Over the course of my 9 year career as an independent adjuster, I was extremely fortunate to spend m

I recently deposed corporate car rental denver colorado representatives from American Family, Auto Owners, State Farm and Allstate Insurance Companies and received car rental denver colorado the following admissions from some of those corporate representatives:
the independent adjuster made an on site coverage determination and informed the homeowner in-person of the denial of coverage-- without prior review of the claim or any supervision by the insurer s claims manager.
Despite all of the above, some of these insurers continue to hire the same independent adjusters over and over again. By pushing the investigation of claims onto independent adjusters car rental denver colorado who do not follow proper claims handling practices, insurers evade responsibility for proper car rental denver colorado claims handling.
This pattern and practice will be the subject of a Colorado Consumer Protection Act claim. car rental denver colorado For policyholders to prevail on a Colorado Consumer Protection Act claim, the insured must prove: car rental denver colorado (1) that the defendant engaged in an unfair or deceptive car rental denver colorado trade practice; (2) that the challenged practice occurred in the course of defendant's business, vocation, or occupation; (3) that it significantly car rental denver colorado impacts the public as actual or potential consumers of the defendant's goods, services, or property; (4) that the plaintiff suffered injury in fact to a legally protected interest; and (5) that the challenged practice car rental denver colorado caused car rental denver colorado the plaintiff's injury. 1
1 Rhino Linings car rental denver colorado USA, Inc. v. Rocky Mountain Rhino Lining, car rental denver colorado Inc. , 62 P.3d 142, 146 (Colo. 2003) . (For more information, see my post from March 20, 2012, Policyholders Are Entitled To Discover Insurance Company's Widespread Pattern Or Practice In Order To Establish Claim Under Colorado Consumer Protection Act , about Colorado s case law regarding discovery of an insurer s pattern or practice).
With the chaos that often follows catastrophes combined with the hiring of what experienced adjusters fondly call"three day wonders" or newbies the above is not surprising. Allowing people to adjust having attended a three day course that focuses on the exam answers does not an adjuster make. Proper education and more stringent licensing is required.The other side of the equation is how do you keep properly qualified folks only needed in time of catastrophe fed in the interim.The system is faulty and needs overhauling.
Over the course of my 9 year career as an independent adjuster, I was extremely fortunate to spend my first year in the industry NOT being allowed to handle my own claims until I was able to accurately scope a risk from the foundation to the roof and everything in between with nothing more than a pencil paper calculator tape measure and a camera. I was also taught that in situations where there existed car rental denver colorado a gray area and a judgement call was required, to error on the side of the insured. The last seven years of my career, I have handled almost exclusively litigated claims and/or claims where the insured car rental denver colorado is represented by a public adjuster. I have worked with all kinds of PA's from top notch to sleazy inflated claims with no supporting documentation to justify anything. Nevertheless, car rental denver colorado the vast majority of those PA's were dedicated professionals looking out for the best interests of the insured.
The past two years I have thought of making the switch to the "other" side. This comes from the fact of moving towards inside adjusting and management. Reviewing other adjuster's work product showed me that few adjusters followed established guidelines and multiple revisions and rejected files were often the result. This would increase ten fold after a major event. car rental denver colorado An interesting fact began to emerge, most often utilizing rookie adjusters after a major event resulted in actually a good solid work product that followed carrier guidelines. It was from so called veteran IA's where the deviation from carrier guidelines occurred most often.
From a recent unnamed CAT event(let's just say if you walk on the beach barefoot, the space in between your toes may get a touch______!! car rental denver colorado I was tasked to review files for an unnamed vendor for an unnamed carrier. A nice day rate and per diem made life very good.
I could NOT believe the garbage I was reviewing. I rejected many a file for egregious flagrant deviations from carrier guidelines. The last straw came in the form of a simple roof claim that was anything but simple. The photos indicated impact damage across all slopes of the roof. Many shingles were lost, multiple openings were created to where rain soaked contents within the attic were clearly visible in the photographs. The adjuster (a 10 year veteran) correctly recommended car rental denver colorado full roof replacement to include 128 sf of 1/2 plywood decking.
The problem was, that is where the estimate ended!! No more pics, nothing!! car rental denver colorado It is my opinion that even a first storm rookie adjuster understands that a significantly damaged roof that warrants replacement is but the first link in a chain of events. It is common sense to think if the roof failed to the degree that the contents within said attic were rain soaked, other damage is inevitable. Yet NO pics of interior anything. car rental denver colorado Nothing car rental denver colorado mentioned about the contents. IF there is no damage, show me proof, show me pics of dry insulation in the attic, show me dry ceilings with NO water stains. If in the unlikely event there IS no further damage, PROVE IT!!
I rejected the file and indicated a return trip to this risk is warranted. I get a strongly worded email explaining car rental denver colorado how many inspections this adjuster has set up for the next 7 days and to go back will severely curtail his schedule. car rental denver colorado I responded that is NOT my problem, I want a comprehensive inspection on this risk, PERIOD!! Do it right the first time! Now I get a call from this adjuster asking if I have read the narrative? Yes I have read the narrative,and? Well didn't you read where the insured was happy to get his roof replaced? Yes, and? He didn't say anything about interior damage!!
I again stated go back and take pics and inspect the risk thoroughly! Now I get called into the Vendor director's office. I was talked with (admonished if you ask me) and was told that rejecting multiple files skews the vendor's closed claims ratios and makes the vendor's adjusters look bad to the carrier. I was further told that this is CAT work, turn and burn, close close close. I asked if they were asking me to arbitrarily approve the claims for closure and bill the carrier regardless of the quality of said claims. Of course car rental denver colorado not! Just give the report the once over and on to the next.I was then told if the insured has a problem the claim will get reopened and we will deal with it then. I said, really??? Here is where they lowered the boom on me and sealed the deal: Remember, you are an independent adjuster , you represent the interests of the carrier!!
I explained that yes my job is to represent the interests of the carrier. That interest is to ensure that the terms of the contract between the insured and carrier are fulfilled and that the insured is brought back to a pre event condition based upon damages incurred as a result of a covered peril!!
As founder and president of Merlin Law Group, Chip Merlin car rental denver colorado has dedicated his practice to the representation and advocacy of insurance policyholders in disputes with insurance companies in Florida, Texas, Colorado, California and nationwide. Since 1983, Chip has served as... More...
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Merlin car rental denver colorado Law Group offers legal services related to insurance litigation, property loss, hurricane damage, car rental denver colorado bad faith, denied claims car rental denver colorado and coverage disputes. The law firm serves residential and commercial policyholders in Florida, New York, New Jersey, Texas, Colorado, California, Arizona and the rest of the entire US.