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Gale

USA
231 Posts

Posted - 04/13/2004 :  00:41:10  Show Profile
Dale with the type of claims background you and Kathleen have gained you should know the needs of the industry. CNA, USF&G and St. Paul had to be good places for you to build the backgrounds needed to create this new service. Are you already doing this on the medical carrier side?

I always put a lot of stock in what Jennifer has to say because she is closer to the real world of claims than most on CADO. As a software vendor who deals with all group of adjusters it is easy to understand the myopic view that often develops in the world of CAT adjusters that only do CATS.

Personally if I experienced a loss and could upload the photo’s the telephone adjuster asked for and get a check in the mail or direct deposit within days that would seem like good customer service to me. To meet with a live adjuster even when required is a pain in the butt and pocket book for most of us. It is nothing against adjusters because the same applies in trying to meet up with the phone or cable installer for example. I even find myself getting upset when I place a call and I have to leave a message for someone with a live person instead of voice mail. Fast and with the least amount of human contact is looked as good service in these smaller types of claims by many I expect.

The carrier knows the faster a claim closes the quicker the insured will forget about it a move on with life. Drag it out and all their friends became amateur lawyers and PA’s. It happened to me once is the reason I know this. After playing phone tag for several months with an adjuster over a car accident it cost his carrier $5K because one day when we actually talked he offered to send me a check for $5K out of the blue not to sue. Naturally I said OK since I never had even thought about suing. They had paid my small medical expenses (<$1500) and paid to repair my car. That was years ago and I still do not know why with no clear reason they settled a claim that was never made.

Dale my story (which is factual) should be good in a sales pitch for the medical side of your business. This adjuster would return my returned call about every 3-4 weeks the best I remembered. I guess he was just overloaded and $5K was cheaper than asking me how I was doing.
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teolson

USA
3 Posts

Posted - 04/13/2004 :  16:36:33  Show Profile
I would agree it seems like companies are trying to do away with field adjusters. I started in this business when I was 19, and you can imagine what a tough time I had getting any respect from body shops contractors etc. That was in 1992 and I have noticed a huge slide of companies doing more business over the phone, however I dont beleive this will last. Contractors , body shops etc. are not stupid, if no-one is ever inspecting these losses it is much easier to fatten up the loss. And in the end I think the companies will see that our small salaries will not only provide service but save them money as well.
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alanporco

USA
112 Posts

Posted - 04/13/2004 :  18:21:32  Show Profile
Every time I attend some function where there is a company represented, they talk a about providing quality customer service. I don't know if that concept works well over the phone. Cost control is another factor to considered.

I work as a Commercial Claims representative handling claims under $5,000. If the claim appeared to be over $5,000, it was refered to a field adjuster. I know for certain that at least one claim was paid that should not have been and I suspect several more, too. The one I'm certain about involved water damage which should have been denied. The claim was paid because the contractor sent to handle it reported back that the water damage was due to a broken pipe. There was no broken pipe, only a scupper drain that couldn't handle the volume of water during a downpour. One year later I was handling field claims for same office and got a claim from the same insured for an identical type of claim in a different area of the structure. To make a long story short: The contractor ripped off the carrier by submitting an acceptable cause of loss, second claim was denied.
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okclarryd

USA
106 Posts

Posted - 04/14/2004 :  07:40:40  Show Profile
The pendelum swings back and forth and right now it is over in the "fast-track" area.

Customer service is at the top of everyone's list as the premiums are more competitive than ever and service is what keeps the policyholder.

I agree that telephone adjusting and customer service at high levels of customer satisfaction may not be obtainable at the same time, same claim, but that is the current trend.

And, if the policyholder gets his/her check in a timely manner, they are satisfied. Usually. There are those that demand a person to come look at the damage and are willing to wait on payment.

If you're an adjuster, you adjust.

I, for one, would much rather be out in the field than be in some dungeon working telephone claims. My preferences directly affect my bank deposits, so I have submitted resumes to several firms that are focusing on office adjusting, via internet.

A smiling voice and years of experience can work wonders over the phone.

And I don't have to concern myself with ladder safety except to change the light bulb in the ceiling fixture.

I'm an adjuster and I'm adjusting.

Maybe.

LARRY D HARDIN
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Czar

USA
66 Posts

Posted - 04/15/2004 :  21:19:55  Show Profile
Today I ran into the most classic case of fast track, desk adjusting that I find very common. I received the claim today, a frozen pipe burst…. and low and behold I look at the loss notice and the pipe burst back at the end of January. I go on to read the comments from the adjuster, and find that the desk adjuster is disputing all of the countertops and cabinets in the kitchen being replaced as well as some other “excessive work”. Of course the insured wants to meet today, so I go. When I walk in the rental house there is mold all over the counters, in the cabinets, growing up the walls. According to the insured, when they originally submitted the claim they were told that the insurance company could not find their policy. Then began the disputes of what was damaged and what was not. The insured asked if they would like to have an adjuster come out and look, and the company told them no just get some estimates, so that is what they did. According to the insured he did not want to touch anything until the insurance company made coverage decisions and the problems with amount of damage were resolved. Although I haven’t ran the numbers yet, I would estimate that to conduct proper remediation will run about $10,000.00 or so. If I had called out a day after the loss, there would have been a $1,500.00 for dry-out and some minor painting and drywall work. Add my fees and they would have been looking at about $3,000.00 claim closed. Do we see a problem here?
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Ghostbuster

476 Posts

Posted - 04/16/2004 :  13:05:51  Show Profile
Yeah! I see a BIG problem. It's your adjusting fee. When are you people ever going to learn that you independents make too much money! Don't you people realize that if we carriers didn't have to pay you independents our honchos could afford a higher class of kept-women???
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Gale

USA
231 Posts

Posted - 04/16/2004 :  15:16:35  Show Profile
Czar, the case you make does not prove or disprove the validity of the “fast track” adjusting solution from a business standpoint. If the homeowner had lived in the house I expect the claim would have been settled much faster and that the counter tops would have been cleaned from time to time if they were in use for example. With some carriers have about 25% of their total adjuster force working as telephone adjusters so someone thinks “fast track” is a valid solution to reduce claims handling cost.
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Czar

USA
66 Posts

Posted - 04/18/2004 :  22:52:37  Show Profile
GB:

I didn't mean to say my bill would be $1,500.00, I just ment the total charge to the carrier would have been about $3,000.00. My bill $250.00 to $300.00. I guess my problem is that there are some claims that require on-site eyes and ears, and I agree some don't. When a homeowner tells you water is everywhere and the ceiling is down, sounds to me that eyes on-site are needed.
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katadj

USA
315 Posts

Posted - 04/19/2004 :  00:32:27  Show Profile
CZAR,

Don’t get annoyed, that’s just Ghost's way of commenting. He had no idea what you were charging, (I hope).

Ghost, why are you always pickin on me? LOL
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Ghostbuster

476 Posts

Posted - 04/19/2004 :  08:03:33  Show Profile
Oh, for God's sake! Don't you recoqnize sarcasm when you see it? To the carriers, it's not what they pay to the Insured that counts, it's what they pay in adjustment expenses that twists their skivvies. And, it's all because the claims costs can be used to set premium increases but, according to some archaic accounting rule, adjusting expense can not.

Now do you understand? Now do you see the sarcasm that is used to illustrate the issue that YOU are an adjustment expense and are as welcome to the bean counters as wind breaking at the grandma's afternoon tea party? It doesn't matter how much your fee bill is, $300.00 or $0.30, you're too expensive. But, if the approved shop contractor over charges by $500.00, they don't care. As long as the premiums can be increased each year to adjust for increasing claim costs, the party goes on.

You folks out there may well need to drag out your high school English books and review the various forms of illiteration so you can keep up.
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newtonclaims

5 Posts

Posted - 04/19/2004 :  08:21:35  Show Profile
Agreed
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Czar

USA
66 Posts

Posted - 04/19/2004 :  15:06:29  Show Profile
GB:

I understood your sarcasm, I just didn't want to give the impression to all of the onlookers that my fee bill for a small loss would be $1,500.00. You never know when backslash boy is watching and wanting his cut.
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Johnd

USA
110 Posts

Posted - 04/19/2004 :  19:00:08  Show Profile
Ghost:
I have been banging on this drum for several months, alas, to no avail. A simple accounting rule change could be the salvation of this business. No one seems to care, or at best, understand. You may have better luck........

John Durham
sui cuique fingunt fortunam
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JimF

USA
1014 Posts

Posted - 04/19/2004 :  21:41:04  Show Profile
quote:
Originally posted by Ghostbuster


You folks out there may well need to drag out your high school English books and review the various forms of illiteration so you can keep up.



Surely you jest.

From reading some of the posts around here which slaughter the Good King's English at best, the question is begged, how can one pull out a high school textbook when they never made it past the 6th grade?
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