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CatDaddy
USA
310 Posts |
 Posted - 03/11/2003 : 19:19:27
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| Every insured is not a contractor and not every insured has been through the claims process. Who do you rely on to guide you and look out for your interest when you submit a claim and you know nothing about construction and insurance companies? Most would say your insurance company because that's what you pay them for. Some companies may not operate with the same integrity that others do and you have doubts about yours. Is a public adjuster the answer to your problems? What is your opinion? |
Edited by - CatDaddy on 03/11/2003 19:42:22 |
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KileAnderson
USA
875 Posts |
Posted - 03/11/2003 : 19:42:12
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I have had only 3 run ins with PA's and they were all in Pennsylvania. None of the experiences were pleasant and were mostly a waste of time on my part and a waste of money on the insureds part.
The worst case I saw was a little old lady who had wind damage. I got a call from the PA before I even had the claim in my hand and he demanded that I inspect the next day. I explained to him that I currently had 60 files and I would be in the insureds neighborhood in 5 days and I would be glad to meet with him at noon on that day. Noon was not good for him, he wanted to meet at 9 a.m. but I already had an apointment for 9, he wanted me to change that apointment to meet with him I refused, and he found a way to meet me at noon.
I got there examined the roof, it was 20 years old and had wind damage to both slopes. He followed me around and agreed with my assesment. Instead of offering to help me with my tape measure, he just stood there and after I measured a run, he would measure it. When we were in agreement on measurements and scope I wrote up the estimate came to a figure and he agreed with it. I paid the claim and closed it.
3 weeks later I get a copy of the roofers bill with a balance remaining. I called the insured, she explained that after she paid the PA 30% for his fee she no longer had enough to pay the full bill, so she gave the roofer what she had and told him she would submit the bill to me to pay the rest. I was really angry and took this to my supervisor who explained to me that we paid what we owed and the insured hired the PA not us. I tried calling the PA, he never returned my calls.
The other two experiences I had were similar. I don't see why they are necessary. I think that an insured would be better off hiring a contractor to do the job, at least that way if it is necessary we can pay them O & P and agree on a scope and price. I don't see why the PA is needed. |
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Dadx9
USA
143 Posts |
Posted - 03/11/2003 : 21:21:13
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Kile,
In principle I agree with you. The claim you described is why we speak of the "dark side" with distain. But pay attention to what is looming on the horizon. If claims processing continues down the slippery slope it is currently on, settling claims is going to become much more difficult.
Slippery slope? I had a couple of interesting conversations with people I highly respect and who have at least 35 years each in our business. Independently we discuused the same thing. The same trend. Many carriers are having difficulty reconciling their severity numbers. Their severity numbers have traditionally included IA fee bills. They no longer do. This is necessary to meet those projections by the accountants who have been authorized to spearhead claims expenditures. Now they are presented with these added expenses that they cannot bury. Claims Managers all over the country are being accosted. The claims to premium ratios are being dropped in the laps of Claims Managers who must tighten up payment restrictions on many of our employers. "We will pay for this, but not for that." Policy language is not adhered to. Then there are those who are selling their products and services to the carriers. They are evaluating our (CAT Adjusters) estimates and they are finding alot of extra items, justifying the tightening of claims. All the while the real problem lies with premium dollars collected and substandard underwriting. (How many times have you totaled an ancient three-tab roof that should have had a non-renewel letter sent out 3 to 5 years before? As the carriers 'tighten up' the uninformed insured trusts their carrier and then is not compensated properly. Or the burden of proof is put on them.
Why do I write about this here? If our industry continues down this slippery slope. We may be required to 'adjust' claims according to instructions that are not right. I venture to say many of us do that in a limited way already. If the policyholders are not commensated for what they deserve, for their premium dollars, or we keep killing the goose that lays the golden egg (inaccurate estimates) work to IA's will continue becoming scarce. It is very possible that the public will not be treated fairly. Then some who read this post may finally get 'fed up' and become public adjusters for the sake of the public.
I'm not interested as they are not allowed in Kansas.
I have seen the necessity of them in Florida after Hurricane Georges.
Anyway there's my nickel's worth. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
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CatDaddy
USA
310 Posts |
Posted - 03/11/2003 : 21:27:00
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Come on now you "readers". This is not a PA roast. Its a thread where everyone give their opinion and put this to bed. Stick to opinion and keep the personal attacks out of it.
You may have had some bad experiences with bad PAs but ya know what, there are some pretty bad adjusters out there too so climb down and tell us your story.
PAs - tell us the benefits of your services and when you helped an insured dealing with an unknowledgeable adjuster.
Adjusters - tell us about your experiences with PAs, good and bad.
Play nice!
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CatDaddy
USA
310 Posts |
Posted - 03/11/2003 : 21:42:47
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Dadx9 - Carriers who bend the rules to save money will eventually gets theirs in the end. Bad faith is a serious issue and courts don't step on toes for it, they step on necks.
No doubt that companies losing billions of dollars have to make changes in their operation to try to recover but not settling claims by the terms of the contract purchased by the insured in order to save money is wrong. I know the changes associated with "one" company and they do not include any of those types of actions.
Thanks for the comments. |
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mshort68
USA
138 Posts |
Posted - 03/11/2003 : 21:43:21
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| Got into it with one in New Orleans and all he was concerned with was my credentials, badge, and business card. He would not get on the two story roof. He said I was threatening and got in his face. Called corporate on me only 3 days before I quit. My boss got into it with his boss and so on. Never heard anything more. I love those guys! |
The grass is always greener on the other side, but it still has to be mowed! |
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Dadx9
USA
143 Posts |
Posted - 03/11/2003 : 21:57:23
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Some are a piece of work for sure. Many are not intersted in evaluating damage, only manipulating statutes and laws. But I believe there is a place for them and that place may be growing.
In regards to my previous post. I was refering to little things like cover and protect, masking. All those little things that add up. Many times they are not necessary but not categorically, like some IA firms yield to.
Thanks for the imput. I know 9/11 was rough on some of the carrier investments, but how long can they hide behind that fact? Are they not still wealthy and liquid? They better remember Customer Service before it's too late. Especially some of the Big Bad Boys who are canceling people left and right. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
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Catmandale
USA
67 Posts |
Posted - 03/11/2003 : 22:05:11
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My opinion of PA's has evolved over the years.
As a repair contractor, then staff adjuster, I couldn't understand why ten guys would battle over one fire loss and spend the rest of the claim arguing over every dime.
When the Northridge quake hit, the volume and scope of the event exposed me to a broader spectrum of PA's, IA's, engineeers, contractors, etc. There are good ones and bad ones in each of those groups.
As for PA's, it might help to step back and put yourself in the shoes of the insured. They are faced with a large, faceless insurance company, the adjuster they get is a coin toss, and if they disagree an army of experts is there to tell them what is what. They are usually far outclassed.
For most, the claim will get handled, and fairly, by the staff or IA assigned. For some, they need an advocate to see that they are put back the way they were.
The concept of hiring a contractor for the presentation of your claim is problematic, as they may not know the policy. They may think they know, having "heard" this is what is covered or not. They also may have conflicting interests... a desire to get on that preferred contractor list that leads to unlimited wealth (sure.)
Getting a good PA(or IA, or contractor) is critical to these people, especially since not all carriers are interested in paying what they owe, or have a different concept of what that is (heresy!) It might be better to get 70- 90% of what you are truly owed rather than 100% of what they offer.
Kile's story of the wind claim is sad. Sad that she didn't give Kile a chance to do the right thing first, and only call the PA if she felt he didn't. I used to tell people that very thing, in a very careful manner.
If I had a claim with certain carriers, I definitely would want either Jim or Bill (or Kile) in my corner.
Dale Strain
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"When we thought that we had all the answers,
suddenly all the questions changed."
Mario Benedetti (1920); Uruguayan writer.
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CatDaddy
USA
310 Posts |
Posted - 03/11/2003 : 22:12:13
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I review closed files all the time and am given the guidelines in which to evaluate them. All I will say is that I have received no such mandate. Hope that makes you sleep a little better.
As for canceling folks, not my department but I'm seeing what you are seeing. Yikes! |
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olderthendirt
USA
370 Posts |
Posted - 03/11/2003 : 22:48:54
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| The PA is created by the insurance industry. Some adjusters and some claims managers enjoy under paying or dening claims. If you have been around company ranks then you have seen it. I even know of one company who gave the adjuster who denied the most claims each month a day off. I find two types of PA's those who are adjusters, they know the business and can usualy be delt with and the others who know nothing about claims but through bluff and bulling have some success. I even meet one in Detroit who liked to show off his hand gun. |
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Dadx9
USA
143 Posts |
Posted - 03/11/2003 : 22:53:30
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| Here in Kansas City claims activity has come to a stand still (all I want is 10 a week - every week!). The main reason has to do with the lack of weather events. But another big reason is after last years ice storm many many many policyholders were cancelled. Made all the radio talk shows and newspapers. I'm sure a record number of DOI complaints were filed in kansas and Missouri. Now agents are 'qualifying' or triaging their claims. The reasoning? The cancellations of many policies. The need to place that business elsewhere. And perhaps wanting to keep the claim count down this year for whatever reasons. I know that some have actually gone out and pre adjusted the claim to insure it's validity. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
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ChuckDeaton
USA
373 Posts |
Posted - 03/11/2003 : 22:53:47
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Would someone please post the name of a carrier that refuses to pay legitimate claims?
Also post the names of companies that are canceling left and right?
I just don't have any experience, current or historical, with this sort of thing. |
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JimF
USA
1014 Posts |
Posted - 03/11/2003 : 23:06:12
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Don it may also be that some agents are trying to protect their year end claim contigency commissions.
Here in North Carolina, I am also seeing some agents who are making it more difficult for insureds to file their claims, and some insureds who are bypassing those agents by reporting losses directly to the carriers through the 800 numbers.
It's all part of that slippery slope you alluded to earlier. And we're all along for the ride down that hill, like it or not. |
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KileAnderson
USA
875 Posts |
Posted - 03/11/2003 : 23:16:15
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This is just a thought, have you actually seen the numbers of cancellations and the reasons for those cancellations?
What I'm wondering is, has the actual cancellation % higher than it was in previous years?
I think most public hysteria comes from inductive leaps, there was an ice storm last year, I got cancelled, it must have been the ice storm, lets call talk radio.
It's possible that many of these same people had several small claims, water leaks and such and the ice storm was just the straw that broke the camels back.
I'm no disputing that cancellations are on the rise in Kansas, I'm just wondering if there is empirical proof. |
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Dadx9
USA
143 Posts |
Posted - 03/11/2003 : 23:19:28
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Here in Kansas City, Big Red is canceling left and right, mainly based on the icestorm of 2002. I have had mandates to not pay for moving of furniture, cover and protecting and remove and reinstall light fixtures. Why? Manager of the National Catastrophe Center told IA owner not to. When I complained saying I was not abusing the recommendation but what I actually believed necessary to do the work. I was overruled and required to change estimate.
What I am not saying is that carriers are refusing to pay legitimate claims. What I am saying is they are setting guidelines and removing the adjusters imput.
That has been my experience as an IA and I have had to 'battle' with senior management as a staff adjuster. Many who have not been in the field for a long time or ever. I've had senior management over property who only handled auto. They tried their best but didn't really know property.
Just my view of things. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
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Dadx9
USA
143 Posts |
Posted - 03/11/2003 : 23:23:08
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Jim,
Couldn't agree more concerning year end numbers. Hey, I don't blame them. We all work to make a living. Most Agents have invested heavily and have alot to lose.
Slippery slope? I figure I've got a couple of years left in me. That's why I am finishing up Grad School classes in the fall. Two more years and time for a career change (at 50). I hope not, I love adjusting, but we'll see. |
Don
"To be held in the heart of a friend is to be a king."
Bruce Cockburn |
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Topic |
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Public Adjusters.......who needs them?
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