We receive hundreds of emails yearly if not monthly from new adjusters specifying they now have their adjuster’s license and are ready to go as they look for independent adjuster assignments. Many will have great backgrounds in construction, auto repair backgrounds, insurance agency, and other related fields.
What they do not have that they do not understand is a grasp on the functional essentials to properly adjust a claim. They may have learned state ethics requirements for adjusters, some basic policy to pass the adjuster’s license exam, but little regarding practical file requirements, carrier claim handling guidelines, forms required, proper communication tools and appropriate forms of communication.
If you think you are ready…try taking this self assessment and see how many questions you are comfortable with before you go out on assignments and see if you are ready!
Whether you take our 50 Hour Fundamentals of Claims Class or obtain training elsewhere, please do not go out on assignments without taking much needed training from PROFESSIONAL sources. We post them all in our Seminars Forum, our Training Material Forum, in industry Claim Conference postings all found right on ClaimSmentor. See About page for all website/contact information.
This is not by any means a complete list of things you should know but just a 125 sample assessment test of SOME of the minimum things you should know before working property residential claims.
Career Self Test Questions:
1) What are pros and cons of being a staff adjuster versus an independent adjuster?
2) What different type of fee schedules are available for independents to work under?
3) What are typical fee splits between independent adjuster and adjusting firms?
4) What parts of independent contract do you need to be careful about before signing?
5) What equipment must you provide yourself to perform your required field adjusting duties?
6) What information will you be given at an induction center meeting versus what you are expected to know at arrival?
7) What things are you required to have on an adjuster’s resume? What format should you use if you are new to the field? If you are experienced?
8) What are holdbacks on fee schedule payments?
9) How much money do you need to deploy on a catastrophe assignment?
10) When should you expect to receive your first fee payments once you start processing catastrophe files?
11) What are dress codes for adjusters as required by carriers?
12) What are expected hours at a catastrophe assignment?
13) What is the difference in pay for an inside adjuster versus a field adjuster?
14) What is the average annual income for an independent adjuster? For a staff adjuster trainee?
15) What career field options are available for you to pursue?
16) How much errors and omissions coverage is it recommended you carry? Should you furnish your own even if the independent adjusting firm offers to furnish it for a fee? Does your E and O cover your defense costs if a claim goes to suit and you are named in the lawsuit?
Adjuster Ethics Self Test Questions
17) Is it ok to take salvage from an insured?
18) Is it ok to take gifts from insureds, contractors, attorneys?
19) Is it ok to select a contractor for an insured or recommend a contractor?
20) Is it ok to meet a contractor over dinner to reconcile differences in your estimate?
21) Is it ok to use an assistant with you in the field who is not licensed to assist with the paper work and calls from insureds?
22) Is it ok to discourage an insured from filing an insurance department complaint?
23) Is it ok to discourage an insured from hiring an attorney or a public adjuster?
24 ) Is it ok to inspect a large group of claims and later write them up once you conclude your inspections?
25) Is it ok if you are using an assistant like a husband/wife team of independent adjusters for the non file assigned person to write the activity logs for the one assigned the file?
Dealing with insureds- Self Assessment Questions
26) What is the minimum time frame most carriers expect you to go by for first contact with insured?
27) When should insured expect a personal inspection once you have contacted them?
28) Can you accept lump sum estimates from insured?
29) When is it required you obtain original documents such as repair estimates from an insured vs copies? Why?
30) When is the appropriate time to get contents inventory forms to an insured?
31) Who are high profile insureds you should give priority treatment during a catastrophe assignment?
32) How do you determine who you should see first if you are assigned a large group of files on a catastrophe assignment when you arrive?
33) What is the appropriate way to zone your assignments if given this large number of new claims upon arrival at a catastrophe site?
34) What form should you review before ever calling the insured and what parts of this form are important?
35) If the insured wants to talk to your manager, what is your appropriate way to deal with this?
36) In addition to getting contents inventory forms to an insured immediately, what other forms should be given to the insured if the home is uninhabitable?
37) If the insured has damage under multiple coverages on a residential claim which one should you discuss with them first?
38) Where would you meet with an insured if the home is uninhabitable? How would you determine the amount of an advance they might need? What authorization can you give them for getting a hotel and eating meals out?
39) When is proof of ownership required on a contents claim?
40) What 4 items should you ask an insured for on each contents item claimed?
Carrier File Requirement Self Assessment
41) What 3 ratios does the carrier constantly monitor to see if you are meeting their time service requirements?
42) Do carriers allow you to use custom made forms such as your own excel contents sheet?
43) Do carriers allow you to use email to communicate with an insured?
44) Do independent adjusting firms allow you to communicate with the staff carrier claim manager or adjuster?
45) Which carriers are going to require you to get a carrier certification exam successfully passed before you can work their claims for an adjusting firm?
46) What language is required on all forms a carrier gives to an insured to sign?
47) Who keeps copies of all claim file documents and material..you or the carrier or both?
48) What do you do if you receive suit papers on a claim?
49) What is required if the carrier receives an insurance department complaint? What steps are you required to take?
50) How do you close out a claim if the insured withdraws the claim? What paperwork is required?
51) What should you do if a severity code is incorrect in the system on a claim? Who sets up the severity code? Why does it matter?
52) How do you establish a claim reserve? How often are you required to change the reserve? What coverages require a reserve? What is the appropriate manner to determine a reserve amount?
Dealing with Insurance Agents- Self Assessment
53) Are you required to keep the agent up to date with the status of the file?
54) Should an agent be copied on all letters to an insured?
55) If the insured has a complaint, should you inform the agent or is it none of the agent’s business since the claim was assigned to the claims department?
56) What contact is recommended with agency offices when you arrive at your assigned catastrophe department?
57) What is the appropriate thing to do if an agent tries to get you to inspect all of their storm losses before other claims?
58) Do claim payments affect an agents loss ratio for regular claims? For catastrophe claims?
59) When should you notify an agent of underwriting concerns such as maintenance issues? Who else should you notify?
60 ) What would you say to an insured that alleges “the agent should have told me that” or “the agent didn’t offer me that coverage”? What process would you have to follow to investigate that?
Attorney and Public Adjuster (PA) requirements-self assessment
61) What file documentation do you need if the insured advises you they have contracted with a PA before you talk to the PA about
the details of the claim?
62) Where do you go to check the rules the PA must abide by in a given state?
63) Is the contract the insured signs with a PA a contract with the insurer meaning the insurer must comply? Does the contract waive any rights the carrier has?
64) Can you still talk to the insured if they have a contract with a PA?
65) Can you ask for the insured to be present if they have a PA?
66) What duties does insured have with the carrier if they now have a PA involved in their claim?
67) Who pays the PA and how much is allowed?
68) Can you talk to an insured if they have hired an attorney?
69) Can you inspect a claim if the insured has an attorney without the attorney present?
70) What documentation do you need from an attorney if they call to say they are representing the insured?
71) Can you send a letter to an insured if they have an attorney?
72) Are you obligated to notify the agent if the insured has an attorney or a PA?
73) What do you do if you get a time demand letter from a PA? From an attorney?
Good Faith Claim handling- Self Assessment?
74) What are you required to do to be in compliance with good faith claim handling statutes?
75) What do you do if an insured, attorney, or PA accuses you of being in bad faith?
76) What are the top reasons for bad faith due to adjuster claim handling problems?
File requirements self assessments questions
77) What 2 things are used if a coverage question or questions becomes known by the adjuster? What is the name of the form? What is the name of the letter? When do you use each? Can you proceed with investigating the claim when there is a coverage issue?
78) What is the name of the report used on large losses, daily claims to summarize the details of the claim? When is it due in to carrier?
79) What is the name of the form used to summarize all recommended payments broken down by coverage ?
80) What are minimum activity log file requirements? What are the “no’s” or do’s and don’ts of creating an activity log? What entries are required to be on the log?
81) What is proper file order for building, contents, and additional living expense documents?
82) What is the proper name for each of the electronic file documents required to be uploaded to a carrier claim file if they use a claim management system?
83) What do you do if approached in the field by an insured and their claim is NOT assigned to you? What does the carrier expect?
84) When is a Sworn Proof of Loss form required? Who completes it? When is it due?
85) What do you do if the insured does not want the mortgage company name of the claim payment? What policy provision do you show the insured?
86) What forms do you use if the insured requires appraisal? Can you demand appraisal? If so, what steps do you need to follow?
87) Are you required to go over the settlement with the insured in person once you have finished your estimate?
88) How should your file be documented when you have items still pending on the claim?
89) What things do you have authority to authorize without the carriers permission when discussing claims with an insured?
90) How do you document your claim file if you disagree with instructions from your claim manager ?
91) What is the best method to approach your manager about questions you have on the claim? What information should you have with you before going to them? How should the file be documented?
Policy Coverage Assessment- Self Assessment
92) Who is responsible to get the policy to the insured, agent, attorney or pa when a request is received for a copy of the policy? Do you give them a sample policy from the carrier office or who and what kind of policy is sent to them?
93) What reference books are recommended to have out in the field with you for policy forms and endorsements?
94) What forms and endorsements and policies should you always have with you in the field?
95) Is it necessary to quote policy language exactly when you deny a portion of the claim?
96) Are you familiar with state mandated form language? How about state mandated mediation programs and forms required to notify an insured of their rights? What dollar limit applies requiring you give the insured this information?
97) What policy language do you refer to if an insured asks for payment for their time completing inventory forms?
98) What do you do if an insured claims items not covered? Property for people not covered on their policy? What letters and forms are required? What policy language would you refer the insured to to discuss this?
99) What many questions must you ask an insured to determine the appropriate place for them if their home is uninhabitable? Is an apt needed, a rental house, and how do you assess this? Who is responsible to locate temporary living quarters? What are abatements on Additional living expense coverage and how do you apply them? Who covers their security deposits?
100 )Settlements- What provision in the policy explains ACV? What process do you follow to calculate ACV and to notify the insured of RC provisons and how they collect them? How long do they have to collect them?
101) How long does an insured have to file suit on a claim? What is the Statute called that applies to this time limit? Where do you find it for each state?
Estimatic Self Assessment Questions
102) What are carrier guidelines on matching issues?
103) How does the pair and set clause apply to contents losses? To building losses?
104) Is it acceptable to offer the insured an appearance allowance on a damaged building or contents item?
105) What are line of site issues when determining how far to scope on building interior damage?
106) What are carrier acceptable methods of determining minimum charges?
107) What are general guidelines for allowing for overhead and profit on an estimate?
108) Can you pay an insured 10% profit if they do the work themselves?
109) How do you detemine the appropriate depreciation for building components? For contents items?
110) Is it ok to enter contents items in a building estimate as a miscellaneous item? Why or why not?
111) What do you do if you are unable to scope a building damaged item? Is it ok to copy the contractors scope and insert it into your estimate?
112) What is the best method for reconciling differences in your scope with the contractors scope?
113) If the insured’s contractors estimate is lower than your estimate what do you do? Which is used for fee schedule billing purposes?
114) IS it ok to recommend contractors to insured? If so, under what circumstances?
115) When are you required to review prior losses to avoid duplication on your current damage estimate?
116) What do you do if you suspect the damage you are inspecting is intentional versus accidental? (Example- insured uses a hammer to create appearance of hail damage to roof)?
117) Is it ok to round up or down on measurements? Is it ok to use the contractors measurements?
118) What are the major reasons for scoping issues when reconciling your estimate to a contractors?
119) What trades is it generally acceptable to allow overhead and profit and which trades is it considered not acceptable?
120) Is it ok to override a price in an estimating program with a manual entry? If so, how should you document your file?
121 ) What estimating program do you need training on? Where is it best to acquire it? Do you need to learn multiple systems? What is the cost involved?
122) Should an estimate need to be revised after you’ve given it to the insured what do you do with the original estimate once you have rewritten it?
123) If you reject acceptance of a lump sum bid insured provides from a contractor, should you keep a copy in your file?
124) Name the company many firms use to send off material samples for flooring such as carpet and tile and the process to follow to submit the sample
125) Are you required to agree to a scope with a contractor the insured has NOT signed a contract with to do the work?
We cover these topics and much more during our 10 sessions of Fundamentals of Property Adjusting class held online LIVE on Monday and Thursday evenings. We will also hold class during the day should we receive enough registrants requesting the day course. Our next class starts March 2, 2009. IF you take the above self assessment and find you need more training, please join us at ClaimSmentor today if you are not already a member to register for our upcoming class. Again this does not begin to cover what you need to know to properly handle claims but gives you a great idea of how much more training you do need in addition to acquiring an adjuster’s state license.
We will also be posting much information in the next week on other sources of training also available as online options as well as the best of the best field training options for those wishing to pursue a career as an independent adjuster.
It is most important you avoid classes held by instructors with little to no experience themselves. It is always utmost important that you learn from experienced personnel and that you ask about the qualifications of the instructor. I personally find it important that adjusters take classes from (at minimum ) folks with both staff and independent experience as they are much more familiar with what goes on from a staff claim management perspective regarding expectations to properly train you in carrier expectations versus possible minimally acceptable file standards that barely meet the muster of carrier file reviews.
I’ve been teaching our Fundamentals of Claims class for several years now with over 200 now processing through our class. I hear their stories and in many cases from adjusters who did go out on their first assignment during Katrina and or Ike who were not given good training and had not known how much there really was to learn only to get sent home and in some cases worse yet to be told they can no longer work claims for a carrier they had worked hard to establish a relationship with. Many assume that if they pass the carrier certification test which is usually on estimatics that they are good to go. Is what these trainees are missing is that the carrier also has high expectations that you already know other basic essentials like proper communication skills, forms, policy language ,etc which definitely is not the case for many sent out.
Is what I don’t like going on in our industry is that many books available and many classes are being hosted by some independent adjusters that have little to no practical experience themselves. It takes years before one should even consider writing a book, hosting a course or other such classes.
It is really becoming an epidemic in the independent field with classes available if you just check around the classifieds and postings on many sites. We hope to direct you in future blog postings to reputable adjusting firms and classes hosted by some of the more professional vendors our members have found in their training path.
One of the fallouts we are seeing from this inexperience being passed on is that the trainers with little background do not understand the backlash of some of the poor instructions being given out and as such I do believe it is leading to the increase in claim litigation due to poor decisions and claim handling skills by newer adjusters improperly trained.
The very last thing you should want is to barely be acceptable and only to be assigned deployment opportunities when they’ve run out of adjusters with more professional claim handling skills. The better you are the longer you will be kept out on independent assignments, the less chance you have in being sued for bad faith claim handling activities, the more satisfied insureds will be with their claim handling experience thus reducing Insurance Department complaints, and the happier the carrier will be with your work product!
**Sorry about the smilee faces showing up every time I use the number eight. Every time I use it is shows up when published as a smilee face. If anyone knows how to overcome that issue please let me know!