Citizens RFP for Daily Independent Adjusters -CANCELLED! The “Claims Cheese” is on the move again!

February 13, 2008

We’ve written in prior blogs about the problems Independent adjusting firms and independent adjusters faced over the RFP (Request for Proposal) for Catastrophe adjusters months ago. I’ll post the links to prior Citizens of FL blog entries at the end of this post. We were most hopeful that things had improved on Citizens/ Independent Adjusting firm planning when they posted the RFP for Daily Adjusters. The deadline for completing the excessive amount of forms and information for consideration came and went February 5, 2008.

Well- guess again folks! Citizens cancelled the RFP 2/11/08 per the announcement (Addendum 4) on their purchasing site and the responding adjusting firms were notified by email 2/12/08 that the RFP has been cancelled after much expense and time has been devoted by independent adjusting firms wishing consideration. This also involved the many calls those of us with Florida adjusters licenses received to  “see if we were available” for daily claims by many of the participating adjusting firms as they had to provide numbers of independents they could supply. The indication on the announcement says that they will repost at a later date with new specifications.

It will be interesting to see what the new specifications are after reading the Citizens Board of Governors Board meeting notes from the 2-8-08 meeting (see links to the many documents on the left column of this web page here for the documents. The RFP cancellation notice is addendum 4.

Here are also the 2-1-08 Citizens Task Force meetings notes addressing the usage of independents and TPA’s as well as notes found on the Board meeting notes above. So what is going on here? According to these task force and board notes, Citizens plans to implement a Claim School by March 2008 for their internal staff with plans to complete that training by 3rd quarter 2008. They also indicate independents will be required to be certified (presently they must pass online courses-here’s a link-look at upper right hand corner for current online classes they have to take). They also plan to handle 80% of the non catastrophe claims with internal staff by the end of 2009.

If you take a look at Addendum three on this page at Citizens (note I’m sure this will move to the Closed RFP’s  or Awarded RFP’s shortly as they normally do once an RFP is closed) you’ll see a Q & A for responding adjusting firms where they were answering their questions about the RFP that was due in on 2/5/08.  This addendum answering their questions was dated 1/22/08. The task force claim committee documents indicate they are dated 1/30/08 only 8 days later (presented 2/1/08). I point that out to be sure you compare the two. Here is an example:

From Addendum 3:

4. Q. The RFP requires the submission of the number of full-time and part-time

employees committed specifically to Citizens Daily claims. However, the RFP

provides no estimates, projections or ranges of claim volume from which a

respondent can reasonably project commitments. Staffing levels for 100 claims

per month are significantly different than for 1,000 claims per month. Can you

please provide some guidance in responding to this question?

A. Citizens anticipates that there will be an estimated 3,300 new claims a month with

approximately 100 of the claims being attributed to liability and 120 claims

attributed to the cause of loss of sinkhole. South Florida represents approximately

70% of Citizens reported claims. Citizens’ policy counts can be found on

Citizens website at www.citizensfla.com.

8. Q. Is their a minimum number of adjusters Citizens requires for the dedicated unit?

A. It is expected that selected vendors will maintain appropriate staff to service

assigned claims volume.

9. Q. Is it expected that field adjusters be dedicated to only handle Citizens claims?A. Yes.

10. Q. Will geographical areas be assigned to IA firms or will this be determined by the

areas serviced by the IA firms?

A. It is expected that firms will have statewide coverage.

11. Q. Is it required that the manager responsible for general oversight of the dedicated

unit be dedicated only to Citizens?

A. Yes.

12. Q. Does Citizens require the dedicated unit to be located in a particular area?

A. Citizens highest claims volume occurs in South Florida. It is expected that the

vendor will have statewide coverage to service Citizens policyholders.

13. Q. Is there a caseload requirement for examiners of the dedicated unit?

A. No. However it is expected the firm will maintain an appropriate examining staff

to meet Citizens quality and service standards.

17. Q. Will Citizens guarantee a certain volume of claims to the IA firm?

A. No.  (note- I have bolded 17 for this blog)

32. Q. The language in the RFP for Daily Property Claims/ Full Assignments on page 7

states “….which Services shall be performed by a claims administration unit

created and dedicated solely to adjusting and administering Citizens Claims.” The

terms “dedicated solely to” implies that that claims administration unit could not

service any other carriers. Are we interpreting that correctly?

A. Yes. Your interpretation is correct.

54. Q. What is your method of referrals to vendor/vendors? Is it on a rotating basis? Is

there a maximum volume per vendor?

A. Claim Assignments to firms is on a rotating basis with no guaranteed claim

volume per firm

56. Q. Can you provide a current or anticipated policy count and/or claim volume by

county? Alternatively, please provide any available information on concentration

of policies by area.

A. Please see question 4.

57. Q. In the case of turnover or staffing changes in a particular service area, will a

vendor be allowed to reject an assignment? If so, is there any penalty to the

vendor for this action?

A. It is expected that selected firms will maintain proper staffing levels to service the

Citizens account with statewide coverage.

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Now compare these answers to the information the Citizens Claims Dept presented to the Citizens Board of Gov and to the Citizens Task Force where they could both provide claims volume as well as presentations on their expected reduction in the use of Independents in these reports. Here are just a few excerpts from these reports:

This came from the Task Force presentation on 2/1/08:

The Claims Organization currently totals 198 Citizens employees,with 67 adjusters dedicated to non catastrophe claims handling.


Citizens’Claims Operations currently handles approximately 36% of all non catastrophe claims

  1.  


    1. By year end 2008, we will handle 50% of all non catastrophe claims

Staff increase of inside adjusters to 60


Staff increase of field estimators to 28

  1.  


    1. By year end 2009, we will be handling 80% of all non catastrophe claims

Staff increase of inside adjusters to 100

Staff increase of field estimators to 53

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Here’s another one- the Board of Gov meeting report shows that 39,890 2007 non catastrophe claims were received and indicates with modest growth that they are expected 42,000 claims in 2008 (non cat). 20% of that if you put the math to it would be 8,400 claims. Now- the Q and A above says that the number of independent firms to handle these on a rotational basis statewide is undetermined. So for argument sake, let’s take the number 45 which is the number of firms they selected (ok 46 now with the 1 firm who appealed yet they’ve never added their name on the IA firm list) out of 78 or so who submitted RFP’s for the cat files (although I know several firms who posted RFP’s for daily that did not for the catastrophe). 8200/45 firms would be a grand total of 182.22 files each adjusting firm might get on rotation.Now you tell me folks…..is this a mess or what?

Take the Q & A and compare it to what they are telling the task force about the claim volume and expected reduction in numbers of independents used in 2008 and 2009 and tell me if you think Citizens gave our nationwide adjusting firms the proper treatment? How in the world could they commit dedicated adjusters and managers to handle Citizens ONLY claims when Citizens is not willing to use a reasonable number of adjusting firms first of all (45 is ridiculous and the mess they went through with the ever changing directives for training on Cat is proof positive that is an uncontrollable number!). No adjusting firm is going to get independent adjusters to commit to work Citizens claims ONLY under this proposal. If you take the numbers further at 182 per firm …just how many files is an adjuster likely to get? Give me a break!

 Citizens…on behalf of adjusting firms who of course cannot speak out nor adjusters who fear being blackballed in the adjusting community, we ask that you please tell us ALL of the information you are considering so the adjusting firms nationwide can make proper decisions on staffing. Adjusters are tired of false promises for work by adjusting firms who have been promised work from carriers such as yourself. Atleast with Citizens, we have the Task Force documents and the Board of Governor meeting notes to find the true facts that you are not sharing when asking Independents to service your claims!

Speaking of Board of Governor notes- I’m quite impressed that the February 08 Claim committee just approved the Claim meeting minute notes of June 2007.  I’ve written Citizens before about the constant delays in getting the minutes posted and they say they are only posted once the claim committee meets and approves it. Well, I sure hope the task  force  makes some inquiries about these constant delays. That is an 8 month delay- how very impressive! The independent side of the adjusting community relies on those Claim Committee meeting minutes to know what is going on but I guess that isn’t a consideration in allowing enough time in your claim meetings to get them approved timely? While the task force is at it- Can you PLEASE post the websites of the 46 selected adjusting firms so independents know who to apply to? You’d think this would be simple. Atleast your Adjuster Resource page now has the RFP award list up(but you haven’t even added the 46th firm you approved to it) but no contact information. You have many of the adjusting firm names listed incorrectly and some names are so common it was difficult to find them. I have listed all of the firms in a Citizens Research paper on the training page at our staffing firm website  if you’d like a copy so you don’t have to look them up Citizens! (Website info on the About page here on the blog)

Let’s look at one more math formula before we go…..if Citizens only plans on having 53 field adjusters handling 80% of the daily claims in 2009 and 100 inside (projected at 42,000 claims by the end of 08 according to these reports)…then how many independents do you actually think are going to be getting the other 20% of the claims? Hmmmmmm……..

On to another side issue- Adjuster training- these documents all contain information about training and plans for a Citizens Claim School in March 2008 with expectations their staff adjusters will complete this by 3rd quarter 08. There are further indications independents will be “certified”(how many more conferences will you need to go to and pay for!). Here are some of the excerpts:

Page 17 of this 2/1/08 presentation  to the Task Force says as they increase their staff that they will be having a claim school- here is what page 17 says:

Current main delivery channel for training is via online modules. 

As we continue to build our internal claims force we will:

  1.  


    1. Launch a claims training school
  1.  


    1. Provide advanced specialized training
  1.  


    1. Refine our metrics to gain further insight on our claims workflow, productivity

and efficiency

  1.  


    1. Enhance our QA process as a feedback/developmental tool forour adjusters

 

  1.  

From page 19:

http://www.claimsclass.com/

Page 19 seems to indicate the Claim School will be up March 2008 with their staff adjusters training completed by 3rd quarter 08 and says IA firms will be “certified” so I assume that is the certification we’d read about in other task force documents I’d posted about months ago. Here’s what it says:

In March 2008, a new claim school will be launched.

  1.  

       

    1. Successful completion will be a condition of employment for existing and new Citizens staff involved in the handling and oversight of claims.

  1.  

       

    1. Core competencies will include, Customer Service, Ethics, Policy, Estimatics, and File Quality Standards.

     

  2.  

 

  1.  

       

    1. Each session of claim school will be 1 full week in length; entire Citizens’claim staff will be trained by 3rdQuarter 2008.
    2.  

     

  2.  

  1.  

       

    1. Ongoing QA will monitor file handling standards.
  1.  

       

    1. Third party administrators and/or Independent Adjusters doing Citizens work will need to be certified in our core competencies

And here are the notes from the 2-8-08 Board Executive summary:

February 8, 2008 (Claims Committee)

Executive Summary

We are launching a Claims Training school in March, 2008. The goal is to train all personnel, staff and independents to Citizens standards.

Upon completion of the training, they will be required to pass examinations and be certified to do Citizen’s work.

Here is another note from another one of the documents:

Here is another comment about Customer Service training found in another document uploaded below:

7. Provide Customer Service training curriculum used to train Citizens’ daily

claims adjusters and Independent adjusters.

Please see attached on-line course curriculum for the following courses: Citizens

101,

Policyholder Declaration of Rights, Ethics, and Avoiding E-mail Pitfalls

This comments comes from page 12 under a chart on time service in a Task force presentation by claims:

The bottom of page 12 on the First Task Force report contains this statement at the bottom of the chart on service:

􀂃As our internal staff has grown, we have seen cycle time, quality and service improvements as well as a downward trend in average paid amounts.

 

They include a Contractor report (in the 2-1-08 Task force docs) evaluating the service of several of the independent firms where they reviewed 10 files of each firm on time service issues. I have to admit the findings aren’t favorable on time service issues but as an experienced adjuster points out- Citizens says in these reports that the majority of the clams are in South Florida and we all know that those normally come in with high PA (public adjuster) activity which could delay the claim. The time service report also doesn’t say if those 10 files per firm were cat or daily-non-cat files. 10 files per firm is hardly representative of the over 60% of daily files they allege were handled by independents in 07 (39,890 was total number of non cat files altogether). Too bad their chart did not include information on how the files were selected and if a random data analyzer was used or if they cherry picked to get the results they wished. Time service can’t be evaluated in the simple format of the report they gave the Task Force. To determine if those are or are not good time service records on closures, you’d need to know the claim dollar amounts in the survey and if public adjusters were involved in the handling which often delays a claim. A simple severity “3” type claim with less damage could be closed very quickly while a field adjustment on a large loss would take several weeks if not months while repairs progress.

Citizens has 1,277,266 policies in force as of 1/31/07 (why are they showing 07 as latest stats on the home page?) per the stats on their site. This is an important issue folks not just for Floridians but also for independent adjusters. I continue to be simply amazed that they can get away with rate freezes we will all pay for later after a major storm but also with the fact that they can be so clueless about claim staffing needs and working with independent adjusters. By the time they ever get this latest fiasco on the Daily RFP for Independents revised, I’ll be surprised if most firms even consider applying.  I hope for sure that they and their independent adjusters pay very close attention to this question in Addendum 3 Q & A if they do apply:

64. Q. Regarding Insurance Requirements: Will you consider proposals from

respondents with the following limitations:

1. It is our policy to provide concurrent coverage (not primary) with any other

valid and collectible policies.

2. Professional Liability coverage is provided for Respondents personnel

without Citizens as an additional insured on the Professional Liability (E

& O) coverage.

A. No as to 1 and 2.And this one:

59. Q. If our coverage denial is challenged, will Citizens handle the litigation to

conclusion and indemnify GAB? If a Bad faith action is filed against GAB for our

coverage denial, will Citizens defend and indemnify GAB?

A. The level of indemnification and Citizens’ duty to defend, would depend on the

level of negligence (culpability) of the vendor/claims administrator

If you haven’t already- read our Guest Blog entry from last week with CPLIC recommending YOU as the adjuster carry your own E and O which was also recommended in a Roughnotes.com E and O article posted in that blog. Based on the Q & A above- it sure doesn’t sound like you can plan on Citizens supporting you on a claim with 100% confidence! Here is a link to that blog here.

Here are links to prior blog entries on Citizens:

https://dimechimes.wordpress.com/2007/07/26/hot-topic-for-independent-adjusters-opportunities-to-work-citizens-insurance-of-fl-claims/

https://dimechimes.wordpress.com/2007/08/09/update-on-citizen-fl-training-direct-from-citizens/

https://dimechimes.wordpress.com/2007/08/24/enough-is-enough-citizens-fl-claim-reserve-problem-to-the-tune-of-300-million/

https://dimechimes.wordpress.com/2007/10/18/citizens-of-fl-adds-46th-adjusting-firm-tornado-damage-in-pensacola-fl/

https://dimechimes.wordpress.com/2007/07/30/who-moved-my-claims-cheesedealing-with-change-in-the-insurance-adjusting-community/

This is also a link to the TAG for WordPress- Citizens FL which also includes some other blogs I”ve written that included references to Citizens:

http://wordpress.com/tag/citizens-insurance-of-fl/

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We also just got word from Eric Gilkey of Claims Magazine that they too have done a breaking news story on this issue today. I’ve located it for you here:( he has the best way of summarizing things and you have to love the title about leaving firms at the altar)!

http://www.claimsmag.com/cms/Claims/Breaking%20News/2008/02/13-Citizens%20Leaves%20Independents%20at%20the%20Alter

I apologize for the Font size problems on this blog post but for some reason the Font size tool isn’t showing in the system today so the copy paste entries from various reports are posting funny. The information is more important than worrrying about delaying this blog post for “pretty” work!

If you too are concerned and want to play an active role in waking up the Citizens Task Force on Claim Handling to the plight of the Independents (especially when they report they are counting on over 6,000 of you on the catastrophe side from the 46 adjusting firms), here is a link to the Task Force committee members. If you don’t want to write your own letter, feel free to attach a link to this post and simply say ” I AGREE YOU NEED TO LOOK INTO THIS” . I’ve also copied the email address from their site to two of their liasons that you can also ask to forward an email to the members:

http://taskforceoncitizensclaimshandling.org/tfm.htm

For staff support and assistance, please contact:

 Staff Director Vicki A. Twogood, CPM
Office of the Insurance Consumer Advocate, Dept. of Financial Services
850-413-2970
Vicki.twogood@fldfs.com

Gloria M. Strickland
Office of the Insurance Consumer Advocate, Dept. of Financial Services
850-413-2862
Gloria.strickland@fldfs.com

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