Adjuster Ethics
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Adjuster Ethics - 1/10/2006 8:46:09 PM
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painterlady
Posts: 4
Joined: 1/10/2006
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I am a homeowner and recently had a fire. My adjuster asked me to select contractors to do the repair work and get estimates. One of the contractors she apparently knew well and she recommended him. I was not happy with some of his prices and told him so. He showed me an eight-page document from my adjuster to him with all the estimates, including those for all the other contractors, along with a personal note about who was getting what money and tried to tell me there was plenty of money there for his work. Do I have a righ to be concerned about this? It seems that one contractor is getting inside information. This is a document that my adjuster never sent me. This document also had my policy number, claim number, etc. on it.
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RE: Adjuster Ethics - 1/10/2006 8:53:59 PM
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Dimechimes
Posts: 256
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Home base: Destin, FL and Franklin, TN
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I would suggest you contact the adjuster's supervisor directly to discuss their company procedures and policies. The manager would be the best person to handle any concerns you have versus seeking opinions from us who are not familiar with the details of your claim.
Each carrier would have different company policies on procedures. The contractor could have been a company preferred contract vendor on the carriers approved list and it may be their policy to share the documents with a company preferred vendor if you had selected him to give you an estimate. We just don't know but I am sure the claim manager for the adjuster would be glad to clarify those issues for you. That is your best avenue for correct feedback.
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RE: Adjuster Ethics - 1/10/2006 9:16:42 PM
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RobertV
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If you asked me, in your shoes? I'd hit thermonuclear meltdown, from the sounds of the situation.
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RE: Adjuster Ethics - 1/10/2006 9:20:41 PM
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painterlady
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Adjuster in question is an independent, her own firm, in Virginia (no licensing requirements as I gather - I was reading some of the archives) so she's the top gun, but I must admit I have been trying to cool off and haven't confronted her as yet.
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RE: Adjuster Ethics - 1/10/2006 9:27:41 PM
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mh0825
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Even if the contractor is in the preferred program it almost sounds like this contractor was pushed upon the insured (Karen). Doesn't sound right to me.
On a further note, Karen, you do not have to use the contractor that has been recommended to you. You have the right to choose whomever you wish.
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RE: Adjuster Ethics - 1/10/2006 9:38:29 PM
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RobertV
Posts: 493
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The sharing your private info is one thing into itself. You still need to know where you stand with the loss. Get another couple of estimates in place of the contractor you don't agree with and press on. Keep your priorities straight. Don't let the problem activity be a stumbling block to reaching an agreed price and getting your settlement.
< Message edited by RobertV -- 1/10/2006 9:47:02 PM >
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RE: Adjuster Ethics - 1/10/2006 9:39:10 PM
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Dimechimes
Posts: 256
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If the adjuster is the head of the firm then we are talking about an Independent vending firm who gets their claims from an insurance carrier. The supervisor I am speaking about would be the claim management person with the Insurance company. I have the same thoughts as some of the other comments in here but still believe the issue should be commented on by the claim manager at the insurance company. We are not public adjusters handling claims for insureds and think we need to be careful about crossing that line if we are not licensed to be doing so. That was the only point of my comments was to give you an avenue within the insurance company who could properly address your concern.
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RE: Adjuster Ethics - 1/10/2006 10:30:59 PM
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painterlady
Posts: 4
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I really really appreciate all your feedback. Tomorrow I will take a deep breath and call the adjuster and get her side of the story. If I am not satisfied, I will go to the insurance company. And I do know now that I can choose the contractors although I do feel I was pushed to accept this one in particular when I was most vulnerable. I do special effects plastering and painting so I know a good deal about remodeling details ( I read with great interest about the plaster issues in New Orleans on this site) and gave the painting aspects to a paint contractor I knew well. I think that is when this guy got the idea that he needed to make up that part of the money since he wasn't getting it - at least that's the feeling I got from the comments he made and the papers he waved in my face. I will keep you posted on the developments.
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RE: Adjuster Ethics - 1/10/2006 11:41:43 PM
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sc_jay
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Home base: Pensacola, Florida
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Perhaps, contacting your adjuster is the place to start as your adjuster is the one handling your claim and probably has more knowledge of the situation than their supervisor or examiner at this point. Give the adjuster an opportunity to do their job and attempt to explain to you their claim procedures. If you have no resolution getting it resolved, then I would consider discussing the issue with the claims examiner handling the loss. Maybe, the adjuster feels they need the assistance of a GC in order to reach an agreed scope of damage and cost of repair with the insured.
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RE: Adjuster Ethics - 1/11/2006 12:37:46 AM
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khromas
Posts: 606
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Home base: Houston, Texas
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Painterlady -
Do NOT contact your adjuster in this situation. Immediately contact your insurance carrier and ask to speak to the senior manager in charge of property claims for your area. Explain your situation and state that you will NOT deal with the adjuster that was retained by the carrier and that you have SERIOUS concerns about the dispensing of your private claim information to a 3rd party without your knowledge and consent. There are numerous claims practices that have been breached here, some possible with legal ramifications involved. High on the list might be conspiracy to commit insurance fraud between the adjuster and contractor they gave your private info to. The adjuster has NO legal right to seek outside help without your consent or knowledge.
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Kevin Hromas
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Definition of a LIBERAL: a person who is so open-minded that their brains have fallen out!
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RE: Adjuster Ethics - 1/11/2006 8:05:30 AM
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okclarryd
Posts: 612
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Home base: Oklahoma City, Ok
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Kevin,
The IA always gets the insured's information. Otherwise, they, nor you, could handle the claim. The assignments/claims you receive has all the insured's information so sharing is not an issue. The contractor could very well be a company recommended contractor that normally receives virtually a copy of the claim file. This information sharing may be status quo.
There's a lot of "could bes" and "maybes" here. I thoroughly agree with your recommendation to contact THE claim manager or whoever is in charge of the company claim department. On the surface, it "can't be good" (from the Dodge commercial).
At least the insured was intelligent enough to recognize that something may be amiss and actually researched the web for information. And, actually came to those that may know a little something about the subject.
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RE: Adjuster Ethics - 1/11/2006 8:39:16 AM
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khromas
Posts: 606
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Home base: Houston, Texas
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quote:
ORIGINAL: okclarryd
Kevin,
The IA always gets the insured's information. Otherwise, they, nor you, could handle the claim. The assignments/claims you receive has all the insured's information so sharing is not an issue. The contractor could very well be a company recommended contractor that normally receives virtually a copy of the claim file. This information sharing may be status quo.
There's a lot of "could bes" and "maybes" here. I thoroughly agree with your recommendation to contact THE claim manager or whoever is in charge of the company claim department. On the surface, it "can't be good" (from the Dodge commercial).
At least the insured was intelligent enough to recognize that something may be amiss and actually researched the web for information. And, actually came to those that may know a little something about the subject.
The difference with IA's receiving the claim information is that they/we have a legal obligation, and the protections afforded by such, to that information in order to process the adjustment of the claim due to the contractual relationship with the carrier and in fact, stand in the carrier's shoes at that time. "The face of the carrier" if you may.
I agree that there are a lot of gaps in the info supplied by 'painterlady' and that there may be a very reasonable solution to her situation. The entire issue here is KNOWLEDGE & CONSENT. If she agreed to pick a contractor, the adjuster should have explained what would be provided. If the info was supplied to one of the companies and not to ALL of them, then I would question the integrity of the process and whether it was an 'arms length' situation.
The key to any and all adjustment issues is to provide FULL DISCLOSURE. I always explain to the insured my position as an Independent Adjuster and that my fee charged to the carrier is based on the size of their loss. I will seek to include every item of damage as long as it is COVERED UNDER THE POLICY. From the perspective of creating a better atmosphere with the insured and assisting in a quicker and more complete adjustment of the claim that disclosure can be immeasureable.
Just my take on the situation.
_____________________________
Kevin Hromas
_______________________________________
Definition of a LIBERAL: a person who is so open-minded that their brains have fallen out!
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RE: Adjuster Ethics - 1/11/2006 9:34:50 AM
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painterlady
Posts: 4
Joined: 1/10/2006
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I am having my morning coffee and mulling over who I will call first and what I will say and decided to see if there were more posts. Wow - really, thanks again. I know I gave info in a nutshell so ask me anything if it doesn't appear clear below.
I can definately say that only the one contractor got the information, the one I am having trouble with.
There were four major expenses 1) the repairs, 2) the replacement of the furnace system, 3) the cleaning/packing/etc. of the house, and 4) lodging while all this went on. Vendors in 2 & 4 are being paid directly (although I co-sign the checks). Vendor in 3 is open-ended and gets paid after all is done. There have been some issues but they have been extremely cooperative. I don't know about the housing people (Vendor 4 - Marriott) but neither the furnace people nor the cleaning people received this information.
That leaves the contractors in the repairs area and none other than the one in question received the information - I have asked and they were shocked about my discovery, which was the reason I started the inquiry.
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RE: Adjuster Ethics - 1/11/2006 9:58:07 AM
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khromas
Posts: 606
Joined: 4/19/2004
Home base: Houston, Texas
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Painterlady -
One additional item to point out is that it is a common practice in the insurance industry to have a 'contractor network' of companies that have been pre-qualified to conduct insurance repairs under a series of guidelines. These networks have a variety of names and are completely legitimate. The key is that you have to CONSENT to using one of those contractors. As the homeowner, it is ultimately your responsibility to deal with the contractor and generally the carrier will have no further liability for the work done. In most of these programs, the carrier will provide a gaurantee of staisfaction with the work done by the contractor (part of their agreement with the companies in the program) and you are somewhat protected in that sense. Having directed that program at the local office for a major carrier, if a problem arose, I can assure you that the policyholder would always be taken care of and then the contractor would be subjected to a "come to Jesus meeting"!
Best of luck in your resolution!
_____________________________
Kevin Hromas
_______________________________________
Definition of a LIBERAL: a person who is so open-minded that their brains have fallen out!
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RE: Adjuster Ethics - 1/11/2006 10:09:26 AM
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sc_jay
Posts: 10
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Home base: Pensacola, Florida
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khromas, it appears to me that you are jumping to conclusions without knowing the facts.
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RE: Adjuster Ethics - 1/11/2006 10:25:33 AM
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khromas
Posts: 606
Joined: 4/19/2004
Home base: Houston, Texas
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Mr. Johnson,
I have assumed no facts not in evidence but only those based on the information provided by painterlady. The totality of circumstances raised the question of whether the claims handling was transparent. I have only sought to provide as complete a picture of the processes involved as possible with alternate explanations so that she could make an informed decision on her next course of action.
What constructive advice have you offered except to provide the adjuster an avenue to get their butt out of crack for shoddy claims handling or even criminal conduct?
If you seek a battle of wits ... make sure you don't enter the fray un-armed.
_____________________________
Kevin Hromas
_______________________________________
Definition of a LIBERAL: a person who is so open-minded that their brains have fallen out!
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RE: Adjuster Ethics - 1/11/2006 10:26:38 AM
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newtonclaimstim
Posts: 154
Joined: 4/26/2004
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My 2 cents. If the contractor is on the up and up, would he not be privy to the scope and pricing that the adjuster used. Also depending on the software used, all the policy and
loss info. is on the print out. It looks like he was given a copy by the adjuster and should and may have included this in the body of the signed contract with the insured. He should
and likely got a OK to be a payee along with the insured and Mortgage Co if one is included. Good Luck
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RE: Adjuster Ethics - 1/11/2006 10:56:31 AM
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givemeroofs
Posts: 301
Joined: 4/19/2004
Home base: Houston, Texas
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quote:
ORIGINAL: painterlady
I am a homeowner and recently had a fire. My adjuster asked me to select contractors to do the repair work and get estimates. One of the contractors she apparently knew well and she recommended him.
Did you call the contractor or did the adjuster?
quote:
ORIGINAL: painterlady
I was not happy with some of his prices and told him so.
I mean this in a nice way, but the insurance company has an obligation to reach and agreed price and scope and why should you be concerned with "prices" if the insurance company is paying the bill?
quote:
ORIGINAL: painterlady
He showed me an eight-page document from my adjuster to him with all the estimates, It seems that one contractor is getting inside information. This is a document that my adjuster never sent me. This document also had my policy number, claim number, etc. on it.
I would not go so far to call that "inside information." Some insurance companies require the adjuster to reach and agreement with a contractor. Contractors who specializes in insurance restoration use claim numbers as a reference, so this is not unusual.
Example: I am insured with a carrier. I have a pipe break and am covered for the loss. I call the after hours claim reporting line. The inside rep know I am covered for the loss and sends Servpro out to clean up the water. Servpro has the claim number on their file to reference to the carrier. Happens all the time.
I would not jump the gun with the limited information. If your adjuster reaches an agreement with your contractor, I don't see where there is a problem.
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RE: Adjuster Ethics - 1/11/2006 11:06:34 AM
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Johnd
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[.]
< Message edited by Johnd -- 2/17/2006 11:24:20 PM >
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RE: Adjuster Ethics - 1/11/2006 11:08:59 AM
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JimF
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Post temporarily removed by Poster to review for compliance with the CADO website owner's guidelines to insure that generally accepted Free Speech provisions of law are not violated by exceptions to free speech recognized by American law, including obscenity, defamation, breach of the peace, incitement to crime, "fighting words" and sedition.
< Message edited by JimF -- 2/18/2006 2:43:19 AM >
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