Insurance adjusters are taught to investigate coverage and evaluate damage. Good faith performance requires that this be done in a prompt, thorough, and honest manner. Most adjusters are taught to document what they see in the field through photographs, video, and the collection of evidence. Good faith also requires that the adjusters undertaking this important job be qualified to adjust the loss they are assigned.
 

Stephen Hadhazi, a Texas public adjuster, recently wrote of a relatively new adjustment practice. When inspecting roof damage from hailstorm, some insurers are sending out either incompetent field adjusters or those with no authority, who merely take photographs of hailstorm damage.

This…addresses the very popular practice of insurance carriers where they send adjusters out into the field to merely photograph some of the damages. These adjusters then send the photos into a desk adjuster, potentially hundreds or thousands of miles away to be reviewed to see whether the damages in the pictures are wind, hail or whatever type of damage is being claimed.

The field adjusters claim to be merely the “Eyes and ears” of the desk adjuster. This sounds really great – until you ask the opinion of one of the field adjusters and he tells you that he is not there to give an opinion. The obvious problem with this is that unless we know how the field adjuster feels about the damages that you are showing him then how do we know when to stop showing him damage – or more accurately, when to stop prodding him to look at damages.

Many times I will be on a roof with thousands of impact marks and after I show the adjuster 15 or 20 marks then he stops me and says “Ok, that is enough…I have what I need”. But, was it enough? We will not know until we get the report from the insurance carrier – which many times is a denial that what was shown to the adjuster was, in fact, hail or wind damage.

Had the adjuster been honest and said “Ok, I have seen the 15 or 20 marks that you have shown me and I do not think that is hail or wind damage” then I might have discussed with him his thoughts on what he felt constituted hail damage and I may have continued to show him hundreds of other marks that might have qualified under his criteria.

However, we are not given that opportunity because most field adjusters will not discuss the criteria of what they consider to be hail or wind damage. They just want to take a few representative photos and send them to the desk adjuster thousands of miles away – which many times leads to a speedy denial.

This practice of field adjusters not being allowed assess damages is nothing more than a shell game by the insurance carriers and it needs to be exposed.

I wonder what my colleague Steven Badger, who represents various insurers with hailstorm claims, would think about this practice if his clients were doing this?

I agree with Hadhazi. I think it is not proper adjustment. It certainly is not how many insurers adjust losses. The fact that it is a practice by some should be exposed to Departments of Insurance. I cannot imagine any insurer doing this would pass a market conduct examination. I am curious how claims executives would explain their decision to adjust hailstorm claims in this manner.

My sources tell me that insurers practicing this method of adjusting include the following:

  • Admiral Insurance
  • The Travelers
  • Allstate Insurance
  • State Farm – at least those claims assigned to independent adjusters
  • Farmers
  • Homeowners Insurance of America
  • Safeco insurance

I will gladly add or remove companies as I gain information.

  • Woody

    This practice goes beyond just wind and hail damage. I have seen it on several water damage claims. Carriers are Kemper, First American, Farmers, and USAA to name a few.

  • Erv Bartlett

    You hit the nail on the head Chip. Today, most IA’s are nothing more than estimators and the estimates are red lined once the desk reviewer gets their hands on the claim. Gone are the days when an IA actually settled a loss on site.

  • The beginning of the end for “Remote Control Adjusters” ;)

  • Lewis O’Leary

    Because nearly all “hail” claims are actually “wind and hail” events, they should always be approached as “wind and hail” despite the possibility that no leaks were reported during the event in question. It is very common for a wind & hail event to be accompanied by little to no rain. Interviewing the tenants or owner as to whether there was significant rain during the event is important, along with finding out if the owner or tenant found an increase or beginnings of leaks during the next heavy rain or that there is a “smell”, stemming from the attic a few days after each ensuing good rain. These are good indicators as to whether or not the loss of seal strips may also be the result of the same wind & hail event. In a recent joint investigation on Mod Bit membrane roofs, we found that side lap failures (the equivalent of seal strip failures with comp shingles), and partial fastener back outs on older but functional roofs at around 50 mph.

  • Steven Badger

    Chip,

    Thanks for the shout out!

    What Mr. Hafhazi may actually be experiencing is a growing reluctance of some field adjusters to have any dialogue during the initial site visit with public adjusters and contractors acting as unlicensed public adjusters given that their words and actions are frequently misquoted and misinterpreted. This is one of the ways the “emerging cottage industry” I refer to in my articles is making the claims process more difficult for all of us. Take, for example, this Craigslist ad posted just yesterday presumably by a Texas licensed public adjuster…..

    http://dallas.craigslist.org/dal/sls/4535454683.html

    This public adjuster essentially guarantees sight-unseen that they “WILL” take any denied claim and get the building owner “paid to get a new roof” with just “1 hit per square.” That’s a pretty bold promise. Imagine what the field adjuster has to deal with when he or she meets on a roof with this company.

    Chip raises a concern about “Photograph Adjusting.” I guess we should call this “Craigslist Adjusting”.

    It is also possible that (as Chip alludes to in his blog response to my recent article) that perhaps this public adjuster never even walks the roof and instead immediately funnels the claim through to a policyholder attorney who, also without ever walking the roof, quickly files a lawsuit. Dozens of hail damage lawsuits are being filed in Texas each week following precisely this process.

    In my opinion, it is this type of conduct — that we all know is going on out there in this industry with increasing frequency — that is making the claims process more difficult for everyone involved and leading to further limitations on available coverage for Texas building owners.

    Appreciate the dialogue.

    Steve

  • Steven Thomas

    I remember my fathers saying “two wrongs don’t make a right”! The simple “truth” is both sides of the claims process is convoluted by blatant dishonesty! If the insurers representatives would diligently inspect for damage as opposed to taking the role of damage deniers many PA’s, Plaintiff Attorneys and Contractors would have little to argue over! However in many instances Insurers hang their hat on the credentials of unqualified persons who inspect for damage. The insurers place more emphasis on a P.E. or AIA stamp then they do the qualifications of whether the individual actually know anything about roofs or damage assessment! I work with many Engineers and Architects and to a person not one has ever said that anything in their curriculum in college discussed roofing damage or testing techniques! I’ve been doing this type of work for a long time and I’m not sure when the damage assessment part of roofing claims became exclusive to Engineers and Architects, however in my opinion a big part of why things are so difficult in this industry today is the Insurers reliance on unqualified personnel to inspect for damage, thus giving rise to those who will defend the rights of the insured to be indemnified!

  • I do agree that their should be a fine line between contractors (preferred vendors – Power of Attorney, Direct Deposit, Insurance Proceeds contract) and Public Insurance Adjusters and not a grey!

    If the insurer is worried about unlicensed Craiglist Public Insurance Adjusters, encourage desk and field adjusters to do one simple step, check Texas Department of Insurance search! It’s that simple (less than 30 sec).

    https://txapps.texas.gov/NASApp/tdi/TdiARManager

    Another way to tackle this is to be a Texas licensed contracting state and have a better education requirements for all (contractor, adjusters, appraisers, etc) and approved proper visual identification with license number and photo from Texas Department of Insurance and Texas Department of Licensing and Regulation.

    I do understand the concept of the insurer. Field or independent adjuster large commission are being reduced and replaced with a desk adjuster or estimator’s low salary plus commission base.

    Restricting initial adjusters from doing their jobs by passing it to a remote inside adjuster sometimes limits the true performance of both adjusters (appraisal seams more civilized, when appraisers “aka – adjusters” don’t bring causation, coverage and limits of liability) and their negotiating skills and closing a claim quickly.

    Separating adjusters makes the claim more difficult with additional steps and multiple parties and closer to litigation?

    KISS – Simple is smoother, cheaper is micromanaging “Take your pick”.

  • David Smith

    Had this happen to me. Large hailstorm in upstate sc had roof checked was told I had damage to shingles vents skylight housing covers for gutters called my ins agent got email from Safeco telling me MadSky const. In Colorado would be assessing he damage. Dude shows up, climbs up top reports no damage asked about a specific area which had lots of dents in skylight housing. He thinks a few seconds then says uh saw one dent your roof is in good shape for years to come (22 yrs old ) I then told Safeco MadSky would not work for me . Next thing I knew there was a speedy denial. Look up MadSky in Google . Interesting

  • Risa Needles

    I am having an issue with an Allstate landlord policy. I submitted a claim on 6-6-16 at 5:45 pm and it was denied the next day. I have melted siding, missing in wall medicine cabinets that had electric in it, other missing items in the house like antique door knobs, door, etc…. water damage from tenant leaving entire home open, windows, doors, for a week or more. Doors hanging by a hinge, cut wiring in garage and bathroom. Begged them to send an adjuster and was told there was none in my area. Denied the claim 12 hours later. No investigation, nothing. I and an neighbor who is an attorney went over policy and I should be covered for most of these issues. Yet the desk adjusters say I am not understanding the policy. I am not a genius by no means, but I am also not a idiot. I have pointed out the page numbers, paragraph and subparagraph to 2 desk adjusters, read and re-read it to them about how I am covered. Yet i am told I do not understand. Well a cut wire will cause a disturbance in the electrical current, pretty sure of that. Yet they say I am not covered, even though my policy says if electrical current is disturbed I am covered. After 9 days of back and forth and finally getting claim adjuster at desk’s supervisor he said he will send an adjuster on Monday the 20th. I fear it will be the same thing as I have read on here. He will take pics, send to them to deny again.
    I have read numerous articles since this happened and Allstate leads the pack of bad faith insurance companies on fbic.org. Had I have known that I would have signed with someone else. I also qualify for rental income as it is not habitable at this point. Electric issues, cut wires, noise coming off wires, busted screen frames on front porch, busted windows in home and garage, missing door knobs so you cannot even open some of the doors, melted siding etc….
    I just do not understand how this is legal for an insurance company to do to a policy holder. It is so wrong to make a customer go through this. I have to have back surgery and am putting that off to deal with this.
    If anyone happens to have any advice for me as I am on a fixed income I would greatly appreciate it. Please any advise at all as dealing with them makes me want to pull my hair out.
    I just want it fixed and I am selling it. I lived in it from 91 till 2011 and have blood, sweat and tears in the work that went into it just to have a tenant leave it open for whoever wants to enter and not respect the owner’s property.