This post comes from the forum that we had during the years 2004 -2006. We lost the forum but not the data. The discussion below is related to the killing of an adjuster doing her job 10 years ago on this date,
My son is now ready to go to college away from home and excluding approximately 21 months in an attempt to try something different in my life as a "financial planner", I have been adjusting, supervising or investigating claims for almost 27 years. By the way, I have worked my share of hail, wind, tornado and hurricane cats for other carriers so I know from whence I speak. Even during the time while I was trying to become a "financial planner", I supplemented my income with adjusting temp jobs and contract adjusting work.
Thread for ANYTHING in the world of adjusting that works to help get the job done- equipment, software, etc.
In this thread adjusters share their thoughts on equipment that works for them.
Original Post by the author. (Note: This is from a 2004 forum post so the information is dated and many of the vendors have revised or updated their information. It is only provided for general information.)
Well I do believe that this project has come to an end, and at the right place. It is my understanding that Roy will enter the survey into this thread as an attachment to a post, at his convenience after I manage to get a post made to open the thread.
Hopefully, this survey will be a useful resource tool for you. It is not meant to be a stand alone tool, but meant as one tool to be used in conjunction with numerous other points of information that you should have and should use; to determine if you do "know before you go".
Please review the Table of Contents, and pages 3 to 7; so that your walk or hike through the data will be easier to absorb.
While we wait for someone far more skilled at the technology needed to attach files, I'll attempt to offer some comment and hopefully give some further understanding to the survey and comparison.
I used the same presentation format as the original survey. However, going from 47 to 104 surveyed schedules, I split each gross loss (GL) price point into a three page set; as opposed to a continuous column. That way, each GL price point (other than a few at the high end) has 3 pages grouping the fees by page within parameters of "Top third & ties", "Middle third & ties" (which also contains the median fee for each GL price point), and "Bottom third & ties".
Although at the time of gathering the data I was surprised to end up with 104 different fee schedules, I now believe that this is probably only about 50% of the current fee schedules in circulation; if you review the list and consider the minor amount of schedules represented by some vendors and the absence of schedules for other vendors.
As for the body of the survey, the comparative summary, at each of the 27 gross loss price points; I am at a loss to interpret or offer any logic on most (if not all) of the findings. When you look at the charts that follow the body of the work, on page 93 & 94, and consider the weak progression of the median fee across the various GL price points; perhaps the lack of relationship between the fee and the escalating gross loss level is more evident.
Another fairly common twist or turn, to most of the groups of schedules - "groups" being the same vendor/carrier schedule, but with two or more different specific fee schedules, i.e. (wind/hail) & (o/t wind/hail), or (residential) & (commercial) - is that most (but not all) converge to the same rate about mid way through the gross loss price points. The logic and value is sound that a commercial fee schedule (for "adjusting" claims) should be greater than the same for residential claims. But, if they converge to the same rate at $30,000 of GL and greater; the logic and value has been lost. The same concept exists when considering some vendor/carrier fee schedules for hurricane losses and hail losses, converging to the same fee rate after the low and mid point gross loss levels.
The "Top 25" fee score sheets, that group gross loss ranges, is where you can more closely assess a schedule. An effort was made to provide a greater number of ranges and to have them overlap. These "Top 25" sheets should be considered - or the schedule tha
A goof discussion related to work schedules to give an example of what can be required.
I don't see anything regarding E & O insurance mentioned. As independent adjusters do folks carry this type of protection as do most Realtors?
This thread is being initiated to allow adjusters to share helpful techniques which may assist newer less experienced adjusters in properly handling and closing claim files.
It is also being set up to assist new and newer adjusters with a thread for asking questions relating to how to proper report file closings.
Please share your positive ideas here as well as sharing your horror stories of 'messed up files' which you have had to rework on reassignments and clean-up.
im has responded to Jerry's question with some great information useful to us all on bad faith claims.
I'm a quasi "court watcher". It is a habit I picked up some 30 years ago while brown bagging my lunch as a new adjuster inside the warm confines of a carrier. As every insurer has in their claims library, we had a court reporting subscription that cross referenced evey conceivable type of action and reported cases. In later years it became an everyday tool in claims handling or management.
I'd like to supplement Jim's dealings with the topic by discussing with case law some of the issues of bad faith. The jurisdictions may be different, but the actions or inactions of the parties giving rise to bad faith claims are universal to North America.
The landmark case now in Canada was heard by the Supreme Court of Canada (SCC) this year, it is "Whiten vs Pilot Insurance Company" (W vs PIC).
A homeowners policy issued by PIC provided coverage for the W home. In 1994 a fire totally destroyed the dwelling and contents. PIC denied the claim in its entirety, alleging arson. PIC maintained the arson defense through trial at the lower court and at the first appeal level.
A Justice of the court addressed the two requirements that must be met to permit an award for punitive damages.
1. The defendant must have committed an independant or separate actionable wrong.
It is well settled in our case law that a contract of insurance is one of the utmost good faith, imposing on the insurer an implied obligation of good faith and fair dealing with its insureds. This is a contractual obligation.
2. The defendant's conduct must be sufficiently harsh, vindictive, reprehensible and malicious as to offend the Court's sense of decency.
The court went on to analyze the conduct of the insurer to justify the bad faith award as punitive damages. Here are less than half of the reported reasons;
(a) the insurer deliberately ignored the opinion and recommendations of an experienced adjuster to concluded the fire was accidental
(b) the insurer never provided the adjusters reports to the experts it later retained
(c) the insurer ignored the opinions of its engineering expert who provided three reports that the fire was accidental
(d) At every step the insurer considered that it could safely deny the claim because the insured would not refuse a reduced offer in the future
The Court therefore concluded that the above two requirements had been met.
The majority opinion of the Court looked to the USSC for enumeration of the factors to be considered in determining whether an award is reasonably related to the punitive goals of deterrence and retribution. It looked at "Pacific Life vs Haslip (1990) 499 US1". for the criteria for appealate review of punitive damages awards.
"Whiten vs Pilot Insurance" has generated a lot of discussion and commentary. The trial verdict of $1,000,000 punitive damages for bad faith, plus every cent of the Whiten's financial loss set a new and unprecedented Canadian threshold for punitive damages in first party insurance claims.
California is truly the bad faith litigation power house, especially related to third party bad faith claims. It began in the 1970's with "Royal Globe vs Superior Court" and led to the rampant rise of bad faith cases that insurers were settling short of trial due to fear and costs. In 1988, the California SC in "Shall vs Firemans Fund", reversed th
In previous bulletins, FEMA discussed wind and flood investigative tips and a logical approach in addressing claims that involve both perils. Attached for your review are previous bulletins that address adjusting practices: WYO Bulletins W-08008, dated February 25, 2008 “Wind/Water Investigative Tips”; and W-08070, dated September 25, 2008 “Flood Insurance Claims Guidance.”
The following will not ask adjusters to do much more than they currently do when approaching any flood or wind damaged building. There is no requirement for the flood adjuster to estimate the wind damage.
When adjusting wind/water losses the, adjuster should use established and proven investigative methods when documenting flood and wind damage to buildings and/or contents occurring during hurricane or storm events. “Wind/Water Investigative Tips” can be helpful.
The adjuster is asked to record the process they always use when approaching a wind/water claim. In addition to looking for signs of flood damage and/or a General Condition of Flood and documenting the exterior water line, the adjusters should note any exterior wind damage, such as missing shingles, turbine or fascia damage. The adjuster should also photograph this damage and mention what was observed in the narrative report.
Remember, the Standard Flood Insurance Policy (SFIP) Pays Only For Direct Physical Loss by or From Flood to Insured Property. Once inside the building, the adjuster should always document the flood water line. Damage below this line is typically flood damage (exceptions like wicking should be noted in the narrative report). Damage above the flood water line is typically wind damage, such as water-stained ceilings or water damage at broken windows or exterior doors. This damage should also be photographed and mentioned in the narrative report. "