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Poor quality report writing
Last Post 09 Nov 2011 01:59 PM by Leland. 20 Replies.
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Leland
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09 Nov 2011 01:59 PM
Some additional comments: I didn't do a PAYMENT RECOMMENDATION caption on this report, and I also didn't prepare a Statement of Loss. I usually do, but not with this carrier. Certain carriers like certain things. In my opinion it is difficult to properly judge the quality of the report if the reader is not familiar with how the carrier likes it. In my experience some file examiners think the way they like the report is the way it should be done for every carrier. This is rarely true. I have one carrier that expects me to make a coverage decision and write my own denial letters. I have another carrier that wants me to avoid making any comment re coverage. Some carriers expect me to send my estimate to the insured. Some get annoyed if I do. It is not fair to judge a report as poorly written report just because the adjuster is doing it the way he was taught for another carrier. Both the adjuster and file examiner need to first have a discussion on what the report should include.

I never use this sentence anymore:

The insured reports no recent plumbing work....

Now I am more likely to put:

The insured reports no recent plumbing work prior to this loss....

Another point regarding "key points" - it is important to resist the temptation to "fix" or improve the insured's comments.

For example, yesterday was Tuesday Nov 8th. If I interview an insured today, and he says "I called the plumber yesterday, on the 6th", here's how the "key point" should look:

the insured called the plumber "yesterday, on the 6th" *

*adjusters comment: "yesterday" from the date of the interview was actually the 7th of November, not the 6th as stated by the insured.

Whatever weird, nonsensical, incorrect things the insured says should be reported. Then make an asterisk with a note or just talk about it in the remarks.

Regarding cause of loss captions:

The cause of loss is often reported incorrectly, and/or a mystery.

Here's an example of how to handle that:

DATE/CAUSE OF LOSS

As shown on the loss report, the insured has claimed that space aliens were using his roof as a temporary washing station on January 1st, 2008. At this time the cause of loss is still under investigation, and we have shown it above as "undetermined". There are three possible causes of loss under investigation at this time: 1) possible vandalism from a garden hose inserted into the attic vent; 2) water overflow from the attic mounted AC unit condensation line; 3) water intrusion from deteriorated roofing during recent rains. The actual loss may also be from a combination of the suspected causes. It also appears that the reported date of loss may actually be the date of discovery by the insured and that the loss may have occurred over several months.

-----------------------------------------------------------------------------------------------------------------------------------------

Don't feel like the cause of loss has to be one word, like "water", or "fire". My example is really crazy but it is to prove a point. If the reported cause of loss is different from reality, say so. If there is more than one cause, say so. If the cause is undetermined, say so. If you aren't sure the date of loss is correctly reported, say so.

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