Nebraska is famous for many things—Cornhuskers football, Warren Buffett, and now, apparently, unethical insurance adjusters. Who knew? Tristan Miles is a public adjuster in Nebraska. She asked me the following question on LinkedIn:

I would love to hear your thoughts on unethical adjusters in Nebraska and solutions for us?

My first thought is that the vast majority of company and independent adjusters in the property insurance claims industry want to do right for their policyholders. I believe this based on my experience of speaking with so many over the past 40 years.

While I am a vocal critic of wrongful claims practices and try to promote policyholders’ rights, I suggest those with similar questions read What Does “The Work of Adjusting Insurance Claims Engages the Public Trust” Mean? In that blog post, I noted the public trust placed on all adjusters, whether they be company, independent, or public, is a very high calling:

All types of insurance adjusters have serious ethical obligations to claimants and the public. The Institutes has published numerous referenced materials teaching these ethical concepts. It is a significant and important calling to be an insurance adjuster and not one that should be lightly taken for granted.

I often say, ‘It is hard to be a great and ethical insurance adjuster.’ There is so much to learn, and the field is constantly changing, requiring constant education. Professional and personal motivations placed on adjusters by others make it a very difficult job to ethically conduct oneself. I have a great deal of respect for those dedicating themselves to being the best at this profession.

The Chartered Property Casualty Underwriter (CPCU) Oath provides in part:

As an insurance professional, I shall strive at all times to live by the highest standards of professional conduct;

I shall strive to ascertain and understand the needs of others and place their interests above my own;

I shall strive to maintain and uphold a standard of honor and integrity that will reflect credit on my profession, my employer and myself.

An ethical point made by the National Association of Public Insurance Adjusters (NAPIA) states:

Members shall conduct themselves so as to command respect and confidence. They shall work in harmony with one another, with their clients, and the insurance company’s representatives, so as to foster a cordial and harmonious relationship with all branches of the insurance business, and with the general public.

As a result, another thought is that all of us should be careful before condemning those working in the insurance claims adjustment industry on social media. Such accusations unprofessionally cast significant doubt on the insurance products and may imply that most are acting unethically. Such accusations certainly do not foster a “harmonious relationship.”

For me, I am trying to do better to learn these lessons and condemn the sin rather than the sinner. I appreciate that public adjusters and insurance industry claims adjusters may become frustrated not convincing others working on claims to agree with their views. Some may emotionally resort to simply calling out the other side and shutting down any meaningful discussion out of such repeated encounters.

But let’s be honest—some adjusters make it really, really hard to take the high road. It’s like trying to hug a porcupine—technically possible, but painful and not recommended. Still, if we want real change, we’ve got to focus on fixing the system and sins rather than just throwing darts at the people stuck in it. We should spend more time fixing ourselves before we wreak havoc on social media.

My studied thoughts about unethical claims conduct by insurance adjusters usually center on some company’s claims management and the goals, pressure, and culture demanded of its claims personnel. One could simply tag all the posts in this blog for “claims management” to see how critical I can be when after loss profit, leakage and claims severity goals are made in a manner that demands otherwise ethical people to choose between acting in the insurance company’s interest rather than fairly and honestly with the policyholder. I would suggest reading Claims Handlers Versus Claims Management, Do Independent Property Claims Adjusters Need More Legal Protection From Unethical Managers, and Why is Your Insurance Claim Underpaid? Many Insurance Companies Reward Adjusters Who Pay Less on Claims, as examples.

Delay, Deny, Defend Professor Offers Suggestions for Meaningful Insurance Claims Reform, listed three reforms suggested by Professor Jay Feinman that everyone can suggest to regulators and lawmakers when addressing this question and what to do about a solution for unethical claims conduct:

  1. Enhancing Transparency: Insurers should provide clear, accessible information about policy terms and coverage to help consumers make informed decisions.
  2. Strengthening Regulation: Implementing stricter oversight can ensure fair claim handling and prevent unjust denials or delays.
  3. Improving Accountability: Establishing legal mechanisms for policyholders to challenge unfair practices can hold insurers responsible for their actions.

The question also referred to “solutions for us.” I take this to mean what public adjusters can do to ensure policyholders obtain the full benefit of the bargain in the face of what may be perceived as unethical claims conduct by the other side. My 2024 NAPIA Annual Meeting speech, What Does Your Client Think of You? How To Be More Successful By Running a Value and Ethical Oriented Public Adjusting Firm, provided many of the solutions. I referenced that speech and some of what I spoke about in The Public Adjuster Hero—Being a Great Public Adjuster Serving the Policyholder Is Hard.

This is the elephant-in-the-room issue for the public adjusting profession.  For some public adjusters, the Thought of The Day from that post may be the most relevant:

The only way you can truly control how you are seen is by being honest all the time.
—Tom Hanks

I say this because some public adjusters tell me they make their claims estimates and theories “artificially” high for bargaining purposes. That might be an honest statement, but it is a dishonest act.

Insurance industry claims adjusters may see this as a pattern from some public adjusters long enough that they start to treat and view all public adjusters in this manner. This is like a cop who may start to view an entire neighborhood as being occupied by bad people. Insurance company claims processes are then made, and the highlighted example is the “Jewish Lawyers List,” noted in Hindin v. State Farm – The Landmark Claims Practice Case That Few Know About Finally Ends. Insurance claims adjusters should always question nonsensical claims. Yet, two wrongs never make a right.

For everyone, including me, asking what you can do to better serve the policyholder is the key solution. Not everybody deserves to be an adjuster adjusting claims. They are not properly motivated, trained, or of sufficient character to be in this business.

For public adjusters, leaders in the field should concentrate on making their license meaningful and significantly raising the bar for qualification if this is to be deemed a profession. In the long term, policyholders are best protected by those with high qualifications and training. The day the insurance industry looks up to simply obtaining a license to practice public adjusting as an impressive achievement is when the public adjusting business can call itself a true profession.

My 2024 NAPIA Annual Meeting speech had some practical points that I suggest are more solutions:

  1. Evaluate yourself honestly and make certain you are acting with integrity.
  2. Dedicate yourself to learning and bettering personal and professional skills every day. Small steps done day after day have a compound effect for significant improvement. In the Forward to Claim Your Success: The Ultimate Guide to Starting and Running a Public Insurance Adjusting Business, current NAPIA Vice President Justin Skipton wrote about a “mindset of continuous improvement and learning.”
  3. Raise your emotional intelligence level. Learn to master the rules of relationship dialogue, which I wrote about in Steve Patrick Endorses Chris Voss and Never Split the Difference. You will find that many of the unethical claims issues may dissolve by becoming a master of these and practicing step number one.
  4. Meet and learn from the best. Ask how they ethically overcome challenges posed by wrongful claims conduct. If you are a public adjuster, join and support quality organizations with the best reputations. This is becoming more of an issue since it is so easy to create a “pretender” organization online with relatively new business gurus providing wrong and damaging information about how to properly handle claims.

While not in my speech, I suggest that Tristan and public adjusters read and adopt the lessons found in “The Public Adjuster,” an article published by Best’s Guide in 1951 and written by William Goodman. I noted it with a link in “The Public Adjuster” — An Article Every Public Adjuster Should Be Required To Read. It will also help ground your emotions when you do encounter an unscrupulous insurance company or independent adjuster.

There are certainly other solutions that must be considered if a public adjuster is unable to overcome a claim that was not ethically handled by the insurance representative. It is best to make certain you have done your best before going to them.

Thought For The Day

“It’s supposed to be hard. If it wasn’t hard, everyone would do it. The hard is what makes it great.”
Jimmy Dugan (Tom Hanks), A League of Their Own