| Author |
 Topic  |
|
pilot48
USA
78 Posts |
 Posted - 11/16/2002 : 12:10:55
|
It seems that everyone claiming to be an adjuster is now sharing opinions of law. No matter what the person hired by a carrier is called, the employing body is the "principal", as such all conduct, actions (or the lack thereof), and deeds are "imputed" to their knowledge.
Any judgement awarded, and supported by the subsequent appeal, by an insured as a result of bad claims practice action, is going to be settled by the employers insurer first. Only if such an award is so great as to exceed their limits, will it roll over to the individual adjusters E&O policy.
If such an action is ever filed, won, and supported on appeal by an insured, and if the award is so stagering, maybe the "adjuster" assigned which caused said action to be filed, is not such an adjuster after all!
When an insurer hires you for whatever payment basis, yet the primary thrust of their offer is....take it or leave it, because we have many others that will do the job for us...., that's great. The contract between you and the insurer becomes one of adhesion!!!! That simple means, they have the control, and they are ultimately liable for screw ups....believe me, they know it too.
$375.00 per day (adjusters share) for everyday actually worked at the desk (8 hour minimum) is more then fair for the work being produced. You can't expect to receive doctors wages for doing para-medics duties, let's get real!
|
 |
|
|
Newt
USA
657 Posts |
Posted - 11/16/2002 : 18:32:25
|
The et al in litigation is what people have to fear, right wrong or indiferent it means time away from home without compensation. The fee
is not what bothers me, its the uncertainty of how long will the job last. No one has a clue, and with that in mind you could be there only a week or two and some motels in the bigger cities are charging over sevenhundred dollars a week and places like Boston are charging over ninehundred for a fleabag, a two star is almost fourteen hundred. Thats not the rule of costs but just an idea of what you could run into. I still say a per diem rate along with an hourly rate or a day rate would work. Being reasonable and fair on both sides would get the job done. I'm not going to throw any numbers around because, I don't see the point right now until we get some cost of living and expenses ironed out. Heres an idea, use the government perdiem rate and go from there. If that is not reasonable then try something else. The three twelve may work for semi-local folks who could get home on the weekend or RVers, depending on the locale but would fall short in some areas.
This an interesting concept and if the carrier is going to implement it, adjusters should know before they go, you may come back broke. The secret would be, how long is an assignment for. How many miles to the site, whats the cost of living like
|
|
|
|
Cecil
USA
35 Posts |
Posted - 11/16/2002 : 19:55:03
|
$450.00 per day for 7a to 7p plus appropriate per diem per worked day for that location. Or, $50 per hour(Adjuster share) plus a daily per diem for days worked. I would rather work on production as an outside adjuster any day. On a job as John mentioned, the adjusters need to be well experienced outside adjusters with good telephone skills. The worst thing for a carrier to do is to start an adjuster as an inside person, or to offer too low an amount so that only inexperienced or poor (in skills and efficiency) adjusters apply.
If you are satisfied with mediocrity or don't care lowball it. If you want it to work the way you want it to work, pay for it and nurture it.
My experience with it has been as one of the other men above mentioned. I received one particular claim and a couple of thousand dollars had been paid but the insured was was not satisfied. He wanted more. I got out there and found that nothing was owed to begin with. I told him that no more would be paid.
It all has to do with expense money. It can not be figured into the premium. Payment on claims can be. You see, I guess it just doesn't pay to pay for good claims handling. |
|
|
|
Kelley
USA
26 Posts |
Posted - 11/16/2002 : 21:02:45
|
| Just one question here, Ghost, where did you go to school ? well maybe two questions) or do you just have a natural gift for so wonderfully putting all things into perspective ? |
One persons dream is another persons nightmare. |
|
|
|
Ghostbuster
476 Posts |
Posted - 11/16/2002 : 23:06:11
|
| ...(snore)...huh? what?...Oh, well Maam, I guess I'm just driven to inspiration by the rapture of your charms. |
|
|
|
fivedaily
USA
258 Posts |
Posted - 11/16/2002 : 23:51:29
|
Let me ask, have any of you independent adjusters handled a claim given to you @ a storm site over the phone? You know, the one where the insd says they have some fence blown down and no other damage and they have an est to repair that is reasonable for the area? Or do you ALWAYS inspect EVERY loss?
As a cat adjuster, I can tell you... I am usually able to handle 10% of my field assignments over the phone with no inspection. I always get their permission to do so and let them know they can call back if add'l damage is discovered. If there are maximum limits for telephone claim handling I let the insured know that if the claim gets over a certain point then it will be transferred. Handling claims over the phone has been done since the beginning. High dollar losses aren't, but minor water or wind losses have commonly been handled this way. The majority of the losses the average independent adj will handle @ the beginning of this storm won't be eligible for telephone handling.
Personally, I think the insurance companies would do better to hire and train their own inside adjusters for staff positions. I don't see that most IA's wanting this type of work. I will say that being an outside adjuster for a while makes you a better inside adjuster.
Jennifer |
|
|
|
jlombardo
USA
212 Posts |
Posted - 11/17/2002 : 08:14:32
|
| Fivedaily...Ther is a certain validity in what you say...Ice Storm-food loss claims--absolutely handle over phone.....Windstorm,fences blown down---go check the roof......just because there is no leak NOW, does not mean NO WIND damage to the roof........Catching the damage now can save $ in the future...why wait until the ceiling is soaked and insulation, dry wall etc. now become an issue.......Inspection also allows a real life person to inspect the risk and advise the Company of any obvious potential hazards or conditions that would make the risk an undesireable insured risk,etc., etc. etc.......As far as Telephone handling from the beginning goes...well I guess it all depends WHEN YOU BEGAN.....There was a time when recorded statements were the exception and not the rule....... |
|
|
|
KileAnderson
USA
875 Posts |
Posted - 11/17/2002 : 11:07:18
|
I have never handled a claim over the phone, no matter how small. The company is paying me a base fee which includes a roof inspection and that is what I give them. I handled a claim just a couple of weeks ago where I was sent out because the house which is on piers now seems to be off level, presumably because of the heavy winds of Hurricane Lili.
The claim was originaly handled over the phone. The front slope of the roof was replaced because the insured said that was the only damage. When I got on the roof the rear slope was almost as bad as the front and needed replacement also. The adjuster on the phone had also paid to replace the ceiling tiles in the kitchen, he got the measurements from the insured. What he didn't know was the kitchen ceiling continued into the living room and down the hall. The tiles were 20 yrs old and yellowed. We owed to replace the whole ceiling but the insured didn't know that. He thought he was going to have to put up some sort of border between the kitchen and living room to make the transition from old ceiling to new.
The adjuster had also paid to plain and refit the front and back doors because they were now sticking, but he never thought to ask why they were sticking. Obviously they were sticking becasue the house needed to be releveled. Wouldn't this be something that would pop into your head as you're writing the estimate? This is just one example of several that I have handled personaly. I find that older people really hate this kind of approach to adjusting. They are used to a higher level of service than is currently being offered in general and they expect to see a adjuster face to face when they have a claim. This may be the way of the future, but that doesn't mean I have to like it. |
|
|
|
ALANJ
USA
159 Posts |
Posted - 11/17/2002 : 11:12:46
|
Dear Pilot 48:
I don't remember seeing you at my law school. I have a JD and years of experience to back up my insights and opinions. What do you have to back up yours?
You must have some kind of monthly billing deal with Ms. Cleo. |
|
|
|
CCarr
Canada
1200 Posts |
Posted - 11/17/2002 : 12:17:08
|
Jennifer's comments give a good anchor to page two of this thread, they cover an issue I wanted to say something about previously but avoided. What she says is a fact of life, regarding the field adjuster "telephone adjusting" a portion of their assigned claims. My feelings and observations, is that the numbers may be closer to 15%. Unless a carrier absolutely mandates one or more photos, it is the logical way to deal with a number of these smaller losses.
Her last statement is also very true, and that is why currently the staffing thrust of these call centers is mainly to find field weaned people to staff these inside positions.
From an assignment point of view, it is much easier to say what type of claims are not funneled through a cat CC; rather than which type is assigned inside.
Notwithstanding specifics on a Cat (for this discussion, the distinction is important to make from a day to day claims CC) FNOL that may stand out more than the normally generic loss descriptions on most, reported hail damage is the least likely not to be handled by a call center, followed by reported interior water damage.
However, there are some cat CCs that take all storm claims, then the FNOL is "pre-judged" and sent out to an I/A storm vendor or assigned to an inside desk person. There is maybe 10% of those assigned inside, with this type of distribution system, that after the first call to the insured it is clear that a field person should attend. These are not normally then sent to the storm I/A vendor, but assigned out as a "task assist" to a day to day I/A vendor.
Generally, regardless of how the FNOL is received in the cat CC, whether "pre-sorted" before arriving at the CC or sorted at the CC, FNOL's reporting losses to only personal property, especially those with special limits, are a primary CC type claim. This would be followed by reported claims to "other structures", and tree claims.
There is no exacting way to make these determinations on what claims are assigned inside or to the field. Surveys and audits are done on both types post-settlement, to review the appropriatness of the original assignment type; and in time a trend emerges.
One, but only one, of the major factors driving the growth and effectiveness of any type of claims call centers is the evolving software providing "desk top solutions" to enable the "inside (desk) adjuster". These packages being advanced by companies such as Bluebook International and Integra Claims, have greatly advanced the capabilities and effectiveness of the CCs. The next "generation" of this development, will carve a further chunk out of your "field pie".
Another of the major factors driving the growth and effectiveness of any type of claims call center is the work carriers have done and are doing up front, pre-loss, with risk identification and awareness. From the underwriting side, this is a loss control function. Last year there seemed to be a rise in the number of physical inspections of homeowner risks. This ranged from the very basic "exterior factors" form being completed with two risk photos, to more detailed forms of reporting. Having done a fair bit of this work years ago, I am completely astounded at how the price of this product has fallen, by more than 50%. However, I am also humbled by the advances digital and computer technology, which along with generally less detailed reporting have contributed to the much lower fee service pricing for this type of work; which continues to escalate in volume this year.
However, what this "risk identification" process has accomplished, that greatly contributes to the growth and effectiveness of any type of claims call center, is that it provides a visual data base of risk characteristics and components. This risk management function has been integrated into the carriers systems and can be accessed by the "inside (desk) adjuster". Now, this adjuster from the call center, while talking to the insured can visualize the risk and damage as expressed by the insured, and can see what type of roof construction and covering exists or can see or generally determine measurements. Therefore, this has brought a large measure of credibility to that "claims conversation" and resultant settlement.
To state the obvious, there are fewer claims being made available to those that hold themselves out as field cat adjusters, and this reduction of available claims will increase due to the items I have tried to explain here.
I won't repeat my "message of doom" regarding the future of "traditional cat adjusting", but the claims industry is quickly evolving away from your traditional methods.
Your piece of the "pie" will always be there, but like chocolate bars, the piece is being made smaller and for the same price; if not less. Further, for whatever reason - and it is puzzling due to the general economic realities of the cat segment currently and over the past few years - there are more people wanting and trying to get some crumbs from that smaller piece of pie. |
|
|
|
Ghostbuster
476 Posts |
Posted - 11/17/2002 : 13:14:30
|
Yeah, and the truly damnable thing of it all is that Kile and Clayton are both right.
Kile's Insureds that prefer the correct way of doing things and actually seeing their insurance tool in action are being done a huge disservice by trying to deal with the disembodied voice 4 states away. The Insureds are not qualified to discribe their situation, they need help from those folks they have paid for the past ___ years.
But here comes Clayton with the carriers latest whiz-BANG solution to all the worlds ills. After they have been thoroughly snowed by the software vendor-of-the-day, the latest, greatest, most cost effective procedure in the history of the Cosmos WILL be implemented come Hell or High Water!
...It's just plain wrong...In fact, it's way beyond wrong, it's clear into willful neglect of the basic function of the carrier, and that's to be there in person to fulfill the promise that the agent sold and the underwriter accepted! To abrogate our responsibility to properly investigate and adjust a loss for the correct disburement of the corporate funds AT the direction of carrier management, is dispicable and ranks evenly with the rest of the corporate rot as typified by recent scandals from the Fortune 500 gang, like Enron and Worldcom.
The telephone adjuster should only correctly function on the most mundane of losses and claims. Things like broken windshields and windows, vandalized mailboxes, or clear-cut liabilty issues with only minor physical damage.
It is the field adjuster who must carry the load and slay the proverbial dragons in their dens. It is to them that true glory and gracious respect belongs. That we have become the favorite target of the corporate hot-shots bespeaks of a fatal cancer eating away at the heart of the basic insurance equation.
Remember the BASIC EQUATION? It's called the milking stool. Our whole world sits on the seat supported by three legs. The customer that buys the promise, the agent that sells the promise, and the adjuster that keeps the promise, evryone else sitting up there is just the teats on a boar hog, basically worhtless. It is this milk stool that has been intentionally and relentlessly dismantled by the Tails-wagging-the-dog in the executive suites that is now falling down and dumping our industry into the cow pile of over priced products, poor service, regulatory and media attention, and dubious stock values.
So much for our Sunday morning sermon. We will now rise and pass the plate while singing hymn #34, 'Don't fence me in'. |
|
|
|
pilot48
USA
78 Posts |
Posted - 11/17/2002 : 16:28:19
|
Dear AlanJ,
JD from University of Oklahoma, 1977. Wasn't stepping on anyone's toes, just telling it the way it is. These company's are going to do whatever they can cost effectively get away with, we all know this, they've done it for years.
Do we price ourselves out of work, or think about how best to play their game......and win? |
|
|
|
CCarr
Canada
1200 Posts |
Posted - 11/17/2002 : 16:47:46
|
G-Buster, I think it is stretching it to say in an all inclusive way that, "'Kiles' insureds prefer the correct way .... and actually seeing their insurance tool in action ....". In that sentence you raised two distinct issues; "prefer", and "correct way".
Your sentiments and comments concerning the evolving trend of call centers are well presented, but will fall on deaf ears of those who are implementing these procedures and growth of that claims niche.
You talk of the "promise", and the abrogating of responsibility in not fullfilling the "promise". You go on to illuminate the "promise" with your interesting milk stool and its triangle of promise.
I assume the "correct way" you spoke of is tied to the traingle of promise, noted in your basic equation thought.
However, first, lets touch on "insureds prefer". Customer surveys are done as much on telephone adjusted claims as their are done on field work. No doubt, some insureds would have preferred a human presence (for all its positive and negative points), but by and large the public concensus of those who have had their claims telephone adjusted were satisfied.
Look at the world around you, and how we as consumers have come to avoid personal contact in our day to day dealings. From online mortgages, avoiding that fearful across the desk scrutiny. To the huge growth of "drive through" almost everything. To the purchase of insurance that is done mostly on the phone now, followed by online choices. To banking, where the ATM prevents us from having our neighbour or her sister as the bank teller update our miserable passbooks. I'm sure you can add three things to this and everyone else could add to it as well. It is our society that has emerged and distanced itself from personal consumer contact where it is not necessary. It is the preference of society in general that more and more functions be handled by phone or machine. It is not the insurance industry, nor the claims world itself, that created this societal trend - it is we the people. From my little window watching this trend evolve, there is no public outcry or any measurable expressed policyholder dissatisfaction with telephone adjusted claims.
The "promise" has not changed, " .... we provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy".
I heard louder and longer crying and whining by insured's 30 years ago, when agents were losing their "power" over claims. Not any settlement authority, but just having themselves removed as one of the teats on the proverbial cows bag; in essence having that quarter of influence removed. Insured's squacked to no end about this. They did, and still to a large degree today, pay their premium dollars to the agent, and there was a much larger trust factor then between insureds and agents; than exists today.
I heard louder and longer crying and whining 25 years ago, by agents and daily I/A vendors, when agents lost their authority to directly assign claims to the I/A of their choice.
Claims were being telephone adjusted in the late 60's and probably before that. That element has undergone change each decade, to now where with the aid of technology, coupled with size; these claims units are now called call centers and their principals are now being imported to so called "cat claims".
Yes, your milk stool has had its legs altered and modified many times. However, its function is still being fullfilled, and allows the "promise" to be delivered; without measurable dissent from those paying for the "promise". |
|
|
|
KileAnderson
USA
875 Posts |
Posted - 11/17/2002 : 18:08:18
|
There are some things that just don't translate to handling by phone or machine. Would you like to call your doctor, describe what you think to be the important symptoms and just have him prescribe a course of treatment, or would you rather have him put the popsickle stick in your mouth and listen to the old ticker with his ice cold ticker-listening device?
How would you like to call your mechanic and describe the sputters and knocks and ticks and have him tell you to change the oil and give it a tune up and call him if that doesn't work?
Most homeowners are busy living their lives. They don't have time to attend roofing seminars and watch this old house reruns every sunday, and walk around Lowe's checking out the new building materials on the market. Most have never seen a water damaged ceiling or set foot on a roof. How can you expect them to adequately describe the scope of damages and materials involved? Once again. I realize that if the carriers want it, then it will be done. But not by me. I would never have the patience to walk an insured through the entire scoping process over the phone. I'd go nuts. But I'm a doer, not a teacher. |
|
|
|
fivedaily
USA
258 Posts |
Posted - 11/17/2002 : 20:04:40
|
An important thing to remember about telephone claim handling is the limits it has. For example, a carrier might impose the following:
Let the insd know upfront about your intent to handle over the phone, you should have their permission. If the insd requests a field adjuster, you make a field assignment
No claim over $2500 w/out an inspection (unless you have mgmt approval)
No roof losses over $1000 w/out an inspection (unless you have mgmt approval)
No ech for hail claims
So, with these basic guidelines set up, I think telephone claim handling is a fair proposition for the insd. And many times this claim can be closed faster than if the homeowner had a field inspection.
Any thoughts on this?
Jennifer
|
|
|
|
Topic |
|
|
|
Inside Adjusting during CATS
Forum Locked
