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Bob Harvey Gold Member California, Central Coast
 Posts:388


 | | 11/11/2007 12:48 PM |
| I think the independent adjuster needs to be taken off the hook for "fiduciary" responsibility...and, put on the hook for "project management." The thing is, most insurance companies do not want to be involved with being responsible for "project management" on the reconstruction, if that's what you mean.
There have been exceptions, with "preferred vendor" programs. And it seems to work OK with cars, getting it repaired at an approved shop so there is no price haggling that the policy-holder gets involved with, it's just between the shop and the insurance company.
But it doesn't work that well with houses. Every one of those programs I have seen, the contractor starts out doing good work, then either gets buried in jobs assigned to him or cuts corners. I had a co-worker who's house caught fire years ago, and the "preferred vendor" did everything as cheap as he could. And the homeowner did not pick the contractor, so it gets very awkward. The insurance company has a financial obligation. That is what the contract says. It doesn't say they are going to send a contractor out to fix the house, or that they will make sure any contractor selected by the property owner does a good job. No, they basically pay what they owe. And they name the lender - who also owns the house.
And if people don't agree, an arbitrator helps them to meet in the middle, and again it is ultimately an exchange of funds that will get them put back in their pre-loss condition.
We have talked about some green adjusters, but there are also some contractors I will refer to as "Johnny 6-Pack". When the Insurance company issues their settlement, the next chapter is between the property owner and the contractor, and that is a separate contract from the insuring agreement. The contractor should have his own liability insurance - but even that policy will have exclusions for his "work product". The homeowners insurance does not want to take on any responsibility other than paying what they owe, and that is a fiduciary responsibility. | | | |
| Ray Hall Adjuster Houston, TX
 Posts:804

 | | 11/11/2007 5:01 PM |
| The long post about Allstate is all automobile liability claims and does not have ANY thing to do with first party property claims. By the way the program is just a guide line. Auto liability claims and for that matter all type BI claims have subjective finding by the doctors doing the examination's in ever case I have ever seen. I would not let a contractor that I did not select to do a MAJOR job on my residence. I would expect the insurance company adjuster to write an estimate that I would except, reject in whole or in part. If I rejected the scope and amount then I would file my estimate with a proof of loss form and a payment demand. I have never seen ANY insurance company who would use a contractor of their choice if ever policy holder was like me. Get an agreed cost and pay that amount ever time. | | | |
| Donny Haight
 Posts:6

 | | 11/11/2007 8:40 PM |
| Don't get me wrong here, these are great posts. I just have an itch for the primary topic of the thread. What will the lawsuit do to the industry? "Anybody got any fresh ideas?" I would not let a contractor that I did not select to do a MAJOR job on my residence. I would expect the insurance company adjuster to write an estimate that I would except, reject in whole or in part. If I rejected the scope and amount then I would file my estimate with a proof of loss form and a payment demand. I have never seen ANY insurance company who would use a contractor of their choice if ever policy holder was like me. Get an agreed cost and pay that amount ever time. Exactly..and, right on the topic of this discussion...Where is the "Claims Industry Going"?....When is someone going to develop a system that helps close a claim from a customers point of view, that actually gives the insurance company data they can use with confidence. It seems to me like buying a new car. Once you are confident that you aren't paying "to much", then you relax, and, let the car dealer make a fair profit. The stress is in not knowing what stuff "cost". Oh yea, and policyholders that milk the system.
If you really want to analyze the "Claim Industry"...we spend a lot of time and money focusing on the "Estimate"...It seems to me that the estimate is just the estimate. It certainly has to be done, however, as we have proven time and time again, and, as is the subject of this lawsuit....what is most important to the "shareholders" of an insurance company is basic "Negotiation 101". Write it Low, and, don't get in a hurry about it! The thing is, most insurance companies do not want to be involved with being responsible for "project management" on the reconstruction, if that's what you mean.
Exactly...and, banks would rather not repo cars..however, if they want to make more loans, for higher interest...it can't be helped.
Why not embrace it? What is replacement cost? Is it the items in an estimate based on an average, using materials and labor that is readily available? Seems to me replacement cost is what it cost? Seems to me that if someone had a system that allowed the insurance companies to cost the reconstruction from a "material list", and, work order basis..then...they could give some of this data to the property owner and help them help themselves. Seems to me that there may be an opportunity in the Insurance Market for a new insurance company that had this technology and "mindset" to capture plenty of marketshare from the current gorilla's. _______________________________________________________________________________________________________ My Point Is there anyone out there thinking "Outside the Box". Anybody out there not working that may want to use their skills helping close claims? Seems like a shrinking market for independent insurance adjusters. Shall we keep doing what we have been doing and getting what we've got, or, does anyone have any idea how to employ 10,000 "catadjusters" in a more "orderly" fashion than dependence on a 10 billion dollar plus hurricane. Again, not trying to offend here. Donny
817-793-2444 | | | |
| Ray Hall Adjuster Houston, TX
 Posts:804

 | | 11/11/2007 8:51 PM |
| Donnie go back in the old CADO files and dig out my FICUS TREE system. | | | |
| Donny Haight
 Posts:6

 | | 11/12/2007 7:25 AM |
| Thanks Ray...obviously...it has been a few years since I lurked around here.... Perhaps we should start a new thread...or private discussion regarding your concepts....I didn't fully read everything you posted, however, see if I understand...basically...you have developed a method for managing humans in the catastrophe realm that actualy resemble the real world processes that take place...yes.... So..the bigger question is "How do you create a company or economy" out of this..and, "What type of web based system is required to implement it? I would love to collaborate with you on this...and, I started a new thread in the general discussion called "Web Based Software Requirements".....If you don't want to talk about it for business and intellectual property reasons...why don't you call me and I will talk to you about what I am doing! I am a contractor / adjuster / software consultant...and, I have invested a lot of time and money in trying to figure out a solution that could help this industry, and, my pocketbook as well. Donny
817-793-2444 | | | |
| Kit Shay
 Posts:4

 | | 11/12/2007 2:22 PM |
| I don't believe any major carrier would tell anyone to underpay a claim. Certainly not an Independant, it would come back to haunt them for sure sooner or later. My point was they do make it a habit of sending the youngest, single, least experienced staff adjusters they have out as the first wave on most cat losses. And although they may be computer literate and able to use an estimating program, they are no where's near qualified to scope a job properly. Hence, you end up with a lot of short sheets. With the sudden influx of new wannabe storm troppers (myself included) you also have to be concerned about the quality of sheets being generated by independants now. These will be weeded out by lack of work and poor product in time. But in the meantime, the carriers are saving a lot of money by underpaying claims, deliberate or not. Most homeowners are not going to follow through, but accept what they are paid and pick up the difference on these short estimates. I for one believe that the carriers are quite aware of the facts and know that by sending in adjusters that are not well trained in reconstruction are saving themselves a chunk of change. Call me old fashioned, but remember the days when contractors wrote the estimates and the adjusters ajusted? I know that won't work in a cat situation, but it should still be available to the homeowners as an option. You can bet your panties that should my home ever have a fire that I'm not going to let an adjuster hired by the company write the estimate I settle on, and neither would you | | | |
| Bob Harvey Gold Member California, Central Coast
 Posts:388


 | | 11/12/2007 3:03 PM |
| should my home ever have a fire that I'm not going to let an adjuster hired by the company write the estimate I settle on, and neither would you How can you feel good about being an adjuster with that attitude?
I don't look at it that way, it's not that black and white. Whoever gets their estimate done first, it is a point of reference for everyone to align the confusion of a damaged property. Maybe the adjuster does a detailed, thorough scope. It does happen. Even if the estimate is terrible, it is a point of reference. "hey you left these 3 things out on this room, and..."
If the carrier issues the first settlement based on available info, and later there are some missed items that come up - it's better to pay the undisputed known claim when you know you owe it. I don't believe insurance companies are evil - or I wouldn't keep doing this job. Call me old fashioned, but remember the days when contractors wrote the estimates and the adjusters ajusted? Contractors are not entrusted with policy knowledge, matching issues laid out by the DOI, and frequently focus on what the customer wants to "put back" as opposed to a strict focus on what was there. You have 25 years construction experience with insurance type restoration claims, so you understand these issues. Lots of contractors do not. I had a claim just last week where a tree yanked off the power line and masthead to the side of a house. Contractor estimate didn't include a lot of the collateral damage to the facia board, and some interior damage from some wiring repair. I never, ever consider a contractors sheet to be a complete statement of damage associated with a claim. Sometimes I learn from them, or find something I overlooked, but truthfully it is more often the other way around. I often find missing items from contractor's estimates, and shine a spotlight on it to see if they were going to do the "unnamed task" within the job, or if it needs to be added. Contractors that do not use Xactimate tend to write very brief, one-page estimates. And when the budget gets tight, opinions can vary on what was or wasn't included in the estimate. That rarely happens with an adjusters estimate - as we focus on unit costs and tend to be very specific in what bits and pieces are part of the claim settlement.
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One other thing, to put this all into perspective. If a house has significant damage, the mortgage company will be named in the settlement. Many lenders take a controlling interest in paying out funds. It is often paid in thirds. Even if you own your house free and clear, you wouldn't pay 100% of the job to the contractor immediately. With that in mind, if you had a green adjuster write your damage sheet and the carrier paid it immediately - it's not like you signed a third-party release of all claims. You have a contract with the insurance company, and they will have to respond to communication in a timely manner, look into alleged supplements or overlooked damages. | | | |
| Steve Zibilich
 Posts:46

 | | 11/12/2007 5:06 PM |
| I guess the Hamburger Restaurant industry will be sued next because of the national pricing policy of Burger King, McDonalds, Wendy's, etc.
Then Auto Repair Shops who use the Mitchell Labor Guide...
what next? | | | |
| Tom Toll Life Member Moderator
 Posts:916

 | | 11/12/2007 7:14 PM |
| Who knows whats next, but one thing for sure, we will find out. This business is ever changing, and unfortunately, not for the better. | | Success is not final, failure is not fatal: it is the courage to continue that counts. | |
| R .D. Hood Founding Member Adjuster New Hope, Pennsylvania
 Posts:210


 | | 11/12/2007 8:08 PM |
| More interesting Reading, what else do we have to do? Perhaps we could volunteer for "dancing with the stars" or work in a Thanksgiving Soup kitchen.
Anything positive will be appreicated: http://news.thomasnet.com/printready.html?prid=535771 | | "Anyone who has never made a mistake has never tried anything new... Albert Einstein" | |
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