturday, August 19, 2000 - 1:44 am:   

Jim Lakes, just because I am up here in Minneapolis with RAC, does not mean that I am "Santa Claus" when it comes to closing files. In other words, I am not throwing money away just to close a file. The insureds are rightfully owed the money for damages, and unfortunately, the first "adjusters" just did not understand that. There are of course, many things that they did not understand.

Jim, I am like Santa Claus however, in that I am "making a list and checking it twice" and Jim, I have a list of "adjusters" who I hope I never see working for RAC (or anyone else for that matter). Keep up the emphasis on quality, and in the end, RAC and all of the quality professional adjusters with RAC will prevail.

Jim, you have my solemn promise that I will do all in my power to see that you and RAC build the most qualified team of quality oriented professional adjusters in America. I am proud to be part of that RAC team.

Jim, I believe that RAC truly has the ability to assemble the most talented capable group of professional adjusters in America who take pride in their work product. I also believe that sooner or later, that emphasis on quality is going to be recognized by the carriers. When (not if) that happens, the insurance carriers will be beating your door down. That is the one scenario where we all win.

Enightened companies in the new millenium recognize employees as people, and they also recognize them as their greatest corporate asset. Enlightened managers realize that TQM (Total Quality Management) starts with the sharing of process improvement ideas both from the ground up as well as the top down. When and if vendors in our industry recognize this, they will come to understand the power which can be unleashed by empowering their own people. New alliances are forged when enlightened managers understand team building. Thanks Jim Lakes for being an "enlightened manager" in this industry. That is what makes you a true visionary as well as an insightful leader.

Folks in order to be a "leader" in anything, you have to have "followers." You are going to hear more and more about RAC in the days to come. They "get it." They understand the power of empowering good people toward the never ceasing goal of total quality management, process improvement, and team building. And, not to sound completely serious, they also recognize that as cat adjusters away from our homes and families, that this should also be a "fun" task as well.

For all cat adjusters out there who take pride in your product and expect as a result to be treated like a human being instead of just a number, may I suggest you send your resume to Jim Lakes ASAP.

Take it from an "old timer." RAC is THE BEST!!!!

And Jim Lakes is right. At RAC at least: QUALITY is OUR product.
Jimlakes (Jimlakes)
Posted on Friday, August 18, 2000 - 9:05 pm:   

Jim Flynt. Gee I didn't think that we were going to create such a furor over some clean up claims.

But, you have hit the Nail On the Head.

I truly believe that if the first adjuster out would just do the job that he is paid to do, you and the others probably would not be in Minn. I too, have been up there on several occasions and done re-inspects on those claims and could not beleive what I was seeing and the type product that was put out. Its no wonder that the insured's and the contractors up there are still submitting claims. If the adjusters reading this forum don't believe this, then they could very well be part of the problem.

Of course I could add that the client called on us to do the re-inspects, because they know that we have "quality" adjusters and will pay what is due and coming to the insured and still not give the "store" away. I also know that it is very frustrating on your part to see this happen in our industry, just as I did.

One other thing. Many vendors tell the carrier that they have a "Quality Control" program just to sell their service, when in fact many of them don't even know what "quality control" means. And you are correct, it is the vendors responsibility to see that their adjusters know their job and this can only be done with such a program. I have drafted many programs for several vendors and watched them do just as I have said. Use it for marketing and thats all.

This is one reason that I am with RAC Adjustments, today. I instituted a quality control program and we do not use new adjusters without re-inspecting some of their completed claims at the begining of a storm to make sure that the mess that you are cleaning up doesn't happen to RAC. As you probably notice almost every post that I make somewhere has the word "quality" in it. As a matter of fact, our company motto says, "Where Quality is our Product."

Keep up the good comments and the education of all adjusters and our profession can not go anywhere but "UP."

Jim Lakes
National Catastrophe Director
RAC Adjustments, Inc.
Admin (Admin)
Posted on Friday, August 18, 2000 - 6:56 pm:   

The links that Tom provided are located in the Resource Center, Under Building and Construction
Tomj (Tomj)
Posted on Friday, August 18, 2000 - 5:35 pm:   

I posted several roofing wedsites some time ago and should be in the archives. If not drop me a note and I'll refer you to my website.
As far as the`estimating, you estimated the loss regardless of limits, obvious coverages situations would require company contact
Jim (Jim)
Posted on Friday, August 18, 2000 - 5:29 pm:   

HSmith, Thanks for your kind comments and what seems to be an excellent suggestion.

Yes, siding is one of the major issues as are window units. But you would not believe the roofing inaccuracies we are seeing either.

I am having dinner tomorrow night with several clean-up adjusters, and will see if we can come up with a concensus on the problems we are seeing. Perhaps we can agree on some major points which should be shared here to prevent these type of file reopens.

There are many helpful ideas one can glean from working clean-up and clean-up files, and I will be more than happy to share some of those with our CADO audience, and I invite others working clean-up to do the same.

Anything we can do to improve the skills of our least adjusters, goes a long way toward improving the reputations of all of our cat adjusters.

Thanks again for a great idea. It will be done.
Hsmith (Hsmith)
Posted on Friday, August 18, 2000 - 4:31 pm:   

To Jim F: Your interesting posts concerning the "under" estimating and generally sloppy adjustments that you are reviewing, perhaps, reveal some patterns.

I am wondering if siding, vinyl, aluminum or other, remains a mystery to many adjusters: When to repair, when to replace, when to paint, where to get a color match, etc.

CADO from time to time has had some very good instructional material on roofing. Perhaps informative and instructional material re siding might help raise standards in our profession.
Jim (Jim)
Posted on Friday, August 18, 2000 - 3:08 pm:   

This morning while I was in the St Paul Company's offices here in Minneapolis, another reopened file was brought to my attention due to the post I had made earlier this week under this thread. I was told that this file was indicative of such incompetency, that many service invoices for the original vendor went unpaid by the carrier.

In the particular file shown me today, an "adjuster" went out and wrote an estimate for $5,100.00 for hail damage from the 5/15/98 hailstorm here in Minneapolis. This adjuster received as his portion of the service invoice $102.00 (assuming a 60-40 split).

This file was just closed this week with an Agreed Value Settlement with the Insured and N/I contractor and the gross total of damages was $49,000.00. The adjuster's portion of the service invoice for the adjuster handling this reopen was $650.00.

Now, we know that the original vendor lost this carrier account. This vendor also lost $332.00 on this file to another vendor who provided the reopen adjuster. Wonder how many vendors lose sleep at night thinking about those kind of losses? Just multiply that degree of service invoice loss X an incompetent adjuster X # of incompetent adjusters X number of storm days + Loss of carrier account = Gross Incompetence or Lack of Managerial Controls or Apathy. Which one is it?

We may guess that service like this may cost the carrier the business of many insureds.

And now, we also know that either in their haste or through their incompetency, that the first adjuster lost $448.00 on this one claim for claims services.

That is why when I read about so called "adjusters" closing ten files in one day, I just shake my head and laugh. I know that sooner or later, Chuck Deaton, Cecelia, myself or some other "clean-up" adjuster is going to have to really close the file, and we are the ones who are going to make the real money on that particular claim.

Some of you folks need to wake up. It's your own money you are losing, and you aren't doing the reputation of our industry any favors either.

Either learn to do it right, or go find another job.

And finally I have one last question: WHERE was the QUALITY CONTROL personnel for the original vendor? This vendor was just as guilty of incompetency as the original adjuster and perhaps more so.
Tomj (Tomj)
Posted on Thursday, August 24, 2000 - 2:26 pm:   

Jim and Rj,
Working with major independants on staff, with companies and as an independant I agree with Rj on many points. I have worked cleanup and can match many a story which are better left alone. However, there is one point that hasn't been addressed, if an adjuster is given a price list and uses good adjustment practices and used the list as a guideline instead of gospel, and gets files kicked back, then redoes the estimate accordingly, then it reopens, whose fault is it?(talk about a running on). If the reinspector has the adjuster redo his estimate so tight the file reopenes and the file is subsequently settled on the adjusters original estimate, whose fault is it. Personally, if I settle a loss with fair and accurate pricing or complete a loss with an accurate scope and explain any questions with a report and I am then told to change it, it is not my responsibilty for any future problems with that file. I have handled many reopens that were settled with the original adjusters estimate. Now I am not discussing those files with inflated or defective scopes, or grossly inflated pricing, but attempting to put a bit of perspective on the situation and the fact that there is more than one party involved in some of these situations.
Oh well, wnated to vacation this fall anyway.
Jpt (Jpt)
Posted on Thursday, August 17, 2000 - 11:16 pm:   


In reference to your hypothetical estimate:

"Fix damage to roof $1575.00"

I have yet to run into a "lump sum" contractors estimate that was under charged. Contractors that "lump sum" do so for a reason, they know that they are over charging and want to hide it.

In fact, I find this practice more prevalent among contractors that have been in business for 15+ years. Would be hard to stay in business that long by undercharging on bids.

Just my $ .02.

Chuck Deaton
Posted on Thursday, August 17, 2000 - 2:14 pm:   

Jim, glad to hear someone else say what I have said on this site on several occasions. When you hire and review adjusters files it is amazing how poor the overall quality is.
Gale (Gale)
Posted on Thursday, August 17, 2000 - 2:08 pm:   

Jim here is a common example of some contractors’ estimates. See what you can do with this hypothetical loss.

Fix damage to roof $1575.00

Jim did the contractor over charge or under charge on this estimate? If this stumps you do you really think this contractor knows his true profit or lost on this job? Was making that overdue house and truck payment go away for a few weeks his over riding objective?
Jim (Jim)
Posted on Thursday, August 17, 2000 - 11:47 am:   

Trust me on one thing Gale. I am the one here who is not asleep. In fact, it is that somber awareness which has caused me to make education and training my signal task and goal within this industry for Newbees and seasoned adjusters alike.

I may be guilty of doing "clean up" way too long and far too many times, but certainly not guilty of just discovering an age old problem within this industry. For those adjusters out there who are doing and have done "clean-up" you know what I am talking about, and it is not a pretty picture.

Gale, I would still at this point disagree with your premise about contractor under pricing, but I think it would be more useful if you would set up and provide us with a more detailed example of a hypothetical loss so that we might either learn or have more serious fodder for a spirited debate.

In any claims situation, there really are only two places a contractor and adjuster can disagree on estimate bottom lines. This assumes of course that there are no coverage questions or policy limits or sub-limits.

First of all the contractor and adjuster can disagree on scope which as you know is the quantification of damages.

Secondly, we can disagree on unit cost pricing which is qualification of damages.

I have always said, there is never a reason for a professional adjuster and a professional contractor to disagree with the first: scope or quantification.

If we can or could just get the first part right, the second part is easy. Just as in my example given in my first post of today's date, the price for replacing Anderson windows is not generally going to be found in your PowerClaim price database nor in the DDS, SIMSOL, or Xactimate price database. I will even go so far as to concede that those price databases should not show window replacement costs using Anderson (or Pella) as a general price of window replacement.

The problem Gale comes in when a newer or "one-peril" (read that to mean hail) adjuster scopes the loss and does not understand the difference between an Anderson or Pella window versus a stock window.

I am sure to catch flack from making this statement, but it is my own experience that the "average contractor" is much more likely to properly scope the loss than is the "average adjuster." And given my earlier example, handing an estimating program to someone who does not understand estimating, construction technique and process, and proper scoping is very similar to handing a scapel to a butcher.

Assuming that the contractor and adjuster can agree on the scope or quantification of damages, then their estimates should be within the same general ballpark in qualification; give or take a 5% range depending on the gross size of the loss.

I do think that too many times, there is the ready tendency by adjusters and contractors alike to overuse or misuse the minimum charge within estimates, and this can alter or skew the actual costs of repairs.
Gale (Gale)
Posted on Thursday, August 17, 2000 - 11:35 am:   

Jim I can see by your detailed post you are truly becoming awake to what is happening out there. You are getting really close to understanding the real reason behind the cycles in the adjusting industry that my research have identified. As to contractor bids, please check with some of the profession ones your are seeing up there and ask them if new contractors and the mom and pop’s are not under charging base on the real cost of doing business. Since PowerClaim uses the same core source (Craftsman Book Co.) as DDS, Pocket Systems and Simsol, the issue is not the line item pricing at all but has to do more with the scope. You will find this hard to believe but many discount their wages, do not charge for hauling, etc because they already have “paid” for the equipment. Like so many of us in business they just flat die broke because they never really understood the true cost of doing business. I will get back to the cycles thing this winter if things slow down. Jim when you are undercharging sometimes you have more business than you can handle :)
Jim Flynt (Jim)
Posted on Thursday, August 17, 2000 - 6:07 am:   

Gale, I happened to wake up early this morning and after reading your post, I had to check in the mirror to see if I was awake or having a nightmare.

You tell us that you have a few contractors buying PowerClaim and then go on to state: "the main reason is that these contractors are learning they are giving the insured bids that are often thousands of dollars less than the insured collected from the carrier."

Gale, if that is truly the case (and I don't believe that it is BTW) then something is terribly wrong with the insurance system.

It would suggest to me that if the contractor by using PowerClaim and it's price database can charge more for the repairs than the contractor is now charging, that there is a terrible flaw in the PowerClaim pricing database. I suppose that would also be true as well for any other estmating software which uses the same or a similar pricing database.

I do agree with you as regards scoping not constituting any more than 10% of the adjuster's function as a professional. Yet, I do think there is a whole lot more to adjusting than simply closing a file so that it stays closed.

This past week I handled a claim here in Minneapolis for hail damage wherein I was the 4th adjuster to handle this file. This mind you Gale was for a hail loss.

The risk was approximately a $600,000.00 dwelling with high quality material construction and as you may imagine, a large roof and siding exposure.

The first "adjuster" wrote an estimate for $4,500.00 give or take a few dollars and as such, his service bill was based on this amount.

When the file reopened (actually it never really was closed), the 2nd "adjuster" came along and wrote an estimate for $8,500.00 and sent a copy to the insured.

Naturally, as some would not be surprised to learn, neither of the first two adjusters even talked or communicated with the insured, other than to send a copy of the adjuster estimate by mail. Perhaps they are among the elite group of distinguished "adjusters" who some have described here on this board as being able to "close" 10 files per day.

The 3rd adjuster (and I know this adjuster and know him to be capable) raised the estimate on a "re-open" by an additional $19,000.00 to cover hail damage to 18 Anderson windows which could not be repaired and required replacement. This $19,000.00 +/- reflected the actual cost of replacement from the Anderson vendor.

Finally the file comes to me because the estimates written to date are still $8,000.00 apart in differences from the insureds estimates.

And Gale, I remind you and other readers, this is for a loss which occurred over two years ago on May 15, 1998. Is that unbelievable or what? It almost rises to the level of 'bad faith.' It certainly passes the bar of incompetency.

Gale, isn't there something terribly wrong with an insurance claims system and process which takes over 26 months to get this type of small claim closed properly?

Perhaps there is no reason to further wonder why the State Insurance Commissioners of our 50 states around the country seem to be so regulatory minded.

Perhaps we can now all have a greater understanding as to why more and more insurance companies are bypassing "adjusters" such as these and opting for telephone adjustments and contractor direct repair programs. After all, how could a contractor have done any worse with their service?

It makes sense why catastrophe adjusters are more and more being labelled as the adjusters of LAST resort.

The 3rd adjuster got it right regarding the window pricing, but his claims handling was done completely by telephone and fax. He failed however to look at the forest and instead concentrated on the trees (i.e, the windows only).

The problem was that the cost to replace the roof alone was around $10,000.00 which was more than either the first or second adjusters allowed. It appears that the first adjuster scoped the roof loss from the ground only; but I guess that is the technique one must choose in order to close 10 files per day to join the more distinguished group of top notch adjusters.

The siding cost for one face replacement was about $10,000.00 which brought the total of all damages to $39,000.00 +/- all of which was legitimate and owed to the insured.

To refresh your memory, the first "adjuster's" estimate was for a gross total of $4,500.00 and the 2nd "adjuster's" estimate total was $8,500.00 +/-. Mind you Gale, that neither of these two "adjusters" were using your software; although I have serious doubt that even your PowerClaim software with it's many wonderful features could have saved these two barnyard idiots from themselves and their visible ranchhand incompetency.

BTW, where do some of these vendors find these half brained idiots who they then send to storm assignments and represent as being "adjusters?" No wonder these vendors lose these accounts. What a price that comes with incomptency for all of us in this industry. Imagine as well the cost to all of our reputations through guilt by association with such cretins.

My point in telling this story is this. Look at the costs of incompetency to everyone here.

First of all, it cost this carrier the claims expense of having to pay 4 different adjusters to "get it right."

It cost the vendor this carrier account by the use of the first two and other similar incompetent "adjusters."

It cost the carrier in terms of service and reputation with this insured.

And it cost this insured the aggravation, frustration and extra time of having to deal with 4 different adjusters. As this insured said to me when we finally closed this file: "why couldn't the first adjuster have done what you did the very first time?" That is a very good question which we all deserve to ponder.

Finally, look at what this type of incompetency cost the first and perhaps the second adjuster. Instead of being paid somewhere in the $1,000.00 to $1,500.00 range for claims services for this one claim, the first adjuster no doubt received 60% of his approximately $180.00 service bill.

So Gale, when you talk about "adjusters" seeing their income erode over the next 5 to 10 years, perhaps there is a reason for it.

Incompetent adjusters cost all of us money folks. And the sooner we all learn that, the sooner we will all seek ways to prevent and avoid it.

We must take steps as an industry to either see that all adjusters are trained properly, or we must find a way to weed them out.

I refuse to believe that professional adjusters have to accept lesser pay for more professional policy technical abilities, estimating skills, quality service and a superior work product. If and when that happens, then you all will see me doing something else. It is time for all of us, including the carriers, to realize you get what you pay for, and as Sly & The Family Stone sing: the nicer the nice, the higher the price.

Either directly or indirectly we all pay a price and bear a cost for any "adjuster" incompetency.

Topics | Home | Current Forum | The Classifieds | Adjuster Roster | Channels | Resources | About « Site Map » An Adjuster to Adjuster Community