Comments for The Claims SPOT

Comment on Insanity: Claim’s Departments Can’t Expect Different Results Without Changing Their Organizations by John Liberatore

John Liberatore — Wed, 16 May 2012 11:37:45 +0000

Love the topic but from my vantage point it comes down to dollars. Claim departments are loath to hire more adjusters (they write checks after all) and the reigns on expense dollars are very, very tight. Example: Damage claim for a bridge is $102,000 and adjuster explained the lack of investigation (no photos) as his being not permitted to “spend the money.” Another and one of my favorites; truck is rear ended on an interstate but no investigation (no pictures again-I love pictures!) the claim develops to where there settlement is north of $500,000. However, lest you think the rear end impact was significant the Adjuster, in their summary, confirmed that the Police Report (at least we had that) confirmed that there was no impact to the rear of the truck. And oh yea, we overlooked that the driver of the truck was represented immediately and had a prison record. The focus on the ALAE and ULAE is feeding right into the hands of two groups; doctors and plaintiff lawyers. OK, now I am off my soapbox.

Comment on Insanity: Claim’s Departments Can’t Expect Different Results Without Changing Their Organizations by Leah Allen

Leah Allen — Mon, 14 May 2012 16:11:47 +0000

Being an adjuster for years prior to opening Ladder Assist Team LLC I can relate to some of these issues still happening today. I have a theory about some of the issues; (1) Bottom line for all carriers is saving money. Decisions about how o do this are most often made by someone behind a desk who has never been in the field, nor spoken with the adjusters to try and come up with a solution. (2) Over the years there seems to be more and more poured on the adjuster to handle and time frames are hard to meet, which creates a large turnover. Being a company owner myself I can say the work ethics of many today do not amount to much. People are hungry for work but take no pride in what they do anymore. Yes, part of this comes from the feeling of no job security from companies as well as a society that has become narcissistic. A carrier needs knowledgeable employees to do the job correctly and to care! (3) As far as investigating a loss; many carriers have implemented pitch limits on roof access for staff adjusters. Many IA’s wont walk very steep roofs either. This causes issues as a proper inspection is never performed on the roof. Carriers are hesitant to pay out for roof inspections as it effects the bottom dollar. What is failed to be seen in this is: If a reputable & trained inspector looks at the roof there is little need for a supplement and as long as they are not associated with the carrier or a roofing contractor, their assessment is not bias and this cuts down on appraisals and supplements. (4) I wonder in the area of paying the appropriate amount how this area is tracked. There are so many variables here; could simply be a case of hidden damages where a supplement needs to be filed after hiring a contractor. An adjuster can only write what can be seen at the time of inspection. (5) The use of IAs for adjusting also can be an issue. Years ago these IAs were used quite often where now they are used as little as possible due to cost and many who come into the field are new and have very little training.
All said; I do believe carriers higher ups need to spend some time in the field doing the adjusters job to gain a real understanding before implementing changes that look good on paper. Carriers need to hear the adjusters needs as they are the ones in front of the Policy Holder and the face of the carrier.

Comment on Insanity: Claim’s Departments Can’t Expect Different Results Without Changing Their Organizations by Mike

Mike — Thu, 10 May 2012 16:54:14 +0000

Failure to properly acknowledge, investigate, pay or deny claims within specified time frames, to provide required disclosures in the claims process , improper documentation of claim files, not processing total loss claims properly or paying the appropriate claim amount . Do we disagree the root cause of these issues is directly related to carriers utilizing an inadequate number of experienced adjusters to handle their claims volume? Properly handled claims generate very few DOI complaints and a properly worked, well documented claim file is a solid defense in a DOI investigation.
Experienced adjusters understand producing a well worked and documented claim file is the appropriate response to a DOI investigation. Sounds like a management decision to delay responding to DOI most like related to the down side result of cutting costs while producing low quality, poorly worked and minimally documented claims files.
Experienced adjusters cause less grief with the public (the source of complaints to DOI) by quickly and accurately adjusting and paying losses. The good will created by said professionals is an invaluable form of advertising which is good for all, including the shareholders.

Comment on Getting More in Your Negotiations by Nancy Hudgins

Nancy Hudgins — Mon, 06 Feb 2012 20:28:11 +0000

Hi, Dan!
Thanks for your question. Negotiations occur all day every day. The book is geared toward all negotiations, with spouses, children, sales people, banks, etc. But I also think these ideas are applicable to civil litigation and claims handling. I’ll be writing more posts about Diamond’s principles, which he teaches to MBA students and executives.
Best,
Nancy

Comment on Getting More in Your Negotiations by Dan Williams

Dan Williams — Mon, 06 Feb 2012 20:17:24 +0000

Very hard to get my hand son an idea using those strategy summaries. Guess I’ll have to try the book and see. Is this geared toward sales?

Comment on Why Don’t Claims Organizations Track Claims Through The Process The Way UPS Tracks A Package? by Dan Williams

Dan Williams — Tue, 31 Jan 2012 17:29:36 +0000

Same here, most of our carriers allow us to track every step of the claim with the ability to email or phone anyone involved.

Comment on Why Don’t Claims Organizations Track Claims Through The Process The Way UPS Tracks A Package? by Cathryn Nellans

Cathryn Nellans — Wed, 28 Dec 2011 19:35:20 +0000

This is basically what my company does. We are a small firm in Ocean City, Maryland and when claims are called into our office, the procedure basically goes as follows:

-Insured calls in claim
- Claims Representative takes info, and submits to the appropriate carrier where it is assigned & adjuster makes first contact with the insured.
- Our office collects adjuster information and follows up with said adjuster & our insured 3 days after claim is filed to be sure that the appropriate parties have been contacted and inspection has been scheduled.
- Every week to 2 weeks (depending on the severity of the claim) our office follows up with both the adjuster & the insured to make sure all parties are on the same page and the claim is moving to resolution in a timely manner.

By our office doing this, we get rid of any need for the insured to make inquiries themselves as we are giving them a “tracking status” during the entire duration of the claim.

One less chore for the insured = happier clients in our eyes.

Comment on 2 Company Types And Their Approach To Claim Audits: The Have To’s And The Wants To’s by Peter

Peter — Sat, 17 Dec 2011 15:59:54 +0000

My company is definitely a Have To.

Comment on 2 Approaches To Early Resolution And Cost Savings For Litigation Guidelines by jatmiko

jatmiko — Wed, 16 Nov 2011 08:56:41 +0000

Why my lawyer always buying time when mediation still in progress ( almost 1 year ) it seems the the lawyer trying to litigation ways , can anybody help me ???

Comment on 2 Approaches To Early Resolution And Cost Savings For Litigation Guidelines by Nancy Hudgins

Nancy Hudgins — Mon, 19 Sep 2011 18:32:48 +0000

Hi, Christian!
Thanks for stopping by.
It’s a mind set to develop, not only for your claims department, but also as an expectation for your panel counsel.
Good luck!
Best,
Nancy