Can Insurance Adjusters Appreciate and Learn From The Policyholder's Perspective?
Some in the insurance industry may read my blog and believe that I am on a crusade against the insurance industry. That is absolutely false. I love insurance. I get upset when insurers violate their good faith duties to customers--probably the vast majority from any perspective do too.
I wrote in response to a comment in The Value of Networking and Sharing Insurance Claim Information:
"The truth is that there are many fine and outstanding adjusters that do a fantastic job getting money to policyholders. The problem in my line of business is that I never hear of those stories because my clients have claim problems."
I have watched hundreds of hours of insurance training videos from various major insurance companies such as State Farm, Allstate, Nationwide, and GEICO. Our library is full of insurance claims manuals and training guides. Most of this training is excellent and teach principles of good faith. The public rarely gets to see this. The attorneys in my firm see it because it is our job to question what is taught and learn what is being done in the field.
I often talk with adjusters on cases before litigation--especially when corporations retain us to consult and help prepare their insurance claim with public insurance adjusters. Most of the adjusters are fairly well meaning individuals, but the adjusters in the field always seem to report to managers. Much of an insurance adjuster's claims attitude is determined by the culture and attitude of the claims supervisors. With some notorious exceptions, the attitudes and cultures are usually not in the training videos.
In those commercial losses where we are retained before the need for a lawsuit arises, the dialog becomes somewhat strained as we point out various benefits the insurance product can pay to help reduce the impact of the loss to the corporation. The adjusters seem bewildered because most of the time, they control their conversations with less knowledgeable and experienced policyholders. Even corporate risk managers and loss consultants rarely understand the full benefits available under a policy and leave millions on the table. Usually, after discussion and delay, the field adjuster gets approval for our view of the loss and the adjustment moves on with far greater payment.
The bottom line is that, from the policyholder perspective, there seems to be very little attitude from the insurance claims management to train field adjusters to use the insurance product to soften the financial blow as much as fairly possible. There seems to be little direction from managements to field adjusters to inform policyholders of information which would reduce their loss. If the training and attitude were otherwise, I probably would not have a job in this field of law.
Assuming that insurance claims management really does want its adjusters to help customers as much as the insurance policy allows, training adjusters to understand the product from the customer’s viewpoint is paramount. An example is Factory Mutual, where they specifically train their adjusters in the industry for which the insurance product is written. However, the vast training is not that way. Dimechimes recently explained in its Blog:
"I have been following consumer advocate attorney, Chip Merlin’s blogs since Hurricane Katrina. Rather than present blogs from an “ambulance chaser” perspective, I have watched him try to educate consumers about coverage issues and warn them about looming statute of limitations coming, for instance in MS post Katrina.
While it may be strange to study from free information from an insured plaintiff trial attorney website and standpoint, I have found it quite educational. Just don’t wear your feelings on your sleeve when you view his blogs as there are comments you may not agree with from an adjuster, adjusting firm, or insurance company standpoint.
......
The value I have found in viewing his blogs (there are several on his law firm site at www.merlinlawgroup.com ) is the fact that first he has an insurance defense background prior to becoming a consumer advocate trial lawyer so he knows both sides of the fence. Second, he posts links to active cases involving current claim litigation with links to important court documents we can learn from. I often link to his blog posts on this adjuster information blog when training new adjusters on Bad Faith as he has many great postings and articles there on the subject as well as other issues we need to know about."
So, for all the company and independent adjusters that read this, I understand that it is tough to hear criticism. Many of my clients never read their insurance policies before the loss happens. When they try to read it, they do not fully understand what it says. They certainly do not know how to use it to soften the financial loss they have suffered and how to measure the loss for complete indemnity. You have an important and demanding job to get them paid fully and quickly. They are in your hands.
So, how long will an adjusting agency stay in business if it gets policyholders paid "fully and quickly"?
I agree with you in saying that's what should happen; but, obviously that behavior is not rewarded. Just thinking how nice it would be if it were.
I think that was quite a compliment from Dimechimes. As long as they don't wear "...their feelings on their sleeve," they (and others) can continue to learn from your Blog. I'm sure there is a plethora of defense attorneys, insurance adjusters, defense experts, etc., who read your Blog to see what you're "up to."
From what I can see, you're doing what you've always done: HELPING THE POLICYHOLDER IN NEED.........INDEED !!!
SHIRLEY HEFLIN
Chip, thank you once again for helping share the word for ALL adjusters. I'm just catching up on some other blogs you've recently written mentioning our Adjuster information blog at www.dimechimes.wordpress.com and our e-mentoring project for newly licensed independent adjusters looking for assignments. As I teach them in our 50 Hour Fundamentals of Claims class, you will never be able to communicate with policyholders if you are not even aware of what their issues on claim hot topics are.
This particular post you just made makes a very important point as well about an adjuster's (staff, independent, public adjuster) duty to properly explain claim benefits. I have now individually trained over 200 newly licensed adjusters through our online ClaimSmentor 50 hour Fundamentals class covering basic items newly licensed adjusters need to know.
Just to give others considering careers in claims just a slight idea of what they need training for POST license, here is a self assessment test I posted for our members:
http://dimechimes.wordpress.com/2009/02/13/have-license-ready-to-go-not-so-quick-take-this-self-assessment-test/
The poll we ran in 2009 on our adjuster information blog about how they felt about information they got at required carrier certification shows that even independent adjusters feel they don't have all the training needs they do need to meet a carrier's file requirements.
As I said in the blog, I feel sure it is the assumption of the carriers that everyone there has knowledge of the general claim handling practices before they deploy but I've learned now going into 4 years of training new adjusters that the training is hit or miss depending on the training they participated in prior to a carrier assignment. We created our Fundamentals class to cover the gaps missing in their basic essential training to include the missing coverage gaps.
By the way, thanks also for your blog about LexisNexis as I have now spent hours upon hours viewing their site and found a list of more great blogs on Insurance law from lawyers on all sides of the fence that are outstanding sources of articles and legal cases I can use to train staff and independent adjusters.
Anyone who thinks Insurance law blogs of are a waste of time is throwing away the most educational training I have found to include time as a staff manager because it makes us so aware of other cases we are not privy to see if we are not assigned or as independent adjusters through long stretches of time between hurricanes or major storm deployments.
Thank you for allowing those of us "across the fence" to share in the information found on your blog. It took me almost 4 years to get up the guts to mention a "consumer advocate attorney" but after watching the information learned from your presentation to the Citizens of FL Task force on claim handling and then the FL Mission Task force, it just reconfirmed my private thoughts you were trying to make the insurance claims process better for all of us with friends and family members.
I've seen enough cases now to see you know when to hold 'em and when to fold 'em.... by following all of the Katrina litigation and I feel sure we haven't seen even a small percent of what goes on with settlments that never made it to trial. And if you don't know when to hold 'em as I think you do, then thank God I've never had to manage a case with you sitting across the table proving your allegations of claims mishandling. I feel very few cases are mishandled due to lack of caring but rather due to lack of training and also the unreasonable volume of claims all adjusters are assigned when a major storm hits.
Between you and David Rossmiller's blogs, those of us on the independent side of claims can learn so much on current hot topics and I thank you both for your efforts.
Hopefully by improving the training for all adjustes, we can improve things for policyholders facing a crisis in their life at the time of a claim. By improving the training and communication, maybe insureds won't continue to get the impression that it is everyone in the claims industry creating further panic by acting like it is the first rodeo on a storm which drives me nuts!
www.dimechimes.wordpress.com if any of your readers want to read the entire blogs which contained the information you have quoted from my posts.
It is truly unfortunate for the hardworking adjusters who try to do the "right thing" by getting the "right" claims paid. How frustrating it must be for them to be told by their superiors that paying claims does not profit the company - taking premiums profits the company - not paying claims. I'm sure some of these adjusters have a hard time sleeping at night, but, hey, they're just trying to make a living and, who knows, every now and then they get the reward of seeing a just claim paid.
SHIRLEY HEFLIN
Shirley,
I am doing everything I can to promote disclosure of pressures that are made by some claims managers of some insurers. A number of former claims adjusters have promised to contribute experiences.
I'm sure you are Chip.
Lots of adjusters should be ready to spill their "guts" soon - espcecially since so many of them are about to be axed (or already have) and, as I've read on your Blog, some of these people have served the company (for example, State Farm) for 3 generations.
SHIRLEY HEFLIN
Chip, I am just wondering how long does it take an adjuster to make their mind up. It has been 3 months and I gave my lawyers all the paperwork and the adjuster needs more paperwork, but the adjuster has everything.