What do you get your friendly adjuster for a Christmas stocking stuffer? How about an itunes app called “Claim Denied!” Here is the description:

Let the claims begin!

Take your perch on the hospital rooftops and build your career as a young new employee in the health insurance industry! Shoot shiny red stamps, throw heaps of paperwork, call in the pre-existing condition clause, and set the blue dogs on the crowds to save your company money and make your future bright!

The National Underwriter noted in App Makes Winning a Real Loss for Adjusters that the game could reinforce negative views about insurance adjusters and the insurance claims industry:

An iPhone app game that focuses on denying claims to win “points” is reinforcing the negative stereotypes associated with those involved in the insurance adjustment process.

Though some may find the jokes and puns amusing, the satire is harsh and disparages the claim adjuster profession. The health insurance industry is the main target of the app’s unabashed criticism, but the game bolsters any public worry that claim adjusters as a whole are out to literally rubber-stamp customers into submission, and won’t help them when they have a claim on any sort of insurance policy.

Though presented in a joking way, “Claim Denied!” shows that there is much work to do to counter the perception and undercurrent of distrust that the public has in the insurance industry, and solving the problem will require a little more than thumb-tapping and scrolling to fix.

The insurance industry should always be concerned about claims ethics, which many perceive to be lacking in the industry. This was discussed in The Public Adjuster Paradox:

One of the most common reasons that insureds retain the services of public adjusters is the perception that insurance companies do not fully disclose and fulfill the promises of the insurance contract. The “all risk (with certain exclusions)” policies created a lot of confusion and unreasonable expectations primarily because insureds tend to hear or read the “all risk” part of the policy and disregard the “exclusions” section. The most disturbing situation that re-enforces distrust of insurance companies is when carriers try to increase their bottom line through the use of restrictive claim payment processes. The recent revelation that some of the personal lines carriers adopted claim practices that resulted in delays, denials, and litigation of valid claim payments has only amplified that perception.

I suppose from the public adjuster’s marketing view, an insurance claims industry that has an image of wrongfully denying or underpaying claims could increase the demand for public adjuster services. Perhaps public adjusters should be sending this app to their best clients.

  • Insurance Veteran

    Only staff adjusters deny claims, independent adjusters do not deny claims, the insurer they represent does. As independents we accumulate information, scope damages and make recommendations that are either followed or ignored. Good adjusters are advocates for fair play and ethical treatment of insureds. There’s no upside to nickel and diming an insured for the professional adjuster with the appropriate training and experience. Sadly that appears to be what is most lacking in the industry.

  • shirley heflin

    Hey Chip!

    Of course, if the PA is unable to settle a claim, then from a lawyer’s marketing view, this increases the demand for legal services. Hey, this sounds like a great MLG gift idea for P.A.’s (as you pointed out in your first paragraph).

    MERRY CHRISTMAS! :)

    SHIRLEY HEFLIN

  • Chip Merlin

    Insurance Vet,

    Thanks for your comments. You are always welcome on this blog!

    There are some cases and regulations in some states that suggest that the independent adjuster is the agent and adjuster for the insurance company with authority to bind the company. So, you have to be careful on the first point you raise.

  • Chip Merlin

    Shirley,

    I have already ordered 10,000 of these apps!!