Claim Career Coaching/Consultant Services for New Adjusters

September 29, 2007

It’s amazing the thousands of new adjusters with license in hand that have no idea what’s next and how to proceed with gaining either employment as a staff adjuster working directly for a carrier or what it takes to get assignments as an independent adjuster. Getting your adjuster’s license is just the first step of many important steps in the area of training required to move forward in your career in claims.

We constantly receive resumes from folks who write us “licensed, prior construction experience, ready to work” having no clue that the license does not prepare you for the specifics required to successfully  process claims.There are detailed file requirements which must be met to have files approved. For a property adjuster, this means estimatic software training, contents training, additional living expense training, training on carrier expectations on building estimates so you understand carrier general guidelines on things like matching, line of sight issues, and much more along with much detailed policy training so you properly make coverage determinations. Construction knowledge is important but only a very small part of the information you need to know to properly handle claims. It isn’t the folks just with construction experience but also those with agency backgrounds, accounting backgrounds, business adminstration,etc who also think that license in hand they are “ready to go”.

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Obtaining your adjuster’s license provides you general information on state insurance regulations and ethics for adjusters, general coverage terms and insurance basic definitions but no where in the license training do you learn the specifics of claim file requirements, training on proper correspondence to be used, file documentation, what claim forms are used and how they are handled, and complying with fair claim handling practices so you are not the cause of litigation against the carrier and against you for “bad faith” claim handling by not complying with timely claim handling procedures along with proper coverage determinations.

Much too often, we read posts in many claim forums about new adjusters learning from forum posts. While the forums are definitely interesting, there are many folks who are giving advice that have not held HR positions with carriers or with independent firms. Many have not held management positions and been through interview training or planning sessions about current hiring guidelines. Many others may have staff only backgrounds or independent only experience and may or may not have management experience in either so they do not have a full perspective on carrier or adjusting firm HR hiring plans other than what they or their buddies have experienced which can be different for each person depending on when they entered the industry and what was going on with claims volume and supply and demand of adjusters at their time of entry into this business. I am not discounting forums for they provide sources of networking and learning about some important things from the current event side of things but they are not something I would strictly rely on for such important decisions as a life altering career move.Things in our industry are constantly changing and you need to spend individual time researching current opportunities so you aren’t lead astray by reading of past practices for hiring when the industry is presently in a mode of change on where employment opportunities exist.  Here are links to our prior blogs where we investigated such issues as “Where have all the claim files gone”, “Are adjusters Fungible Billings Units” and “Are Independent Adjusters a Dying Breed”. Here are links to these blogs about changes in the claim adjusting community  here, here is  a link to the 2nd one and the 3rd one here. Listen folks, you need a clear road map to success in this business. Hit or miss postings in claim forums do not prepare you for the requirements of the job.

 Carriers require staff adjusters participate and successfully pass basic claim schools that generally last 2-3 weeks that teach just basic property and liability policies so you can properly understand coverage for the basic property coverage for a homeowners, mobilehome, and boatowners policy then intermediate schools follow which also last several weeks for more training on liability issues and more advanced training on commerical claim policy training as well as other residential and commercial estimating schools. All of these claim schools are followed during your career by excellent ongoing seminars the carriers sponsor for all kinds of topics like taking statements, properly handling written communication and letter writing skills to properly communicate with insureds, and seminars by attorneys teaching you about the issues that lead to lawsuits so you avoid them. I could go on and on about the value gained at these schools you attend as a staff adjuster. Looking back, just the first 3 basics schools we were required to attend were 3 weeks each for a total of 9 weeks in class. The career path for a staff adjuster generally takes 5 years of combined training and field claim handling before you are considered a claim specialist and considered to have the knowledge and background to handle all types of basic property and liability claims.

Unfortunately, independents are relying on many 3 day classes and in some cases 1 or 2 day seminars at independent adjusting firm seminars to learn a myriad of things like estimate software and file requirements. This is totally insufficient. The problem lies in the fact there is no clear path for independent training. There are some excellent schools available but you have to know what schools those are and what is available, what will add value to your skill set and what is considered of value by adjusting firms and carriers when they review the thousands of resumes received. There are some great claim conferences you can attend and others that are a waste of your hard earned dollars. During our online classes at ClaimSmentor, I hear regularly from independent adjuster trainees who have spent thousands (some $10,ooo or more) that tell me things we teach in our online 40 hour Fundamentals of Claims class that they have learned very basic things in our class that they have not been taught at these hit or miss seminars. I don’t know how they could work claims without these basics. It does no good to obtain assignments as an independent if you are just going to get sent home due to failure to properly handle claims. We’ve even had numerous folks who worked Katrina claims that tell us they wished they’d had this training prior to being “thrown to the wolves” when adjusting firms were too busy to concentrate on training during one of the worst storms in history. In our forums, I’m amazed to learn that even today when things are mild on assignment volume that new adjusters are being given daily assignments for fire losses, theft losses, and liability claims without the first instructions for where to begin or what is required in the file.

We offer several basic services and will be vastly expanding on those services in 2008 as we move forward in our efforts to enhance the career path for new independent adjusters. It is important for all of us in the independent adjuster arena to improve the image and skill set of those entering our industry if carriers are to continue to use us.

So where does a career consultant for claim career coaching fit in? The ideal situation is to spend  time with a claim career coach even before you take your adjuster license classes to make sure you understand the extent of commitment required to continuing education both from an expense standpoint and from a time commitment. If you’ve already obtained a license and don’t have a clear understanding of “what next” then it is well worth the investment of your resources to have a career planning session to set you on the right course. We walk you through a road map to success in your career so you know the expectations, the opportunities for training and employment/ deployment with adjusting firms and carriers. There are different paths you would take depending on your educational background, the budget you have available for taking classes and claim schools, and the time you have available around your current job to be out of town for schools. There are online training options, self study programs, field classes, field conferences, and many options exist in each area of claims depending on your interest in homeowner, auto, marine, crop hail, or multi line adjusting. We stay in tune and up to date on what is available both from a training standpoint and an employment stand point with an unbiased opinion since we are not affiliated with an adjusting firm or carrier which many are concerned about as they are not sure if the plans given are an effort to obtain their training dollars versus training that will bring them more opportunities with all firms and carriers. There is a difference.

During our career coaching sessions with you individually, we review your background in depth to determine what the appropriate path and options are for you. It is not a one size fits all path but to determine where you can fit in within the claims industry and goal setting strategies to help you achieve the most reliable training out there within your  budget so you can achieve your dreams of successful employment. We’ll review your resume and make suggestions for improvement if you choose to include that option in your career coaching sessions. There are ways to stress your strengths to improve your resume as a new adjuster so you do get noticed and not just overlooked as one having no experience. If you missed our blog on resumes, here is the link. We will schedule follow up sessions with you as we monitor your progress and set priorities for your next training goals and your next course of action when applying for jobs with the right carriers and the right adjusting firms that most closely match your career interests. We can conduct mock interviews with those preparing for upcoming carrier or adjusting firm interviews so you know more about adjusting specific interviews and questions commonly asked with appropriate answers to these claim specific typical questions and much more which is customized  with our career coaching services to meet your individual needs so you accomplish your goals. It is time and money well spent so you avoid the pitfalls many are experiencing by random selections for schools, training, and job opportunities.

One of the most important times you should consider using a career coach is when you are making a life altering decision such as  those of you considering leaving a carrier career to go independent or vice versa. I was amazed to really grasp how different the two career paths are when I left the carrier corporate environment in 2001 after 28 years even though I’d managed independents on catastrophes for years. (That is an entirely different topic I’ll blog about one day as things are not what they seem when working with independents as we thought inside the carrier offices…there is alot carriers need to learn to understand these differences….you’d be amazed at what goes on that you don’t see!) If you didn’t read our earlier blog on the pros and cons of each career, here is a link to that blog.

If you are interested in scheduling an appointment for one on one career coaching, email us for our pricing information.

We also will be offering our next 40 hour Fundmentals of Claims class which will be held over at ClaimSmentor  in October 2007. The classes will run on Monday and Thursday evenings from 6-9pm CST online LIVE. The class does require pre-class homework assignments which are posted in our forums which include reading assignments so you understand the topic and question/answer sessions. The class is informative as well as fun. We’ll do REAL life like sessions on mock disaster drills and zoning your assignments to maximize your potential for meeting carrier quotas, form and letter training and exercises, additional living expense training, a contents claim handling session, address communication issues with insureds, public adjusters, and attorneys, estimate reconciliation procedures so you understand carrier guidelines and ways to more quickly assess the estimate differences between your estimate and a contractors, activity log training, and much more regarding carrier expectations on your received to contacted and inspected ratios and inspected to closed ratios so you understand time service expectations and tips on how to improve your statistics and file document submission so you too can eventually become a core adjuster when you learn to perform above the average adjuster. New adjusters are overwhelmed on catastrophe assignments with the extensive requirements when they don’t know these basics. Going live without understanding important basic requirements is surely a recipe for failure but it happens every day when new independents are sent out into the field without proper training during major catastrophes. This course is very time intensive and you’ll need to be able to dedicate a minimum of 40 hours to the course requirements to handle all required reading and homework assignments. Upon successful completion of the course, you will receive a certificate of completion of 40 hours in basic training. This class will compliment some of the training you’ve obtained in the field by providing a much more detailed explanation of file requirements. The class includes field reference guides for you to take out in the field for personal reference when actually working claims as a reminder to information learned in the class.

Should you be interested in this class or other classes on ClaimSmentor to include other courses such as Contents Claim Handling, detailed Additional Living Expense training, Fl Condo Assn Claim handling,  and other classes you will need to register for our forums to take these classes. A link to our registration information is on the About page here on the blog.

Enjoy your weekend! We’ll post more on the tropics later should it appear the many new storms brewing may bring new assignments.

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Independent Adjuster vs Employee?

September 27, 2007

Storm season always brings up the topic “are you an independent adjuster or are you an employee” as independents start receiving new contracts from adjusting firms for the season.

We wrote a blog about the caution new adjusters need to use when signing independent contracts in our blog called Splish Splash don’t go takin’ a bath. Here is a link to it.

While we are still hoping for a great employment attorney to provide an opinion on some of the issues Independent adjusters commonly face, (am I dreaming someone will come forward and volunteer to interpret these things for us as a guest blogger employment attorney or volunteer employment attorney participant)? I’ll post some links to some interesting things we found while researching this topic.

While I’m not sure we entirely understand the issue as it relates to court decisions, we think we’ve come up with a consensus that the issue relates to “independent judgment”  and “control” issues vs whether or not you or your adjusting firm considers you as an independent.

The majority of independent contracts the adjusters have shared with us state the adjuster understands they are a 1099 reporting independent but there are several such as ASU which states on their website here that their adjusting firm is 100% employee owned. I had the opportunity to meet several of their members at the 2007 NACA convention and find this approach most appealing for adjusters to have benefits, educational assistance, 401K plans and many other benefits independents normally don’t have access to with the majority of firms. Do you know of other firms providing employee status vs independent? It would be great to hear about these opportunities via reply to this blog if so!

I found an interesting site called The Society for Human Resource Management (SHRM). Here is a link to their website. They say they are the largest professional organization devoted to Human Resource management.

Their website points out that there are many agencies that have statutory jurisdiction over the “independent vs employee” issue. Here’s an excerpt from their site about this:

“The many statutory jurisdictions that cover classification of independent contractors include the Family and Medical Leave Act, the Americans with Disabilities Act, the Internal Revenue Code, the Fair Labor Standards Act, the National Labor Relations Act, and individual state-by-state unemployment insurance codes” thus the comment above about not being sure we understand all of the issues because there are just too many federal and state laws involved in the classification determination.

An employment law attorney and member of their site addressed the House Labor and Education committee on July 24, 2007 stressing the need for guidance for employers to properly classify employees due to the confusion with all of the programs listed above. Here is a great article about her testimony. I think the following statement in her testimony best addresses the problem independent adjusting firms, carriers, and adjusters face as they create and sign contracts:

“Every new working relationship brings with it the challenge of asking the right questions to ensure the employment situation is being properly classified as an employee or non-employee worker,” said Walters. “In my experience, employers do on occasion unwittingly, misclassify employees as independent contractors,” she said.

Here is a link to the House Committee July 24, 2007 hearing that includes links to the webcast of the testimony at this meeting and to the presentations of several other speakers to include Paul DeCamp, Wage and Hour Administrator from the Department of Labor. Note that the question in the title of the hearing was “What Policies and Practices Best Protect Workers“. 

Chairman Andrew’s  opening statement is found here  and Chairman Woolsey’s opening statement is found on this link. These are worth the read as they outline the reasons employers may misclassify employees…basically to avoid health insurance and workers comp and other benefits such as social security payments they would have to pay or an employee would be due. From information gleaned in Woolsey’s opening statement, CA considers the problem so significant ( see yesterday’s blog too on CA and adjuster overtime issues) that they have State Assembly Bill S.B. 622 that if passed would assess penalties of up to 15K per violation or 25K  per violation if employers have engaged in a pattern of misclassification. This document here says that this bill passed the Assembly 9/10/07 and the Senate on 9/12/07. Those are pretty hefty fines and I hope that adjusting firm owners have been advised of these new provisions by their employment attorneys and have reviewed these issues as they pertain to using independents for each various operation such as carrier daily branch assist on daily claims, inside adjusters in carrier claim central operations, as well as their classifications for catastrophe independent adjusters especially for the types of contracts I’ve seen that require exclusive work with the independent firm or carrier. Would the use of independents as inside adjusters be cause for concern about classifying them as other than 1099 employees? How about daily assist or daily adjusters working under an exclusive contract? I don’t know but I bet a good employment attorney would know the proper classification. I would also want to know about how a bill such as this one passed in CA would apply to an adjusting firm going out to CA to work earthquake claims. There are many firms holding California Earthquake Certification classes in preparation for an inevitable earthquake out there but have they done equally thorough research into classification of adjusters and if those rules would apply to out of state adjusting firms coming in to work catastrophe assignments? I’m not sure how those laws apply when your working out of state as a vendor vs it being the permanent state of your adjusting firm office.

Paul DeCamp’s testimony found here is longer but if I were an adjusting firm owner, I’d certainly take the time to read this and look at the list of 7 items he calls relevant factors to determine if a worker is properly classified. The one I found interesting the most from the independent adjuster standpoint is the relevant question of “Permanency of the relationship”. Page 2 of his testimony also goes into interesting details about “the process” of reviewing these factors and payroll records and how they conduct their inspections. I had no idea that the Wage and Hour Divisions primary responsibility was dealing with complaints as the testimony says 70-78% of their work is addressing workers complaints on these issues. It is  also very important to read the comments further down on page 5 that says that temporary help is often in the most commonly misclassified category. I’d also read the comments  since this is a national program and the testimony states that they are recommending misclassifications  found by the Wage and Hour Division (WHD) for many other violations for some of the other agencies(listed at the beginning of this blog) that they find value in sharing that information nationally with other state and federal programs(page 6). Pg 7 indicates that GAO feels that employers should be notified when they make these reports to other agencies to investigate while WHD did not think it was appropriate for them to report them due to the fact they do not know the rules nor administer the programs for the other agencies looking at independent classifications. 

Another point interesting to property and catastrophe adjusters would be the comments on page 4 indicating that construction companies are in the group receiving the largest findings of misclassifications. The findings in Decamps report about this are echoed by Sara Stafford with a construction firm who testified that firms such as hers are often penalized by losing contract bids as they include the cost of employee benefits in their estimating costs (overhead and such) when other construction firms improperly classify employees as independents which costs the complying firms work by abiding by the classifications. I imagine this would be the same for independent adjusting firms who would have to increase fee schedules to cover their overhead for employee benefits if they were required to provide workers comp and benefits. Here is the link to Sara’s testimony. I didn’t have time to get to the testimony of two other speakers you can find on the links above.

Other research we found in the past few months includes:

This informational article from the state of Texas on form C-8(0406) found here which contains 20 relevant topics to test your classifications.

Here are some interesting comments on independents here with several more good factors to consider.

I really liked this 20 factor check list for small businesses to determine employee vs independent contractor check list to determine under common law what factors apply found here.

This article here from another law firm discusses NY’s “right to control” factor. It’s an older article from 98 but a good article. This website is full of employment articles at www.ebglaw.com.

Here is a good weblink for IRS information on independent contractors which refers also to links for several publications  you would want to refer to found here on their website.

I found this case from Vermont that the Insurance Journal posted quite interesting from May 2007 where at home workers for a knitting company were determined to be employees versus independent contractors. Here is a link to the article.

It took several days to have time to finish up this blog entry due to weeding out alot of repetitive information and narrow it down to some of the most concise current information you might find useful. The research has been well worth the while as I’ve learned that these issues are not set in stone but very active current topics of discussion, court cases, and federal and state agency hearings and discussions right here and now in 2007. The National Law Journal  at www.NLJ.com on their 9/27/07 article update says this will be a banner year for Supreme court labor and employment cases as they have granted review of many cases in this overview of the article:

September 27, 2007

TODAY’S NEWS

FROM THE UPCOMING ISSUE  |  Supreme Court loads up on employment cases
Besides adding such high-profile issues as the constitutionality of lethal injection executions and voter ID laws to its docket, the Supreme Court ensured, through its latest grants of review, what is likely to be a “banner” year for labor and employment law.

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This appears to be the time for independent adjusting firms to update the opinions from their employment lawyers if they haven’t already done so to verifiy if their current practices meet all of the 2007 regulations with all of these current discussions going on. All Independents are waiting on weather (wow as independents call it) for assignments so while everyone is waiting you might want to take the time to double check the classifications to make sure everyone is compliant with their state and federal 2007 regulations. I am most curious about how the state laws apply when an adjusting firm from one state ventures into other states to handle losses. Are they subject to those other state laws too? This feels like going to college! The more you learn the more questions you have!


Insurance Adjuster Overtime Pay Issues and Complaints in the news

September 24, 2007

I’ve been trying to find time to write about the big ongoing question about adjuster overtime pay and a related issue on the commonly asked question ” am I an independent or am I an employee”.  The new suit brought by two AIG adjusters   in September 2007 again brings this topic to the forefront and we’ll watch this case to see if anything new develops to help us understand these issues. We would appreciate any comments by employment attorneys to help us clarify these issues. Today we will provide information on the overtime issue and tomorrow we’ll blog about the Independent adjuster vs employee questions which we are frequently asked about by adjusters when signing independent adjusting firm contracts.

Here is a link to the news article about the AIG adjusters new suit. Here is also a link to the Bloomberg article on this new suit.It’s not just carrier staff adjusters and employees filing these suits as this article shows adjusting firms are the subject of such suits also in this article saying Pilot Catastrophe  Services  also received a Complaint in 2004. I’d like to know how the adjusting firm case was resolved but could find no information on the web about the outcome of the case.

The AAICP -American Association of Independent Claims Professionals wrote an excellent article on this overtime issue in June 2004 found here. This article in part says:

“Insurance claims adjusters are still exempt from federal overtime requirements under the United States’ Department of Labor, Wage and Hour Division’s final version of the controversial changes to the white collar exemption regulations. As requested by the American Association of Independent Claims Professionals (AAICP), an association of independent claims adjusting companies, the Labor Department specifically noted in the new regulations that claims adjusters are generally exempt from overtime pay requirements regardless of what kind of company they may work for – an insurance company or an independent. The new regulations also make some adjustments to exempt salary requirements that may affect claims adjusters, including raising the minimum exempt salary and creating a new pseudo-presumption of exempt status for higher wage-earners.”

Here is more important information in this article:

“As requested by the AAICP, the new regulations specifically use insurance claims adjusters as an example of an exempt administrative employee:

Insurance claims adjusters generally meet the duties requirements for the administrative exemption, whether they work for an insurance company or other type of company , if their duties include activities such as interviewing insureds, witnesses and physicians; inspecting property damage; reviewing factual information to prepare damage estimates; evaluating and making recommendations regarding coverage of claims; determining liability and total value of a claim; negotiating settlements; and making recommendations regarding litigation.  ”

Please read the full article for other important details.

Here is another article from the AFL CIO which specifically addresses insurance adjusters and overtime issues which concurs with the article from AAICP stating in part:

“Insurance claims adjusters—Again, court cases on whether insurance claims employees receive overtime pay have gone both ways—some courts have said they are exempt and other have said they should receive overtime pay. This is a very heavily-litigated field, and corporations have not been able to win a blanket victory. The Bush Administration has handed them that victory by changing the nationwide regulation to specify that these employees are generally disqualified from receiving overtime pay. (New Section 541.203(a)) A quarter of insurance claims adjusters make less than $35,000 a year. “

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In a more recent case involving Farmers, White and Case provides this analysis of an overtime case in multiple states in this February 2007 article on Farmers prevailing in a case on the claim adjuster overtime issues. Here is the link to their article.

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One of the most excellent articles I could find (here)is  from Holland and Knight in December 2006 which addresses the duties of adjusters who alleged use of computer estimating systems and claim manual among other things took away their individual judgment thus they were entitled to overtime pay. Some important comments in this article include:

 

 

“The Farmers claims adjusters asserted that they were not exempt from the overtime pay requirements because the work that they performed was part of the “production” side of the business, not the “administrative” side. They also argued that because they had to follow claims manuals and guidelines, and use computer programs to determine loss values, they did not exercise sufficient “discretion” and “independent judgment” to fall within the exemption.The trial court found that all of the claims adjusters were doing “administrative” work; that is, that their role was on the administrative side of the business, not the “production” side. In addition, the trial court found that most of the claims adjusters used a sufficient amount of discretion and independent judgment in their work to qualify for the exemption. However, the trial court found that some claims adjusters, such as automobile adjusters and adjusters who mostly handled claims less than $3,000, had to follow so many guidelines and rules that they did not exercise an adequate amount of discretion and independent judgment to meet the exemption”. 

I found this article addressing the size of the claim particularly interesting in light of all of the claim central operations handling smaller losses.

Here is another good article by the Jackson Lewis firm from November 2006 outlining more duties of adjusters and providing more information on the Ninth Circuit ruling that claims adjusters are exempt from overtime pay while noting that CA courts reached opposite conclusions. This brings us to this September 19, 2007 article  here by National Underwriters discussing some recent CALIFORNIA cases where Allstate, State Farm, and Farmers agreed to pay millions on other cases out there. Is this because they are cases in CA subject to other laws or is it because of overtime regulation interpretations prior to the new overtime rules of the Federal Labor Standards Act?

This MSNBC article here from August 2004 explains what changed with the new overtime regulations when they went into force. I’m not an employment attorney so I am not sure of the answer to this question as to why some carriers were settling these cases but it may be due to the regulations in CA differing as an article  addessing several CA cases settled by carriers in Los Angeles Business Journal explains here. 

 Here is an interesting article from October 2006 by CFO.com indicating the 2004 update to the FLSA has increased the confusion on overtime pay and the number of suits filed. Particularly interesting on page 3 of this article is the list of FLSA auditor “red flags” indicating things they look for to see if a firm is in violation of overtime issues such as having all employees on salary versus some time card employees. Adjusting firms should read this article.

The bottom line in all of these articles seems to verify that adjusters are not entitled to overtime pay with the exception of CA (see this 2nd article here from Holland Knight on CA regs opposed to Federal regs) . I’d make sure your adjusting firm is compliant on these issues especially during catastrophe operations when many firms are working employees at the required carrier hours of 7am-7pm 6 or 7 days per week. Check with your employment attorney to verify you have your firm properly classifying your employees and adjusters. There are many new in office programs adjusting firms are participating in such as running call centers, using an increased number of adjusters in claim central operations at carrier catastrophe centers, running additional living expense and contents claim units from their adjusting firm home offices or field catastrophe centers.

Due to the increased number of suits as a result of the new 2004 FLSA decisions as indicated in these articles, it appears wise to get a legal opinion on your overtime decisions BEFORE your firm is subject to such a complaint. Review of this Department of Labor article found here says it best:

 “The status of an insurance claims adjuster, however, does not rely on the “claims adjuster” job title alone.  There must be a case-by-case assessment to determine whether the employee’s duties meet the requirements for exemption. “

In my earlier years as a staff adjuster, we were never paid overtime pay except when moved to “time card” status while attending claim schools as they advised us training status required overtime pay while normal work did not. We were never paid overtime as claim managers in line field units, claim central operations, or while serving as catastrophe claim managers working 7 days per week 12 hours per day. In more recent years when performing temporary catastrophe management duties with independent adjusting firms, they also paid us on salary with no overtime. I can assure you in both staff and independent positions that adjusters normally work far beyond a 40 hour work week to keep up with carrier performance guidelines and Department of Insurance mandated deadlines during catastrophes. This 28 year carrier career was all prior to 2002 with the independent experiences from 2003 to the  present.

 I am curious what adjusters today (after the 2004 changes) are experiencing on these salary, time card, and overtime issues and hope to hear from many of you in reply to this blog. Please list your position, your state of employment, your carrier or adjusting firm, and your method of pay both for regular 40 hours and overtime. Should you not wish to comment in the blog, you can send emails to us and I can post your input anonymously in reply to this blog. We’ll also post this in our  forums at ClaimSmentor for continuing ongoing discussions with our members.


Tropics Active- Tropical Depression 11 forms – Hail in Phoenix,AZ?

September 23, 2007

Tropical Depression 11 is being monitored for development with reports indicating it may reach Tropical Storm status later today. Here is a link to the first advisory.

Ralph’s Tropical weather site is confirming what Fox news is saying that there are numerous other storms being monitored for development. Here is a link to Ralph’s weather site. It was last updated very late last night so check back for regular updates.

The news is also reporting golf ball size hail in Phoenix, AZ last night. The only thing I can find here on NOAA storm reports for yesterday is 1 report for Gila county with 1.75 size hail. There is also a report on there for hail in Fresno,CA. **update-Fox news weather is showing the golf ball size hail photos from Scottsdale, AZ. I couldn’t find anything in the local news reports in Phoenix or Scottsdale news.

We’ll update this later today as things develop. As far as TD 10 went, it made landfall next door in Ft Walton and we had absolutely no damage that I’m aware of in the panhandle.


Possible Tornado in FL and MN on 9/20/07- Tropical Disturbance 93L

September 21, 2007

We received state of FL emergency alerts throughout the evening as high winds and tornado warnings went up in various FL counties as a result of the soon to be expected tropical storm passing through FL yesterday and today.

We are gathering damage assessment reports now on the storms. Thus far, Eustis, FL in Lake County FL is the area suffering the largest amount of property damage. Fox news is reporting only 50 homes damaged with 20 of those being uninhabitable. This will definitely not bring in the need for storm troopers. Many carriers such as State Farm and Liberty Mutual  have regional offices in the area in Orlando and Winterhaven,FL. The great news is there are no fatalities. Here is a link to an article coming from their local news.

There was also a possible tornado and definite storm damage in MN in many counties. Here is an article that summarizes the damage and also indicates they had large hail. Unfortunately, there has been 1 fatality with a 13 year old boy in this storm. Without reading more reports at this time, it is hard to assess what the need may be for independent adjusters but we will update this blog entry throughout the day as more becomes known.

You can continue to watch Florida tornado warnings throughout the day using this link here to state alerts for reports and of course following the NOAA storm reports for today and yesterday by using this link here to storm reports which is constantly updated.  The reports for 9/20/07 in this link do show hail in MN on 9/20 and wind damage reports from several FL counties. The FL county reports are already reporting many tropical storm alerts posted for panhandle counties for  subtropical storm depression ten. The first advisory was posted at 10am CDT.

Note that the Mineral Management Service website is reporting oil rigs and gas platforms in the Gulf are already undergoing evacuations in preparation for 93L possibly turning into a Tropical storm in the next few hours and Fox news is reporting possible tropical storm status or hurricane status later today on 93L currently being investigated. Here is a link to the top story on the Mineral Management website.

I sure hope we don’t lose power here later tonight in the panhandle! I’ll update this today if there are significant updates on damage assessment information from the 2 storms and to 93L warnings and progress today.


Valued Policy Law case in Florida overturned- Update on Mierwza /Safety Concerns-Part 2/Fl Insurance Crisis update-Go Jeb!

September 21, 2007

I’ve got quite a bit of blogging to catch up on after extending my business trip this week to 5 days versus the 3 we expected to be out for as there were many developments in the claims industry during my trip.

For starters- we were discussing adjuster safety in one of our last blogs here and the fact that insurance carriers do not define a weapon in their Code of Conduct forms although they forbid adjusters to carry them. Well, I’m sure glad they did not define it as FAA regulations do! Flying up for our business meeting, the mascara and lipstick were confiscated and coming back the cigarette lighter was! So- I guess things could be worse if we had to live by those restrictions! (Smile) If your an adjuster reading this, you might want to catch up on numerous reply postings over on the topic we posted on CADO (here)about the next opportunity to view “Muffled Cries” on Forensic files which is 9/22/07 at 6:30 PM EST. This is the show about Tampa adjuster, Katie Froeschle ‘s murder while handling a rental dwelling claim. There have been a significant number of replies from adjusters on the Cado forum topic by experienced adjusters who have also faced some pretty tough situations while working claims indicating this was not an isolated situation with Katie but a situation many of us have faced (yes, I have many of my own war stories from my years in the field). The thing that surprises me the most is that many of these incidents happened to male adjusters contrary to my thought that had a male adjuster gone out on the claim Katie did that a murder may not have happened.

The most important breaking news applicable to settling claims comes out of Florida where the Valued Policy Law settlement guidelines for total losses established in the Mierzwa case were overturned. We wrote about valued policy laws and recent decisions in this blog here. If you read this blog, it contains an explanation of the Mierzwa case and how that applied to the FL Valued policy law so just take a minute to read that blog if your not familiar with the case.

While we were out, this case was overturned. Here is a link to the Supreme Court decision on this Florida Farm Bureau vs Cox case. Rather than reinventing the wheel, I’ll refer our readers to the Insurance Coverage blog entry of 9/21/07 here which explains the new decision. Basically, this was a win for the insurance industry as described here in this news article also which in part states:

“The unanimous opinion written by Justice Charles Wells said Florida’s 108-year-old valued policy law was intended to prevent haggling over the worth of destroyed property, not to be used to cover perils that were not insured”

According to this article, this takes the case for the insured back to court now to decide what damage was attributed to wind vs what is flood damage since this decision would no longer allow them to collect policy limits since the major damage was caused by non covered flood damage. The policy limit was 65K and Florida Farm Bureau had evaluated the building damage at less than 12K. The way the Mierwza case stood, the carrier would have had to pay the limits under Valued Policy laws even though the majority of damage was from a non covered loss (flood ..and note the insured did not have a flood policy which amazes me having handled many flood claims myself back in my days as a Santa Rosa County, FL staff adjuster dealing with repeated flood claims on Blackwater river there).

I’m glad to see these recent court decisions both in LA and FL where the courts are upholding policy provisions and the intended purposes of valued policy laws. I wonder how much has been paid by carriers in FL on the Mierzwa case ruling and what this will do to the many other pending cases on these very type of issues.

Wind and water decisions will continue to be tough for all adjusters to evaluate. The consumer groups are being very active pushing for passage of the 2007 Multiple Peril Act being pushed by MS Gene Taylor. It is unfortunate they do not begin to realize what they are pushing for and the ramifications of having wind handled by the government similiar to the Flood policies. I’m going to try to get a blog entry in next week explaining just some of the horrors in the flood policy exclusions such as the 12 square foot of deck landing coverage,etc. I think if policyholders understood the  coverage available in a flood policy better and the extreme limitations in coverage they might be much more hesitant about moving the wind to the government if the wind coverage would be as restrictive. It is definitely NOT consumer friendly nor is it adjuster friendly to understand the flood policy or the many unnecessary forms and procedures by NFIP to handle those losses. I don’t think many pushing for it even realize the flood policy has had a 250K limit on a residential building. In layman’s terms just ask yourself this question- how many homes on the beach can you buy for 250K? Give me a break! I sure hope the wind policy won’t contain such unrealistic coverage limitations. These consumers probably also do not know anything about the news releases last year when the powers that be ran out of funding on the flood claims? I’ll post some of those articles in next week’s blog. 

I am a proponent of having the coverage by private carriers to end this ridiculous necessity for an adjuster to have to determine what is wind and what is water damage providing the appropriate rates can be charged for this coverage. This would also satisfy the politicians and the insurance consumer. None of us …..adjusters or insureds …….like the current exclusions under the homeowner policies. Just think how much easier the life of an adjuster would be to go in and assess all damage and close the file. Better time service on claims and more income to independent adjusters who can close more files! Chubb insurance is one of the carriers already doing so. See their press release from last spring here about their coverage. Why can’t other carriers do the same? I imagine this is a mute question at the moment with the mass exodus of coverage as they non renew and send out policy cancellations by carriers in coastal communities. I’d imagine the need by insurers for engineer’s who help assess the cause of each type of damage would be greatly reduced, the cost to defend litigation on the wind vs water would be eliminated, less claim managers would be needed to manage the litigation and coverage issues, and reduced claims costs for such huge expenses should lead to greatly reduced policy premiums so it would be a win win for all parties. Think of the reduction in Insurance Department complaints when consumers no longer have to argue over the coverage assessments for wind vs water damages! Makes sense to me!  You can’t blame them(carriers)if they don’t want to write the combined coverage no matter how much the public (myself included as a coastal resident) protests with the recent political developments in LA and MS on litigation for non covered flood losses and actions by MS Congressman Gene Taylor and Senator Trent Lott as well as Charlie Crist  in FL who has been a one man torpedo destroying insurance relationships in FL by his anti carrier policies while at the same time throwing out all rating rules for his big push for the growth of Citizens of FL with his rate freezes on their premiums……don’t even get me started on that but watch for a blog next week on more about this issue! For now I’ll leave you with a referral to another Rossmiller Insurance Coverage blog that addressed Jeb Bush’s recent comments about the insurance crisis in FL which also happened while we were gone this week! I’m very glad to see Jeb Bush speak out as he was so respected while in office here. Oh for a return to those days!


Defusing an angry Insured-Dealing with Dinosaur Brain lizard logic thinking co-workers

September 15, 2007

Continuing yesterday’s discussion regarding adjuster safety concerns in this blog, we thought we’d recommend a few good books for adjusters by Albert Bernstein, Ph.D. who is a clinical psychologist dealing with explosive people for over 30 years. His books are outstanding.

Here is a link to his website with many of his books listed and links for purchasing.

Years ago as a staff manager, someone recommended his book titled “Dinosaur Brains” which is definitely entertaining and full of great advice for dealing with troublesome relationships at work with both bosses and co-workers. Here is a link to some information on the book. You’ll love the Lizard Logic and fight or flight information. Here’s a sample of it from his website. It helped me put things in perspective when dealing with some emotionally charged situations with co-workers, staff adjusters reporting to my department, or some executive level managers who drove me nuts from time to time with unrealistic demands and the results were amazing making for a much smoother work life in the stress filled pressured environment we often find ourselves in dealing with catastrophe claims assignments when nerves are shot after months on the road. This book takes a very funny look at difficult work relationships and how to deal with them that you’ll find both informative and entertaining!

We also recommend his book on “How to deal with emotionally explosive People” ….here’s a link. Bernstein has great tips on Defusing Anger  here which provides some good advice adjusters should utilize when dealing with an emotionally charged situation while out in the field or over the phone on claims.

A third recommendation is his book “Neanderthals at Work”..here’s a link which explains the many different types of personalities and motivations people have for getting ahead at work. It’s a must read for career oriented adjusters!

Carriers do not expect you take abuse from insureds using profanity, physical threats, and other forms of abuse. If you haven’t already, you should participate in seminars on dealing with customer service issues. You can’t just slam the phone down on an insured who is spewing profanity or get in a free-for- all out in the field. One of the most common explosive situations occurs when public adjusters try to push a staff adjuster or independent adjuster or manager over the edge. There are professional ways to handle these explosive situations. We hope these books will be a start to a good background in dealing with these issues.

We’ll provide links to some great online classes on these soft skills next week. Many a manager who mentored me as I came through the staff ranks said they would much rather train a person with good people skills on the technical aspects of adjusting than take an experienced employee with poor people skills and try to teach them how to deal better with insureds. After years in management, I’d have to agree with these former mentors. Poor people skills leads to increased complaints to the agents, the regional carrier offices, and to insurance department complaints that can overwhelm any busy manager. I hope to see an increase at adjusting firm seminars about customer service with reality based discussions on the many issues facing adjusters both in the field and in claim central operations. We are working on a self study guide specific to independent adjuster’s on these issues and will post that in the coming weeks.

Other self study guides are available on the training page of our staffing firm website here.

We’ll be back Wednesday for our next blog as we’ll be out of town on business through Tuesday…see you back then!