Valued Policy Law Katrina decisions in the news this week and Fl Valued policy law updates since the 04/05 seasons

August 31, 2007

I wasn’t expecting to create a new blog entry until the holiday was over but we’ve had developing news this week on the LA Valued Policy law cases going through the court systems there. We also have several storm disturbances mentioned in the news so I want to be sure to distribute these updates before folks are going running out on any hurricane losses this season.

Here is a news article from the Associated Press put out by Advisen regarding the Landry vs Lousiana Citizens Property Insurance. This case originally went to court in December 2006 and ruled Citizens did have to pay policy limits on the case because of the valued policy law although it was another wind vs water case of attributing damage between these perils. However, Tuesday of this week, the 3rd Circuit Court of Appeals stated the following according to this news release:

“But the state 3rd Circuit Court of Appeal on Tuesday, in a 3-2 decision, set down this standard: if the Landrys can show that the “efficient or proximate cause” of the destruction was such covered perils as wind, rain or hail, Citizens would have to pay the full value of the property _ without a deduction for flood waters. To avoid that, Citizens would have to show the main destruction was caused by floods. ”

The article goes on to say that 3 weeks earlier a federal appeals court in NOLA affirmed a lower court ruling in favor of insurance companies saying the LA Valued Policy Law does not apply unless the damage is wholly attributable to a covered peril such as wind. I found the case referred to in this Claims Journal article citing the Chauvin vs State Farm Fire and Casualty case here. Here is another outstanding paper by the Tort Trial and Insurance Practice Law Journal (Winter 2007) which provides a short summary on the Chauvin case found on the Zelle firm’s site where you’ll find other excellent information on their articles page. This article is worth the time to read all 36 pages. You’ll find the Chauvin cases discussed on page 35/36 as well as other cases in FL we’ll discuss below. This Times-Picayne article also provides more details on the Chauvin’s case and comments from trial lawyer spokesman, Allan Kanner, hoping other cases will make it to the state Supreme Court for more favorable decision for policyholders. Here is also a “public opinion” blog on the ruling by an angry consumer over the issue here.

I checked the Insurance Coverage blog to see if there are any mentions of the new rulings and found this June 06 blog with links to both the FL Valued law and the LA valued law which also mentions another case I’m not familiar with. I’m curious what they’ll have to say now if they provide new information now that we have these additional new LA nd FL cases providing other new decisions.

Fl has also seen much news on the FL Valued policy law as a result of Hurricanes Ivan and Dennis. This article summarizes the well known Mierzwa vs Fl Windstorm case as well as the subsequent decisions by the courts on the FL 1st DCA 2006 cases of Vanguard Fire and Casualty Company vs Golman. That case involved allegations of breach of contract and bad faith and this article provides interesting reading to understand FL valued policy law changes. This is important as many independent adjusters have not worked cases in FL since Dennis in 05 and this is an 06 decision. (Vanguard is now in receivership by the way) The Zelle Property coverage update referred to above and again here reviews the Citizens Property Ins Corp vs Ceballo case holding that although the FL Valued policy law covers policyholders, they are not entitled to 25% of limits for Ordinance and Law coverage without proof of incurred expenses. This is found on page 35 of this document. Note that the information in this document goes on to say “that the court certified it’s opinion to the FL Supreme Court realizing that it’s opinion may be in conflict with another appellate court decision”..referring to the Mierzwa case.

It should be an interesting season with the continual new decisions coming out of the courts. From what I can best assess at this time, these decisions do seem to be upholding the intent of the policy contract provisions. I do wonder how many cases were settled on these valued policy law initial decisions as many of the articles linked to above indicate carriers did settle some of these cases out of court over the initial decisions. Hopefully, one of these great legal blogs we follow will address these decisions and provide their opinion as to what this all means for the 07 storm season in LA, FL, TX, and other storm prone regions. I hope adjusters will take the time when looking at these links to observe and read some of the many great blog entries and news articles free for our reading to better understand the claim issues.

Speaking of developing information- take a look before you sign off the blog at this new Ordinance and law information coming out of FL which indicates a new statute may be in effect in October 1, 2007 requiring extensive wind mitigation measures be done to homes in excess of $300,000 in designated zones. It sounds quite expensive as a roofing trade association is quoted as saying the extra cost to replace a roof would run about $6,000. I am very curious if the insurance agents are aware of this new potential expense and are offering increased Ordinance and Law coverage in the event an insured in a designated area must replace their roof subjecting them to this new requirement to do so. This will have a major effect on insurance damage estimates if carriers have to incur this cost. The trade association says they are working with Crist to try to postpone this. I sure hope so, the last thing we need in FL is another expense right now on top of the skyrocketing insurance premiums. This article I just came across today says that the majority of carrier rate increases have come in prior to the upcoming deadline and are averaging about 28% rate increase requests and some of the major carriers have not filed their requests yet. (Could this be due to Crist taking them all in for rate increase hearings as he recently tried to do ??? )You can imagine what the passing of this rule would do to Floridians in addition to the current rate hike proposals should this pass. It is still amazing that Citizens has a rate freeze through 2009. I’m running to Tn when those rate freezes are lifted! We’ve had the same neighbors going back 10 years and have lost several neighbors who have moved out of state after witnessing Katrina damages combined with what is going on in this state with property taxes and insurance for coastal residents.

I updated the stats on the earlier blog this week on new suits on the 2 year statute of limitations cases. According to the articles coming in, thus far about 2, 964 new cases were filed this week in LA. Here’s that blog if you want to read the updates.

**Update 9/1/07- After writing this blog I did in fact locate an updated opinion on the Insurance Coverage blog on the new decision in LA on the Valued policy law (it just wasn’t showing up in an internet search when I was researching earlier today). Here it is and it’s highly recommended reading for a legal opinion as to how this attorney feels this confuses the anti concurrent cause provision and what this this means to us. You read it and form your own opinion.


5th Circuit upholds anti concurrent cause provision as unambiguous

August 31, 2007

Here is an update located on the Insurance Coverage Blog along with the AP article and a pdf of the ruling all found in this blog entry. This was on the Nationwide vs Leonard case.

http://www.insurancecoverageblog.com/archives/first-party-insurance-nationwide-v-leonard-fifth-circuit-upholds-anticoncurrent-cause-provision-as-unambiguous.html

Below is a PDF of the ruling:

http://www.insurancecoverageblog.com/Nationwide%20v.%20Leonard%205th%20Circuit(2).pdf

The AP Story

http://www.sunherald.com/306/story/131448.html

I highly recommend reading this article by Attorney John Pappas “When is a flood a flood” to understand the terms in the insurance policy and court interpretations. There is a citation in this article on this Nationwide vs Leonard case.

Here is also a good news journal article on the issue from 8/15/07. I’m surprised we didn’t catch this ruling before!

Update 9/1/07-Here’s some additional articles. You won’t believe Gene Taylor’s reaction mentioned in this article:

The Sun Herald has a link to the pdf court docs I’m also posting in case the other link to another copy comes down:

http://media.sunherald.com/smedia/2007/08/30/18/Leonard_opinion.source.prod_affiliate.77.pdf

This news article quote from Congressman Gene Taylor’s Public director- I cannot believe his comments on “any carrier with anti concurrent language in their policy should be barred from participting in FLOOD” (as a WYO carrier)..I wouldn’t be surprised to see the carriers drop the WYO service- you can see the writing on the wall for the next flood storm! This spokesperson obviously has no understanding about insurance coverage or maybe it’s just too early in the morning to soak in the comments today!

http://www.sunherald.com:80/278/story/131328.html


Have you thanked your adjusters as we enter Labor day weekend?

August 30, 2007

As we enter labor day weekend the next 3 days, we hope that many catastrophe adjusters share time with their families and friends with what may be the last of long weekends for sometime should hurricane season activity actually pick up in September. Here is one of the latest pictures from our new favorite weather site, Ralph’s Tropical Weather,  showing atleast 5 new lows being investigated as we speak!

This week we’ve learned of friends deployed to Midwest flooding, CO storms, and other locations finally getting assignments after the very slow storm season for 2006 for many independent adjusters so they will be unable to share the holiday with their families. We hope the insurance consumers will come to appreciate the many sacrifices adjusters do make to choose the life of a catastrophe adjuster.

How interesting to read here  that the 12 hour/7 days a week American work schedule as we entered the Industrial revolution lead to unions to help the deplorable conditions American employees suffered in the late 1800’s ! Did someone forget to share that with insurers who still require those very hours today for storm adjusters?

Today is a great day for carriers and adjusting firms to take a moment out to thank adjusters who service their claims before labor day weekend begins. We used to recognize adjusters committing to work disasters with storm banquets to thank them for their service as they rotated in and out of assignments back to their regular offices every 30 days. That practice today has basically become extinct now that carriers have dedicated catastrophe operations initially created so an insured would not have to deal with an ever changing group of adjusters for consistent handling of their claim. That was a great concept in it’s time and still is but the beauty of the program is eroded over the past few years due to the current practice of in office claim central units requiring insureds again  to deal with “team” adjusters  who are not familiar with their file. It  also became unpopular for banquet facilities to post signs with a carrier name for such gala events and even for conferences due to a large number of consumer complaints on carriers wasting “premium dollars” on such wasteful spending. Other issues arose regarding the serving of liquor or hosting cash bars as well as sexual harassment issues for jokes in today’s ever increasing world of litigation. It still amazes me today the number of insureds that will call in to a carrier office to complain of adjusters taking a long lunch or telling jokes in a restaurant “when they should be out handling my claim”. Listen folks, adjusters are human also and field adjusters commonly work 15-18 hours 7 days a week. They return from 10-12 hours in the field to their rooms at night to enter claim estimates to meet stringent carrier quotas on inspected and closed files due each and every day while out on assignment. They need a break and they need recognition for their hard work. It’s fighting an uphill battle to even mention things like this with the negative impression of “adjusters” out there. New adjusters need to be most careful in following carrier guidelines not to wear storm clothing after hours and to always be cognizant of the public when out in groups for dinner. You can be over heard discussing private cases and this is not a very good thing in the eyes of the public. Instructions from most carriers require you wear “civilian” clothing when going out to dinner on your way back to your room to work files.

Hmmmm……..I guess we don’t learn from history very well in the claims industry. Our work hours meet time frames from the 1800’s and we have totally done a major turnaround in the current “claim central” operations circumventing the very reason we created catastrophe claim field operations to begin with. An in office adjuster who has never experienced the trenches of disaster does not share the same empathy as they have no understanding of the trauma experienced by insureds during a storm. They have never walked up to a home that looks reasonably repairable from the street only to walk to the back of the structure and see it torn in half. Nor have they marched down the street with a ladder in 100 degree heat to measure roofs when you’ve been dropped off  from a carrier bus on a street corner during an “Andrew”. I have managed in office adjusters, field adjusters, and catastrophe adjusters and there is a major difference in the understanding of urgency and the empathy of these different groups of adjusters if they have never worked in the field on a catastrophe operation- especially during the initial phases of cat operations.

I hope we will all take a few minutes to thank our adjusters in some form or fashion over labor day weekend.

We at Dimechimes Corporation thank the many dedicated adjusters servicing the property insurance industry! We look forward to working with members of our rosters as new staffing requests are received this season. Please be safe on your way to your new assignments.

We’ll see you back on the blog next Tuesday!


Adjustin’ to Adjusting-Guest Blogger Linda Goodson-First Storm Duty was Katrina

August 30, 2007

In our first of a series of new articles by adjusters on their experience the first time out on the road as a catastrophe adjuster, we have  Linda Goodson out of Enterprise, AL sharing her experience as a first time cat adjuster during Katrina.

Linda is a ClaimSmentor Honor Award lifetime member due to her major volunteer contributions on our site assisting with class certificates and preparation of material for exhibit booths we attend at claim conferences. She has spent hours this year attending adjusting firm seminars, obtaining carrier certifications, and also attended our 40 hour Fundamentals class picking up many things she says she wished she had known prior to her first time out on the road. Below you will find a summary of her experience not only on her first cat deployment but in her recent efforts to complete FEMA damage assessor training which many adjusters are doing to supplement their income during non storm assignment periods. Linda also had a short stint with the LA Road2LA program in 2007. Linda’s email is woodnnails3@yahoo.com. We hope new adjusters can learn things to expect from our guest bloggers sharing their experiences. Linda’s bottom line advice to other new adjusters is to accept in office assignments vs field as shown in this following comment from Linda followed by her story:

I worked Katrina and Rita from September 05 to April 06 in the capacity of field adjuster and agent advocate. Volunteered time with adjusters working supplementals and doing some scopes here and there with a small IA firm that belongs to a family member.  If there’s a way to save money, this gal can find it. I lived in a pop up trailer most of that time in the field spending around $200 a month for a place to park it. Honestly, that first year, I think I made more in office than in the field just because of the cost of working field versus working office  still not knowing the cost cuts that I know about now. It was a guaranteed amount every week. During these two particular storms the going pay was around $10,000 a month. No software costs, low gas usage, and when I retired for the evening, I had no phone calls to deal with as it was 12 hour days, 7 days a week. You just have to decide what you can do and no matter what you decide, do it to the best of your ability. The people your there to help deserve that.

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What an Experience-Katrina duty-My First Time Out! By Linda Goodson

 

Okay I admit it. I’m covering all my bases. I decide to up my chances of work by applying for a position with a Federal Agency.

I was told to get my fingerprints done I would have to drive to their nearest facility which was 1.5 hours from where I live. When I asked why I couldn’t get my fingerprints done at my local police dept., they said they felt more comfortable allowing their own staff to do it since they were more efficient and the process was much quicker for them. Made good sense to me that they wanted to use the people they had trained to do this. So I drove to the facility with social security card and drivers license. Everything I needed in order to make this a smooth process.  I didn’t want to slow down this well greased machine they were sending me to.

 

When I got there, the employee in charge of doing my most efficient and quicker process was stressing that she wasn’t sure what was wanted but she would do her best. It took her approximately 30 minutes to figure out what information her computer wanted. When she couldn’t figure it out she said, “Oh well, whatever doesn’t end up on the fingerprint card, I’ll just write it in”.  While she fumbled with the computer, I asked her if she wanted me to go ahead and complete the paperwork. “Oh no! That will take you a WHILE to complete. In fact, you may want to take it home and fill it out”.

 

Finally, she did enough on the computer to make her feel she had done her job well, and we began the fingerprinting. As a former law enforcement officer, I knew these prints were the worst I had ever seen. I was relieved when she made a mistake of some sort and had to start over. But to my dismay, the second set of prints was just as sloppy. However, she was convinced they were gorgeous and there was no convincing her otherwise.  What took 10 minutes to do the week before at a police department for my FL adjuster’s license, took her 1 hour 20 minutes to do and it was incorrect.  And as I was leaving I realized they were packing up to go home. Hmmmmmm … I looked at the paperwork she handed me on my way out. It would have taken me no more than 10 minutes to fill out.

 

Upon leaving the facility, I called the agency that sent me to them but got no answer. Finally 30 minutes later, I got an answer and I’m put on hold for 12 minutes. I hung up when I realized their office had closed 5 minutes ago and they probably weren’t coming back.

 

When I got home, and began looking over the fingerprint card, I noticed she had switched my birth day and birth month. Once again, I called the agency to hopefully stop this card from being sent to Washington. To my surprise someone answered, allowed me to explain what I was concerned about, politely put me on hold. 15 minutes later, I hung up.

 

Email!! I would email them. Just a brief email explaining my concern of the incorrect information but I’m still waiting for a response.

 

As I sit here, I’m reminded of my first year of storm season employment. It would seem if you were doing everything they wanted done, according to how they wanted it to be done, you would go through some sort of desperate confusion. And it didn’t even have to be a government agency.

 

Really it took me back to my first storm and my first experience with an IA firm. Within 24 hours of being hired, I was expecting that any minute of my training and contract sessions, I would be branded on the butt, or my ear tagged.

 

My first year out felt like I was spun around blindfolded and turned loose at ground zero with a computer in one hand and a measuring tape in the other.

 

The first lesson in adjusting was learning how to adjust to my situations. Let me explain.

 

I passed a training center in my own town, to go to one of their other training centers many hours away, where I had to pay for room, food, gas,GAS, oh my word, gas. Not to mention it took us longer to get where they needed us to be. We spent two days on the road that we could have spent in the class back home. Then our training was cut short. We got three of seven days of training, and we were sent out with a promise that there would be someone there to help us, called a TA. I had seven TA’s in a course of 3 months, and only met one of them. Can I be self-taught? You bet I can. I learned how that year.

 

Very few classes included people that you would feel confident to learn from. People demanding respect by trying to belittle the people they were put in charge of. Talked down to in classes, help rooms, and help lines only to find out that most of these people were moonlighting until their positions were available again at some casino or local bar. If you were fortunate, an adjuster with years of experience headed your class.  As I myself am very talented at many things, I would not be a great teacher. Teaching, in itself, is another gift that I don’t necessarily possess. Trust me, like 7 days of cheese; if you don’t know your software program, your system will lock up. All the knowledge you have is worthless if you can’t correctly get it into that program. It can take you 3 hours to do a scope, and if you don’t know that software, it will take you 6 hours to get it ready to be sent out to the company.

 

One fellow, whom I was told to direct my questions to, was walking around with people following him, grabbing his shoulder with intent in their eyes to get answers they had obviously tried to get elsewhere.

I thought to myself, “If I could only touch the hem of his coat”.  I never could reach him. When there was no one around trying to get life giving information, there was still a wall of conceit, and arrogance. I refused to grovel. There had to be another way.

 

Research was my only tool and I used it daily. Yes, it slowed me down. I wasn’t able to do as many claims as I should have been able to do with good training and support. Atleast what I did was right and I was able to sleep at night knowing that and it helped knowing that I didn’t have to throw my pearls before swine to get it done right for the insured and the carrier I was representing.

 

Borrowed a pop up trailer from a friend. Made sure I got my tetanus and other shots before I got started. I brought my handy dandy first aid kit, rubber gloves, hand sanitizers, and 50 cent face mask. After working 3 months of flooded homes, I found out just how important a GOOD face mask is while spending hours in flooded areas. I ended up hospitalized.

 

I was  discharged two days later from the hospital. I was next  offered a position in office with the same company. As an advocate, I was able to continue helping and that was very important to me. My slight concern of being cooped up inside was diminished when I saw how busy the offices were. Keep me busy and I can handle anything. This gave me the opportunity to see this storm work from a different perspective and I was grateful for the opportunity.

 

After working two offices to completely closing the storm, I was given the okay from the doctors and I began working as an assistant to any adjuster friend who needed help out in the field with supplement claims.

 

In all my dealings, I learned so many things about myself.  I can handle any situation as long as I stay positive, motivated and continue to help others.

 

I can survive a pop up trailer, as long as I stay focused on the people I’m there to help, who lost their home.

 

I can survive pork and beans and Vienna sausage as long as I stay focused on the people I’m there to help who lost  ‘everything’.

 

I can live away from my loved ones during this time, as long as I stay focused on the people I’m there to help who lost loved ones forever.

 

When I look back on the monetary gain, I think about the cost of gas, food, tires, air cards, cell phone coverage, and rent. It takes a lot of money to make a lot of money. The largest reward is in knowing that somewhere each day, I helped someone find hope. A way to get back as much as they deserved, to begin a new life while representing with respect and passion the carrier who believed in me enough to let me be a part of this tiring, challenging, and yet extraordinary line of work of Adjusting.

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We thank Linda Goodson for sharing her story with her reality based view of her experience. We encourage other adjusters to share your story with our readers. If you were a first time adjuster during one of the worst disasters in catastrophe claim history, we’d love to hear your story and share your advice for new adjusters.  You can submit your story to  us through our staffing firm. We will publish a few of these stories each week for others to learn from before they go out on the road the first time.

 

While the majority of carriers require a stated experience level such as 2 or 3 years of experience under normal circumstances, many rules had to be bent during Katrina requiring deployment of many adjusters who had completed training and adjuster licensing but had no practical field experience prior to Katrina.

 

The stories of their struggles to complete their job are heart breaking under the worst of circumstances during Katrina storm duty assignments. I know of MANY who worked and were not paid a dime after incurring over 10K in housing ,office, and travel expenses. We hope to make a difference for new adjusters by sharing some of the warning signs  to look for so they are not taken advantage of by the few firms out their taking advantage of trainee adjusters inexperience. We can tell their stories without naming the adjusting firms involved to avoid libel problems. It’s the key issues such as contract issues, fee bills, warning signs, and other key “red flags” new adjusters need to learn to avoid some of the same problems you will read about as these folks share their stories with our readers.

 

You may read in many adjuster forums snide comments about “3 day wonders” referring to the many new adjusters coming from the influx of 3 day (some maybe 3 hours!) training schools for some courses alleging to teach an adjuster everything they need to know to earn big six figure incomes. That is far from the truth. It takes years of experience and training to properly understand the serious nature of the adjuster position. We hope by following our blog entries on adjuster income and some of the lawsuits costing adjusting firms, carriers, and adjusters that you will learn more about becoming a true professional representing the Independent adjusting community well to preserve all of our jobs in the industry. Take a look around the prior blog entries on income and adjusting and take the advice to heart.  Learn from these “new adjuster” stories and stop the name calling. These folks who went out the first time are people with families to support. We need to learn to work together to help mentor them and to improve the training programs available to new adjusters. They do not know that some of these schools aren’t properly training them until they work with experienced adjusters who point out the error of the training processes some are out their teaching. If you read about “how to overcome the three year requirement by vendors” advice you might consider running to another more reputable training facility. I can’t thank the valued experienced participants of ClaimSmentor enough for their constant sharing of information with others.

 

 

    


Statute of Limitations- Katrina 2 year anniversary brings deadline to file LA suits

August 29, 2007

The 2 year anniversary of Katrina  is today while the LA statute of limitations came and went yesterday which was the deadline to file Katrina lawsuits in LA by insureds.

LA had extended their statute of limitations on property claims from 1 year to 2 years following the Katrina storm damage. Yesterday was the last day for insureds in LA to file suit. AL and MS have different terms with AL with a 6 year limit and MS with a 3 year according to the chart below so it may still be years that we continue to see new litigation. The chart also shows a 2 year property damage statute in TX (Rita claims). We do not yet know if there were a mass number of suits filed or not this past week in LA. We will report back on that when information becomes available.

Here is a good blog article by the Merlin group  giving a simple explanation as to what that means for insureds on their claims in LA as well as from an attorney’s perspective. They point out, as I did in the Citizens blog on the task force last week, about the 5 year statute of limitations in FL which a task force board member indicated he wanted to reduce because of the long tail on  claim file reopens. Click here for that blog. The interesting thing is that just because an insured can no longer file suit on a case, does not mean that a carrier will refuse to take a look at a claim request to reopen a file for supplemental damage, it simply means the insured no longer can file suit on the case.

Don’t mistake this for their handling of a newly reported loss at this late date. Claims with late reporting barring unusual circumstances are always handled under a Reservation of Rights while the cause of the reporting delay is investigated with a denial in order for late reporting if the investigation determines the carrier’s right to inspect a loss and investigate the claim have been prejudiced by the late reporting.  Here is a good article written about liability claims but explains reservation of rights letters and provides very good instruction for completing one. The Citizens 2007 Claims Procedure manual also has some ROR sample forms as does a link in my blog on  Scruggs  about the 242 carrier exhibits which contains many actual ROR letters sent out on coverage issues if you need to see  samples of finalized ROR letters.

You might also be interested in looking at the actual FL statute of limitations which does not just pertain to insurance claims but to other actions such as 1 year for a lien to be placed on real property for services or material performed(such as a contractor may do if an insured fails to pay the bill).

Here is a good article explaining both the Statute of Limitations and the Statute of Repose if you do not know the difference. This next article here gives general guidelines on the number of years different statutes run while this last article gives you a chart for all 50 states. An adjuster needs to make sure these are up to date stats before applying them to a particular loss. Make sure to note that there are different statutes for different kinds of losses such as an injury versus a property damage loss. Other factors such as federal or state laws will govern the proper limitation period as the articles linked to above explain. This explanation  from FL on “tolling” a statute and things to consider when dealing with minor children is also good information to know as to when the statute “clock” stops running on various issues.

Here is also information on the federal statute of limitations under the Federal Tort Claims Act that pertained to the Katrina Canal Breaches Consolidated litigation.

The Merlin blog points out some issues in MS causing delays there and here is an article coming from Alabama about FEMA grants and the Increased Cost of Compliance allowances to elevate a building in a flood zone there. It is hard to imagine that two years later they are just working on raising homes in the damaged zones. Anyone driving through MS in places like Biloxi can see the reconstruction problems abound as demolition has not even begun in many cases on the coast. The Fema trailer camps break your heart when you realize those folks have been living basically on a concrete pad with wall to wall campers not much more than the size of a small one or two man tow camper.

As these anniversaries approach bringing with them state statute of limitations, do not just assume you are to deny a claim or not respond  and timely answer a suit through your carrier’s counsel. These are major issues you need to immediately bring to the attention of your claim manager for direction and guidance on claim handling for any loss approaching or surpassing the state statute of limitations.

I’ll let you know as soon as we start seeing the numbers of new suits alleged to be filed with this week’s deadline in LA. Lest we forget while thinking of this two year anniversary, there were 2,000 deaths, 800,000 homeless, and extensive damage as this anniversary article summarizes. It puts insurance policies and statutes of limitations in perspective. In the insurance world they are very important but to the Katrina victims the coverage issues and statutes just bring a new storm of pain and trauma as they learn of these problems after the storm. I’ll end today’s blog with this insurance article summarizing the stats from both Katrina and Rita with numbers. The number of files that may be effected by the statute of limitations is a very very small percentage of the claims settled as you can see. One can certainly appreciate the comments of this news organization regarding trial lawyers “self serving fiction” spouted in unfounded comments about insurance contracts/claims when viewing the REAL numbers of claims which are unsettled.

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Update 8/30- This article is being added as it gives an update on new suits filed which seems a minor number in this article. Also note this report indicates there are a few deadline changes allowing for an extra few days to file.

Update 4:30pm 8/30/07- Here is a new article indicating brisk activity at the courthouse

Update 10:20 Pm 8/31- According to this new article– 2,984 new suits were filed in the last week just in the two jurisdictions mentioned in this article- and these are unrelated to the levee cases which are also mentioned in this new article.


Additional Job Opportunities Available for Aviation, Property, Casualty daily adjusters

August 29, 2007

We’ve been out of town and returned to the following additional staffing requests for  daily(non catastrophe) adjusters to work these assignments with Independent adjusting firms. If you are interested AND MEET the qualifications specified below, please view the information requests on our staffing firm website. Please view the requirements for all candidates listed on our opportunities tab.

1) Additional Aviation adjusters needed- nationwide

2) Property and Casualty adjuster needed in Miami,FL. Must be a resident there with a permanent FL license. Minimum 3 years of experience. This is a request for a billingual adjuster with a passport as this position will be handling international claims. This position is for an independent firm but a salaried position with full benefits. Approximate salary is 70K plus expenses.

3) Auto adjuster needed in Wyoming. Must have Wyoming adjusters license. Software is CCC Pathways. Must have experience auto adjusting. Prefer minimum of 2 years of experience.

4) Property/Casualty adjuster needed for Lafayette, LA. Must be a resident and must have the new LA adjuster’s license. Minimum experience 2 years. I’ll have the estimating software requirements later today.


Enough is enough- Citizens FL Claim Reserve problem-to the tune of $300 Million

August 24, 2007

Hadn’t I just written about claim reserves last week in this Claims / Agency Relationship blog?

August 22, 2007 www.Tallahassee.com published this article regarding Citizens of Florida stating that an outside auditor has told Citizens it needs to add almost $300 million to its reserves. The article goes on to quote some folks from Citizens who indicate it’s due to files reopening from Wilma at the encouragement of public adjusters and south Florida attorneys.

The article quotes Mr Julio Robaina, who chaired the legislative task force on Citizens claim handling, as saying “he will introduce legislation to stiffen regulation of public adjusters and to reduce the amount of time consumers have to file a claim”. Chip Merlin of the Merlin Law Group had quite a comeback you’ll have to read about in the link above to this article. Does Mr Robaina really think he’d get the votes necessary to “reduce the time consumers have to file a claim”? Look at what is going on all over this great state to property taxes and mortgage foreclosures and Mr Crist’s efforts 100% pro consumer/ 100% anti carrier as recent articles explain. Does this political representative know anything about the statute of limitations and what is involved in over turning the state laws on these regulations?

Read further here on this Merlin Law group presentation to the task force on page 7 where he addressed the fact Citizens lacks sufficient home office and staff management. Now I’m not sure what the Merlin group who handles bad faith cases against insurers has to do with presenting to the task force but I am sure glad someone is pointing out the problems. Don’t you think that is giving them fair warning of the problems they should already be more than aware of? Where is Citizens going to be when it comes to defending adjusters accused of bad faith due to their claim handling instructions if that becomes an issue as it has with other insurers during Katrina?

Didn’t FL just tighten up public adjuster licensing 7/1/07 which now requires a public adjuster to take the exam versus the exemption from licensing exams by taking online courses? As to the other practices by PA’s made in this article about giving gifts to insureds, we can surely hope the Dept of Insurance is curtailing that now rather than waiting for new legislation to be passed. Here is a task force document  on page 10 already addressing PA’s and task force recommendations.

I did double check the Merlin blog to see if there was a current blog entry on this new announcement.There is not yet but this entry from late July  goes into a great deal of information on the financial problems at Citizens of FL. There is another more recent blog here addressing the Florida crisis and insurance reform problems.

New adjusters may not be familiar with loss reserve procedures and should read  this great simple explanation on claim reserves and how they are set found here. Many independent adjusters are surprised reading this to learn that this is part of their duties when evaluating a claim even long before your estimate is completed based on your initial assessment of the damages as this article does a great job of explaining. While bulk reserves may be set up by a carrier on all claims based on past historical data at the onset of a new cat, there is still a responsibility to have accurate reserves…especially when it comes to large losses. In recent years, there has been concern expressed about reserves set coming up in court cases when they differ from settlement amounts so you will need to know the carriers current reserve procedures before making recommendations to a manager in your log notes and reports.

The part I do not understand is how the Citizens Board of Govenors just got the news. Establishing and updating reserves on pending claim files is one of the most basic of carrier management duties during an open file review which should be done at regular intervals (bi weekly or monthly) on large pending cases to determine how the case is progressing and to double check that reserves are either adequate or that a revision to a reserve needs to be made either up or down based on the current damage assessment on the case. Most carriers produce management reports listing the cases that need a reserve review on a regular basis.Was this not being done (that seems pretty obvious …… what am I missing here)? Claim file reopens do not all happen at one time unless there is unusual activity such as a class action lawsuit? The only two cases I’m aware of are the two mentioned on the Hurricane law groups site here with one for roof damage building permits and the other on wind damage to glass and FL building codes. The class action link does have attachments to the suit in pdf forms. It is routine for storm losses to reopen due to  construction industry price increases after a storm. This can occur much later than when the initial estimate by the adjuster was written due to contractor workloads or lack of available local contractors in a given storm zone. No surprises there either. Adjusters remaining on the site handle those revisions as necessary on an ongoing basis. So what’s up?

You can find all minutes of the Board of Govenors meetings right on the Citizens of FL website here. I’ve been very disappointed with the promptness with which the website posts the meeting minutes from the Claim Committee notes. For instance, there was a meeting June 14th and the minutes for that meeting still showed minutes from an April Claim committee. I wrote the web master and received a response that the June minutes were still not up in August because they have to be approved by the committee and they did not know when the next claim committee meeting would be. Come on’ folks…the task force shows the claim committee met with the task force I believe it was August 1 yet the minutes from a June meeting were still not up? Those committee notes are the only direct source information adjusters can go to to verify information they are getting from different vendors since the emails they are getting vary so greatly! If you can’t get the minutes up timely to your meetings, how in the heck are they going to manage claims for 1.3 million Floridians in a timely fashion?

I am not picking on Citizens but I do think it is very important to bring out issues independents are concerned about. Citizens of FL is now the #1 insurer in our state. Our independent adjusters want and need the claim assignments. PLEASE treat us fairly, please enhance the communications, and please be alot more realistic about time service expectations during a major disaster. Your threats of imposing huge fines is not having the effect you apparently expected (what else are we to assume?)..instead, adjusters are hesitant to service your claims and you are confirming their concerns every day by the way you are handling the pre-assignment training. (Example-one vendor email says Citizens now requires adjusters must enter their Xact  email address…hello ..you make sure independents understand they are not “employees” yet to have an Xact email they need an active keycode…are you going to pay that hefty fee for a quarterly subscription to Xactware while they are sitting at home idle waiting for THE POSSIBILITY you may deploy them???).

It is appalling to me that Citizens outlines many different fines for infractions against adjusting firms in their Adjusters RFP which are going to be passed on to adjusters but there is no effort to give timely notice to independents on important information they need. Some of these fines are listed at $1,000 each. Just in the past two weeks adjusters who had completed pre-disaster training were again told to go back and take another course on ethics and apparently the adjusting firms had as little or barely more than 1 week’s notice to get this information out to their rosters, accomplish the training, and report back. What a mess this continues to be and adjusters don’t have claim 1 yet from a new hurricane nor one dollar in income from you !

I’ll be making another blog post next week on the current “pre-disaster” training issues adjusters are experiencing as well as I have great frustrations regarding some comments in the June Board of Govenors meeting where a large FL Independent agency group, FAIA, expressed concerns about Citizens training from the agency side feeling that agents are regulated by state insurance departments for licensing and for CE credits and they had some issues with the mandatory Citizens training for agents (they didn’t mind taking it but I gather it was the way it was being administered). At this same meeting, the Citizens claims committee was there and there was no one representing the 6,000 expected independent adjusters at the meeting to express what would be our major concerns about what has taken place the last month over the continual changes and adminstration of independent adjuster training to work their claims. Just one minor example is the fact Citizens has never even bothered to post the website addresses and email contact information on their Job links so these independents would even know where to apply. The only information, if you searched hard enough, is in the purchasing documents where the announcement was buried (like adjusters would even think to look in purchasing documents? ). The announcement has several incorrectly named firms and no contact information. Here is the link to this meeting board notes. You will find the FAIA (FL Assn of Insurance Agents) comments on page 32-37 and the claim committee comments to the Board on page 45.

I guess if we have one thing to be thankful for over this additional Citizens of FL reserve fiasco, it’s that it isn’t as bad as the Citizens of LA case where they have major computer glitches going on and lots of lost financial data. They apparently aren’t doing a good job of managing claims either. You can read all about the Citizens of LA fiasco here and here.  This article addresses further issues of information blocks while they are trying to  gather information needed to fix the problems over there.

This Insurance Institute article on carrier insolvency brings up the recent FL insurers, Poe Financial Group and Vanguard Insurance, insolvencies. Why is Citizens allowed to operate with inadequate rates and improper reserves? I just don’t understand. Hopefully, someone will come forward and explain to our readers why this is different.

Make sure when you read the document linked above from the Board meeting notes on their discussion on Citizens being a “governmental” agency on page 10. Well, if Citizens of FL actions on reserves, pre-disaster training, the Citizens of LA issues, and the FEMA and congressional hearings on the wind/water issues are any example of government running as an insurance carrier and their suggestion of the Multiple Peril Act of 2007 adding wind coverage to FEMA ,then why should we want any part in supporting such proposals? Please let the private carriers go back to doing what they WERE doing best in the private market.

While none of us in the adjusting community like denying claims under the wind/water controversy- it is still the contract insureds agreed to no matter how many cry “big bad insurance company”and until private carriers develop a comprehensive policy covering both, I’m 100% against the government administering additional programs. Insureds need to ask themselves…if they  signed a loan agreement to pay back x dollars and did so then the loan company came back and told them that the contract didn’t matter- they need to cough up several more thousand dollars they did not agree to- what would they do? I assume as a loan recipient, if they used the same line of thinking they use with carriers, that they would just roll over and pay the extra thousands so they don’t get bad publicity. I still do not understand why so many expect that carriers should pay what was not covered in the insurance contract. I do “get it” that some bad calls may have been made on a small percentage of individual claims which never should have happened. The current midwest floods show that the public still does not “get it” regarding the need to buy flood coverage. Just this week- 2 years post Katrina- news reports are coming out that many locations in the midwest are reporting much damage with only 5-10% of homeowners in flood zones having purchased coverage. Again, I do believe we will see the carriers and the adjusters be the “fall guys”. Things need to improve in this industry but I think the FEMA and Citizens examples show it’s not the answer to turn it over to “governmental” agencies.

If the government wants to do something for the very necessary adjusting community, how about developing an Insurance Claims Advocate group member on your task force like you do for consumers..click here for task force member links. This committee list shows two claim members- one from Citizens and one from another insurance carrier. There is not one member of the task force committee investigating claims from the independent adjuster group yet they are relying on 6,000 plus independents to service their claims. It could not be one of your 45 selected vendors if you want valid input as they would have to give you “politically correct” input to maintain their appointment. Think about it…we might be able to help straighten out some of these “claim handling issues” you are investigating. Independents work for many different carriers and they might just be able to provide outstanding information on improving claim handling procedures. It sure seems like Citizens is missing the boat if these articles are any examples of what we are going to face servicing their claims.

Please don’t get the wrong impression- we have LOTS of empathy for insureds when we must deny a claim due to coverage issues. That still doesn’t give us the right as adjusters to change the settlement terms we must abide by. We are also very concerned citizens of the state of FL with our friends and families in this state. We have inside knowledge of how claims should be handled and we fear for what the coming hurricane season brings our state.


Scruggs Contempt case developments- Update ( 3 of 3 blogs on this subject)

August 24, 2007

We were able to obtain a copy of the Scrugg’s attorney’s response filed on the Contempt charges from the WSJ blog entry of 8/23/07  found here. Here is a link to the court document responding to the Contempt charges asking for dismissal.

It’s interesting to note if you read my earlier two blog entries here and here on the contempt case and the history of the whistleblower case that this response provides additional information. The other documents linked to in my earlier blogs indicates that they said the Rigsby whistleblowers first became involved with the documents in documents to Scruggs in  April 2006. However, this court response says they first contacted Scruggs in February of 2006 with a few engineer reports and the now forever infamous sticky note I wrote about in this blog. ( It just won’t go away!) then again in April 2006. Also, interesting to note in this court document, they state that there would not be charges filed against the Rigsby’s unlike the news article posted in our earlier blog this week that said there was still a possibility. Other things to note of interest in this recent filing by Scruggs attorney requesting dismissal of the charges is information that the appointed prosecutors may have a conflict handling such a case as they are opposing counsel on some railroad cases that Scruggs is also involved in.  It will be interesting to see how this case develops.

National Underwriter has also just put out this breaking news story on the Keker( attorney out of San Francisco who is representing Scruggs on the alleged criminal charge) action with a quote from insurance trade group PCI (Property Casualty Insurers Assn of America) who is pleased that this action is being taken. They also hope that the media will help get this information out so we are hoping you will read these comments and let others in the adjusting community know about these issues. We will continue to keep  you advised on any major developments.

6pm CST update 8/24/07- 

***Here is a late breaking announcement made on the Insurance Coverage blog with a judge’s decision on the Rigsby issues. Read it here .

*Update 9/1/07- Interesting updates on the Scruggs case in this 8/31/07  WSJ blog


Claims Magazine Claims Salary Survey is up..please participate!

August 24, 2007

We are honored that Claims Magazine, Managing Editor, Eric Gilkey has requested both ClaimSmentor participants and Dimechimes Corporation roster folks participate in the 17th annual survey on claim salaries. Feel free to pass this on to anyone participating in claims whether carrier personnel or independent adjusters. The more participants the better the results will be when we read the survey in the October 2007 issue. Please help make a difference in claim income for adjusters by taking this survey.

Here is the information from Eric:

Claims Magazine is currently conducting its 17th annual salary survey for claim professionals. The survey is meant to convey opinions and salary ranges for carrier and independent claim staff professionals, from adjusters to vice presidents. It’s meant to be a tool for industry professionals to use to compare their salaries to other professionals in the industry and get a snapshot into the industry’s current state. All salary figures will be kept confidential and are only used to tally results. Comments used in the write up will be ensured anonymity if used. To participate, go to www.claimsmag.com and look for the survey link under the breaking news section. 

Eric Gilkey

Managing Editor | Claims Magazine | Florida UnderwriterProgram Chair | Calif. Insurance Fraud SymposiumThe National Underwriter Company

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We had recently posted two different blog entries on adjuster income as found publicly on many websites and in the press here if you missed them. Here and Here

Thank you all in advance for participating in this survey.

 “Make things Happen” by participating!


Category 7 by Bill Evans – Book Review

August 23, 2007

Need to “change your brain” as my mother likes to say after all that heavy duty reading on the whistleblower cases ?

Adjuster Donald Johnston shares information about this new book out by Bill Evans he highly recommends for reading with our membership!

Here is a link to information on this new book I located on the web:

http://abcnews.go.com/GMA/Books/story?id=3362114&page=1

This looks like interesting reading for those of us who love catastrophe adjusting and it should provide more reason to support the need for carriers, independents, and politicians to work together to make sure events like the horrors witnessed in the aftermath of Katrina never happens to Americans again.

Maybe if we’re lucky…..Bill Evans will see this blog and send us a few autographed copies for our ClaimSmentor Roving Reporters to evaluate the book! (Include an extra for me if you do Bill!)


Whistleblower cases and your E and O coverage- part 2

August 23, 2007

I have updated the 8/22/07 blog today to include information on the 2nd whistleblower RICO case, more info on the Scruggs whistleblower case, as well as to discuss adjusters need for E and O coverage. You can view that entire blog here:

https://dimechimes.wordpress.com/2007/08/22/special-prosecutors-file-criminal-contempt-charges-on-ea-renfroerigsby-whisteblower-case/

Here are two more articles to read with Scrugg’s attorney commenting and a WSJ update from yesterday on the case:

Here are the first comments I’ve seen published from an attorney representing Scruggs on this:

http://online.wsj.com/article/SB118780916398705534.html?mod=sphere_wd

Here is also the WSJ Law Blog entry from yesterday on the case:

http://blogs.wsj.com/law/2007/08/22/dickie-scruggs-charged-with-criminal-contempt/

See you tomorrow!

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Well- nothing is simple on these cases. As soon as I thought I’d finished reporting on the whistleblower cases, the next item reviewed is this August 23rd blog alleging more allegations against carriers:

http://news.bbc.co.uk/1/hi/business/4251394.stm

This was linked to in this AM in the morning blog entry:

http://aminthemorning.blogspot.com/2007/08/insurers-being-sued-over-katrina.html

Here is a June news article  on the Hood  breach of contract suit and a NU news article from May in case you aren’t familiar with that action involving the Katrina cases:

http://sev.prnewswire.com/insurance/20070615/DCF01515062007-1.html

http://www.propertyandcasualtyinsurancenews.com/cms/nupc/Breaking%20News/2007/05/02-HOOD-dh

Here is an August 2007 Clarion news article about the carrier attempting to dismiss the suit:

http://www.clarionledger.com/apps/pbcs.dll/article?AID=/20070810/NEWS/708100370/1001/news

I hope all of you  are trying to objectively understand what is going on with these cases. Take the time to go directly to the carrier websites and look at their news and press releases for their “direct from the source” news releases. You’ll find  quite interesting information in what appears to be a war of the press releases by all parties involved but I prefer to think of it as the carriers trying to educate the public about many misconceptions found in the press. I’m glad to see them posting information from their perspective when years ago they remained silent on these issues on their websites.

Off to work now..no time to specially link those articles vs just posting them as is!


Special Prosecutors file Criminal Contempt Charges on EA Renfroe/Rigsby Whisteblower Case

August 22, 2007

We will expand on this post later today but here are links to  yesterday’s breaking news stories on the EA Renfroe Adjusting firm/ Rigsby sister whistleblower case. The appointed Special Prosecutors in the case filed criminal contempt charges against Scruggs 8/21/07:

Here is a link to the AP Press news article: click here

Here is David Rossmillers’s Law Blog on the news: click here (see 8/22/07 entry)

Here is an August 15th Birmingham news story that the Rigsby sisters may also still face prosecution: click here

If you aren’t up to date on the recent appointments of the Special Prosecutors, here is a great Findlaw summary of this from August 3rd: click here

Here was the Judge’s order naming them: click here

Here is a transcript of the Contempt hearing  March 2007 with Judge Acker: click here

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While this case is coming back to the front line news again, this is a good time to remind you of discovery and activity log notes. If you missed it, view this blog on the infamous sticky note arising through many articles and court documents on this whisteblower case. Click here.

I will be updating this with more news on the issue later today. In the meantime, Fox news is reporting that TS Felix should be named in the next few days and I’ll post the first news stories on that shortly along with updates on the Midwest flooding claim stats.

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Update on this topic 8/23/07:

Some of the first news reports are coming in on the announcements and here’s one of the most detailed  from this WSJ report providing comments from Scrugg’s attorney indicating they are filing to have the charges dismissed. Click here. Here is also Peter Lattman’s WSJ law blog of  8/22/07 Click here.

Back to some of the more important news stories and documents posted over the past year on this topic(sorry I didn’t get back to this yesterday!) here is a list of items adjusters may wish to read to familarize themselves with the history on this case:

Jan 07 Claims Journal article summarizing the grand jury probe: here

2007 AL spring article on the initial contempt hearing: here

Sun Herald article explaining Rigsby allegations, carriers involved, and info on unsealing the court case: here . Note that the Sun Herald has run numerous stories on the case but the links we have show many of those articles are no longer available. Several can still be found on their site by going to search in their archives.

Tort blog about the unsealing of the documents: here

One of the most informative documents on allegations in this First Amended Complaint on this False Claim Act document. This document states that the Rigsby’s reported this case in 4/06 to the US Attorney then gathered the documents in 6/06 with the Rigsby’s then notifying the carrier after the “dump weekend” as it’s referred to in other documents. This document says they then left for vacation and upon return to the carrier’s office were “escorted out of the bldg” (gee- what did they expect!). It goes on to say in 9/06 that Renfroe initiated suit to return the documents. There is much info in this document to again include a copy of that infamous sticky note (drives me nuts..it’s every where on the net and an excellent example of why an adjuster should NEVER use anything other than the appropriate activity log to document file activities..adjuster 101 stuff!). This report also discusses Haag, the carriers, and the employees  alleged to have shifted damages to wind, Xact Total, and much more. If you don’t read anything else, read this whistleblower’s summary of the activities they allege took place. Here.

Here’s a still current link to the Sun Herald summary of the case when it was unsealed..here

Scruggs group post of the exhibit on the EA Renfroe Code of Conduct form here

You might want to follow this current Clarion Ledger new poll -the results are to be published 8/24 asking if the whistleblowers should be prosecuted..thus far today it is showing only 2% say yes and 87% say no..here

Here’s the Scruggs June 07 Press release on the RICO case they filed on these allegations: here

Here is the RICO complaint filed 6/20/07 (101 pages of interesting reading) here

If you are not aware of it- here is a seperate whistleblower case we are also following making similar allegations of movement of damages to NFIP vs the wind carrier . Here is an article from a NOLA Times Picayne blog summarizing this 2nd whistleblower case: here

Thanks to this posting on the Insurance Coverage blog- here is the Complaint on the unsealed second whistleblower case: here

This complaint document names the names of many carrier employees/independents? Make sure to view the treble damages requests beginning at approximately page 88 here. We’ll try to get to a blog entry discussing errors and omissions coverage and things an adjuster needs to do for coverage to protect themselves against such a complaint as many new adjusters are not aware of their need for insurance coverage protection.

This is a large document at 242 pages which are the exhibit documents Scruggs group had posted. Click here. All adjusters should read this document to see what happens during discovery with your letters and file documents. They can become part of suit documents as they did on this case. This document discusses the names on many different cases involved in the allegations and provides exhibits of many carrier documents. Trainees who don’t know what correspondence on various issues should look like could learn alot from viewing this entire document to learn about coverage denial letters, reservation of rights letters, statements of loss,etc.

Another interesting WSJ blog from 6-21-07 by Peter Lattman “The Thrilla in Pascagoula”. This blog gives alot of details of further actions filed trying to have Scruggs removed from the case. Here

Here’s a good www.nola.com article on the 2nd whistleblower case: here

Here’s a Mobile Press Register article quoting Pilot Adjusting Co’s attorney: here

Here is a National Underwriter story summarizing the case: here

This National Underwriter article lists all the names of the adjusting firms and parties alleged to have shifted damages to flood (the whistleblower names have still not been revealed that I am aware of): here

This article posted again here to make a point…this explains what the whistleblowers stand to gain by making such allegations: here

Congressman Gene Taylor’s posted information on alleged wrong doing by carrier’s: here

Here is a summary 7/6/07 in the Bloomberg news on the 2nd whistleblower case: here. Note the quotes by various carriers commenting on the case..I believe this might be same link but here it is if not: here

Here is another article 7/9/07 saying the judge withdrew request for federal intervention on the whistleblower case: here

Here are 3 things you should read on this Insurance Coverage blog entries/attachments on the case here, here , and here on the Judge withdrawing the request. These documents include Homeland Security reports and other important documents you need to read to learn where these cases are going.

Here is another important document by the above blog which is a Branch consultants document on the 2nd whistleblower case. Here Note the alleged 4 whistleblowers are still not named in this document. I’m curious if these folks are still out adjusting claims?

While trying to understand all of these court documents and issues mentioned in these cases, I did some research on the False Claims Act and was interested to learn that the Acts vary by state. Some states allow only for False Claims act cases on health claim issues. Here is  state by state information found at www.phillipsandcohen.com website located while researching these acts:

Here is the one with the state links: here

And this one provides excellent information on the False Claim Act in general: here

So where is this all going? I can’t pretend to know. We’d love to have an attorney interpret all of this for us if we have any volunteers but here are some things you may find very interesting. First of all- while doing this research, I found this report on the web which PRE DATES KATRINA by the GAO office in April 2005 in testimony to the house. Make sure to make note of the number of flood certified adjusters at less than 5,000(now can you imagine what this means for all the current Midwest flooding today?). Here it is. Note this report also says that only 4% of flood files were reinspected. So let’s move forward to the GAO testimony over 2 years later in this June 2007 Testimony about the inability of FEMA to assess the wind damages vs flood damages found:  here  Combine these 2 GAO reports with a review of the September 2005 directive by Fema to WYO(Write your own) carriers with expedited instructions on handling flood claims found : here and the single adjuster concept for flood claim handling found in this FEMA procedures document: here sure makes you wonder if the right hand knows what the left hand is doing. Is there any wonder there is so much confusion?

If you missed our blog on more current info on the fee issues on the wind vs water, take some time to read this earlier blog on Adjuster Fees in the news found: here

I am posting all of this information in the hope that adjusters will learn to understand how very important proper documentation is in their claim files. All of these suits, news articles, congressional hearings,etc drive home the very point that your file is subject to discovery and much discussion in press articles.

You cannot take this lightly and it is of utmost importance in today’s environment that you properly protect yourself with E and O coverage and other coverage  you may need. Many adjusters are leaving their E and O needs to the adjusting firm but those I’ve asked have never even considered asking the adjusting firm for a copy of the E and O policy which is alleged to protect them. Do you know what coverage you have? What are the E and O limits that protect you? What are the policy terms? Who is the carrier and the policy number? Is there a deductible? Does the E and O policy protect you if you are one of the adjusters named in one of these suits? Does the E and O policy provide defense costs for you? We’ve had an adjuster advise us this past year that his personal attorney fees to defend an allegation were not covered and over 40K over a 2 year period. I am not an  E and O expert but you need to talk to your adjusting firms to determine how you will be protected BEFORE this happens to you and get the answers to these important questions whether you are providing your own E and O or they are and deducting it from your fee bill payments.

This CNN Money article says a January 31, 2008 deadline has been set on the whistleblower case: here so I imagine that there is much more to learn about these cases in the next weeks and months ahead.

Here is a link to info on E and O posted on the National Association of Catastrophe Adjusters website you might want to look into if you are not presently covered: here There is also good info here on health coverage. Speaking of that..I’ll end this long blog entry directing you back to this important blog entry about FL having open enrollment for health insurance benefits for self employed and independent contractors during the month of August 2007 so you don’t miss the deadline to apply should you also need this important coverage: here

See you tomorrow!


Hurricane Dean – Info on Adjusting firms working in Mexico, Misc adjuster needs in Mexico

August 20, 2007

We’ve done a bit of research for those of you asking for information on working losses in Mexico due to Hurricane Dean making landfall in Mexico. While we are not yet staffing for a firm planning to work there, we have done some initial research for adjusters on firms that do work there.

We also include links on visas, work permits, auto insurance needs, internet services you will need and cell phone coverage information. We’ll do additional checking tomorrow should the need arise for additional information and will post it in reply to this topic. Should you have additional information for adjusters wishing to work in Mexico on Hurricane Dean claims, please provide reply comments below we’ll post to aid in their search for work on Hurricane Dean losses. For example, I was not able to locate information on estimatic software used while adjusting claims, book value guides for Mexico which might be helpful to auto adjusters, and a few major other items such as Errors and Omissions coverage for adjusters going over, workers comp coverage issues while working there, and Mexico insurance adjuster license requirements. We’d appreciate any details our readers can provide. Here are the links you may wish to view if your considering assignments:

First see this article which says US Insurance adjusters can’t go to Mexico to adjust claims so tells RV owners to drive their RV to nearest point in US for inspection:

http://www.aonrecreation.com/ardhome.aspx?_act=display&_con=RVing%20In%20Mexico

Crawford and Company- Mexico location contact info

http://www.crawfordandcompany.com/content.aspx?CID=222&SID=7#Mexico

Cunningham Lindsey Mexico Contact Info

http://www.cunninghamlindsey.com/office_locator.asp?country=Belize

GAB Robins-handles claims in US and Mexico:

http://www.highbeam.com/doc/1G1-138311034.html

Coast Claims

http://www.coastclaimsadjusting.com/aboutus.htm

Jeremy Bellemy Adjusting Co

http://www.jimbellamy.com/

Risk Mexico

http://www.riskmexico.com/eng/ctc.asp

Spencer Claim Service

http://www.spencerclaimsservice.com/

Claim Service Guide with contact information- may be able to locate adjusting firms here: (Also see Legal guide on this site.

http://www.igib.com/claim_service.html

Mexico Insurance Professionals out of AZ may be able to provide some adjusting firm names:

http://www.rockypointdirectory.com/mexican_insurance.htm

Temporary Vehicle permits needed to go beyond 15 miles of border- Link to order permit online:

http://www.mexicoinsuranceconsultants.com/Travel.aspx

What personal things are you allowed to bring in

http://www.mexicoinsuranceconsultants.com/Travel.aspx

Pemex Gasoline only allowed in Mexico

http://www.mexicoinsuranceconsultants.com/Travel.aspx

Passport / Permit info for Mexico

http://www.mexicoinsuranceconsultants.com/faq.aspx

Passport needed if flying/ permit if driving:

http://studenttravel.about.com/od/mexicostudenttravel/f/border_mexico.htm

Frontier Airlines- to 7 Mexico Cities from 13 US Locations

http://www.bizjournals.com/albuquerque/stories/2007/08/13/daily3.html?jst=b_ln_hl

Excellent advice on Auto Insurance needs if going to Mexico:

http://www.mexpro.com/press/dsun062006.php

Driving in Mexico and your US Insurance may not cover you- FAQ:

http://www.mexadventure.com/MexicanInsurance/Frequently_Asked_Questions.CFM

Tips for Driving in Mexico:

http://www.mexicantouristpro.com/in_mexico/driving.html

FAQ- Can you take a rental car from US to Mexico:

http://www.riskmanagement.ucsb.edu/faqs/mexico.htm#19

Work Permits to work in Mexico

http://www.mexperience.com/liveandwork/working_mexico.htm

Mexican Visas

http://www.mexperience.com/liveandwork/immigration.htm

Summary of differences in Auto and Property policies in Mexico vs US coverage

http://www.ontheroadin.com/travelinnformation/comparingusandmexicoinsurance.htm

Sample of a Mexico policy for auto coverage

http://www.mexinsure.com/coverage_terms_and_conditions.php

US Consulant General Mexico- More info on VISAS/Work permits

http://ciudadjuarez.usconsulate.gov/wwwhnivtnlist.html

TN Visas for Mexican and Canadian Disaster Insurance Adjusters

http://www.visaus.com/tnfaq.html

Mexico Business Visitors rules

http://pubweb.fdbl.com/ihp8/global/media85.nsf/public-country-briefs/mexico?opendocument

HIgh Speed Internet Providers in Mexico

http://www.google.com/search?q=+high+speed+internet+service+in+mexico&rls=com.microsoft:en-us:IE-SearchBox&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7GGLJ

Cell phone coverage in Mexico

http://www.google.com/search?q=Cell+phone+coverage+in+mexico&rls=com.microsoft:en-us:IE-SearchBox&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7GGLJ

US Consulate- Travel Accommodation Guidelines for Mexico June 2007

http://travel.state.gov/travel/cbpmc/cbpmc_2223.html

*************

Here is the latest Bloomberg report put out just after midnight with lots of facts and info on the territories and population in Mexico where the eye wall is approaching now:

http://www.bloomberg.com/apps/news?pid=20601087&sid=aLnbekJbtTik&refer=home

Thank you to Claims Magazine Managing Editor, Eric Gilkey for requesting to link to this blog entry in their breaking news feature here:

http://www.claimsmag.com/cms/Claims/Breaking%20News/2007/08/21-mexican%20claims

9/1/07- Update- here is another contact for adjusters on another firm operating in Mexico:

Mexico City


Felipe Ramírez
Orizaba 32
Col. Roma Norte
Del. Cuauhtemoc
Mexico City
Mexico
C.P 06700
+52 55 3000 1880
+52 55 3000 1889
felipe.ramirez@charlestayloradj.com


New storm expected for East Coast of FL and ClaimSmentor Class Schedule Updates

August 20, 2007

We’ve all been tracking Dean’s expected landfall which is no longer projected for landfall in the US.

Here is an updated alert for a new storm showing a projected path for the US Fl East coast.

http://www.wunderground.com/tropical/tracking/at200792_model.html#a_topad

Here is another report calling this newest storm Invest 92L (scroll below the Hurricane Dean update) for the 9pm update:

http://flhurricane.com/

**Update 8/22/07 3:12 pm- Fox news is reporting possible announcement of TS Felix by late this week. Here is an outstanding new link shared with us by DWilliamson which has great graphics which shows 2 tropical disturbances today: http://ralphstropicalweather.homestead.com:80/RalphTropicalWeatherOut.html

We’ll update our blog entry tomorrow. We’ve been tied up in staffing projects. Please note the Marine Manager candidate submissions have been completed. There is a potential for additional Marine adjusters down the road once the final candidate selection is made for the Marine Manager from the final candidate pool.  We are still accepting resumes for aviation adjusters at this time as well as Citizens FL experienced adjusters, catastrophe adjusters for our rosters, and daily claims adjusters nationwide for future opportunities. View our previous blog on FAQ  here for resume submission information.

***********

Update on ClaimSmentor online class schedule:

Next 40 hour Fundamentals of Claims class begins 8/27/2007. Class will be held Monday and Thursday evenings from 6-9pm CST in our online Live classroom. This course includes all Self Study training guides shown on the training tab at our staffing firm site.This class consists of 24 hours live online classes and 16 hours of pre-class reading assignments and homework for practical experience. This is not an estimatics course with the exception that 1 of the 8 lessons does cover estimatic reconciliation issues to resolve disputes on estimates. The remainder of the class covers many other topics you need to know before working claims to include ALE training, complaint handling, file requirements, mock zoning and disaster practice session, and much more .

8/22/07-  6-9pm CST- Contents Claim handling class. Includes Contents Claim handling self study guide for field reference.

8/28 and 8/29/07- Additional Living Expense claim training. Two night session which includes the Additional Living Expense self study guide for field reference.

8/31/07- 8 am –11 am CST- Fl Condo Claim handling class. Includes self study guide for field reference.

If you are in need of these classes and not yet a ClaimSmentor member, you will find registration information needed to register here. We also offer these classes in the field for adjusting firms or groups of students. Contact us at  ClaimSmentor should your firm need field assistance presenting these field classes for pricing. ClaimSmentor members will find the course information in our Training Sessions-Roots and Wings Forum with a complete description of each training course.


Billingual Adjusters in Big Demand! Please update your resume if applicable! Translation services for others listed

August 17, 2007

dimechimes468_6015.jpg

Billingual Adjusters in Big Demand

While I haven’t had time for a blog entry today, I wanted to remind adjusters that their Billingual skills are very important to carrier and adjusting firms. We have approximately 100 adjusters who have commented on it on their resume.

If you have billingual skills and that is not on your resume, please resend your resume asap to Debbie@Dimechimes.com and put Billingual in the subject field with your last name and state then make sure your resume includes your billingual information. Please make sure you have read our blog entry on adjusters resumes here before submitting information required for consideration.

You’d be amazed at how much that can increase your odds of deploying in some territories not only with our firm but with adjusting firms and carriers.We received a staffing request in 2005 that requested we deploy all licensed adjusters whether experienced or not that were billingual. The inexperienced were used in the adjusting firm and carriers offices as interpreters.

Should you not have billingual skills, you might find some of these services helpful if your adjusting firm does not have services available when communicating with an insured that does not speak English .Many experienced adjusters also advise they will hire local temps to travel with them to appointments to act as interpreters. Trainee adjusters- this may be the perfect opportunity for you to train with an experienced field adjuster by offering your billingual translation services as you ride along with them for training.

http://babelfish.altavista.com/

Translate text to spanish /other languages

Translate entire web page to other languages

*This was most interesting- try entering a web address in and watch it turn the site into another language!

Adjusting firms can add a link to Babel Fish that a customer can click on to interpret their website in many languages

http://www.wordreference.com/es/translation.asp?tranword=transfer+desk

English to Spanish translation dictionary

http://www.courtreportersnet.com/transcription.html

To transcribe a recorded statement spanish/english/others

http://www.cbsnews.com/stories/2006/10/18/tech/main2100781.shtml

Dial an Interpreter Service through AT and T

*I’ve used this before on claims

http://www.claimspages.com/documents/

Claimspages.com has many commonly used forms  and pattern letters in Spanish

http://www.languageline.com/page/welcome/

If you look on the Products and Services tab- this can be used by individuals who have infrequent needs (listed as personal service) and also another plan for businesses such as independent adjusting firms under the business plan.

We’ll add others next week. We hope everyone has a great weekend! See you Monday!

Please add comments in reply if you have other advice or contacts for billingual services to share..thanks!


Crisis Intervention while Catastrophe Adjusting by guest blogger Steve Ebner

August 16, 2007

We welcome our first guest blogger, Steve Ebner, to our Dimechimes Corporation Adjuster Information Blog. Steve and I share a common background in both staff, independent, and catastrophe adjusting. Steve is also a valued member of ClaimSmentor and CADO.

Steve Ebner has a Master of Divinity degree and is a former United Methodist minister and chaplain at Methodist hospital in Philadelphia.  His second career as a claim adjuster began in 1990, when a claim superintendent at State Farm had the foresight to realize that someone with training in crisis counseling may have skills that would be valuable in claim adjusting.  Steve has been an independent catadjuster since 1998.  He has worked large and small commercial, homeowners, mobile home, and occasional auto claims.  He has worked both the property and casualty claims.  His home base is near Scranton, PA.

Here is Steve’s outstanding blog entry contribution on Catastrophe Adjusting and Crisis Intervention. We felt this article was timely with the peak of hurricane season approaching and the difficulties adjusters face personally as well as while dealing with insureds suffering many personal tragedies caused by storm damage:

Cat Adjusting and Crisis Intervention by Steve Ebner (Medulus@aol.com)  

As cat adjusters we fill a certain niche in the insurance industry in that we are often called to serve those who have experienced some level of crisis.  While this is in some measure true of any adjuster, it may be more intense and widespread during a cat event.

We are not counselors, nor should we attempt to be.  However, it would be helpful for us to have some understanding of crisis intervention to inform our claim handling.  This will only serve to help us settle claims more fairly and finally, and to add another dimension to our ultimate goal of indemnification – returning the insured to a position of wholeness.  More often than we realize, the policyholders we encounter expect us to be agents to assist them in recovering from the crisis they have experienced.  A savvy adjuster will look beyond the surface and see some of the factors that make settlement of claims more difficult in a crisis situation.  Further, they will attempt to address those factors and concerns to the extent it is appropriate for us to do so.  I would like to try to address the concepts of crisis intervention in a somewhat simplistic manner, and relate these concepts to catadjusting.  In this article I will only be scratching the surface.

Let me explain some of the emotional/psychological scenarios we could face by way of an example from my own life.  I was living in Santa Monica, CA, when the Northridge Earthquake struck.  Santa Monica, because it is near the ocean and built on sandy soil, experienced liquefaction more than any other city located more than ten miles from the epicenter.  At about four o’clock in the morning of Martin Luther King Day 1994, my ten year old daughter shook me awake and said, “Dad! Hurry! Get in the doorway!  It’s an earthquake!”  I woke to see my two children and the two children who were staying overnight huddling in the doorway.  The house continued to shake for another very long minute.  The electricity was out.  When the shaking stopped I went into my bedroom. My floor to ceiling bookshelves were all tipped over.  Every one of my over four hundred books was on the floor in a jumble we had to crawl over.  I then tried to put the children back to bed.  But every couple minutes the earth shook again – over and over and over.  No one was going to get any more sleep that morning in the apartment.  About an hour later the panicked mother of the two visiting children arrived to pick them up.  She had been unable to open her garage to get her car out.  There were no phones or electricity working.  Then my children and I went out to the car to sleep because it seemed the safest place to be. 

My workplace had all the windows broken out.  The building was off limits for some time.  There was a curfew in affect the first night.  But that was not a problem because most people were in shock, and didn’t want to go out anywhere anyway.  By the second night, most of the bars were open and packed to capacity.  In the first week many new couples were formed because no one wanted to sleep or live alone anymore.  And the ground kept shaking again and again for months afterward.  Every time it did, people would exit the buildings they were in.  People started talking about moving elsewhere, about how they didn’t like living in Los Angeles anymore.  Every time I closed my eyes and started to drift off to sleep, I would get a sensation that the ground was shaking and it would wake me up.  Every street became as congested as the freeways had been before the earthquake.

As you can imagine, people living in this type of environment are not going to have the same expectations as people living under normal circumstances.  Some may very well make demands beyond the norm of their claim adjuster.

What constitutes a crisis?

I should begin by defining what a crisis is.  The term “catastrophe” as defined by the insurance industry is not synonymous with “crisis” as defined in psychological terms.  “Crisis” has a personal component.  As another adjuster pointed out to me this week, a crisis has more to do with the person experiencing the loss than the size of the loss itself or, for that matter, the number of people affected.  We might find that some people react to almost any severe weather event as a crisis.  However, certain events – for example a hailstorm – are generally not a crisis.  In most cases, no one is injured or killed.  For some it may lead to a personal crisis, but this will be the rare individual.  The hailstorm, however, could be declared a catastrophe because a cat is declared based on the expected dollar cost to the insurance industry. 

Crisis has been defined as “an acute response to an event wherein homeostasis is disrupted, one’s usual coping mechanisms have failed, and there is evidence of significant distress or functional impairment” (Critical Incident Stress Management, Everly & Mitchell, 1999)  We often find insureds who are in this situation after a hurricane such as Katrina or Ivan.  People who, for instance, might normally be rather even-keeled and unflappable may very well be in some level of panic after their roof is blown off or after they have been living in a motel for a month.  Instead they are wondering when they can return to their home or their job.  The “Big Easy” was not taking life so easy by September and October of 2005. 

A Simple Discussion On Working With Someone In Crisis

As catadjusters we are in a position to be of significant assistance to those who are experiencing crisis.  Crisis Intervention, as a counseling discipline, focuses on very practical considerations.  It focuses on identifying resources for recovery.  We are one of those resources.  As adjusters we can be of great assistance in helping policyholders recover a sense of normalcy – the ultimate goal of any type of crisis intervention.  As I have mentioned in my previous article on CADO, I was an ordained minister for more than a decade.  I have sometimes described catadjusting as “ministry with a checkbook.”  More than any other type of emotional intervention, crisis intervention focuses on the practical.

By examining the definition of “crisis” above we can extrapolate what must happen in order to bring some sort of wholeness to the lives of those we serve.  The first element of the definition is that crisis is an acute response.  It is intense but not permanent.  Though it may seem to the insureds that their lives have been permanently changed in a dramatic manner, the fact is that the precipitating catastrophe has created a temporary situation.  While it would be ill-advised for any of us to flippantly tell someone whose house has been destroyed that this is just a temporary situation, there are nonetheless ways to assure someone that they will recover.  Without overstating the case, it is appropriate to explain to the insured that the insurance carrier exists to help the insured return to a normal life after such a crisis.  The fostering of hope is very important when things seem hopeless to those in crisis.  It can also be appropriate to remind the insured of other resources such as FEMA, The Salvation Army, and The Red Cross.  It is inappropriate, however, for us to tell them specifically what these other agencies can do for them.  We do not speak on behalf of any of these other agencies.  We represent the insurance carrier solely.  We must especially never send them to another agency for anything covered by the insurance policy.  Our first responsibility is to include all covered or potentially covered loss elements in our claim reports with our best analysis of coverage.

The second element of the definition is that homeostasis is disrupted.  Even the most creative or disorganized among us tend to follow certain routines that help us structure our lives.  There is some element of similarity in what we do each day.  The precipitating crisis event disrupts this.  If water supplies have been disrupted, the insureds may not even be able to brush their teeth easily upon waking up.  Their routine of watching a television program or reading the paper in the evening may be impossible due to an electrical outage.  They may have no workplace, no mail delivery, no open markets, no open restaurants.  The corner bar where they meet and talk to their neighbors may be closed.  They may be staying in a shelter, sleeping among hundreds of strangers with whom they share facilities.  They may temporarily have no privacy.  This will be particularly difficult for the introverts among them. 

To the best of our ability, we are in the business of helping people restore normalcy to their lives.  Those in crisis are looking to us for answers about when and how life will ever be the same again.  For some, it never will be the same.  There will only be different routines that will create a new normalcy.  We can help, once again, by focusing on the practical processes that will help to create some semblance of order in their lives.

The third element of the definition is that, for someone in crisis, normal coping mechanisms have failed.  What usually works for people to deal with stress in their environment no longer works.  This is particularly true in a major catastrophe.  When someone’s workplace is not accessible, the normal cash flow for a family is disrupted.  The home that provided shelter and comfort is no longer a place of guaranteed safety.  The goal of crisis intervention then, for us as catastrophic claim adjusters, is to help the insured identify means of coping with their new reality.  This may be in the form of assisting them to locate and pay for alternative housing, to rebuild what was destroyed, and replace what was lost.  It has often been expressed on CADO that our job as adjusters is to find coverage wherever it exists and allow for all that we can under the terms of the policy.  Some of the coverage afforded by the insurance policy may not be familiar to the policyholder.  It is our job to know what can be afforded to them in order to help them recover.  In this way we become part of the solution, and fulfill the contractual promise the insurance carrier makes when the insured buys a policy.

The fourth element of the definition is that the person in crisis is exhibiting severe distress or functional impairment.  Though this is the final element of the definition, it is often the first with which we must deal.  This means that when we encounter that policyholder who seems stressed out, unfocused, and scattered we may not be dealing with that policyholder operating in their normal mode of behavior.  This insured may not simply be a “crazy person”.  He or she may be a perfectly sane and rational person who in the midst of a crisis.  The very nature of a crisis is that it disrupts someone’s life and emotional state.  We have all had the experience where we greet the insured at the front door and suddenly it is as if we have entered a vortex.  The insured starts leading us around the house pointing to this and that area of damage faster than any human being could write down the scope of damage, let alone measure it.  Or the insured may continue to tell us all the horrible things that occurred on the day of the storm, or insist on talking continually so we cannot even concentrate on our work.  Then they call each day with some new damage they located or something else they forgot to tell us.  They may exhibit unusual behavior like walking through their house with a flashlight looking for fresh plaster cracks each night.  This is not their typical mode of behavior.  This is likely to be a result of the very catastrophe we are there to help them work through.  This may be because their world no longer feels safe, and they feel powerless to make it safe again.

It is not our job to help them through the emotional component of the crisis, but we need to at least defuse the anxiety long enough to do our job and to obtain the insured’s assistance in scoping the damage.  The first tip I have is that it will benefit us greatly to practice some empathic listening.  The ceramic outlet covers may seem unimportant to us in the whole scheme of the loss, but if they are important to the insured (because the insured keeps mentioning them) then they should be considered important.  We may discover – as one of our colleagues did – that the tattered old phonograph is the only thing the insured cares about because she used to sit and listen to it with her deceased husband.  The claim may not be settling because you want to take it as salvage.  She may settle the claim if you let her keep it, even though it no longer works.  A bit of empathic listening can reveal important details such as that. 

When working re-opened claims the number one complaint I hear is, “That first adjuster didn’t even listen to me.”  Sometimes I am able to review the estimate with the insured and show them that the concerns they have really are addressed in the estimate.  Therefore, the adjuster really did listen.  But it did not seem to the insured that the adjuster was listening, and that was what re-opened the claim.  The claim adjuster exhibited no empathy.  These people were in crisis and it seemed that no one cared.

The second tip I have here is that it is important not to buy into the panic or the manic behavior.  Speak in a calm and authoritative voice.  Invite the insured to sit down, perhaps, long enough to listen to what is important to them and take control of the situation.  We can accomplish little while being led from room to room frantically by the insured.  We may want to say something like, “Let me explain how the claim process works.”  A colleague explained to me that she spends 10 to 15 minutes with each insured simply listening to them and explaining how the claim process works before moving on to the inspection.  She believes these ten to fifteen minutes saves hours later on.  I believe she is correct.  Apparently, so do the people for whom she works.  She and her husband regularly work even in slow times when others are waiting for the phone to ring.  Most people have never had a claim before and do not know what to expect.  Take a few minutes to explain how you would like to take one room at a time, check that room thoroughly, measure it, and then move on to the next room.  Then explain what will happen with their claim after you leave their house.  This will often save you a time-consuming game of phone tag later.  All this may serve to put the insured at ease and move them gently out of panic mode.  Even if you have ten other inspections that day, it will benefit your scheduling to take a couple extra minutes to help the insured focus on the task at hand.  It may mean the difference between scoping all the damage on the first trip and having to return to this insured’s home to scope something that was missed the first time.  Though you are really not offering any long term emotional help for the insured (because you are not there as a counselor, pastor, or psychiatrist), you are focusing on one of the tasks that will help ultimately resolve the crisis. 

This has been a mere skimming of the surface of the issues involved in working with people in crisis.  I suspect the most important goal I have tried to achieve is simply fostering awareness that we are not dealing with people in a normal situation or normal frame of mind.  Therefore, we may need to be in a state of heightened awareness ourselves, and not simply write people off because of some exhibited bizarre behavior after a major catastrophe.  We are generally paid very well to handle a catastrophe, but we are not really hired to benefit ourselves.  We are hired as a benefit to the insured.  Our problems should be left at the motel so we can focus on the insured’s problems.  A brief study of crisis intervention techniques would serve many of us well.  This should go without saying as we prepare to go into a hurricane zone, but it may not occur to many of us that the emotional result of a storm may have a significant impact on the interaction between the insureds and ourselves – or, ultimately, of the claim settlement process.

  I would like to express my gratitude to those who reviewed this article before publication, and in many cases, contributed something of value which I incorporated into the article.  These people are Pastor Lee Carlton, Peter Burch, Mike Kunze, Deb Moroy, Meg Watts, Steve Beaumont, and Janice Toll. 


Temporary Housing Links for Adjusters- Temporary Housing options/Additional Living Expense training

August 15, 2007

We have been reporting on temporary housing options in our ClaimSmentor forums. We want to share these links on Temporary Housing Agencies extracted from the exhibitor booth lists for the PLRB conferences this year.

Dean is expected to reach Category 3 status within 5 days according to the 5 day hurricane predictions so it isn’t too early to start thinking about YOUR housing needs and possible housing options for policyholders on their additional living expense claims. We hope you will find these links useful. Here is also a good website to check on TS Dean while it’s in the Caribbean: http://www.caribbean360.com/News/Weather/Stories/2007/08/14/NEWS0000004755.html

Just remember, if you are considering apartments or rentals where utilities must be connected by you that you may experience delays. In the FL panhandle during Ivan and Dennis, new utility services took a back seat to restoring utilities to existing customers. It’s always best to locate a furnished unit that has utilities included in the rent so you don’t encounter this problem when possible.

Able Mobile Housing, Inc.
Tom Lackey
11780 Northfall Lane
Suite 303
Alpharetta, GA 30004
800-273-5774;  800-273-5774;  Fax 800-283-3774
http://www.ablehousing.com;   tom@ablehousing.com
Temporary mobile homes, park models, double wides, travel trailers, and mobile offices. We deliver to the insured’s home-site, complete set up. Furnished or unfurnished homes.

ALE Solutions, Inc.
Rowena Zimmers
One West Illinois St., #300
St. Charles, IL 60174
630-513-6434;  866-885-9785;  Fax 866-814-6832
http://www.alesolutions.com;   rowena.zimmers@alesolutions.com

The preferred nationwide temporary housing company for displaced policyholders. Our consultative approach helps both the adjuster and the family avoid cost drivers and pitfalls throughout the relocation process
 
 
Assured Relocation
Legia Oswald
50 Woodside Plaza
Suite 441
Redwood City, CA 94061
888-670-9700;  888-670-9700;  Fax 888-233-9752
http://www.assuredrelocation.com;   legia@assuredrelocation.com
Assured Relocation provides fully furnished housing customized to the unique needs of the policyholder and adjuster nationwide. Our phones are answered by trained relocation specialists 24/7.

 
CRS Temporary Housing
Fawn Cheng
10851 N. Black Canyon Highway
Suite 700
Phoenix, AZ 85029
800-968-0848;  800-968-0848;  Fax 800-659-2727
http://www.crstemphousing.com;   fcheng@crstemphousing.com
We are a leader because of our innovative solutions for the industry. Try us for outstanding service, quick response times, and unique management tools.

DMA Insurance Housing Assistants
Ryan Dinsmore
140 Marine View Ave.
Suite 218
Solana Beach, CA 92075
858-350-4660;  800-550-1911;  Fax 858-350-4654
http://www.dmahousing.com;   rdinsmore@dmahousing.com
Temporary housing for the unique needs of the Insurance Industry. Providing National Service for A.L.E / L.O.U Claims.

IHS Housing
Shari Tillotson
P.O. Box 508
Victor, NY 14564
877-500-3590;  877-500-3590;  Fax 877-259-8209
http://www.ihshousing.com;   sharit@ihshousing.com
IHS Housing offers full service temporary housing without the high costs of our competition. Please stop by our booth and ask how we do it!

Klein & Co. Corporate Housing Services Inc.
Karen Schuster
914 Washington Ave.
Suite 230E
Golden, CO 80401
303-796-2100;  800-208-9826;  Fax 303-796-2101
http://www.kleinandcompany.com;   k.schuster@kleinandcompany.com
Klein & Co. is the first choice for your stress free, nationwide, temporary housing needs. We specialize in placing your policyholders in a safe and comfortable environment.

Marriott ExecuStay Ins. Housing Solutions
Kelly Cockrell
3130 Balfour Road
PMB 260
Brentwood, CA 94513
800-990-9292;  800-990-9292;  Fax 800-990-3271
http://www.marriottinsurancehousing.com;   kelly.cockrell@marriott.com
Choose Marriott ExecuStay for a fast and professional solution when disaster strikes. Our experienced team will provide you with a comprehensive solution for your national temporary housing needs.

Oakwood Worldwide
Toni Andell
2222 Corinth Ave.
Los Angeles, CA 90064
310-444-2345;  866-249-9675;  Fax 877-336-2596
http://www.oakwood.com;   insurance@oakwood.com

For 45 years, Oakwood has provided exceptional value in temporary housing for insurance policyholders, catastrophe teams and employees to meet our clients’ global needs.

Oakwood Worldwide
Toni Andell
2222 Corinth Ave.
Los Angeles, CA 90064
310-444-2345;  866-249-9675;  Fax 877-336-2596
http://www.oakwood.com;   insurance@oakwood.com

For 45 years, Oakwood has provided exceptional value in temporary housing for insurance policyholders, catastrophe teams and employees to meet our clients’ global needs.

Relocation Housing Specialists
Travis Sumners
1337 Howe Avenue
Suite #104
Sacramento, CA 95825
916-332-2804;  800-690-0070;  Fax 916-641-0148
http://www.rhstemphousing.com;   travis@rhstemphousing.com
Specialists in customer service, completely itemized billing, flexibile accommodations, free fair rental values, cost savings, online access, customized solutions for policyholders and CAT adjusters, 24/7.

Temporary Accommodations
Keri Dennis
6 Piedmont Center
Suite 411
Atlanta , GA 30305
941-685-3324;  800-548-5196;  Fax 404-264-8557
http://www.TemporaryAccommodations.Net;   kdennis@temporaryaccommodations.net
Temporary Accommodations, is proudly celebrating 10+ years of service to the insurance industry and its displaced policyholders by providing the fastest, most convenient, cost effective, and comfortable temporary housing.

http://www.temporaryhousingdirectory.com;   Teresa@temp-housing.net
Temporary Housing Directory is the first company to bring together the full service solution of nationwide hotel placements (with no added fees) and furnished housing to one point of contact.

*****************

Should you prefer to do your own research, here are some links to nationwide apartment rental guides for longer assignments:

http://www.apartmentsnationwide.com/BrowseState.asp

http://www.forrent.com/

http://www.apartmentguide.com/corporate/

This is an excellent link found on www.Claimspages.com for Temporary housing and the few I looked at included temporary corporate housing and rv rental links too :

http://www.claimspages.com/directories/catfirst2.asp?Search=Category&ct_catName=Temporary+Housing&ct_IDNum=8300

www.Claims-Portal.com has a “Housing-Temporary” category on their vendor directory where you can search by city,zip,etc here:

http://www.claims-portal.com/cdps/

RV Rentals Nationwide

http://www.cruiseamerica.com/

http://www.rvrentalsofamerica.com/

http://www.rvra.org/

RV Park Directories

http://www.myrvsite.com/rvparks.html

http://www.gocampingamerica.com/

http://www.campusa.com/

http://www.militarycampgrounds.us/

To locate housing with other roommates:

http://www.roommates.com/

http://www.roommatenation.com/

http://apartments.about.com/od/roommatefindersources/Roommate_Finder_Websites.htm

Here is a good link for per diem rates for your housing/expense allowances:

http://www.rentalrelocation.com/per_diem_rate_information.php4 

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Feel free to share these links with others in the adjusting community by clicking on the title to this blog entry and forwarding it to them.

If you are a newer adjuster and need a great Additional Living Expense excel sheet for use on claims and Additional Living expense training, we have an excellent self study guide available.

We offer online LIVE training which includes this self study guide in our classes on ClaimSmentor as part of our 40 hour Fundamentals class and as a stand alone class in two evening sessions. Additional living expense is one component of claims that is often handled inadequately by adjusters. It is far from acceptable to just tell an insured to go get a hotel and save their receipts for hotel and meals. You need to know how to evaluate their circumstances and make the best cost effective decisions for them and for the carrier. You need only to examine  the very limited insuring agreements in homeowner policies to see you will find very limited guidance on handling these losses. You need to understand when it is best to recommend hotels, long term corporate housing, leases, and rental units. There are many other issues such as ALE advances, ALE carrier generally accepted claim handling guidelines, and how to control these expenses. Policies differ on ALE coverage terms such as number of months covered or if they are tied in to a percentage of other policy limits. If you do not understand these procedures, consider registering at ClaimSmentor and taking our course or at minimum purchasing the Additional Living Expense self study guide above. Adjusters taking our class are amazed to learn how quickly they can lose control on ALE expenses had they not trained properly to handle these losses. Some ALE provisions have limits based on time while other provisions allow a fixed dollar limit or percentage of another policy limit.  Many ALE policies do have a dollar limit and you do need to know how to help an insured maximize how  they can  help their family meet those needs within those limits when applicable. Many insureds aren’t aware of the wide variety of options they can use to control expenses given their unique circumstances after a loss.

Staff Claim managers I speak with site poor claim handling on ALE losses and contents claim handling (“we can use our own support staff to add up receipts if that is all that is involved” is the common comment we hear) as a good part of  the reason for the unbelievable growth in staff claim central operations which only allow independents to handle building scopes and damage on limited assignments. Let’s work to improve that negative image!

If you’ve never heard of Maslow’s hierarchy of needs  motivational management philosophy, you should take a minute to read it. Here is a link to the hierarchy pyramid with a good explanation of man’s need first for their biological and physiological needs to be met before they can proceed to other activities in life. Funny, I really liked the theory and find it applicable to so many issues in life. When taking the Management course as part of  the CPCU program series, I used the theory frequently when asked to state a management theory that applied to a problem stated in a question. Basically, it says you cannot motivate people until you take care of their concerns in a given order or “hierarchy of needs”. Housing and safety concerns are at the top of the list. I’ve never understood why carriers and adjusting firms are not more proactive in helping independents locate housing (some great firms do try to block hotel rooms for independent adjusters on new storms). An adjuster also needs to have their housing taken care of before they can proceed to properly service storm losses. I would love to see communities help fill their needs by allowing use of vacant campus housing, church housing facilities and the other great programs out there to meet emergency housing for other groups such as utility firms and emergency service options. Independents are the “forgotten crowd” when it comes to emergency housing needs. Hopefully, more adjusting firms will be proactive in developing pre disaster housing information for their adjusters. If nothing else, you can click on the title to this article and share it with your adjusters!

 It is not appropriate as an adjuster to march into an insured’s home in your haste to meet quotas and progress through scoping and addressing building damages with the exception of emergency repairs before you provide information regarding their additional living expense needs. Insureds number one concern is additional living expense advances and coverage before they give one darn about what you have to say about their building estimate. Put them at ease and cover this first. They need to know their family is taken care of for temporary housing, meals and other extra expenses covered under ALE provisions on severe losses causing their home to be uninhabitable from a covered loss. We hope our guides will help you if you need  a better understanding of adjusting additional living expense claims. 

Other news in the temporary housing market that might interest you are these articles:

New Lowes “Katrina housing” as an alternative to FEMA trailers. Click here to see the article. Here is also another link for plan Katina cottage plan options. A participating adjuster on ClaimSmentor advised she had the opportunity to view these cottages too while in New Orleans that are put out by Home Depot. She thinks the firm linked to was the exclusive builder of these cottages for Home Depot.

Fema trailers have made the news quite a bit lately with suit recently filed over the toxic issues. Here are a few of the most recent articles:

Fema has “Fire sale auctions”- MSNBC article.

Fema offers to Buy Back Fema trailers –click here for article

Emergency Medical unit buys one at significant price reduction-click here for article

Insurance Journal article with instructions for an insured to buy back a Fema trailer-here

Associated Press article- group suing Fema trailer manufacturers-here

These new suits and policies of FEMA may further increase your need to understand housing options for insureds if there is a decrease in available options for them this season due to these increasing health concerns as problems with Fema trailers come to light.

Be safe out there this season in your travels as hurricane season is ramping up. Plan for your living needs before you depart from home so you don’t encounter many problems adjusters incur when they just “wing it”. Take these few days before TS Dean makes landfall and look into some of these housing options for you and insureds you may be dealing with. Many insureds and adjusters rely on classified ads where everyone else is searching. We hope these options assist you in meeting your needs as well as the insureds you serve. It’s important that you obtain your managers permission before recommending, authorizing, or securing temporary housing for an insured so make it a priority to determine the carrier position on these options before implementation.


Adjuster Fees in the news- The time is now to educate the public and Insurance media and press

August 14, 2007

We talked about adjuster income a week or so ago here in this blog due  to the frequently asked question by new adjusters about income. I commented in that blog about comments often made on forums that we shouldn’t discuss it in public as it’s not appropriate. Well, I hate to be the bearer of the news but adjuster income is regularly discussed by the news media and it’s time we speak up and set the record straight so the media understands the reality of independent  and staff adjuster income and the many types of payment methods and schedules that exist.

Sam Friedman, Editor/National Underwriting, runs  a blog I particularly enjoy following. Sam invited Bob Hunter of Consumer Federation of America to address the wind/water issues and the allegations of damages being moved to NFIP here in this article on “Hunter  blasts Insurer Conflicts on Flood “. Hunter was invited as he is a past federal administrator of the program. His comments indicate the financial incentive is to move the claim to flood in these comments from the article:

“Worse, the insurer gets fees for settling the flood insurance claim that go up as the size of the payout goes up. The temptation for insurers to determine greater flood damage than is justified—and less wind damage—is great. ”

Apparently, Mr Hunter isn’t familiar with the September 21, 2005  FEMA directive on NFIP claim handling expediting procedures put out to  WYO(write your own)carriers which instead limited fees under the 2005 to flat fees if 2 of the 3 claim handling procedures were used by carriers. Here is a copy of that directive. See page 2 for those fees. I’d imagine you could poll any experienced adjuster who could verify the carrier wind fee schedules paid more to adjust serious losses. A bit off topic but it might also interest you to read the Single Adjuster program by FEMA for WYO companies dated in 2005 just prior to Katrina since Mr Hunter advocates for seperate adjusters on the wind and flood program. In addition, staff adjusters that work directly for a carrier are not paid on fee schedules but are normally salaried employees earning a base salary with possibly a daily additional small flat rate per day out on the road plus per diem to cover expenses and meals while traveling. Staff adjuster hotels are located and paid for by the carrier. They do not perform under fee schedules used to compensate independent adjusters brought in to help with the burden of a large influx of claims during major catastrophes. Let me be the first to apologize to the well respected Mr Hunter if I have misinterpreted his comments on incentives to move the damages to flood.

Rebecca Mowbray of the Times-Picayne also commented on the fees in this article in June 2007. I’ve read many other news articles around Florida misinforming or providing incomplete information to  the public on the way adjusters are paid. These are just a few of the examples out there.

While it’s difficult to post carrier wind fee schedules for independent adjusting firms, we’ll use this published schedule  found on the web  by the NC  Joint Underwriting  Association for comparison. This is a typical type of gross damage fee billing schedule where the fee bill is based on the amount of damages which is what Mr Hunter apparently was referring to. This type of schedule is commonly used on losses but the figures on the gross sliding scale differ greatly from carrier to carrier. During 05, I reviewed many schedules and fees for the same amount of gross loss on a major stuctural loss varied from $1,700 to $3,500 depending on carrier for the same amount of damage. Factors included differences in residential schedules versus commercial fee schedules and other issues.

There are component based fee billing schedules that rather than pay based on a gross fee schedule, the carrier will pay based on the item inspected until meeting a dollar threshold such as $15,000 in damage then the schedule moves to a percentage of the loss such as 2-3%. This would include a fee allowance for inspecting the roof such as $150.00, another allowance for inspecting the interior, another for handling the contents,etc. I don’t have one I can find on the web but this is a common practice with some of the large carriers and adjusting firms.

There are daily rate schedules often used for adjusters such as inside adjusters, reinspectors, claim managers and adjusters remaining to handle reopens on files which occurs frequently on claims as insureds get in higher estimates in from contractors due to market price increases or supplemental damage to roofs and interior leaks as new rain storms happen prior to completing repairs. Here is an example of daily fee rates on page 8 in this  publicly posted Citizens FL RFP manual for adjusting firms servicing their claims. Note also this includes a gross fee schedule on page 7 and time and expense billing information found on page 8.

Don’t overlook other limitations and additions to these fee schedules. You can see an example on Citizens schedule above which are common with carrier fee schedules such as the limit on this one to hold the reinspection allowances (good luck finding adjusters to handle reinspections for new damage to $50.00 and only if it’s new damage- they apparently aren’t thinking ahead to the fact an adjuster staying for clean up handling reopens for other adjusters who have left will not reinspect a claim for free when it’s a case the original adjuster missed damage in their scope….that’s why you move adjusters staying behind to handle reopens to a daily rate!). There are allowances such as shown on this schedule for steep/two story losses due to the extra training and equipment needed for rope and harness qualified adjusters.

Time and Expense billing is another fee schedule option used by some adjusting firms to handle fees. You will often find this type of fee arrangement on large commercial losses, daily claims, and liability losses. Here is an example from an adjusting firm publishing theirs on their website. Normal ranges seem to run between $65.00- $125.00 per hour with other allowances for expenses such as mileage, photos,etc. while the one above for Citizens allows $58.00 per hour. We ran into this in 05 with the state of LA wanting to pay only $50.00 per hour on some large commercial claims ( I’m not sure how that story ended).

Should insurance news reporters come across these type of published fee schedules they don’t seem to have any idea of how those published figures are then distributed to adjusters so let’s discuss some of the fee schedule deductions for adjusters.

All fee schedules are not handled the same. Some carrier fee schedules are the same for daily and cat claims. Some carrier fee schedules have different rates depending on the strength of the storm such as a Category 1 or 2 being X schedule while a Category 3 or 4 brings a higher fee schedule. Supply and demand of catastrophe independent adjusters plays a part in the reason for these different allowances by severity of the storm. Carriers also differ on full versus partial assignments further limiting an adjusters income when the carrier handles the contents and additional living expense and other claim components that independent adjusters used to handle for them. Carriers and even adjusting firms are in greater numbers using preferred contractors or unlicensed estimators to scope the damage at much lower adjusting fee allowances for scopers with their staff adjusters settling the claims although the staff adjuster has never viewed the damage or personally met in the field with the insured.

First there is a fee split. The adjusting firms typically place the fee schedule split in their contracts with adjusters. Typical fee splits are 60% to the adjuster and 40% to the adjusting firm. Daily claim (non catastrophe losses) may be less to the tune of 50/50 splits. Some firms do reward the more senior adjusters by paying a larger fee split such as a 70/30 split to retain a more experienced staff. Last year, newer adjusters advised  many of the firms were offering them 40% of the fee schedule due to the increased need for trainers, helpers, and additional management needed to supervise less experienced adjusters.

In addition to deducting the adjusting firms percent of the fee split with the adjuster on the damage, firms vary on what miscellaneous expenses they also take a percentage of on photos, mileage, gas allowances and the like. Adjusters need to be sure this is spelled out in their contracts. This can make a remarkable difference in an adjuster’s gross income.

Adjuster expenses are much more than the public can imagine. Here is a great outline on expenses an adjuster incurs annually to work on the road as a catastrophe adjuster found on a catastrophe training firm’s website. You have to remember these dedicated adjusters are seeking out of town housing facilities under the worst possible of conditions when insureds are also seeking temporary housing when their homes are damaged. While carriers pick up the tab for housing for their staff adjusters, independent adjusters must pick up their own tab. I have personally driven adjusters around for days after Ivan seeking any possible location to house. During 04, I actually slept in our small cat office on a lawn chair for six weeks joining a local gym nearby to go in and shower each morning before the support staff came in for the day. We do what we have to to handle insureds claims- stories abound on just such deplorable living situations for independents trying to find housing the first few weeks of storm while still trying to meet quotas carriers set and deadlines the insurance department sets for carriers. There are few exceptions when housing may be paid for an independent manager or as the Citizens schedule shows per diem allowances may be made to Q & A reinspectors,etc. but the norm is for an independent to pay their own housing running into thousands each month. The expense problem is compounded by the fact independent adjusters go 30-60-90 days or longer before seeing their first dime due to the delays having closed files reviewed and approved and the lag time from carrier payment to adjusting firm who then passes the split fee payment to the adjuster.

Gas expenses are  also becoming a major issue for field adjusters with gas in the $3.00 range even prior to a major storm hitting. Here’s the headline from an AM Best special report A.M. Best Special Report: U.S. Hurricane Catastrophe Review — One Blow Away From $10 Gas in May 2007 – here’s a quote from it:

“A Category 5 storm moving on Houston through the northern Gulf would dwarf energy industry disruptions from Katrina and Rita. Forty percent of U.S. refinery production could be shut, as well as nearly all offshore production facilities. In the short term, a spike in gasoline prices proportionate to that seen as Katrina targeted the Gulf and made landfall would take the national average for all grades within striking range of $5 a gallon. In a protracted disruption to supplies, $6 a gallon or more would not be out of the question.”

Here is also another article from CBS4 News indicating that FL now requires generators at the gas stations which may further drive up gasoline costs.( Adjusters should keep this link as there is a link to the stations that will have generators should you have to go there on storm duty).

This article found on the Fl Dept of Financial Services site reminds us of other problems adjusters faced with fee schedules in 04 with the firms who did not share the carrier schedules with the adjusters who were underpaid based on the fee split type of billing. Luckily, the RFP’s  for this carrier are now published and adjusters should not experience that issue this year.

We need to do our part in helping educate the press so the real facts and issues regarding adjuster income is known. The time to remain silent is over. I’ll refer everyone once again to the reality of adjuster’s income in this Claims Magazine article here. The title Overworked, Underpaid, and Under Appreciated accurately describes the real world of adjuster workload and payments. I hope you’ll take the time to look this over. Share it with a reporter when you see articles misinforming the public to help educate everyone on the realities. We are getting bad press and need to work to enhance understanding of our jobs in the media.


Splish Splash don’t go takin’ a bath- Understanding independent firm contracts

August 12, 2007

 I love the way music so aptly expresses so many things going on in life and love to use songs that help express issues much better than words ever can.  It’s a light hearted way to remember a principle we’re trying to drive home for  adjusters. Last week, our claim song of the week was Peter, Paul, and Mary’s song “Where have all the flowers gone” as our theme song for adjusters on “where have all the claim files gone ” here in this blog. This week we’ll talk about splishin’ and a splashin’ out on your new assignments and delving through the terms in many independent contracts. Here’s the link to the Splishin’ and a Splashin’ lyrics so you can follow along!

Every storm season brings out some of the best and the worst of adjusting firms and  contracts. We hear of adjusters “takin’ a bath” on their fee payments over some of the contract issues and non payment issues going on with hopefully a small number of unscrupulous firms.

Here are links to two very good commentaries on contracts. The first  here  comes from a blog entry over on CADO made by a senior adjuster and this article  by Donny Greer of Gulf States Training at the University of North Texas who shared this article with us over at ClaimSmentor with permission to post it in our blog :

Selection of a CAT Firm or CAT Claims Company

by:  Donny Greer of GulfStates Insurance Training at University of North Texas

http://www.adjustereducation.org

CAT Firms or CAT Claims Companies come in all shapes, sizes and flavors.   Not to mention their expertise levels and experience in running a real business.  
This type of business model structure brings out the best of  people and unfortunately the worst.  

Here’s what I am saying:  

These types of firms are generally started and run by professionals who are truly educated and experienced in both business and the insurance field with an emphasis on claims processing.  By and large, these firms are honest, forth-coming, and are personally chartered to “do-the-right-thing”.   But as you know, each and every field has its wolves!

Firms that process claims for insurance carriers earn their keep by accepting under agreement a claims assignment report containing many claims, from ten to five hundred, maybe even into the thousands as is the case during a major storm.   These claims could be auto, home, business and even in some cases casualty claims.  These homeowner types of claims are then farmed out (contracted) to Independent Adjusters whom are then sent out on the adjustment path to glory.  At least that is how it starts out.   

When I/As (independent adjusters) take on these claims, they likewise do so under the control of a contract offered to them by the CAT Firm (firm).   This is where things can first start to erode.   First, you receive a call from some firm with whom you have earlier registered with.  Next they ask you to go to the distant site.   With all your excitement, you’re off and running.  Now all seems well.   

Soon on the site, you are usually required to attend a Storm Meeting held by the firm with the goal of orientating new adjusters.  This meeting is quite beneficial as this is the place where all information is conveyed to the adjusters now on-site.   Miss this meeting and you miss the boat on policies, procedures, introduction to storm support personnel and so on.  Sometimes unscrupulous CAT firms purposely wait until you are at the storm site, and have incurred expenses before they present you with a contract to sign.  Don’t sign, and you must go home.   Could this be a contract signed under duress?  

What? you Say! 

Any contract is necessary for you and the firm you are working for, as it is the sole document that list out your agreement to provide services and spells out expectations of both parties.   This is a good thing as Martha Stewart has Said a few times.   The problem is not all firms are looking out for the adjuster’s best interest.  Read on… 

Most of the better firms out there are good, honest and looking out for the adjuster, and ask the adjuster to sign the agreement prior to deployment and before you the IA incur expense, but some, want you to bring in money for them, and under a very strict agreement written with mainly their interest in mind.  These firms however, are only concerned with a fast buck, and a BIG BUCK at that.   

Be aware of any contract wording BEFORE you leave your home for a storm.   Do yourself a favor and read the contract they are asking you to sign, before you invest in doing business with a firm you don’t really know.   Never wait until you have arrived in Ft. Lauderdale, entrenched in a hotel, in debt. for a new laptop computer, and then review a contract!  Know before you GO! 

In reading the contract, look for clauses where you are waiving your right to sue in court.  Read carefully the section that covers the adjuster’s hold back portion (portion normally held back by the CAT firm until all claims have been paid and settled).   Know this percentage BEFORE you travel and begin working.  Holdback is normal and there is nothing wrong with this type of arrangement.   Just be aware of how a contract might address such an issue.    

Again:  KNOW WHAT YOU ARE SIGNING  AS BEST YOU CAN. 

CAT firms bill the carrier based on the gross amount of say one of your claims.   They publish to you a fee schedule showing how you earn a percent of the billing amount.   The billing figure being an arbitrary figure listed on the fee schedule.  Shown as a split, in some cases 40/60 with 40% for the firm and 60% for the adjuster.   One question that comes to mind is what is this percent actually a percent of?  It is a percent of what the firm says they are billing the carrier for the claim.  Fact is, you don’t really know the true amount of the billing from the CAT company to the carrier, only what you are shown on the fee schedule. Your fee schedule only reflects your percentage of some listed amount published for the sake of the fee schedule’s completeness.  You are only allowed to see and know what some limited number of these firms want you to see.   

Keep this in mind when shopping for a firm to work for.  A 40/60 split sounds good, but your 60% is 60% of what?  You should know this answer  before you get engaged with a firm and way before you travel on your dime to a storm site.  You just might be working for pennies, not knowing it, and lining the pockets of some unworthy CAT Firm.   Be wise to Check-It-Out.  And beware of ads that solicit adjusters with talk of 70/30 and 80-20 etc., etc., etc.   Without you knowing what this percentage works against, you might be actually working for less that other adjusters with splits of 40/60. 

Speak with other adjusters on adjuster web sites that post experiences from other more experienced adjusters.   Join some web site forums and ask other adjusters who the good companies are.   Check with the Secretary of State’s office in the state the CAT firm resides to see if they are in good standing as a corporation.    

The best way to check out a CAT firm is to ask seasoned adjusters on portal website forums.   Trust what they tell you,  its better information than no information at all. 

Watch out for CAT firms!  Most are good, but try not to get so absorbed in deployment, that you forget to tend to the basics of being a good business professional.   

Any truly good company would have no problem at all allowing you time to review a contract prior to deployment, and any truly good company would invite any questions you may have about their structure, their officers, and how long they have been in business.  

One more time:  MOST ARE GOOD AND HONEST. 

Donny Greer
Donny Greer of GulfStates Insurance Training at University of North Texas 

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Our Blog continued below:

Don’t go out their “reelin’ with the feelin’ and a movin’ and a groovin’ with your excitement at obtaining placement on a roster or receiving new assignments without getting this most important document finalized.

Already this year we are hearing from adjusters receiving independent contracts faxed or emailed to them that contain “blanks” in the contract forms for important things such as fee splits, holdbacks, etc.  We have reports from one group of adjusters attending recent seminars for carrier certifications that could not find one person in the adjusting firm office or at the conference that even knew who signed contracts for their firm nor could the adjusters get copies back signed by an AUTHORIZED person with the adjusting firm. The firm had no idea where they were filed and they were not with the adjuster’s personnel records they sent in.  We have other adjusters being told ” that’s ok on the blanks- we’ll fill those in later”.    Now what does that tell you? Hello????????

One of the concerning contract terms in many of this year’s contracts concerns fines assessed back to the adjuster. We haven’t seen any yet that spelled out what exactly those fines were or the dollar amounts involved although I’ve heard there are some out there with specifics. The Citizens FL RFP manual for the adjusting firms does outline the many $1,000 fines to be assessed to adjusting firms yet the companion independent contracts the selected vendors have that we have viewed only indicated “any fines assessed will be passed on to the adjuster” type clauses. You need to have specifics in writing.

How about the non compete clauses? We saw one firm’s contract last year that didn’t allow adjusters to work for any other adjusting firm in the Southeast USA for 2 years! You need to check with your attorney regarding the validity of such non compete clauses in your state. I see many postings from adjusters giving advice about those “not holding up” in court. We’ll see. I’m monitoring the development of a suit file right now over in Alabama that was recently filed in June and we’ll link to it as things develop beyond the initial complaint and answers as well as searching for other cases involving adjusters and adjusting firms. We welcome any links if you are aware of any others.Don’t believe that the firms won’t enforce them! They are there for a reason and you need to abide by these contract agreements you sign.

We are looking for a good employment contract attorney willing to volunteer some time to look at a few of the examples of contracts we have to provide some general advice to adjusters if you know of anyone interested.  We’ll post their advice and links to their services both here on our blog and in the ClaimSmentor forums.  We are seeing simple contracts about 2 pages long to hearing reports of some in excess of 18 pages long. BE CAREFUL about what you are signing.

We recommend you seriously consider these terms in contracts and consider running all contracts by your attorney. I am not an advocate of “forum advice” posts being your sole venue of information on something so important as an independent contract. In my never ceasing quest to get insurance carriers and state insurance departments to help protect adjusters, I’d like to suggest if they aren’t doing so that carriers exam the independent contracts that adjusting firms give to their adjusters. It is not enough that the carrier sign a contract with the adjusting firm outlining their expectations but they should get involved in making sure that independents are not being taken advantage of in the independent contracts with the adjusters. Is it the “employee” versus “independent issue” keeping them from doing so? If so, state Insurance Departments need to establish acceptable standards for acceptable terms adjusting firms can use and have a published area on all state insurance department sites that list adjusting firms and their complaint ratios just as they do for consumers to determine what a carrier’s complaint ratio is before buying an insurance policy. I have a real problem with the fact a carrier has first hand knowledge of firms they have fired for poor claim service yet where do they publish that information for other carriers to avoid using them or for adjusters protection in accepting assignments for such a firm? They would fear being sued I’m sure but if the Department of Insurance required this they’d have to report it. I cannot stress enough we need to improve the communication gaps in the independent adjusting community for the protection and preservation of our careers.

Effective dates, Hold Harmless terms, Fee Schedules, Fee Splits, Payment terms (before or after carrier pays?), Witholding provisions(how much they withhold as well as how long), Non Compete Clauses, Venue (City/State/Court?)for where any disputes are handled, Other provisions such as Arbitration of Disputes, Fines to be assessed to you, information on who provides the Errors and Omissions Coverage, and many other important terms.. Seek your attorney’s advice BEFORE signing such provisions if you are in doubt.

We have many adjusters who sign contracts but then do not ask for a copy of the contract back after an AUTHORIZED person with the firm has signed it. We had a large group of over 30 adjusters working for one firm in 05 who could not pursue legal action for non payment on over 90 days of work as they had never gotten back a signed copy of their contracts showing any agreements between them and the adjusting firm. ASK for a copy of the Independent contract up front before you leave home as Donny points out above. If the vendor tells you they will sign them at the induction center, make sure you have two original copies with you and sign both and request they sign both and take one with you and keep it in a safe place in case you need it later. This will help you  avoid running into those situations where the “gathering” place has no facilities or staff to give you a copy on the spot.

Don’t assume because it is a large well established adjusting firm that you are safe signing their contracts. We have reports from several adjusters that contracts they assigned with a large vendor signed for Katrina duty contained 60% fee split agreements yet the payments received were 40% and they were then told that the 60% only applied to experienced adjusters. I’m curious if this would hold up in court since the fill in the blank could be twisted on the 60/40..is that 60 to you or 60 to the adjusting firm….we don’t know if it’s not specified in the contract right? Folks, that is not what their contract said. Make sure the fee split does apply to YOU and not termed “in general fee splits are….”.

Go movin’ and a groovin’ this storm season with the comfort of knowing you are protected if you encounter one of the tough situations with a non paying adjusting firm. Splishin’ and a Splashin’ just isn’t the way to handle business contracts professionally! Put those “dancin’ shoes on” AFTER you have properly prepared for accepting new assignments! We hope you will pass the word on to other new adjusters so they don’t go “takin’ a bath” this season!


FAQ and Current Job Opportunity Info/Catastrophe Roster opportunities August 2007

August 11, 2007

Update 9/13/07- Here is a link to our latest Job Opportunity classified ad.

Below is our latest ad for roster candidates and for adjusters wishing consideration for upcoming catastrophe and daily claim assignments. We mass mailed those on our rosters the past two days. We had several (30 or so) emails bounce back due to out of date emails so we are posting the information here for those viewing our site. Please send us an updated resume with your new email address if you did not receive our recent mailing and know you’d previously submitted your records for consideration. We are also updating all of our records and request those who have submitted a resume longer than 6 months ago send updated information. Thank you.

Since we moved to this new blog, our old FAQ posting is no longer up. Just to be sure everyone understands our process this is our normal routine:

1) We handle staffing requests received from independent adjusting firms for catastrophe and daily adjuster assignments. We also handle carrier requests for permanent staff adjusters for carrier operations. Once a staffing request is received, we sign a contract with the adjusting firm and/or carrier to solidify the staffing request whether it be a one time request for placement candidates or time sensitive requests throughout the year as new needs arise for them. Some firms use us exclusively to handle all requests while we work with others side by side to compliment their own firms staffing as we have access to candidates they may have difficulty finding as we advertise on many boards constantly that many cat vendors do not utilize. We do not conduct the background checks at this time for these firms. Our contract is clear that all background checks and credit checks are handled by the requesting client to keep our costs extremely reasonable for them. Our services can range from anything as simple as mass mailing their offers for seminars and job openings all the way to extensive services up through induction center activities for our arriving adjusters at their operations.

2) We do NOT charge a fee to our adjuster and management candidates. All fees to Dimechimes Corporation are paid by the adjusting firm or carrier. To their advantage, we do not charge them a portion of your earnings on the fee schedule. We charge a one time flat fee at the time they sign a contract with you. We are one of the only firms we know of that provides a guarantee on our candidates providing them a replacement should they not be satisfied with a candidate we submit.

3) Once we receive a staffing request, we notify the adjusters and managers on our roster lists so they can consider the opportunity and have first option. We will also post on job opportunity boards such as Greatinsurancejobs.com and Claims-Portal.com and CADO from time to time to refresh our candidate lists but prefer personal relationships with those who submit resumes to our firm as first priority. Note that we will obtain a copy of the adjusting firms independent contract and fee schedule at the time of the staffing request so you may consider the opening once we have confirmed you meet their qualification requirements. We have them tell us how many years of experience they require and what software and carrier certifications you must have with each staffing request.

In our first year, we did learn a tough lesson that alot of firms would make staffing requests only for roster building purposes. Thus, we no longer handle such requests requiring a security deposit on staffing requests to document the seriousness of their intent to contact and utilize our candidates which should help everyone on our rosters understand the postings are genuine. We had a few cases where vendors would solicit our services then take months to contact the candidates and/or later change their mind regarding opening a slot in a given territory leaving us and our candidates waiting for information. We hope to avoid any of those chances in the future and have seen improved more prompt results with our new processes during late 06 and 07.

4) Should a candidate be interested in our opportunities, they should refer to the Opportunities tab on our website at to be sure they include all information we need to submit them as a candidate. Remember we are a staffing firm and we must pass your information along to others.

5) Once we review the list of candidates who have expressed interest in our openings, we will go through their resumes and select the candidates best meeting the staffing request for consideration by the vendor managers. They will notify us who they are interested in interviewing. We do ask that they contact you back within 2 weeks of our submission for preliminary interviews. The process time is normally much quicker for catastrophe requests than daily or staff opportunities.

6) Upon selection of the candidates to be offered independent assignments and contracts, the vendor notifies us for our invoicing purposes. We ask that adjusters selected also notify us immediately upon receiving assignments.

7) We do ask our candidates in exchange for our free services to them that they not refer other adjusters/managers to the vendors as this would circumvent our staffing firm fees. Should you have others interested in these opportunities, please have them submit the required resume and references to us  and let us know you referred them.

8) If you ask why use Dimechimes Corporation? We do not require exclusive contracts with us. We can enhance your opportunities by alerting you of new opportunities vendors share with us. There is no obligation to accept these positions. You will be notified of the vendor or carrier involved BEFORE we are submitting your resume/references to them for consideration in the event you have a conflict with that firm and do not wish to proceed further in the candidate selection process for that company.

9) The independent contract you sign is between you and the adjusting firm. They issue all payments to you. While we would not staff for a firm known to have a negative reputation in the adjusting community, it is just as difficult for us to locate information about various firms as it is for adjusters. It is up to each adjuster/manager to do their own research on vendor feedback and reputation as your contract will be handled based on your own investigation on these firms. We will share with you what we do know if you are considering a position they have to offer which we are staffing for.

10) If you have not signed an exclusive contract with the adjusting firm, we will continue to keep you on our rosters so you will be aware of additional openings. Many times, independent firms do not have enough work to keep you busy full time and do not mind your handling additional claims for other vendors. If you have signed an exclusive contract, you can simply ask that we place any further referrals for you on hold then let us know when you wish to become active on our rosters again.

11) We staff for independent and staff positions only. We do not staff for public adjusting firms but there are numerous sources you can check on the web if you are a public adjuster looking for assignments.

12) At this time, we do not share our Dimechimes Corporation staffing rosters with ANY firms. They only receive the resumes from those who have confirmed an interest in a particular job opening. Should we later decide to have open roster services, you would be emailed to express or reject  interest in participation in that type of service as we will not post your resumes for others to see without your agreement to do so as we understand you do not wish to destroy relationships with vendors you may be servicing at this time.

The participants at ClaimSmentor ,which is our online community for adjusters, claim managers, adjusting firm hr staff,etc do have an open roster which participants choose whether or not to participate on. In that case, vendors participating on that site can view those participants resumes. This includes many vendors we do not staff for who would receive exposure to your resume. The registration information and all resume records for ClaimSmentor participants are seperate from those at our staffing firm so you would need to apply to ClaimSmentor should you also wish to join there. Dimechimes Corporation is the founder and sponsor of ClaimSmentor but records between the two operations are not shared. We have hundreds/thousands of adjusters participating on the Dimechimes staffing firm rosters who are not participants at ClaimSmentor.

Feel free to contact us anytime you have additional questions. You can also feel free to post questions of a general nature in reply to this blog entry and we will reply in this forum blog.

Here is our latest job posting found  at www.Claims-Portal.com:

Independent Adjuster and Independent Claim Managers needed now
Dimechimes Corporation, a nationwide Claim Recruiting and Staffing firm provides assistance to Independent Adjusting Firms and to Carriers for permanent staff adjuster job opportunities. All fees are paid by the Adjusting firm or Carrier with no charge to our candidates.We have current openings in August 2007 for the following:Independent Aviation Claim Manager-includes salary,bonus commissions, and fee schedule assignment potential. Candidate must have experienced marketing adjusting firms to carriers.Independent Yacht/Marine Claim Manager-includes salary,bonus,commissions, and fee schedule potential. Candidate must also have experience marketing adjusting firms to carriers.Marine Adjusters with a minimum of 3 years of experienceAviation Adjusters with a minimum of 3 years of experienceCatastrophe Adjusters to work Citizens FL claims with 2 years of experience minimum required

Independent Adjusters to work Daily claim assignments- new opportunities regularly nationwide

Two Claim Sales Marketing Manager opportunities- Must have prior established marketing experience to work as liason between adjusting firms and carrier executives.

Catastrophe Adjusters with a minimum of two years experience to work miscellaneous assignments through vendors during 2007 Hurricane Season.

We have specific information we require to consider candidates. Those requirements are listed here:


Resumes for qualified candidates only are welcome to Debbie@Dimechimes.com. Stop by and visit our newly launched Adjuster information blog today at www.dimechimes.wordpress.com

Here is a copy of the mass emailing to those on our rosters:

To:  Dimechimes Roster Candidates

Re: Current Job Opportunities

Visit our newest ad at www.Claims-Portal.com here http://www.claims-portal.com/clps/clitem.cfm?adsid=223 listing current opportunities

Our most pressing needs include:

Marine Yacht Division Claim Manager to handle carrier market for adjusting firm as well as manage marine adjusters. Position pays salary, bonus commissions for business brought into the firm and fee schedule claim handling assignments. This is a new marine division you will be establishing for a major vendor. Minimum 3 years of experience. We are also looking for experienced marine adjusters.

Aviation Division Claim Manager- same as marine division with the exception this requires an Aviation claim background of 3 years minimum. We are also looking for experienced aviation adjusters.

Two Claim Marketing Manager job opportunities. Must have prior experience handling adjusting firm marketing directly with carrier executive level operations. Pay includes salary plus commission.

All other opportunities are also listed on the job opportunity link above.

We look forward to hearing back from you should you qualify for these opportunities. We will continue to notify you as new opportunities become available. Just let us know should you wish to be removed from our roster mailing lists. If you have received this more than once, it would be due to the fact we have you listed on multiple rosters meeting your background so we apologize should this create concerns from your end.

Other information adjuster information in the news:

Visit our new Adjuster Information Blog at www.dimechimes.wordpress.com

Have you seen the new 8/1/07 Citizens information to the task force on new adjuster training initiatives? It’s linked to in our 8/9/07 blog entry for you.

Best Regards,

Deborah Moroy,AIC,IIA

Dimechimes Corporation

www.dimechimes.wordpress.com