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CCarr
Canada
1200 Posts |
 Posted - 10/23/2003 : 08:21:22
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PoppaCat, I'm not here to defend William, but I do think you have misjudged some of his statements.
"An IA can not deny a claim of 10 cents", or as Bill more specifically stated, "an IA does not have the 'legal authority' to deny an insureds claim of 10 cents".
As I said in my first post, first paragraph, "or by an IA in accordance with the instructions of the carrier", sets the parameters of the IA authority.
Legally I believe, the noted statement by Bill is correct. In reality, there are many versions of it which vest from the instructions of any given carrier. What authority is granted by a carrier to an IA? This will vary from 'day to day' claims, cat claims, adjusting firms and specific adjusters in those firms; and unfortunately at times that authority (whatever it is) can be implied as well as expressed. At one end of the spectrum, certainly outside the cat claim world, the very specific function of an IA is to "investigate and report", period, no authority. Obviously each carrier, and likely regionally different, will grant or limit authority to an IA as they deem appropriate. I do think your feelings on this specific item, are more closely aligned to the other end of the spectrum with regards to granted authority. There is nothing wrong with either end, as long as both parties (granter of authority and holder of authority) know exactly what it means and doesn't mean.
Next, William did not say, nor do I feel he inferred, that a staffer has more knowledge than an IA. Bill's comments in relation to this issue you raised, I think are related to privity of contract issues, not knowledge of a policy wording issue.
Bill's reference to a PA, again was in a legal sense, as opposed to the insured's contractor negotiating with the adjuster.
Anyway, that is just how I interpreted the things you took issue with. |
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CatDaddy
USA
310 Posts |
Posted - 10/23/2003 : 08:57:25
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IceDog, the policy is the contract. You pay premium and it says what we will and will not cover. There is no hidden language that only staffers have the code to. Not where I come from. Now, I guess I need to realize that other companies handle their business in a different way than I might be use to. Is that why all this sounds Greek to me?
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CCarr
Canada
1200 Posts |
Posted - 10/23/2003 : 09:06:43
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| Yesky, and those different companies will differently handle the different classes of claims within their own borders. |
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Ghostbuster
476 Posts |
Posted - 10/23/2003 : 11:03:02
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Clayton, yes, But...for the true independent Bill is correct as is Joe, an independent can only rightly 'recommend' a settlement action. However, as a temp working for Big Red, one IS the company and has the check for up to $10,000 to prove it, as well as the ability to say NO in the same way as a staffer who has the retirement plan that we don't.
This is all part of the brave new world that no body likes because life is far more complicated than it should be for those of us who still have a memory of the past. |
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KileAnderson
USA
875 Posts |
Posted - 10/23/2003 : 20:32:10
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I am an independent and I settle claims every day. I write checks and I dictate denial letters (Water loss not covered Section 1 losses not insured 2.C. 1,2 & 3.) I have it memorized. I don't know what you guys are talking about but I settle and deny claims all day long. That's what they pay me for and that's what I do. Don't paint all IA's with the same brush. The field is vast and every company does different things.
Catdaddy and I work for the same company so I will back him up on all of that, we do the same things. |
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CCarr
Canada
1200 Posts |
Posted - 10/23/2003 : 20:54:27
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Kile, I think you are misinterpreting some of what has been said in this thread. It has nothing to do with good or bad, better or worse type of adjuster; or anything like that.
Authority granting is a procedural thing, very explicit and very predominant in 'day to day' claims, but still not uncommon with cat claims, varying from carrier to carrier; with SF being on one end of that scale through their choice.
You are not being painted with a negative paint brush, each company has their own practices and procedures as it relates to authority. |
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KileAnderson
USA
875 Posts |
Posted - 10/23/2003 : 21:30:34
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| Sorry, Clayton, I wasn't saying anyone was being painted with a positive or negative brush. Just not the same brush. Everyone has a different scope of duties in their job. I was just pointing out to others that if they do it one way it isn't the ONLY way that it is done. That's all. |
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