Etienne Font and Chip Merlin in Puerto Rico this week handling Hurricane Michael claims after the IAUA Conference

Insurance is an important product. It is hard for all insurers to get clams handling right after a major disaster and claims accuracy is much less certain. That is what is taught and that is a fact. I could explain that problem and give a pass to the insurance industry and even try to help educate my policyholder friends through this understandable delay and inaccuracy which is almost inevitable.

But one comment on my post about delay, Policyholders—What Are the Four Questions Every Insurance Adjuster Should Be Asked and Then Required To Answer, deserves publishing and I am publishing my comment for your consideration:

“Chantal Roberts,

Thanks for your comment.

If you are being slammed for 20 plus claims a day, that is not good faith claims management. There is no way you can handle 20 plus claims per day properly. If that is the normal course of operations, no wonder there are so many poorly adjusted and delayed claims.

The policyholder signed up to have full service right away with people dedicated to provide the full amount of money right away. Not excuses for delay and excuses from adjusters showing that they are more concerned about finding ways not to pay and not having time to do a timely investigation—which means right away!

If the insurance company does not provide this type of service after a loss, it should not be in the business of selling insurance policies in the first place. It is simply ripping off the public and causing the types of problems we find in the Panhandle of Florida and elsewhere.”

Twenty claims a day? Geez, I have often taught (and then litigated) how more than two a day is stupid and wrong. How can one spend enough time and accurately assess all the damage for people suffering from a major disaster with twenty claims a day.

When I was speaking at the IAUA Conference earlier this week, adjusters in the audience said they are to do ten claims a day.

Seriously? Holy Cow! No wonder there is a claims problem. Insurance regulators should be pouring over data about this. We need laws to stop this. People trying to do the right thing should not be abused trying to adjust claims unethically and policyholders should never be abused by what is going on.

I did not make this up. This is what is going on in the field. We need reform and more laws holding insurance companies accountable.

Thought For The Day

A woman’s guess is much more accurate than a man’s certainty.
—Rudyard Kipling

  • I should have known better than to think we were talking hypotheticals. Am I allowed to write giving an alternative view?

    Do claims adjusters get 20+ claims a day in a catastrophe? No. That’s absurd which is why it was used as an extreme example. I was attempting to make a point that adjusters have lives too, and miss their children’s extracurricular activities to care for the insureds in this time of need. Should there be more adjusters? Yes, absolutely.

    Will there be? No. And I could tell you why in a blog post.

  • Bill Wilson

    An analogous situation is some of the insurtech startups (and even traditional direct writing carriers) that say they can place, for example, your homeowners insurance in 60-90 seconds without ‘troubling’ you for anything more than your address.

    At least with a claim delay, you quite possibly have coverage in place if you had an agent who took the time to accurately and adequately assist you in identifying your exposures to loss. If that diligence wasn’t done at the point of sale, claim delays are likely to be far more common because coverage is likely to be inadequate or nonexistent.

  • shirley heflin

    Dear Chip:

    I’m not surprised this is happening in the insurance industry because I’ve talked to enough Insurance Adjusters in my career lifetime to know that some are overworked. Indeed, I’ve talked with many who have asked me to refresh their memory on the claim at hand. Further, as a Paralegal I’ve handled way too many files at once “for comfort” at one time or another. It can be done, but the end result is someone is working a lot of overtime and getting burnt out on their job. Its the same thing in the insurance industry. The adjusters are assigned too many files “for comfort” and the insureds are suffering because their claims are not getting the attention they deserve. To be assigned two claims from inception to end is considered laughable and a luxury!

    Tampa, FL

  • wmerlin

    Chantal—we would love a guest blog post. We appreciate different views and especially from those of you working insurance claims where the rubber meets the road.

    Following my post, a friend that works for insurance carriers wrote me privately that an experienced CAT adjuster can write 8 to 10 losses a day. In my world, the adjuster would be spending at least an hour just to speak with the policyholder to go over the policy, the claim details and what to expect in the claim process. Then, go back over the details of the inspection and findings after thoroughly going over the loss and call to get an approved payment for undisputed damage sent to the policyholder that is a high percentage of the ballpark amount owed. That takes a lot more time than one total hour at the loss site.

    There is a huge disconnect between what the insurance customer expects, the public demands and what the insurance claims industry provides.

    So please, your view is important and I look forward to your guest blog post.