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Last Post 04/11/2007 10:00 PM by  Ray Hall
The reverse side of FICUS TREE
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Ray Hall
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01/17/2007 6:08 PM

It will take the adjuster to dictate a scope on a dwelling about 15 min. Thats 3 per hour with short drives, tight zoned file or about 6.5 hrs in the field. for the 20 files. The scopes would be typed by a $12.00 temp sec. from the local service 10x12= $120.00 2 x1800 =$156.00 per day. The FICUS would get $70.00 per house x7=$490.00x3=$1470.00 per day if no per  deim of $125.00 per day. The 2 puter-putters would get $50.00 per file each. Office rent and supplies $150.00 per day. grand total of $2,776.00 per day or 138.80 per file cost.. Pay the temp sec. $50.00 per day to pick up the data from the field and the cost is $141.30 per file. 

Just ask your vendor to allow you to do this and ask the fee schedule average bill and see if you can make a profit. Remember the rules set in stone "you must inspect and work each file" have you not done that?

It will take you about 2 days to hire locals and work out the bugs. Just think of the warm good feeling that you will have" helping people in time of need" when not enough "smart" adjusters are available. Also you are an independant business person, who they need as well as you need them, UNTIL the carriers hire you direct and cut the fee's 40%. Good luck.

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Ray Hall
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01/19/2007 2:04 PM
I have two vendors that will alllow me to work this way. Thats not the best part. X-mate is not required and since I must furnish the pooters for the puters I will use the most bang for the buck. I have done some math and if the big one hits I may retire and hang with Durham, Hromas and Flynt. Some of the new ideas will have to come Bryan, Jud, David R, Dirt, CC, Charles, Chuck any many other fine posters present and past.
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HuskerCat
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01/19/2007 5:36 PM

My impression with your concept was that you would be the vendor, working directly for the carrier.   But now you say you are going to do this thru a vendor.  I don't blame them for allowing you to try it, what do they have to lose?  They still rake off the top end, and may see some increased production.  But the bottom line is, your name is on everything and after training the 2 day wonders locally, I wouldn't want the headache of fixing everything twice before submitting it to the vendor. Your revenue just went down with the vendor involved. 

An acquaintance does auto drive-ups in Cats, and says he would be thrilled to death to get 20 done/day on the simplest hail losses he could imagine (hood, roof, deck lid)...and that's with scheduled appts bringing the car to him.  Some people don't show, or show late, only want to come in after 6 pm or over noon.  Same thing with the HO's, makes it darn tough to fill out a day with field appts on 20 minute increments...no, makes it impossible.

 

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StormSupport
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01/21/2007 12:47 PM

I have run the basics of this idea by a friend who happens to be a labor attorney and his comments were - "While the concept may have merits, are they aware that it would create an 'employer-employee' relationship and require all of the necessary aspects of that scenario? Since the 'adjuster' is directing the activities of all those people working for him, he would have to provide all of the ordinary aspects ordinarily provided to employees. Workman's Comp Insurance, withholding, un-employment benefits when the job ends, even possibly health insurance when the state's start requiring that of all companies, Trying to claim that these people are all 'contract employees' would never fly."

The IRS guidelines can get confusing. Behavior control, financial control, and the relationship of the parties are critical issues. 

Misclassifying workers can create requirements to pay huge sums in back pay relative to overtime pay and benefits.

Usually, there are two tests that the IRS looks for when making the determination of whether a person is an employee of a business.

Test one: Does the business control the way how things are done by the individual? If the business has control then the individual is an employee.

Test two: Does the individual perform the service for more than one business? If the individual works solely for one company there is a high probability that the IRS might consider this individual an employee. If this person works for several companies, there is a likelihood of him being considered an outside contractor.

 

 

Do the right thing, ALWAYS
~Meg~
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gordon1
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01/21/2007 5:25 PM
I agree with the poster who stated this would raise issues regarding the "helpers" being employees & not sub-contractors of the adjuster. You WOULD have to dictate when the work would get done & how it would get done, in order to meet the turn-around time suggested by Mr. Hall & the carriers handling requirements. By doing this, you then become an employer, liable to all of those wonderful employer regulations, liabilities & taxes. You would also have to supply a reliable vehicle or face the likely possibility that the runner has an unreliable vehicle. What local would be ready on short notice to work a cat as a runner? If they are sitting around & available then they likely don't have steady income, which means they likely don't have reliable transportation. While I think this FICUS thing has some merit, I don;t think it should be discussed in open forum, where insurance executive bean counters can get any more crazy ideas. If they do, they will likely just want us to become inspectors/scopers & they will handle the clerical end, taking even more money out of our pockets. While they already know we can make a better living than salaried employees of insurers, they also know that this is the price they HAVE to pay to have someone travel long distances, live in less than desirable situations & work EXTREMELY long hours on end and all on very short notice.

The idea I had read in this thread was the Xactimate scope thing for the PDA & syncing it with the program. If someone could email me & provide more information, I would be very thankful. My email:NewYorkClaims@AOL.com

I have heard by some huby/wife teams, that the best way to become the most efficient is with the mobile office & 2 way radios. One party sits in the mobile office with a laptop & headset, the other party measures,scopes & photographs while relaying the info. via walkie-talkie. When finished, one person drives to the next loss, while one writes it up, so it is 75% finished by the time they get to the next loss. If anyone has experience with this, please contact me or post some info.

Hope all of you fellow & gal adjuster are doing well & have a GREAT new year!!!
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Ray Hall
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01/21/2007 8:57 PM

I only  know of two vendors Crawford, Pilot that have temp employees. Please name the others ?

I have worked for Pilot who is the largest and possibly the best, and the most honorable in my opinion. I will go back to work for them if they will allow me to use the FICUS TREE and I will inspect each {risk} and write the scope.

If 100 other catastrophe vendors use the 1099 method, why would I be tripped up with the same plan.?

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Ray Hall
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01/21/2007 9:19 PM

Gordon, please this old adjuster has 50 years in the business, but I have never made the statement that I was smarter than the executives that run the great fire & casualty insurance companys of the globe. They are always trying to find a better way. The FICUS TREE is just another way to do the job with more accountability from one adjuster. 

Does FEMA hire inspectors when they need them and train them in to do the work in a 2-3 days ?

If the adjusters found a good  FICUS, why not buy him/her a $90. camera and take the rental car cost out of their paycheck.

In regards you future is shakey. Don.t think so... the cream always rises to the top.

 

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StormSupport
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01/21/2007 9:37 PM
Ray, Unless I'm missing something here my understanding of your FICUS method was for one adjuster to hire several inspectors and a few secretarial type people and monitor the work done by those people.  Adjuster to review the files, sign off on them and send to vendor. 

These actions, assigning the work, monitoring the work, reviewing the assigned tasks, providing a vehicle or supplies constitute  an "employee" relationship, at least according to the IRS. 

I was under the impression under FICUS that the adjuster was to do the hiring of his/her staff of inspectors and office personnell, and the vendor assigning the claims to the adjuster has nothing to do with the adjuster's staff. 

Am I misunderstanding your FICUS plan?

Also what you wrote:

"I will go back to work for them if they will allow me to use the FICUS TREE and I will inspect each {risk} and write the scope.

This does't make sense to me, if you're working the FICUS plan, why would you inspect each claim yourself and write the claim when your whole idea is to farm out the work and have the adjuster supervise the work?  You've talked about having the staff to do 20 or more inspections a day.  But if you, as the adjuster are going to inspect and write the claims yourself, where is the FICUS plan? 

Do the right thing, ALWAYS
~Meg~
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Ray Hall
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01/21/2007 11:43 PM
Yes  Virginia you may be missing something, If you read all the post I have made on FICUS TREE [ copywrite] on this site  ClaimsMentor and some publications  in the last year you will see the advantage to the insurance companies.
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JJ308
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01/22/2007 12:01 AM
I am a newbie, wannabe, whatever you want to call it. I'm also 42 years old and have been a police officer for 16 years. I would feel no more comfortable counting on someone else to do most of the work on a claim with my name on it than I would be testifying in court on a case where someone else wrote my report. I want to be the one with the firsthand knowledge in anything that bears my name.
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StormSupport
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01/22/2007 10:10 AM
I have read your posts and I ask you, Is there a possibility that your plan is not completely flawless? 
Sarcasm and a condescending attitude will do nothing to promote your plan, nor will it convince me that this is the Mecca of claims adjusting.
(Sigh)
Do the right thing, ALWAYS
~Meg~
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stormcrow
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01/22/2007 12:42 PM
I am the insured. I guy comes in runs through my house in 15 minutes and departs. He is not the "adjuster" and likely knows nothing about coverage. Am I a happy insured, not likely.
I want to die peacefully in my sleep like my grandfather, not screaming in terror like his passengers.
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ChuckDeaton
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01/22/2007 2:28 PM
Most all insurance companies use Ray's FICUS TREE [ copywrite] (sic) concept.

The method is used on almost all large commercial claims. The adjuster is the inside guy and his supervisor who work behind the desk in the Cat center. The inside guys (adjusters) hire outside people to do part of the work. The Independent Adjuster inspects, takes photos and scopes, the Engineer, inspects, takes more photos and determines the cause of loss and scopes and the building consultant writes an estimate and negotiates with the contractor. If Time Element coverage is involved a forensic account is hired.

The Adjuster (inside) assembles the collected information, applies coverage and makes payments.

Actually there are very few adjusters. Most are the hired hands Ray talks about in his FICUS TREE [copy write] (sic). If you are working on insurance claims and the company will not provide a copy of the policy and you do not have the authority to "deny" coverage then you are a hired hand and are not "adjusting" the claim.
"Prattling on and on about being an ass with experience doesn't make someone experienced. It just makes you an ass." Rod Buvens, Pilot grunt
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Dimechimes
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01/22/2007 2:34 PM
Stormcrow,

Having experience from the staff management side of things where we had the use of staff field estimators (we had 1 to every 5 adjusters in the mid 90's), many problems ensued.

First, if the insured disagreed with the scope of the original field estimator, the field adjuster matched and primarily responsible for the file had to go out and rewrite the estimate not the field estimator.This caused many hard feelings and employee concerns between the adjuster and estimator.The reason was that we were now in the "adjustment of the claim"
territory requiring a licensed adjuster to make those negotiation decisions since a field estimator cannot handle claim adjustment negotiations.

Second, it created an adjusting problem when the unlicensed field estimator was out on the scene and coverage issues were involved in the writing of the scope such as rot found while scoping a shower pan claim,etc. The field estimator could only document the non covered items via photos to show the rot but could not discuss coverage with the insured and thus could not finalize the estimate telling the insured "I'll have your adjuster call you",etc..and an unhappy insured because someone was sent out that could not complete the job.

Third, the field adjuster still had to handle the ALE claim, the contents claim, and any coverage issues and all settlement negotiations with the insured.

There were overtime issues with the field estimators who were time card employees vs adjusters who at the time were salaried when the field estimators ran overtime thus limiting the time of the last appointment we could schedule for field estimators during periods of time when the carrier would not allow overtime(budgets,etc)

We tried it both ways- for a period of time we used the field estimators to write up the large loss scopes and enter estimates to free the adjuster's time allowing them to work many other files. Complications included again the coverage issues and settlement negotiations when trying to resolve scoping differences leading to borderline "adjustment" calls versus estimating only. We then tried using them to do smaller claims and a larger volume of estimates on the smaller losses but again, they ran into so many coverage issues on the smaller water losses and things like matching issues,etc that they again had many instances of running into "adjustment" versus strictly scoping issues.

This may be part of the reason you are seeing many carriers using licensed adjusters in the carriers in office claim central operations and licensed field adjusters in the field when need be versus using just "scopers" and "estimators"...this alleviates the worry of an estimator meeting with an insured and crossing the line.

Some feedback from IA firms I've staffed for indicate that the carriers are telling them that even in cases where the state may allow a non licensed adjuster to work claims (see new TX DOI rule on emergency adjusters,etc) that the carrier is still going to insist on the license to allow the adjuster to work as they feel it is beneficial as it gives the carrier atleast verification the person has some knowledge of claims via having passed a licensing test AND importantly that the person has cleared a background criminal history search before they let someone out into an insured's home. If this is the case, how would you overcome the coverage and checks on the scopers backgrounds? Also, how would a carrier have any say so over who is out meeting with their clients if unknown scopers are working? Should a suit be filed, all parties are at risk for depositions,etc and I'd think a carrier would want to know more details about the adjuster/scopers going out there. An example is in the CADO bulletins and the recent post by Darryl with Worley that State Farm is now requiring the photo id's. I have no idea the reason other than problems carriers have with complaints from insured's about who is out there and their need to document who the adjuster is that is being sent out on their claims. I just can't imagine a carrier leaving those decisions up to an adjuster and not keeping them in the loop on the qualifications and licensing information on their scopers.. I feel sure there would be reporting requirements at a minimum on the scopers being used.

The other points by storm support about employee versus independent status also would cause quite a concern for the adjuster and scopers alike due to potential for injuries and other suits,etc. Also, would the independent firm hiring the primary adjuster's E and O cover scopers or as storm support pointed out..would the primary FICUS adjuster be responsible for providing it? There seems to be much to work out for this theory to become a reality. Leading to another concern, if the primary adjuster doesn't pay the scopers, would they not try to go to the carrier to seek payment even if not appropriate further giving independents a black eye by carriers?

I think someone mentioned above about the FEMA 2 or 3 day classes and the point there would be they are still requiring they go to a class and get certified right? If I understand FICUS theory of Ray's correctly, all the decisions are made by the adjuster not the carrier or firm hiring the primary adjuster or certifying them?

Just some thoughts from another school of thought(reverse side of ficus?) Knowing that many carriers staff national catastrophe teams have to be as cost effective as ever since they have to "sell" their services to regional operations who then have to budget and account for their use of national staff catastrophe teams, I do think the carriers are looking for the most economical way of handling claims yet to do so professionally with the increased number of suits involved in claim handling activities. It doesn't seem that those decisions will ever be left by a carrier up to the Independent adjuster to determine who will and will not be handling claims for them thus FICUS would have to be a concept sold to carriers and approved by them?
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Tom Toll
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01/22/2007 7:10 PM
During many Hurricane Cats, we were informed that the estimates must be written by and scoped by the licensed adjuster, especially during Hurricane Andrew. It sometimes really gets to be a problem when you have many claims in the millions of dollars of damage, but you must do what you have to do.

I see nothing wrong with doing a proper scope and hiring someone to convert the scope to estimate form. Of course the licensed adjuster must inspect the final estimate prior to consulting with the GC or insured and certainly before submitting it to a carrier. I see too many problems with the FICUS scenario. I personally could not afford to pay an estimator, furnish his liability, E & O, computer, training, and vehicle.

I see nothing wrong with adjuster's trying to figure out how to be more proficient, but it has certain limits. There is nothing wrong with someone generating the estimate, setting appointments, routing, and taking phone calls,  This would save the adjuster a lot of time well spent on scoping and discussing the loss with the involved parties.
Success is not final, failure is not fatal: it is the courage to continue that counts.
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Ray Hall
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01/22/2007 8:15 PM

As I stated the licensed adjuster will scope the loss and the FICUS will take the photos requested by the adjuster and measure the rooms with a labeled tic sheet. The adjuster will have the face to face when he is at the house and  phone the insured when the estimate is complete. What is left out now.  In regards background check this is available on line for a nominal charge. The great state of Texas does not do a background check. They just ask and the felons just lie.

Now the biggie that is really a screen out the cold calls of hungary adjusters. E & 0 and GL. I want anyone on this site to tell me if their E & O covered the cost of defense and judgement. How many of you have ever been sued and the E&O says it does not meet the definition of the coverage template.

One of the vendors I work for charges me $200.00 per year on their claims. I work bare for 4 other carriers.

Just ask some of the old boys in Indy this year how they closed several thousand roof claims EACH.

I work FICUS TREE now and I will work it until I quit this vocation for some ,profession to a few hundred. And we can lock this topic if you all want to and I will not sneak in any more.

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gordon1
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01/22/2007 9:38 PM
I see big licensing issues with FICUS, especially in NY & FL. It is in an area, which is specifically excluded under the NY license & perhaps in FL. How does one find time to review ALL of the estimates, while scoping 20 per day and supervising a staff? How does one meet the usual requirement when on CATS, of submitting 5 completed files within 3-5 days, especially while locating locals, training them, supplying them with the equipment, researching the statutory employer requirments for the locale & complying with them ,all while making the presious 1st contacts? I would like to ask Mr. Hall how many files he closes in an average 6 week hail storm & 6 week hurricane storm?and what is added costs amount to for the "extra baggage"?
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Ray Hall
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02/01/2007 6:10 PM
Did any one have the article that they could post about the Florida commish placing a 90 day limit from storm date to a paid claim in hand from a catastrophe ?
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Dimechimes
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02/02/2007 9:29 AM
Here it is trader- I don't recall that it applied to cat claims only but will look at it again. I posted it in the topic on CADO about the FL Govenor's Hurricane conference also yesterday:

http://www.flains.org/public/sessum07A.pdf

The info about the 90 days is on page 10 of this pdf document about the entire emergency order.
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Ray Hall
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02/18/2007 4:34 PM
Well now it seems the FICUS TREE is making its move. Pilot has trained several hundred since theHurricane Wilma experiment in the Dallas call center for State Farm. Since that time not only State Farm but Liberty Mutual is on board. I also hear Hartford and Crawford & Co will use the FICUS TREE this season. If State Farm splits the business 4 ways as they always seem to do than Ebrels, Renfrow & Worley must be doing the same. I know some of you have been trained as inside adjusters; but can not come out of the closet yet......
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