Property claims adjusters are supposed to promptly evaluate damage, investigate coverage, and provide full benefits to policyholders. Adjustment is about giving the customer the service promised and paid for when the policy was purchased. This service is not paid with "indemnity dollars," but with insurance company claims expense dollars, which insurance companies must spend to make certain their policyholders are promptly and fully receiving benefits.

The insurance industry recognizes this obligation of customer service. Here is a recent quote from Carl Van, President and CEO of the International Insurance Institute, Inc.:

Claims is a 100-percent customer service business. We don’t build anything. We don’t make anything. We don’t fix cars; someone else does that. We don’t mend wounds; someone else does that. We don’t rebuild houses. We arrange for those things to happen, and that is the customer service component. Sometimes we pay people, and other times we don’t pay them but at least explain why. Even doing that is part of the customer service we provide.

…I will be speaking on these three areas: Creating a culture of customer service awareness; setting a standard that improvement is part of the job; and providing the training and support for people to reach their potential.

Many claims organizations will say they do all this already, when in truth it is their greatest weakness. (emphasis added)

No joke. Consumer Reports made the following revelation regarding insurance company claims performance in an article, "In Sandy’s wake, roll up your sleeves—for possible fight with your home insurer":

As survivors of Superstorm Sandy start cleaning up the estimated $20 billion in destruction, homeowners need to prepare for another possible squall—with their insurance company, according to the latest data from the Consumer Reports National Research Center.

When disaster strikes, your home insurer might not live up to your expectations, especially if you have a large claim, based on the results of our 2011 survey of 11,250 subscribers who filed claims in the past few years. The greater the damages, the greater the likelihood that home insurers paid less than expected, we found…

Overall, almost 10 percent of respondents reported disagreements with their insurer over the amount of a claim payment. But when damage was $25,000 or more, 19 percent disagreed with their insurer’s assessment of what was due. That was more than three times the disagreement rate for claims worth less than $2,500.

My experience is about the same. Last week, I again asked for construction estimates and analysis Zurich Insurance Company consultants made last fall regarding a governmental claim. You would think the response would be, "Gee Chip, we thought we gave that to your client months ago and will email them right away." Instead, everybody has to wait for Zurich claims management to give the "okay."

In my speech last week in Manhattan, I referred to many claims organizations as the Three Monkeys (–see no damage, hear nothing from the policyholder explaining damage, and never ever speak about all the benefits available under the policy and how to maximize recovery).

No wonder the public insurance adjuster industry has seen tremendous growth over the last decade. Policyholders need help, and many do not perceive it coming from their insurers. Perhaps the insurance industry should consider the pictorial maxim of the Three Wise Monkeys sometimes has a fourth monkey symbolizing the principle of do no evil.

  • Insurance Veteran

    As you know independent adjusters are under strict instruction to not comment on coverage in their reports to insurers in most cases. We provide a damage assessment, loss detils on circumstance and causation and the ultimate decision on payment is not ours to take. Therefore even though we can assist the insured we are not authorized to do so. Caught between a rock and a hard place. Until claims handling practices change the prevalence of public adjusters is guaranteed. Same for plaintiff counsel.