Louisiana Citizens Insurance Company offers $80 million to settle fines over claim handling delays from Katrina and Rita hurricanes

February 10, 2012

There are numerous articles out this week regarding Louisiana Citizens Insurance company and attempts between all parties involved in settlement negotiations.

This article states that yesterday Louisiana Citizens Insurance Company offered $80 million to resolve this class action suit, Geraldine R. Oubre et al v. Louisiana Citizens in the 34th Judicial District Court in Jefferson Parish , with approximately 18,000 policyholders while approximately 6,500 other claims still are pending at the carrier:

www.houmatoday.com/article/20120209/WIRE/120209535/0/entertainment02

The next article from NOLA.com  of 1/31/12 explains the US Supreme Court refused to delay the judgment against Citizens of Louisiana:

http://www.nola.com/crime/index.ssf/2012/01/high_court_refuses_to_delay_ci.html

This next article from 2/3/12 discusses the $6 million fees to seize the assets to the sherriff’s office following the Supreme Court 1/31/12 decision:

http://legalnewsgroup.com/2012/02/03/louisiana-citizens-goes-to-u-s-supreme-court/5040

In a different class action titled CHALONA v. LOUISIANA CITIZENS PROPERTY INSURANCE CORPORATION No. 2008-CA-0257. Fourth Circuit, the Louisiana Supreme Court had granted class action to this group as well. For complete details you can view this article which explains how the two class actions may overlap but says in part:

“While it is possible that some individuals could be included as members of both the Oubre class and the instant class, the relief sought in the two cases is not the same.   Thus, a judgment in the Oubre lawsuit would not have the effect of res judicata in the instant suit.   Although the defined classes in the instant case and the Oubre case may overlap, we do not find that the court was manifestly erroneous in denying LCPIC’s lis pendens exception.”

http://caselaw.findlaw.com/la-court-of-appeal/1003260.html

I’ll add articles to this blog as I can locate updated information regarding the settlement of these cases. If you can provide links to court documents or pdf of same, let me know and I’ll add them to this topic. We’d also appreciate any legal counsel who would like to interpret this information into layman’s terms for the rest of us and what impact this will have on other state run insurance companies in the future.

All articles located do say that these fees will be passed on  as assessments to insurance carriers doing business in the state and thus ultimately on to policyholders.

#Update 2/11- Here’s another article discussing the settlement negotiations and criticism for the negotiations being made public:

http://www.propertycasualty360.com/2012/02/10/talks-to-settle-louisiana-citizens-class-action-be?t=regulation-legislation


Filed Court Documents on Class Action filed against Worley and BP by Adjusters on Overtime Issues/Daily Rate- Part II

February 11, 2011

We previously posted about the information learned about a Class Action lawsuit filed on behalf of BP adjusters working oil spill claims.

Here is a link to the original post if you missed it:

https://dimechimes.wordpress.com/2011/02/09/adjusters-handling-bp-claims-file-a-class-action-lawsuit-on-two-issues-overtime-pay-and-failure-to-receive-65-of-daily-fee-per-contract/

This post now contains the two Complaints filed by the adjuster seeking to represent the Class of adjusters who worked the claims:

Altier v Worley BP et al gov.uscourts.laed.145020.1.0 This is the Complaint filed seeking Class Action on Overtime Pay Issues although they were independent adjusters working on a daily rate

Alteir v Worley only  This is the Complaint filed seeking Class Action on alleged failure to pay BP Adjusters 65% of the daily rate they received per Adjuster

Thank you to the source who provided the copies of the court documents. We will continue to follow this case and post updates as we learn them as we feel this is a significant case that all carriers and adjusting firms as well as adjusters will follow due to the daily rate/ employee vs independent contractor/ and overtime issues involved.


Must see video of BP’s Ken Feinburg at AL Townhall meeting yesterday- Hope to meet many of you this morning at the Fort Walton Beach Townhall Meeting

January 19, 2011

Here is some must see video footage of the Orange Beach, Alabama townhall meeting held yesterday with BP’s Ken Feinburg:

http://wkrg.com/1204118/

We will be attending today’s townhall meeting along with other independent adjusters in the Florida panhandle this morning being held here today in Fort Walton Beach, FL along with the founder of the Pensacola, FL Gulf Coast Claims Association and several other independent adjusters in the area. I’ll blog on that either later today or tomorrow.

In the meantime, I am putting together an article on the fruitless efforts made by hundreds if not thousands of adjusters like myself who applied to work these BP claims jobs from TX to FL  and were not utilized to work these claims. I have heard from hundreds who have applied and were not used being told that they were saving the experienced adjusters for hurricane season which never did cause damage in 2010. Information I’ve learned from many adjusters who were in the operation says that Ken Feinburg had changed the job title to “evaluator” from “adjuster” when he took over. Why? Is that so non adjusters could work the claims?

We’d like to piece together our side of the BP claims story by hearing from the many of you who applied and did or did not work claims. You can reply to this blog and I’ll approve the comments or if you wish to remain anonymous you can email me at dkmoroy@dimechimes.com and I will not use your name in any article or upcoming blog on the subject.

Thanks!


“The Independent Adjuster and the Oil Spill; Opportunity or a Trap” Guest Blog by CPLIC Risk Management- Errors and Ommissions Coverage for Adjusting Firms and Adjusters

June 22, 2010

Each year since founding ClaimSmentor, I have turned to CPLIC  for advice to share with our members on Errors and Omissions coverage for independent adjusters. We consider ourselves very fortunate to have members of this firm participate on our site. This year is especially important due to the added complications we may be facing this hurricane season with the oil in the gulf coast. I cannot thank them enough for their support providing this information for our members and all of you in the independent adjusting community. Their specialty is dealing only with Errors and Omissions (known as E & O ) coverage for the claims industry.

The following statement to their members is reprinted with permission from the Claim Professionals Liability Insurance Co., a Risk Retention Group created by independent adjusters for the risk management of independent adjusting companies.  See WWW.CPLIC.NET for more details:

Urgent Message from

CPLIC Risk Managment Concerning Oil Spill in Gulf Coast.

The Independent Adjuster and the Oil Spill;

Opportunity or a Trap?

The June 14 edition of the Wall Street Journal ran a full page ad on page A18, the back page of the first section. It outlined how BP wants claimants to file a claim, and their claims philosophy.

This is prior to the meeting at the White House, in which BP put $20 billion into the hands of an independent commission. How that will affect the present operation BP is now running we do not know.

All of us want more work, and we all, probably, would be willing to be involved in this claim settling process. But there are some pitfalls.

At CPLIC, we have analyzed the situation, and would like to offer some insights, suggestions, and comments. Remember, this is all prior to the White House meeting.

The Present Situation

Our understanding is that Worley has been engaged to handle claims on behalf of BP. Crawford & Co. represents Transocean. We are not aware of how the work is being spread between the two, or if it is only BP/Worley that is processing claims at this time.

How the $20 billion fund, now in play, will be handled is anybody’s guess. However, this could mean some opportunity for independents.

Geographical Areas

Obviously, the area covered is the Gulf Coast from Louisiana around to Florida. Considering the number of claims that are going to come out of this spill, you probably do not need to be in that area to be involved.

If you are in that area, here?s a word of caution. Forecasters predict this to be the most active hurricane season since 2005, and the Gulf Coast could very well be affected. If you get a chance to be involved in the BP claims, please be judicious in resources you commit to BP. Remember that a hurricane will also stretch you, and that you have regular clients who depend on you. These situations always stretch and challenge us, but do not get so overloaded that things get out of control. When this happens, the chance of E&O claims goes up. Using resources wisely protects your deductible.

Type of Claims

At first blush, you would think these claims would be third party claims, and so they are. However, determining liability will not be the issue. Damages will be the issue.

Many of these third party claims will handle just like business interruption claims. Make sure you use adjusters knowledgeable in this area. You may also encounter some hull claims, as well as other kinds of property damage claims.

There may not be many first party claims. The pollution exclusion may see to that. There also may be trigger problems. One of our members thinks that fire or explosion may be the trigger. In the end, this may be a decision for a court.

If the claims are first party, you will be working for a carrier, not BP. If there are questions of coverage, do not forget to take a non-waiver, or a reservation of rights. Those cases where you should have reserved rights, and did not, are hard cases to defend. If you are not sure, talk to your principal. If you are still not sure, or cannot get an answer from your principal, reserve your rights anyway. It is better to be safe than sorry.

If there is coverage in your claim, subrogation will be in order. This leads to a potential trap.

The Trap

If you find your regular client base sending you work that leaves you subrogating against BP, and you are taking BP cases in addition, you may find yourself in a conflict of interest situation. Be very judicious in the work you accept.

For those of you doing work for governmental entities in the Gulf area, be especially careful, particularly if your client has a shoreline. They may have cleanup costs, and ask you to handle their subrogation. Certainly, BP will be the target. You may run afoul of Public Adjuster laws.

CPLIC can offer no hard and fast rule here. Be judicious, use good judgment, and err on the side of caution.

What To Do At The Beginning

Even if you take every precaution, you will be sued. We are dealing with a highly politically charged situation. The plaintiff’s bar will be running ads soliciting clients. We will draw some suits. How do we protect ourselves?

This is the situation our insureds and CPLIC faced after Ike/Rita. First remember this is an agency situation. We all understand the principle of agency. In any contracts you sign with clients in association with this (or, if possible, any) work, make sure there is a clause under which the principal agrees to defend and indemnify you, absent a specific count of negligence against you.

This is a partnership here. Make sure your client understands this. Your client wants you on his side when the yelling starts. Do not give the plaintiff?s lawyer the opportunity to separate you. Even if there is a specific count against you, your principal may still defend you, depending upon the allegation.

Make sure you have your lawyer look at the hold harmless agreement in this light. If you need help in this area, contact us.

Closing Comments

What is written above may sound scary. It is not intended to scare. It is intended to make us wise about the opportunities out there, and to prepare us to meet them. It comes out of CPLIC’s six years of experience defending you. And there are opportunities, hopefully for many of us.

As you go forward, let us know of problems you encounter in following our suggestions. If you think we are off base, or missed something, let us know. It will help us serve you better.

K. M. Johns III CPCU, ARM AIM

Risk Management Committee Chair

Major contributors to this article were:

Alan Mayfield & Bruce Mountjoy

All Rights Reserved

© CPLIC 2010

*******

 

Please view their Q & A they did for us in 2009 here. Most importantly note the recommendation that independent adjusters have their own E & O policy for their own protection:

CPLIC 2nd E & O Info

Here is also a link to our first guest in August 2008  blog post by Dale Moore and Michael Hale of CPLIC with additional FAQ:

https://dimechimes.wordpress.com/2008/02/08/errors-and-omissions-coverage-guest-bloggers-dale-moore-client-relations-director-for-cplic/

During my 50 Hour Fundamentals of Claims class, we cover Error and Omission Coverage with new adjusters. I am constantly amazed at their answers to questions on adjusters E & O coverage. Most state that they would rely on the coverage of an adjusting firm to protect them. When I question them further, it is interesting to see that I have never had one adjuster be able to tell me who the adjusting firm’s E & O policy is with, what the policy number is, how to contact the E & O carrier, what the E & O policy covers them for, if the E & O policy provides for defense costs for them if they are named individually in a lawsuit. In other words,  they are working without even knowing about their coverage.

In recent years, many carriers, especially state run insurers like Texas Windpool and Citizens Property of Insurance in their RFP 08-0016 had terms stating they did not protect adjusting firms or independent adjusters so they were basically out on their own as far as providing an Answer to a Complaint (lawsuit) which is a costly proposition. I especially disagree with this position as the majority of claims litigation issues post hurricanes Katrina and Ike involved disputes insurance consumers had due to insurance company coverage decisions on wind/ water issues, wind debris to shingle issues, and other coverage or carrier guidelines an independent adjuster is required to follow.  It is long past due that  insurers,  the government,  and now BP and the Ken Feinburg group administering the BP Escrow fund  grant independent adjusting firms  and independent adjusters a  fair and meaningful defense and indemnity agreement.

This guest blog is a great example of what ClaimSmentor is all about. It is not about what I think as a former staff adjuster and claims manager nor about my experience as a participant in the independent claims industry. It is all about bringing together a professional group of reputable resources to provide proper advice and information to the independent claims adjusting community who have a most difficult time gathering current industry information applicable to claims assignments and catastrophe operations except when they are out on assignment.

I urge anyone who does not have their own E & O policy to run not walk to CPLIC to address your questions and check on your own E & O coverage.

Thanks again from ClaimSmentor to CPLIC for allowing us permission to share their 2010 Urgent message with our members.


Eternal Father Strong to Save- A prayer for Americans during the BP Gulf Coast Oil Spill Recovery- Open Letter 3 to President Obama and Admiral Thad Allen

June 15, 2010

President Obama is speaking from NAS Pensacola, FL as I write this. It is the most support I have seen him express to the brave men and woman serving in the US Armed Forces  since he began his Presidency. I am taking this particular speech very personally as my father, my brother, and my brother in law are all buried at Barrancas National Cemetary at NAS Pensacola.  I cannot bear the thought of the memories of our childhood being destroyed with the gulf oil tar nor of disturbing the area so others can  grow up with the same wonderful memories our family shares from the area during our youth when my father was stationed there.

I still  have family in the area including my nephew Ryan who is attending college at the University of West Florida  following in the foot steps of my wonderful father and brother who also attended the University of West Florida in Pensacola, FL. His degree is going to be in the marine industry. He too is watching his dreams disturbed by the worst environmental disaster in Amercian history as he faces unemployment working part time in the beach restaurant industry as a means of income to help cover his expenses while in college.

President Obama- thank you for doing us proud with your military speech in Pensacola and for finally showing our military of all branches the respect and honor they so much deserve. As a military brat as us military children are known as, we do know the sacrifices having watched our fathers depart on Naval aircraft carriers, departing for war, and the fear and sadness we experience as we support our brothers, sisters, neices, nephews, sons, daughters, and our fathers as they protect Amercians at assignments both at home and have to regularly leave us to go abroad to protect us around the world.

I’ll end this thanks with the words of my very favorite navy hymn heard every Sunday growing up on military bases and attending church at military chapels where our father was stationed.  If you really listen and read the words, I think you will agree this song represents all of our prayers for our military, our national guard members, our claims adjusters who will have to work in these coastal environments during hurricane season, and our BP responders constantly exposed to the oil spill tar and disperants as they clean up our beaches and marshlands and experiencing illness as a result. We also extend this as a prayer to all gulf coast residents suffering from this oil spill :

             Eternal Father Strong to Save – Original Version

             The original words are:

Eternal Father, strong to save,
Whose arm hath bound the restless wave,
Who bidd’st the mighty ocean deep
Its own appointed limits keep;
Oh, hear us when we cry to Thee,
For those in peril on the sea!
O Christ! Whose voice the waters heard
And hushed their raging at Thy word,
Who walkedst on the foaming deep,
And calm amidst its rage didst sleep;
Oh, hear us when we cry to Thee,
For those in peril on the sea!
Most Holy Spirit! Who didst brood
Upon the chaos dark and rude,
And bid its angry tumult cease,
And give, for wild confusion, peace;
Oh, hear us when we cry to Thee,
For those in peril on the sea!
O Trinity of love and power!
Our brethren shield in danger’s hour;
From rock and tempest, fire and foe,
Protect them wheresoe’er they go;
Thus evermore shall rise to Thee 
Glad hymns of praise from land and sea.

For links to the origins and history and other more modern versions of this song, visit this link:

http://en.wikipedia.org/wiki/Eternal_Father,_Strong_to_Save#Lyrics

**Note the Episcopal version is also very appropriate and shown on the link above

I find the following musical version very comforting at times like these and hope you will enjoy the music and pictorial vision as well:

http://www.cyberhymnal.org/htm/e/t/eternalf.htm

Please pass this on in hope it brings a focus to the faith that God will protect us and keep us safe. Especially for the families of the victims killed in this BP Oil explosion. Our prayers are with you every single day. Just click on the title to this blog today and you can then copy and paste it into an email to your friends and family suffering through this disaster or serving in recovery efforts.

Respectfully,

Debbie Moroy, AIC,IIA  ClaimSmentor Founder www.claimSmentor.com

 

 

 


Louisiana Citizens- Does anyone understand this AIA recommendation? Would you work claims as an independent adjuster there?

March 29, 2010

AIA  (American Insurance Association ) who represents approximately 300 insurance companies says proposals to abolish Louisiana Citizens  are misguided in this March 18, 2010 article:

http://www.insuranceheadlines.com/Homeowners/6563.html

AIA’s main argument was the need for available insurance in coastal communities. I find this argument interesting in light of the 100 million incentive Louisiana offered as incentive to induce insurance companies to offer insurance in Louisiana as outlined in many articles. Two of the articles are linked below which explain the details of the incentive:

http://www.insurereinsure.com/BlogHome.aspx?entry=223 and this one posted on the Louisiana Department of Insurance website:

http://www.ldi.state.la.us/InsureIncentiveProgram/index.htm

There were also many post Katrina articles about the carriers taking out policies from Louisiana Citizens such as:

Here is a list of several of the carriers who did take out policies from Louisiana Citizens through the incentive program:

http://www.2theadvocate.com/news/business/17179086.html?showAll=y&c=y

40,000 policies removed by six carriers:

http://www.ldi.la.gov/public_affairs/Press_Releases/2008_Press_Releases/10-8-08%2040,000%20Insurance%20Policies%20to%20be%20removed%20from%20Citizens.htm

This seems strange in view of the many articles posted post hurricane Katrina about problems with Louisiana Citizens after Katrina to include but not limited to some of the following issues:

This article just came out March 23, 2010 regarding a former executive pleading guiltyf to theft charges:

http://ifawebnews.com/2010/03/23/former-louisiana-citizens-executive-pleads-guilty-to-theft-charge/

This February 2010 provides more details about the alleged charges against this executive and the trial then upcoming in March 2010:

http://www.autoquotenow.com/auto-insurance-news/state/former-insurance-exec-to-go-on-trial-in-louisiana-2040.php

What about this class action against Louisiana Citizens per this LA Department of Insurance press release on a 17 million dollar settlement for their failure to settle Katrina claims within the statutory deadlines?

http://www.ldi.state.la.us/public_affairs/Press_Releases/2009_Press_Releases/8-19-09%20Citizens%20suit%20press%20conference.htm

This article from April 2009 outlines information about another class action lawsuit against Louisiana Citizens for failure to pay overhead and profit on claims:

http://blog.nola.com/tpmoney/2009/04/a_state_appeals_court_has.html

How about the news the Louisiana Citizens Board approved 35 million to settle yet a different class action lawsuit that involved 30,000 insureds due to poor claim  handling:

http://channels.isp.netscape.com/pf/story.jsp?floc=FF-APO-1333&idq=/ff/story/0001%2F20081114%2F0813395122.htm&sc=1333

This next article discusses a court dismissing a federal case against Louisiana Citizens for  racketeering, money laundering, wire fraud and mail fraud for their own enrichment :

 http://www.nola.com/business/t-p/index.ssf?/base//money-1/1218864023315000.xml&coll=1

In this article regarding disputes between the LA Insurance Dept and the legislative auditor over release of Insurance Dept emails it says:

http://www.theadvertiser.com/apps/pbcs.dll/article?AID=/20080204/OPINION/802040302/1014

“Jim Donelon, state insurance commissioner, and Steve Theriot, the legislative auditor, are old friends now engaged in a months-old spat over Theriot’s audit of the Department of Insurance. Along with subpoenas, a lawsuit, the occasional snide remark and accusation of wrongdoing, each man has used public hearings to air his grievances about the other. ”

This article from 2007 discussses a major overhaul needed of Louisiana Citizens and citizens outrage over assessements as well as a good explanation about who the members of the Citizens board consists of:

http://blog.nola.com/times-picayune/2007/10/citizens_board_taken_to_task.html

Article discussing Citizens of LA settlement of hundreds of cases of “slabbed” claims from Katrina:

http://fpn.advisen.com/?resource_id=611446981029447447#top

Links to articles about the MAJOR computer glitches and accounting audit nightmares experienced at Louisiana Citizens after Katrina:

http://www.property-casualty.com/News/2007/3/Pages/La–Last-Resort-Insurer-Missing-Audit.aspx

While I don’t know the current status of improvements at Louisiana Citizens, here were a few articles post Katrina showing some good things for adjusters and citizens of Louisiana to include:

Senate Bill No. 183 requiring Lousiana Citizens utilize adjusters and adjusting firms who had been domiciled in the state 5 years or more and was effective in August 2007:

http://legis.state.la.us/billdata/streamdocument.asp?did=436266

Most importantly is that Louisiana did not have adjuster licensing requirements at the time of Katrina’s landfall but did begin requirement adjusters be licensed since then. Resources for adjusters seeking resident, non resident licenses, emergency licenses, and more information on the Claims Adjusters Acts should use this link:

http://www.ldi.state.la.us/Licensing/Producer/index.html

Here is more info on Louisiana adjuster licensing from when they initial announced the licensing requirements:

http://www.ldi.louisiana.gov/documents/licensing/adjuster/AdjusterLicensingInLouisiana.pdf

http://www.ldi.louisiana.gov/documents/licensing/Producer/LAClaimsAdjusterAct.pdf

This article had indicated part of the problems were lack of staffing and resignation of an accounting manager leaving no one to answer the audit questions due to the severe computer glitches and problems with accounting:

http://www.insurancejournal.com/news/southcentral/2007/04/05/78506.htm?ref=feed

Another article says most of the paperwork could not be produced on over 300,000 in expenses:

http://www.insurancejournal.com/news/southcentral/2007/06/25/81076.htm

While I don’t have more time today to spend on this blog, a good place to start your research on current trends and activities, here is a link to the Board of Governors meeting minutes for the past several years you might want to review before considering taking claim assignments from them. http://www.lacitizens.com/MeetingAgenda.aspx

It is not only the adjusting firm you need to do due diligence on before accepting work but also the carrier you will be assigned to to protect yourself from the ever increasing possibility of delays and non payment issues on fee bills. I study the state wind pools for members of ClaimSmentor as the wind pools often present the greatest opportunity for independent insurance adjuster assignments during major disasters. Only you can decide if you are comfortable working for an adjusting firm or insurance company. We do hope the links posted above  help you make the best possible decision.

Should you decide you do wish to work assignments for them, we have been able to locate only one adjusting firm thus far offering Louisiana Citizens Adjuster Certification and that is AmCat.  Here is a link to their training site offering not only Louisiana Citizens certification but certification for many other carriers:

http://www.adjusterclasses.com/


Galveston Amended Court Order of 1/25/10 on TWIA Deposition on Hurricane Ike Claims

February 17, 2010

I ran across this Amended Court order of 1/25/2010 regarding TWIA Depositions on Hurricane Ike Claims and wanted to provide a copy for our members who may be involved in TWIA Claims litigation: view here


Texas full of claims news! TWIA Adjuster 2010 classes, TX Appraisal update, TWIA Class Action lawsuit from January 2010

February 2, 2010

I’ll start with a link to the released Texas windpool Adjuster 2010 class schedule for any adjusters seeking attendance. Our notice came through Crawford and Company who did ask in their email that you notify them when you have completed the class so I’d send them your resume if you haven’t already and plan to take the TWIA class:

http://www.twia.org/Portals/0/Documents/WS_Reg_Form.doc

We have posted links to this site before which updates weekly on new Hurricane Ike lawsuits and in January they made  a post about a new class action lawsuit on behalf of 210 Texas residents against Texas Windpool (TWIA). Here’s a link to that posting:

http://www.setexasrecord.com/news/224259-200-bolivar-peninsula-residents-file-class-action-against-twia

While your concentrating on TX claim handling issues and classes, here is another great post by Attorney Chip Merlin’s firm on TX appraisal issues you may also wish to view:

http://www.propertyinsurancecoveragelaw.com/2010/02/articles/insurance/recent-court-decision-in-texas-regarding-appraisal/

Update 2/4/10- Special thanks to Chip Merlin for linking to this blog post and recognizing our blog- it is very much appreciated!

http://www.propertyinsurancecoveragelaw.com/2010/02/articles/insurance/sinkhole-coverage-analysis-every-wednesday-and-dimechimes-is-a-good-blog-for-adjusters-to-follow/


Links to Blog Post corrected from FL Round table post on Insurance Appraisal Provisions

January 6, 2010

We apologize that yesterday’s post contained some incorrect links which have now been corrected and updated for those wishing to review the blog postings referred to in our post:

https://dimechimes.wordpress.com/2010/01/05/fl-consumer-advocate-round-table-1610-topic-is-appraisal-in-fl-policies-dont-miss-it/

In addition, Merlin’s site has a new post commenting on two additional Florida Insurance Carriers also revising appraisal provisions in their policies. Click here to view


FL Consumer Advocate Round Table 1/6/10 Topic is Appraisal in FL Policies- Don’t miss it!

January 5, 2010

H/t to Attorney Chip Merlin’ for posting information on his blog important to the adjusting community (no matter which side your on!)  that we can call in or watch the January 6, 2010 Florida Department of Financial Services Consumer Advocate Roundtable with an utmost important topic not only to Floridian’s but to insurance adjusters as well on the topic of Appraisal provisions in Fl policies.

Here are links to his posts- I know I for one will be listening to it since Citizens of FL which many of my family and friends are insured with has already removed the appraisal provision from homeowner policies. Here are links on the topic so you can listen in or watch as well:

Post of 1/5/10 at Merlin’s blog with his planned recommendations at the round table: Click here

Post of 1/4/10 at Merlin’s blog with the contact information to call in and/or view the 1/6/10 roundtable: Click here

For a complete list of panelists (impressive group but where are the large independent adjusting firms or representatives from Citizens and why are they not also included on the panel)? Here’s the link to his post on the panelists: Click here

Link to prior post on his site regarding appraisal provision removal on Citizens Property Insurance Corporation of FL removing the appraisal provision: Click here

*Note it is also public information posted on the PAST link for the Citizens of Florida Board of Governor’s meeting notes : Click here to view their direct information

Here is a direct link to Sean Shaw’s press release over at the FL Dept of Financial services website from his 12/17/09 news release with more information on the purpose of the round table and the participants: Click here

Here are the specifics on connecting to tomorrow’s meeting:

January 6, 2010
10:00 AM – 3:30 PM
House Office Building, Committee Room 404

The Capitol, Tallahassee, Florida

Conference Call-in Number: 1-888-808-6959 Code: 4132880

WFSU Florida Channel 

See Merlin’s blog for more agenda and attendee info on the above blogs.

 

 


Chinese Drywall Claims Making Their Way through the Courts- Guest entry by Attorney Thomas Little

June 17, 2009

Attorney Thomas Little has joined our Dimechimes ClaimSmentor Claims Industry group at Linkedin at www.linkedin.com/in/dimechimesclaimSmentor . He provides an update on the hot topic on the Chinese Drywall Claims Litigation here on his blog. We appreciate you sharing this information for our claims group and we pass it along for others as well since this is such a hot topic:

http://alabamainsurancedefensereport.wordpress.com/2009/06/11/chinese-drywall-coverage-litigation-working-its-way-through-courts/


Tracking Hurricane Ike Claim Litigation in Southeast Texas drives home the need for Errors and Omissions coverage for adjusters

June 6, 2009

This website posts newly filed insurance claim lawsuits for southeast TX several times each week.

http://www.setexasrecord.com/news/

Click on any of these links to find not only the suits against TWIA but other carriers as well. You’ll note that many of the cases against TWIA include the adjuster and the adjusting firm named in the complaints filed here is just one example:

http://www.setexasrecord.com/news/219283-latest-hurricane-related-insurance-suits-filed-in-jefferson-county

You can track the cases going all the way back to the month Ike hit.

This should drive home the seriousness of carrying E and O these days. We have two other posts on this blog with advice fromwww.cplic.net who specializes in carrying Errors and Omissions coverage advising adjusters should be carrying their own E and O coverage and not relying on coverage by the adjusting firm.

https://dimechimes.wordpress.com/2008/02/08/errors-and-omissions-coverage-guest-bloggers-dale-moore-client-relations-director-for-cplic/


Texas Senate Bill No. 14- View the issues- Deals with Claim Disputes and changes to damages allowed on TWIA Claim Disputes

May 21, 2009

Attorney Chip Merlin (consumer advocate attorney)  provides the following two blogs on Texas Senate Bill No. 14 due to some changes proposed on claim dispute handling against TWIA:

http://www.propertyinsurancecoveragelaw.com/2009/05/articles/hurricane-ike/proposed-twia-law-smacks-hurricane-ike-claimants/

Attorney Chip Merlin has a 2nd blog up recommending TX residents take proactive steps to contact their representatives in this blog. Note also in the first link above that Merlin does include a link to the Senate recommended changes on TX Senate bill No. 14

http://www.propertyinsurancecoveragelaw.com/2009/05/articles/state-legislation/what-twia-policyholders-need-to-do-now-to-stop-the-bad-legislation/

 

I did some basic research on the web and the Texas Senate discussion on their passage of this bill  in their website post of April 30, 2009 does not address the changes that Merlin writes about  and I’m sure many others are concerned about:

http://www.senate.state.tx.us/75r/senate/Archives/Arch09/p043009a.htm

Now to see if we can find some opinions on this from the TWIA side……………

Here is what the TX Department of Insurance currently has up on their website about complaint resolution process with TWIA:

http://www.tdi.state.tx.us/consumer/storms/cpmtwiaclaims.html#resolving

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Update 8:30 AM- I no sooner got this blog up then Merlin posted an update on the activities on this legislation from the House side along with a link to a San Antonio, TX news article on the House action on their counter bill:

http://www.mysanantonio.com/news/45551952.html

http://www.propertyinsurancecoveragelaw.com/2009/05/articles/state-legislation/texas-house-representatives-pass-bad-insurance-bill-they-have-not-read/

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Update once again 10:30 am cst- Merlin provides a 4th blog about TX House version of the bill -here’s his post:

Merlin sends a 4th blog link out about some of the language disappearing from the House version that passed:

Summary:
After reading what actually passed, the House Committee seems to have struck all of the Senate language concerning 2210.552, and then added a new subsection (on page 36 of its 51 page bill) which reads : SECTION 40. Section 2210.552,…

View the entire entry:
http://www.propertyinsurancecoveragelaw.com/2009/05/articles/insurance/not-so-fast-on-calling-the-texas-house-bill-badthe-bad-language-mysteriously-disappears/index.html

Dern! I don’t want to be in violation of linking too often to a site- WordPress emailed a few weeks ago about limiting links to others sites too often so I do have to be careful!


Overhead and Profit issues remain an issue in claims litigation- Louisiana Citizens Class Action Cases On O/P/ Update on Chivers vs State Farm and other O/P cases

May 15, 2009

Remember these prior blogs on overhead and profit claim litigation cases we’d been following in the news?

https://dimechimes.wordpress.com/2008/04/10/overhead-and-profit-claim-settlement-issues-under-attack-in-3-ongoing-cases/

Well, here is the latest I’ve received a notice on here with Lousiana Citizens…apparently there are two different class action cases going on in two different jurisdictions. The part I found particularly strange was the comments in the article alleging that at one time LA Citizens paid the o/p, stopped at a later point, then resumed paying overhead and profit at a later date:

http://blog.nola.com/tpmoney/2009/04/a_state_appeals_court_has.html

We’d appreciate any updates on these cases if you know what the status of these cases is as we could find nothing much by way of updates on their status on the web and we don’t have access to court documents like some sites do so any help discussing these overhead and profit cases would be appreciated. Here is a 5/13/09 published article on new develops on the Chivers vs State Farm case updating info on Chubb insurance and Nationwide Insurance who apparently settled out of court for a substantial same rather than produce massive discovery documents:

http://www.setexasrecord.com/news/218979-nationwide-settles-foremost-faces-order-to-produce-documents-in-ongoing-class-action

Here’s a link to a second article which goes into more detail about the Nationwide overhead and profit case:

http://www.setexasrecord.com/news/217364-arkansas-judge-orders-expedited-hearing-for-class-certification-against-nationwide

 Replies welcome to links to news articles or court updates,etc so we can all learn how these cases have come out in case law if resolved at this point. I’m not hearing any changes about carriers handling these issues differently from adjusters I’ve discussed the topic with at this point.


Just a ClaimSmentor Moment #6- Update 3/09 on EA Renfroe/ Rigsby Whistleblower case-Possible Settlement

March 20, 2009

 

No time for blogging today but you won’t want to miss this blog over at Slabbed on settlement updates and court documents on the EARenfroe and Rigsby Whistleblower case. Slabbed thanks for updating this as many claims industry members are very interested in this topic. I’m hoping for EA Renfroe’s sake that this does settle. They sure did NOT deserve what the Rigby whistleblowers have put them through since Katrina. We have some old blogs here (just enter Rigsby in the search field to locate them. One of the Rigsby’s actually said in their deposition that EA Renfroe had done nothing wrong. More on that later:

http://slabbed.wordpress.com/2009/03/17/anita-lee-reports-from-team-rigsby/

 

This is an important case for adjusters to study from the stand point of Code of Conduct forms you are required to sign by carrier’s and what happens when you violate those code of conduct forms.

By all accounts I have ever heard from independent adjusters, EA Renfroe is an excellent adjusting firm to work for. I also managed their independents during my management career and found the same to be true. What a shame these whistleblowers put them through this when by their own admission their complaint was with the carrier.


Organization Chart for the Claims Handling Blame Game- A Humorous Graph -A Serious Look at Claim Bad Faith Issues

March 6, 2009

Insurance Company – Adjusting Firms- Claim Staff -Reinspectors -Independents  – Public Adjusters
Claim Litigation  Attorneys
 
→   →   (Everyone to R)       ←     ↓        ↑  →                           ←   ↓   →                                 ← (all 3)  →                                                 ← (all 4)
************************************************************************************************************************
What a mess  that makes no sense and it isn’t humorous at all. This is a huge insurance consumer issue. Just check out the Bad Faith organization or NAIC (National Association of Insurance Commissioners) for all kinds of information and surveys on claims handling. The link I put to NAIC is their 2009 Report on the Top Complaints by insurance consumers. You can sort by carrier, by type of complaint, by state I think, and much more!
 
When are we also going to get Insurance Departments on board to help improve this by doing the following things I’ve discussed in this blog before:
 
1) Require Insurance companies to report to all state insurance departments consumer links where they provide complaint information for carriers to provide information on adjusting firms that have been dismissed by a carrier for trends of bad faith claim handling issues. Presently, I know of no place when independent adjusters can validly find this information until it is too late. Dismiised firms are not required to be reported (if they are I am not aware of it) so they just move on to solicit new carriers so even more insurance consumers continue to be harmed by firms with bad consumer servicing problems.
 
2) I believe insurance companies require liability and errors and omissions information from adjusting firms before they use them. Are there any reporting requirements by state insurance regulators on claims ratios on E and O policies for adjusting firms or independent or public adjusters so 1) policyholders don’t hire a PA who has a large complaint ratio 2) so adjusting firms have a source to know (other than just checking regulator sites to be sure an adjusters license is still active), and so adjusters can have a valid source to see the complaint ratio of an adjusting firm so they can make a good decision about which adjusting firm they wish to deploy with so they don’t get hooked up with a firm that might be unprofessional?
 
3) Insurance Regulators should require that adjusting firms be required to disclose the name of the owner and the name of any key executives they may have on the payroll and post them on their website.  Often if an adjusting firm develops a bad reputation with adjusters or carriers, they just either a) move to another state so carriers and adjusters cannot find bad information about them at insurance department licensing sites that allow you to research licenses or b) the adjusting firm owners or key executives just change the name of the adjusting firm so adjusters don’t know who they are.
 
4) Another thing that concerns me when trying to find good adjusting firms for newly licensed adjuster recommendations , when asked by ClaimSmentor members , is that so many of the adjusting firms do not list one thing on their ABOUT pages about who the key owners are. I tell them just to go to http://www.whois.net/ but this only tells you when a website domain was open and the contact name and information for the person who opened the site. Sometimes the only results you get there are to the website company they opened the site with but it is one source of information you might try.
 
5) Adjusting firms should be required to post links on all of their websites such as Department of Insurance Consumer Complaint contact information AND information for independent  adjusters as to where they can report violations of adjusting firm contracts with independents and adjuster non- payment of fee bill complaints. If you don’t think there is a need, just check out this site that opened post Katrina and when overloaded by complaints of non payment to adjusters, their system crashed many many times : www.professionalfeecollection.com (site was opened post Katrina and we have no idea what happened to this agency and it’s alliance of attorneys working proactively to collect unpaid independent adjusting firm fees. We know they were overwhelmed by the claim files faxed in to them and the thousands of adjusters attempting to utilize their services. It was run by a Terry Bagsby out of TX. The interesting thing was that these adjusters were all complaining about the same continuous group of adjusting firms based on discussions I had with him in 05/06.
 
6) Adjusting firms should be required by State Insurance Regulators to not only have a contract for independent insurance adjusters but they should be required to have two signed originals so one can be given to the independent adjusting firm and one can be given to the adjuster. I cannot even begin to tell you how many new adjusters have been frankly taken advantage of either not being given a copy of the contract or no contract at all.
 
We wrote in our blog done a few years back called “Splish Splash don’t go taking a bath” on this topic.(See link at bottom of this blog) I always teach new adjusters in our Fundamentals class not to deploy without seeing the contract and making sure they agree to the terms, not to sign blank forms, to watch out for Non-Compete terms, to make sure they know what the fee split is with the adjusting firm (how much they keep of the fee schedule and how much you get based on a percentage fee split) or what your daily rate is if you are getting paid a daily rate how much it is and what your fee split.
 
There is much more information in the blog I wrote linked to above. The very best advice that I would give you is to see your personal attorney about E & O insurance coverage information in the contract to be sure YOU are protected and to be sure that you are not signing something you shouldn’t be signing.
 
7) Insurance regulators need to regulate a) the length of time a carrier has to pay independent adjusting firms and TPA’s who process their claims, the time an adjusting firm has to pay the independents, holdback percentage provisions in contracts and hefty fines for those adjusting firms not paying them within a regulated time).
 
8   ) Insurance Regulators must begin setting regulations for insurance carriers as to what claim handling fines a carrier can pass on and require of  independent adjusting firms and adjusters.
 
They have gotten totally out of control on the RFP requirements I have seen such as Citizens of FL 2007 RFP 08-0016 or 07-0003 with fines as much as 1,000 per vioation. Is what developed after these fines starting being imposed in RFP’s is that independent contracts started transferring these fines on to adjusters in contracts without even specifying what these fines were.
 
9 ) Insurance regulators have got to put a stop to the erroneous information being advertised about the TEXAS adjuster’s license for independent adjusters. Just take a look at the many classifieds telling those interested in a claims career that the TX license with give them licensing in any where from 25-32 states.
 
This is inaccurate as the adjuster still has to fill out applications, finger prints and pay licensing fees for those non resident licenses. Dr Birzon at the University of Central Florida’s Insurance licensing online program has been forced to post a warning such as this on their website link (see News flash column on left of that link) because so many residents of FL had taken TX licensing classes thinking that they were waived from taking the FL Resident adjusters license.
 
I regularly receive resumes from adjusters who are permanent residents of FL that is all that I see in the licensing information of their resume is their TX license info. Dr Birzon has been so helpful answering questions on ClaimSmentor on licensing issues and even helped out a few of our adjusters who were in non compliance on CE’s and had to retake Fl license requirements again so we referred them to his online FL licensing program which the state regulators approved as a means of getting your FL license and bypassing the FL adjusters exam. These adjusters who were working out of a state on a catastrophe assignment could meet the FL Department of Insurance requirement they sit for the exam again by taking Dr Birzon’s online class at night and still service claims assigned to them out of state.
 
10 ) Insurance regulators need to require that any training firm producing adjuster 
training classes be approved by the state department of insurance to meet minimum claims experience requirements ,which I would insist included experience in claims management, as well as professional insurance education requirements that are recognized in the insurance industy such as AIC (Associates in Claims) and/or CPCU course through AICPCU. I have completed IIA, AIC, and 9 sections of CPCU with only one left to go (the much dreaded Accounting session). I cannot tell you strongly enough how much I recommend these courses  for independents as well.
 
11 ) While the insurance regulators do not control which independent firms a carrier uses, they should at minimum require that adjusting firms and TPA’s require some kind of screening. The one I prefer the most is the membership requirements at the National Association of Insurance Adjusters which is an association of independent adjusting firms who have had to go through substantial financial screening and other membership criteria you can view here.
 
12 ) There are good procedures established by the insurance regulators, emergency management, and state governors for adjusters coming in from out of state. They are called emergency adjuster regulations.
 
In a new trend the large adjusting firms are now requiring of independent adjusters, they are requiring that adjusters obtain non-resident licenses in all coastal states and those like Oklahoma  and Minnesota that have regular windstorms. There are valid reasons because carriers and independent firms cannot activate non resident adjusters who do not hold a non resident license in the state of a storm until the governor announces that by his order at the time of an emergency that independent adjusters are allowed in the state to work claims on an emergency license. 
 
If an adjuster secures a non-resident license in all the states a carrier MIGHT deploy them, they can stay longer because emergency licenses are temporary in nature and only allow adjusters to work a storm designated a catastrophe by the governor. Carriers also do not use their national catastrophe teams if there isn’t enough volume in a given state although I’ve read about alot of improvements on this. This is usually do to the fact that they have to bill the region where they deploy the adjusters for their services. Can we do something about this? It appears to me to be the only way carriers and adjusters can deploy adjusters and get around the governors emergency disaster authority. It has created a huge financial burden on independents and on CE reporting requirements when they should be concentrating on servicing insurance consumers. It is also creating a “dumbing down” of independent adjusters that can be used as we often see less experienced independent adjusters deployed because the experienced adjusters tend to leary of jumping through the huge volume of hoops and know that when the big one hits they will be deployed when carriers through out all pre-storm requirements.
 
I regularly refer new independent adjusters to these firms meeting the NAIIA criteria as hopefully a safety net for them when finding reputable firms. See their membership directory here. While I cannot guarantee it will, I would think that it would atleast provide a place to start when considering who is your “A” list of adjusting firms you will work for. How about for carrier independent staffing needs when their core adjusting firms “run out “of  core adjusters (their A team of who they will first deploy based on experience and certifications and licensing”.
 
I do know some excellent firms that might not yet meet all of the NAIIA membership criteria who are trying to do the right thing. Several that come to mind as I have gotten to know their owners through years of membership at ClaimSmentor or through the staffing side of my operation are CSP claims (owners are retired carrier management), Legacy Claims (the one owned by the Ellis’s), and Action Catastrophe Claims. I do not post those here lightly as I have spent almost four years now getting to know them and I listen intently to what experienced adjusters working for them have shared with me, I’ve watched their adjuster training programs, and I’ve heard great reports on their CMS Claim Management systems and payment records with adjusters who complied with file requirements.
 
I know of very very few independent adjusting firms run by owners or managers who have these course certfications. One of my clients who feels as strongly about this is Dennis Martin, CPCU  who runs the FL Division and catastrophe division  of William Kramer and Associates. He is a joy to work with since he understands the issues facing our claim industry , the Florida insurance crisis , and knows what happens when an adjusting firm doesn’t properly manage claims and claims adjusters and CONTROL compliance with file requirements. This is especially important with their primary concentration on commercial claims such as very large Condominum Claim Associations.
 
We co -authored an article for Claims Magazine as the featured story titled “ A Box of Chocolates” in 2008 about condo claims handling. We both can’t thank Eric Gilkey, Editor of Claims Magazine for his skills and patience working with us as neither of us had significant experience in writing an article)!
 
                                                                                                    Some Things to Ponder
This is also another thing that inquiring minds want to know!  If a file is approved first by an independent adjusting firm manager and sent on to the carrier management for approval and they approve the file and pay the claim based on their review how can they possibly go back and fine an adjusting firm a year later when their auditors catch the mistake. I know of a few firms this has happened to. Where are the insurance regulations on this?
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Why do carriers always tell our members and my staffing firm that they don’t want to consider very good experienced catastrophe adjusters for staff positions when they meet all other qualifications such as a four year degree, insurance continuing education requirements,etc? I was astonished over the past four years to receive staffing requests from 3 major carriers that said the following ” we need adjusters but we can’t get approval in our budgets to use a staffing firm. Will you send them out free to your rosters? ” You’ve got to be joking! Take the resources I have developed over 4 years of staffing and building contacts and mass emailing for them free? I did post their notices in our Career Forum where we do post jobs such as these that we come across but I sure wasn’t servicing them free. Also, while I can understand that they think cat adjusters will jump as soon as a major storm hits, don’t tell us that your staff adjusters do not do so as well. What is your turn over rate? The only thing that keeps staff adjusters on your employment lists is the fact you often offer benefits such as health but adjusting firms are
getting just as savvy in some cases and they often get employment applications from your staff adjusters just like my firm does.
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Last but not list in the things to ponder list is the failure of carriers to put a stop to “hand me down” claims. Almost every issue of non-payment to new independent adjusters has come through a 2nd or more tier adjusting firm subcontracting claims out to another adjusting firm when they run out of adjusters. Often , I doubt the carriers even know about it. When the unpaid adjusters contact the carrier, they are often told “sorry….we don’t have a contract with that adjusting firm”…well dang….I guess the first tier firm made a sidetrack agreement with the 2nd tier firm leaving the independent adjusters to hang out to dry. I’m referring to adjusters who have a contract with firm 2 or on down the line but they have no contract with the adjusting firm who had the contract with the carrier. During the 04/05 season when the FL Dept of Insurance set deadlines with HUGE fines, I saw many a carriers hurt when the primary adjusting firms couldn’t account for claim file status. I never even knew this went on until I transferred to the independent claims industry. I had one firm call me and say “and we have the 1st tier contract with the carrier” on this one. Maybe I am wrong and this is a regular practice, but I can tell you the majority of calls my staffing firm received on non-payment issues when they were looking for a new assignment because they weren’t getting paid was from 2nd or more  hand me down claim adjusting firms. I simply think the practice should be forbidden.
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There are four ways I can think of to add these regulations which are long overdue. Not being an insurance regulator, but someone with a huge interest in protecting independent adjusting firms and independent adjusters to preserve our important service to the claims industry:
 
1) Click on the link here to all insurance departments and print out a copy of this blog (just click on the blog title and it will open up just this blog versus reviewing a string of our blogs) and send a copy to either your state insurance department or to any insurance departments where you have worked assignments and/or are licensed. If you fear for your career in claims, just print it out and mail it in and don’t sign your name. If they get flooded with enough copies of this blog, maybe they will listen.
 
2) Print and send a copy to the NAIC who is responsible for cancelling the recommendations for National Licensing. Again, don’t sign it if you don’t want to. Volumes of copies of this might help. The link to the blog on this act is included at the bottom of this blog entry.
 
3) Insurance regulators who are responsible for claim handling regulations can add requirements such as these to their Good Faith claim handling regulations and licensing requirements for independent adjusters and adjusting firm licensing requirements.
 
4) How about Insurance Regulators developing a Code of Conduct form for independent adjusting firms (similar to what carriers require independent adjusting firms and adjusters are required to sign). Look at the NAIC Code of Conduct they require their member adjusting firms comply with
 
There are so many possibilities that can be done to improve the industry, reduce insurance consumer complaints, to reduce the number of consumers who have to resort to use of public adjusters thus reducing their insurance indemnification dollars, and to reduce the ever growing field of claim litigation. It is worse now than I have ever seen in over 30 years in the insurance industry.
 
Which claim career field is really responsible for the problems in our industry? Here’s a complex self assessment test. Is all it takes is four questions:
 
1) Who issues an insurance policy with insurance consumers with obligations required of both insurers and insureds? (Key to answer you will find the answer in column 1)
2) Who has to take instructions from who? (Key to answer- see column 2, 3, 4  as they answer to #1)
 
3) Who contributes to the training issues for the claim industry? See columns 5,4,3,2, and 1
 
4) Are public adjusters and consumer advocate attorneys the only driving force behind the increase in claim litigation? Yes in some instances they are but could they be successful in winning claim litigation cases by the hundreds if they weren’t finding examples of bad faith across the board- see 1, 2, 3, and 4 in the graph).  I don’t think  they are the only contributors of these huge costs which are being passed on to insurance consumers when carriers have to consider defense litigation costs when rates are determined by insurance companies.
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So why are we all mixed up and playing the blame game? This is such a goofy game not befitting of an industry that has such an important place in the lives of  every person in America that has been going on as long as I’ve had a career in claims. Here’s how the game works:
 
Step 1 ) Insurance Companies (common to all major insurers) use independent adjusters when a major storm such as Hurricane Katrina and Ike
 
Step 2) Insurance Companies provide training before the storm only to independent adjusters with atleast 2 years experience and to their staff claim departments UNTIL the big one hits
 
Step 3) Carrier Auditing Departments, Claim Examiners and Managers.  and Reinspectors start rejecting files because they don’t provide training or enough information to adjusters. It is provided during a carrier certification class which is usually a one day training session put on by CARRIERS through ADJUSTING FIRMS THEY SELECT or at a one day catastrophe induction center where they do present a good outline of file handling guidelines if you are experienced enough to just make exception to general claim handling instructions you already know
 
Step 4) Newly licensed adjusters are activated to handle claims when carriers lower their 2 and 3 year experience requirements when they THINK they have run out of adjusters based on information from the pre-selected adjusting firms who may service there claims. ***Let me point out here it is like a “where is Waldo” game for independent adjusters entering the industry to find out who is servicing the claims because the majority of CARRIERS provide no information on their website about which firms are handling their claims (God forbid someone might consider them “employees versus independents). See our prior blogs on the cycle
 
Step 5) Don’t overlook the fact that the file requirements and claims guidelines are changed by CARRIERS almost daily when on storm. Even if an adjuster’s file meets file requirements one day, by the time it make’s it through the claims management cycle (Independent or staff adjuster →Claim Examiner or Claim Manager→Insurance Company who approves claim settlement payment and settles claim with insured (often with in office claim trainees who have never handled a field inspection or an inoffice claim operation TEAM so the insured can get bounced around and never talk to the adjuster who actually inspected their claim?
 
Step 6) Who pulls the authority from most independents which takes away great customer service of explaining their itemized estimate to the insured in person while they are out there …see column one. This also applies to carriers who have pulled field adjusters from handling contents claims and additional living expenses so the insured once again has to deal with multiple adjusters (field and in office) rather than having the personal claim service they desire from one adjuster?
 
Step 7) Carriers then blame everyone in column 2, 3, 4, and 5 for causing poor claim survey results and swears to never use much needed independents so experienced independents leave the claim industry as they have no way to support their families.
 
Step 8. ) A major catastrophe such as Ike and Katrina hit and independent adjusting firms are asked to deploy again to assist storm insurance consumers who have no idea what changes have taken place at the carrier’s regarding claim handling standards as the Carriers in Column 1 do not communicate with individual adjusters or hold yearly claim conferences updating them on the hot topics they have been dealing with while independents were at home trying to support their families. Why don’t they have newsletters for independents (refer to comment above on employee/independent issues). No instead they insist they will stop using independents again.
 
Step 9 ) Return to Step 1 and the cycle we regularly experience starts once again.
For two examples of the blame game see the final report of the Citizens  FL Task Force on Claim handling where they submitted their findings to the Citizens Board of Directors blaming both independents and public adjusters for reopen claim issues. I don’t recall seeing where any responsibility was accepted by this now largest insurer in FL except possibly understaffing with field adjusters but they are moving in the right direction training staff and Independents deployed pre-storm and with face to face meeting requirements that they are visiting unannounced to be sure the adjusters are being taught their claim handling expectations and not just glossed over.
 
See also this news article I posted recently where General Manager, Jim Oliver, of the Texas Windpool partially puts the blame on inexperienced adjusters. This is very exasperating to me when I am going on my fourth year of searching for all carrier claim certification classes for members of ClaimSmentor. I can rarely find them except by the few adjusting firms posting in classifieds which are cost prohibitive to most firms when they haven’t gotten many carrier assignments such as in 2006 and 2007. Carriers have staffed up with employed staff adjusters due to their erroneous decisions in the steps above instead of looking SQUARELY in the eyes of their claim training operations, their current trend to leave the responsibility of deployment of independent adjustering firms instead of the carrier maintaining control (again employee vs independent issues).
 
Should anyone question my dedication to keeping independent adjusters informed for the right reasons…it took me 8 hours of volunteer time to produce this one blog entry to provide resources and information for you.  I had no clue as all of our resources were internally generated as claim staff employees.
 
It has been a very long four years studying the independent insurance adjuster industry and learning that while  I had managed them for years that I knew nothing about what went on before they deployed with us. It has been a major eye opener which I openly share with those in our field who need to get caught up to speed immediately in their decisions on entering the independent field and once they confirm that decision learning the professional way to perform their duties. **Update 3/7/09: You can follow this blog through RSS feeds as long as you are not placing it on a site that has banner ad sales or revenue generated through google ads (exception CADO who also spends untold hours volunteering his time for his site). I am getting referrals to this site from Blog Colony which I still have to research which are new this week and have another site copying my links on right column on their website. I am taking proactive action through ICAN  and this wordpress administration who controls websites so be forewarned if you want to remove them if you are using a link to this site to generate revenue for yours. All independent adjusting firms or claim groups are free to put up a blog roll on this such as the one CADO (www.catadjuster.org) has on their blog page in bottom left corner. WordPress does NOT allow banners or search engine ads at this location so I will be proactive with them to shut your feed to this blog if you are using it for such purposes which we can see on our administation dashboard.
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I welcome any volunteers who want to edit my blog entries to correct mistakes made. I was always taught by my mentor , my dad, not to present a problem without a solution….smile. If you have the solution for my lack of social networking editorial skills I welcome your help in this additional e-mentoring project.
 
For other great resource links, articles, and claims news I highly recommend Roy Cupps CADO  site at www.Catadjuster.org which has operated atleast 10 years. His article section, news section, employer rating section, adjuster resume data base, and so much more . The archived forums provide a wealth of information about the independent opinions. We formed ClaimSmentor with Roy Cupps blessing initially in those forums but took quite a bit of harassment from a few bad apples who felt we were taking away their job opportunites so we moved the site to a private site at www.ClaimSmentor.com. I have nothing but the very highest regard for Roy Cupps and the resource links he keeps updating on his site.
 
Here are links to all prior blogs we have written in our archives since we began this service in July 2007 that discuss these issues on emergency licensing, carrier’s deploying adjusters, claim training, insurance regulations, and all other topics we’ve discussed in today’s current blog for a more thorough understanding of the changes needed :
 
https://dimechimes.wordpress.com/2009/03/06/just-one-claimsmentor-moment-2-twia-adjusters-blog-on-ike-claim-handling-issues/
 
https://dimechimes.wordpress.com/2009/02/27/adjuster-overtime-issues-supplemental-info-from-none-other-than-attorney-gloria-allreds-current-news-letter/
 
https://dimechimes.wordpress.com/2009/02/26/compare-twia-manager-jim-olivers-comments-about-a-major-galveston-storm-608-to-209-statement-on-ike-claims-part-i-of-ii/
 
https://dimechimes.wordpress.com/2009/02/23/branch-consultants-whistleblower-case-reinstated-appeal-court-decision-february-2009also-links-to-info-on-the-rigsby-whistleblower-cases/
 
https://dimechimes.wordpress.com/2009/02/19/citizens-of-fl-board-approves-selection-of-30-selected-adjusting-firms-see-list-here-with-websites/
 
https://dimechimes.wordpress.com/2009/02/19/citizens-of-fl-board-approves-selection-of-30-selected-adjusting-firms-see-list-here-with-websites/
 
https://dimechimes.wordpress.com/2009/02/14/twia-texas-windpool-offers-two-adjuster-certification-workshops-in-march-and-april-2009/
 
https://dimechimes.wordpress.com/2009/02/13/independent-adjusters-participant-in-our-poll-on-carrier-certification-exams/
 
https://dimechimes.wordpress.com/2009/02/13/have-license-ready-to-go-not-so-quick-take-this-self-assessment-test/
 
https://dimechimes.wordpress.com/2009/02/05/have-you-registered-for-your-2009-nfip-adjuster-certification-class/
 
https://dimechimes.wordpress.com/2009/02/05/2509-updates-on-the-state-farm-announcement-in-fl/
 
https://dimechimes.wordpress.com/2009/02/03/we-are-back-next-50-hour-online-fundamentals-of-claims-class-begins-march-2-2009/
 
https://dimechimes.wordpress.com/2008/10/08/2008-claims-magazine-claims-salary-survey-is-up-in-the-october-2008-issue/
 
https://dimechimes.wordpress.com/2008/09/20/new-source-for-temporary-housing-in-houston-tx-area-for-adjusters-and-insured-additional-living-expense-temporary-housing-part-ii/
 
https://dimechimes.wordpress.com/2008/09/17/independent-agents-rank-claim-service-as-top-measurement-of-carrier-performance-part-ii-of-claim-and-agency-relationships-can-make-or-break-an-adjuster/
 
https://dimechimes.wordpress.com/2008/09/03/preliminary-damage-statistics-from-hurricane-gustav-updates-on-temporary-housing-in-gustav-damage-territories/
 
https://dimechimes.wordpress.com/2008/08/26/hurricane-gustav-expected-to-be-major-emergency-tx-and-la-license-links-claim-statistics-for-ts-fay-eduardo-dolly/
 
https://dimechimes.wordpress.com/2008/08/21/fl-emergency-adjuster-regulations-for-tropical-storm-fay/
 
https://dimechimes.wordpress.com/2008/08/26/hurricane-gustav-expected-to-be-major-emergency-tx-and-la-license-links-claim-statistics-for-ts-fay-eduardo-dolly/
 
https://dimechimes.wordpress.com/2008/08/07/ms-ag-hood-and-state-farm-reach-agreement-on-katrina-disputes-wednesday-86/
 
https://dimechimes.wordpress.com/2008/08/05/citizens-of-fl-cancels-rfp-for-independent-adjusters-yet-another-time-in-2008-rebid-now-times-4/
 
https://dimechimes.wordpress.com/2008/07/23/hurricane-dolly-makes-landfall-in-texas-checking-availability-for-rosters/
 
https://dimechimes.wordpress.com/2008/06/26/nationwide-insurance-proposes-one-policy-covering-wind-and-flood-coverage/
 
https://dimechimes.wordpress.com/2008/06/02/auto-adjuster-claim-training-updates/
 
https://dimechimes.wordpress.com/2008/05/29/what-role-are-rising-gas-prices-going-to-play-in-your-deployment-decisions-for-hurricane-season-2008-carriers-and-adjusting-firms-should-meet-the-need/
 
https://dimechimes.wordpress.com/2008/05/23/colorado-hail-tornado-of-may-22-2008-updated-damage-reports/
 
https://dimechimes.wordpress.com/2008/05/19/concerned-regarding-adjuster-fee-schedules-for-citizens-of-fl/
 
https://dimechimes.wordpress.com/2008/05/14/citizens-of-fl-changes-independent-training-requirements-for-2008/
 
https://dimechimes.wordpress.com/2008/05/01/insurance-carrier-claim-certifications-where-do-you-test-for-them-much-improvement-needed-in-the-process-of-certifying-independent-adjusters/
 
https://dimechimes.wordpress.com/2008/04/30/va-tornado-damage-the-carrier-claim-numbers-are-coming-in/
 
https://dimechimes.wordpress.com/2008/04/28/top-blogs-of-interest-to-new-adjusters-july-2007-april-2008/
 
https://dimechimes.wordpress.com/2008/04/18/supplemental-request-41808-for-tx-licensednationwide-certified-adjusters/
 
https://dimechimes.wordpress.com/2008/04/11/immediate-need-for-experienced-adjusters-tx-license-for-storm-claims/
 
https://dimechimes.wordpress.com/2008/04/10/overhead-and-profit-claim-settlement-issues-under-attack-in-3-ongoing-cases/
 
https://dimechimes.wordpress.com/2008/04/09/state-farm-seeks-dismissal-on-rigsby-false-claim-actklg-update-levee-break-sher-decision-including-overhead-and-profit-issues/
 
https://dimechimes.wordpress.com/2008/04/08/fifth-circuit-appeal-opinion-overturns-punitive-damages-in-broussard-vs-state-farm/
 
https://dimechimes.wordpress.com/2008/04/07/allstate-releases-mckinsey-documents/
 
https://dimechimes.wordpress.com/2008/04/02/adjusters-read-about-class-action-lawsuit-in-ok-on-overhead-and-profit-issues/
 
https://dimechimes.wordpress.com/2008/03/29/cori-rigsby-january-2008-deposition-hoped-to-remain-anonymous-lets-compare/
 
https://dimechimes.wordpress.com/2008/03/28/branch-consultants-whistleblower-case-appeal-filed-on-the-dismissed-case/
 
https://dimechimes.wordpress.com/2008/03/06/rigsby-whistleblower-rico-case-motion-to-dismiss-3-of-insurance-carriers-to-focus-on-state-farm/
 
https://dimechimes.wordpress.com/2008/03/06/national-association-of-catastrophe-adjusters-membership-drive-to-31508/
 
https://dimechimes.wordpress.com/2008/02/23/state-farm-vs-hood-part-iii-an-interesting-news-alert-today/
 
https://dimechimes.wordpress.com/2008/02/21/60-earthquake-rocks-nv-ut-parts-of-ca-22108-adjuster-information/
 
https://dimechimes.wordpress.com/2008/02/08/errors-and-omissions-coverage-guest-bloggers-dale-moore-client-relations-director-for-cplic/
 
https://dimechimes.wordpress.com/2008/02/06/storms-in-tn-ky-ak-al-in-mo-ms-of-2508-adjuster-information-on-emergency-licensing-and-damage/
 
https://dimechimes.wordpress.com/2008/02/05/luckwhere-preparation-meets-opportunity-published-208-in-claims-education-magazine/
 
https://dimechimes.wordpress.com/2008/01/11/update-on-the-rigsby-ea-renfroe-whistleblower-case-will-the-klg-get-dismissed-on-cases/
 
https://dimechimes.wordpress.com/2008/01/10/do-you-really-know-what-your-errors-and-omissions-coverage-covers/
 
https://dimechimes.wordpress.com/2008/01/09/should-your-adjusting-firm-or-carrier-be-blogging/
 
https://dimechimes.wordpress.com/2007/12/18/renfroes-deposition-in-the-rigsby-whistleblower-case-interesting-look-into-their-thoughts-on-the-case/
 
https://dimechimes.wordpress.com/2007/12/13/ok-declares-state-of-emergency-allowing-emergency-adjuster-licenses-link-for-application/
 
https://dimechimes.wordpress.com/2007/11/20/major-changes-in-the-way-carriers-recruit-and-train-adjustersis-there-really-a-lack-of-available-adjusters/
 
https://dimechimes.wordpress.com/2007/11/14/tomorrow-is-postmark-deadline-to-get-applications-in-to-join-naca-national-assn-of-catastrophe-adjusters/
 
https://dimechimes.wordpress.com/2007/10/25/what-can-adjusters-learn-from-the-2003-cedar-fire-regarding-litigation-and-complaints-on-claims-from-ca-wildfires-blog-4-ca-wildfires/
 
https://dimechimes.wordpress.com/2007/09/29/claim-career-coachingconsultant-services-for-new-adjusters/
 
https://dimechimes.wordpress.com/2007/09/27/independent-adjuster-vs-employee/
 
https://dimechimes.wordpress.com/2007/09/24/insurance-adjuster-overtime-pay-issues-and-complaints-in-the-news/
 
https://dimechimes.wordpress.com/2007/09/21/valued-policy-law-in-florida-thrown-out-update-on-mierwza-safety-concerns-part-2fl-insurance-crisis-update-go-jeb/
 
https://dimechimes.wordpress.com/2007/09/14/field-adjuster-safety-concerns-be-careful-remembering-katie-froeschle-of-tampa-fl/
 
https://dimechimes.wordpress.com/2007/09/13/humberto-makes-landfall-as-category-1-hurricane-damage-links-and-stats-and-adjuster-licenses/
 
https://dimechimes.wordpress.com/2007/09/12/commitment-part-2-standby-calls-what-should-i-do-how-are-cat-codes-determined/
 
https://dimechimes.wordpress.com/2007/09/12/tropical-depressions-8-and-9-humberto-and-ingrid-standby-discussion-commitment-discussion-continued/
 
https://dimechimes.wordpress.com/2007/09/10/the-big-c-commitment-problems-with-independent-adjuster-relationships-advice-by-guest-blogger-rocke-baker/
 
https://dimechimes.wordpress.com/2007/09/08/ts-gabrielle-east-coast-windpool-and-emergency-licensing-information/
 
https://dimechimes.wordpress.com/2007/08/30/adjustin-to-adjusting-guest-blogger-linda-goodson-first-storm-duty-was-katrina/
 
https://dimechimes.wordpress.com/2007/08/23/whistleblower-cases-and-your-e-and-o-coverage-part-2/
 
https://dimechimes.wordpress.com/2007/08/12/splish-splash-dont-go-takin-a-bath-understanding-independent-firm-contracts/
 
https://dimechimes.wordpress.com/2007/07/31/naic-model-independent-adjusters-licensing-act-cancelledand-changes-in-nm-nc-and-tx-licensing/
 
https://dimechimes.wordpress.com/2007/07/30/who-moved-my-claims-cheesedealing-with-change-in-the-insurance-adjusting-community/
 
https://dimechimes.wordpress.com/2007/07/27/claim-career-information-the-pros-and-cons-of-going-staff-adjuster-versus-independent-adjuster/
 
https://dimechimes.wordpress.com/2007/07/26/catastrophe-adjuster-resumes-the-requirements-to-get-noticed-do-differ/
 
https://dimechimes.wordpress.com/2007/07/26/most-commonly-asked-question-is-how-much-income-can-i-make-as-an-adjuster/
 
 

Just one ClaimSmentor Moment #2 – TWIA Adjusters Blog on Ike Claim Handling Issues

March 6, 2009

I found this today when looking at a new feature on yahoo linking to this blog:

http://www.propertyinsurancecoveragelaw.com/2009/02/articles/hurricane-ike/views-from-hurricane-ike-twia-insurance-adjusters/


Breaking News (Smile)- David Rossmiller is Back! First full post on Zach Scruggs

March 3, 2009
 

In the first of our Just a mentor moment sponsored by ClaimSmentor for quick claim hot topic links here we go!

Wow, I had just posted about two days ago in a post about how much those who follow the legal developments on social networks miss David Rossmiller’s posts at the Insurance Coverage Blog.

 Between David’s famous blogs that thousands in claims on our side of the fence (and those just lurking from the other side) get a pretty well rounded pictures of current claim litigation hot topics if you combine reading at Rossmiller’s site expressing an insurance coverage /defense attorney standpoint, Chip Merlin’s blog from a consumer advocate attorney ( an now the infamous Citizens Mission Task Force Consumer Advocate) , now throw in a Slabbed blog review and we have atleast all sides of the published internet social network opinions for viewing.

Yall politics you will love if you want all sides of the stories published together! Hey Yall Politics- when you are you going to add in the Chip Merlin blog to the Scruggs stories so we have all the important blogs? Hint hint…. by the way – wouldn’t claims adjusters and managers love to see these 4 together LIVE on a panel for a Q & A discussion? It would be sold out within 10 minutes!

By the way- if  you scroll down the right side of our blog here, you will find links to Claims Blogs of Interest I have found quite interesting when trying to locate information! We hope you will enjoy them!

http://www.insurancecoverageblog.com/archives/industry-developments-scruggs-nation-zach-was-halfway-home.html#trackbacks

Just another mentor minute link-When was the last time you thanked your mentors?

Here is who I thank as my mentor! Have you thanked yours by paying it forward?

http://www.claimsmentor.com/about.php (Now at 1,010 members and growing)

ClaimSmentor began on 12/08/2005 in recognition of William Robert Kane Sr. my father, my mentor, my friend.ClaimSmentor inception was on the 5th anniversary of his departure.. I thank him continuously for his willingness to mentor me throughout my life and my career. We hope all of you seeking a mentor get matched up so you have someone to truly thank for helping you along the way and that you too pass that on to a new trainee years from now.
 
Thank you David, Slabbed ( I still don’t know who they are), Chip Merlin, and Ya’ll Politics! Now when  will the carriers pipe in? (Yes we know they  THINK they can’t) Feel free to reply to this post and let the claims community know who you want to thank publicly!

Compare TWIA Manager Jim Oliver’s comments about a major Galveston storm 6/08 to 2/09 Statement on Ike Claims- Part I of II

February 26, 2009

It is amazing what you can run across on the internet when you just spend some time looking around.  Anyone that follows posts made here knows we certainly do that…if only we could afford a great editor to turn this information into fine editorial posts!

Atleast we plug along the best we can here given very very limited time these days due to my daughter’s medical recovery from tumors discovered in 2008 and subsequent major surgery a few weeks ago to correct damage caused when the tumors shattered nerves and bones as they developed and the radiation damage caused in the aftermath of tumor removal operations. So bear with me  here and take the information and article  links we post here and gather as much information as you can from the articles. Our goal here is very clear to those in the independent claims industry who have a most difficult time when they are not on assignment with carriers gathering hot topic information to educate them on the problems facing our industry. Reporter NOT…Editor NOT..Journalist NOT but interested in helping independent claims adjusters understand our industry…now that is a BIG YES! I sure miss the days with a carrier having a great administrative assistant to take my reports and by magic turn them into professional appearing work product! (Thank you Gail, thank you Cindy and many others!). So set aside your grammar, spelling, and run on sentence checkers and read the professional articles linked within this post.

While researching information today after reading an article from the Galveston news the other day updating the statistics on TWIA (Texas Windpool ) claims from Ike quoting manager Oliver found here, I ran across another article quoting the General Manager at TWIA, Mr Jim Oliver, over at Gene Taylor’s old website/blog here .

I hope you read both- it is almost scary how very dead on he was about the “what if a Category 3 hit Galveston” written in June 08. I have to say that manager had the intuition and knowledge to evaluate the what if’s correctly and what effect it would have on the state of  Texas and the policyholders. He was almost dead on as well about the dollar amount of damage. This is a don’t miss comparison. Do his comments sound familiar about major carriers pulling off the coastal coverage?

A few comments on the first link in the February 09 article found on MS Congressman Gene Taylor’s old blog.

Here we go again about “inexperienced adjusters” quoting from comments by Jim Oliver. I’m sorry but someone has to stand up for those inexperienced adjusters  and independent adjusting firms (whose hands are tied as to who can and cannot attend the carrier training based on experience) who they had working some  of the TX Windpool claims. I am not blaming TWIA .It is a constant problem in the Insurance Company/ Independent Adjusting firm/ Independent Adjuster relationships.

Let me explain why. I feel qualified to do so after founding and supporting our site  at ClaimSmentor where we have over 1,000 partipants with about 50% of them being new independent adjusters. I can tell within 30 days of membership those who are serious about their training and those that thought  it was a “get rich quick scheme” or career because they either 1) walk away and forget the thoughts of a claims career  when they find out how much is really involved BEFORE deploying or 2) they are extremely serious in their pursuit of professional claims development and I see them on the site forums at night and on weekends (you would NEVER find staff doing so if they aren’t on salary or on the clock).

They spend literally thousands  of dollars and time without the benefit of an employers expense account for per diem while attending carrier certification classes, taking required estimate software training classes, adjusting firm conferences, being forced in some cases to pay for training   just to get on rosters in hopes of being deployed on a storm (I’ll post some unbelievable samples for you tomorrow).

Now here is the real kicker that goes on every day in this industry which drives all of us crazy as there is no such thing as a carrier mentoring new independent adjusters. All national carriers and the windpools set a minimum number of years experience  required BEFORE an independent adjuster can sit  in at an independent adjusting firm designated by the  carrier’ to administer  required training for them. The carriers may send one to a few representatives to the adjusting firm selected to present the material but that isn’t always the case either.

It is usually a minimum of two or three years experience required yet the carriers do NOT allow them to take carrier certification exams without the experience….until something major hits and then they often waive the certification requirement if they are licensed. Heck- look at TX emergency adjuster license information  on the TX Ins Dept website and they even allow emergency adjusters to work under an experienced adjuster (unless they changed something recently).

 Also, check around on the majority of carrier websites and you will not even find mention on their claim links  information or links to independent adjusting firms who they can take classes with so independent adjusters  even know who presents them. It is all based on who they  (independent adjusters )  know and what advertisements or forum posts they find as to where they can find an exam to take.

In additon, thousands travel across the country just to find one. I do not know of any carrier yet adminstering them online. Rumor has it one major carrier will be presenting their training on laptops given to the adjusting firm but the independent will still have to travel across the country to watch the laptop presentation and to take the test. We understand the need for a proctor to administer the exam but come on….how about Prometrics or one of the exam centers with national services where adjusters take license exams? How about the fact that an independent has no clue who may call to deploy them from an adjusting firm standpoint so they have to take as many carrier exams as they can complete before each storm season so they can go? What about the fact the carrier’s often think that there are no experienced adjusters available when the reality is there are many many independents who are turned away because they just haven’t taken their exam yet prior to the storm the carrier will not make any common sense exceptions yet they have 20 years in the  claim industry? Believe me this does go on…I hear it from adjusters, adjusting firms, and my claim staffing firm has experienced this many many times.

I am not supporting inexperienced adjusters with a license only…just the inexperienced adjusters who have taken classes (not 3 day schools or worse yet a one day class!)  and by that I mean classes approved by state insurance departments who approve  trainers  for CE courses sometimes requiring  at minumum 5 years or more experience in the m industry person and continuing insurance education in insurace such as the AIC or CPCU designation?  It is one thing to have field adjusted claims and an entirely different thing to manage claims and understand all of the reasons there are file requirements due to Bad Faith claims and the current litigation environment.

Today there are many experienced adjuster resumes from adjusters with 10 plus years experience with a vast amount of litigation experience that can run circles around some carrier “claim examiners”, reinspectors, and entry level claim managers. I hear these war stories too from the field. Why is ok for all the blame about what went wrong on a storm squarely on the shoulders of independent adjusting firms and independent adjusters who are required to follow carrier established guidelines. As the saying goes “if they tell you to staple the photos upside down…don’t argue or we will lose our contract to service their claims”.

Now exactly how are they  (independent trainees ) supposed to gather that experience?

Experienced independent’s do not have time to train them as it slows down their productivity and they do not make one dollar until closed files get approved and they receive payment usually weeks and months later. Believe me, the carrier quotas for contact and inspections in  this industry are sometimes impossible for staff or independent adjuster to meet. The carriers are driven by Department of Insurance deadlines for contact, inspected, and closing numbers and atleast in the past they had to report those numbers at minimum to the department of insurance on a weekly basis. The second concern I hear regularly is that they would be concerned about liability issues if a trainee they aren’t responsible for as an independent fell off of a roof or if the adjuster happened to be involved in an accident while handling inspections on their daily agenda? These are valid concerns. That is why we started ClaimSmentor- to see what we could accomplish online to avoid those concerns and I can tell you – it works and they will be much better trainees when they can accompany a field adjuster later during a storm.

I agree with the decision of carriers to best service the policyholders however….when something major such as Ike or Katrina causes massive damage those requirements are thrown out the window and anyone with a license can successfully deploy without any real life training or often given a one day training seminar when they arrive on site.

How about the carriers that cross train  staff claim central adjusters who have NO field experience versus a good percent of independent adjuster trainees that often have fantastic construction general manager experience, insurance agency experience, or other skills much more easy to work with than trying to train someone on construction.

I can vouch for the fact it is easier to teach a contractor who knows construction and estimate programs to complete claim forms and learn policy than it is to teach an in office phone adjuster who has no construction experience to learn that side of adjusting. I know- I started in office and moved to the field after two years in office so I understand the difficulty dealing with construction training while handling an insured in crisis.

Ask anyone who has deployed with merely a license if an adjuster’s license prepared them whatsoever for a carrier’s file requirements, estimate format or estimate scoping guidelines and they will tell you definitely NOT!

What about the carrier staff adjusters who may not even have a non resident license in that state? Check any insurance department website and see what they have to say about waiving non resident licenses for staff adjusters. Is it because the carrier has deep pockets and independent adjusting firms and adjusters do not in the event something goes wrong or do the insurance departments merely assume the carrier’s have trained all in office folks before deploying them on a major disaster?

 How about the carriers that are forced to use auto adjusters to adjust property claims because their executive office forbids use of independents in these poor economic times and worse yet underwriters who definitely have a great grasp on coverage but no clue how to handle a claim or to understand construction  repair concepts?

This is a nationwide problem with most carrier’s which I have never understood.  If we accept premium dollars do we not owe it to policyholders to have the properly trained claims adjusters?

Hail damage experienced adjusters do not necessarily understand total losses for major hurricane damage or major fire loss damage estimates.

There is alot of improvement needed all around in the catastrophe claims industry on the carrier side , the independent side, the insurance department regulations, and the National Assn of Insurance Commissioner’s who cancelled the proposed National Independent Adjusters Model Licensing Act which those who are independents do not understand to this day. I’ve blogged about that in the past and will post a link to that blog in Part II.

Watch later this week for part two….for tonight- enjoy reading the two articles. You will definitely be quite shocked at Jim Oliver’s correct assessment of what would happen in Galveston.

I’ll also leave you with a link for Slabbed’s  interpretation of this article and TWIA from a consumer perspective written today after I shared a link to the Galveston article with them based on an entirelydifferent  blog discussion we had the day before . You’ll find their blog article here.

You may disagree with Slabbed posts but if you follow them regularly you will atleast come to the understanding they are diligent in their efforts to help slabbed  homeowner’s(those who lost entire home but the slab during a storm) in the fight about homeowner policy exclusions that create the non coverage issues . I feel the same way about Attorney Chip Merlin’s blog entries. If you don’t know Chip…and I have never personally met him..he is a force to be dealt with. He has offices in FL, MS, and now Houston as well.You can also find photos of him giving a seminar at the National Public Adjuster Association conference at www.NAPIA.com.  

 In fact, I link to his  blog often as well for training purposes. Yes, I do understand he represents the insured not the insurer but that does not change the fact we can learn from his articles and blogs when you don’t find any insurance attorney’s writing such great blogs (except Rossmiller who hasn’t blogged for almost 6 months). If an independent or staff adjuster read them such as his posts on Bad Faith…he is “shouting from the roof tops “that would prevent adjusters from being sued if they just followed fair claim handling guidelines. You just have to “toughen up” to read both and have a thick skin so you don’t take the negative comments about the insurance industry as a whole personally. By the way…if you are a Fox news  fan or Headline News  fan it might be, he is regularly interviewed on the horrific missing childrens cases in central FL (Caylee and Haleigh) . You shouldn’t let the negative comments keep you from reading some important information and articles on his website and blog. Both Slabbed and Merlin’s blogs post links to court documents on active insurance claim litigation we all rarely ever get an opportuntiy to view since staff nor independents are privy to file documents on a claim not assigned to them.

 Truth be told, adjusters inheriting files from a few bad apples  (experienced and inexperienced it just depends on the adjuster’s ethics and training) make the same comments about some files involving poor file claim handling by a percentage of adjusters. The only difference is staff and independents cannot post publicly for fear of losing their jobs. It still doesn’t mean we can stick our heads in the sand and not study the issues and all work a little bit harder to do the right thing no matter what pressure we are under and we all know how bad that pressure is on storms such as Ike and Katrina.

I’ve been there and have so much empathy for not only the claims industry but for policyholders suffering these losses with no coverage. I’ll post more on the 2009 Multi Peril Act as well later this week.

Speaking of Attorney’s, what happened to one of the rare great blogs with the insurance company perspective many of us followed over at David Rossmiller’s blog? Those of us who follow these forums and blogs miss the point and counterpoint between the insured’s perspective and the carrier’s perspective! If you know if Rossmiller is ok, let us know! I think his last blog was in September of 2008 which is remarkable considering his opinions posted on Scruggs and Scruggs recent appearance in MS court with no comment from Rossmiller.

********

Update 1:24 am CST- Ok- I just had to add one more great article titled “Talent Cultivation” from a February 09 issue of Claims Magazine found here:

http://www.claimsmag.com/cms/Claims/Monthly%20Issues/Issues/2009/02/Features/FEATURE%20cover%20story?origin=channels-Education-Training

**Link will move to archived links there when the March issue comes out.

When will carriers learn if they are going to depend on independents for major catastrophes as they downsize their staff that they need to make carrier certifications more accessible online and that independent adjusters need to be trained when they don’t have an inbox overflowing with new assignments waiting for them after a storm class on scene. They can have an “A” list of experienced certified independents that are activated on regular hail storms and a “B” list of less experienced independent adjusters also trained and ready to go when the major storms like Ike and Katrina! Now that would be talent cultivation and a claims mentor of the finest nature! We have hundreds of very trained adjusters  as well as experienced adjusters. At ClaimSmentor  you can deploy with NO fee as we invite your HR departments to post job opportunities for both experienced and for trainee adjusters  and independent claim managers and claim examiners regularly!

Join us and come in and download their resumes!  You decide if many of them are better than a newly licensed only trainee!

**Update 2/27/09…Just one more link: Here is a Self Assessment Test with 125 questions a newly licensed adjuster can review and see how many of these topics covered in our Fundamentals Class at ClaimSmentor  and this is far from a complete list of basicessential things they need to know before deploying.

You can’t teach this im a 1 day or a 3 day class. They may learn very very basic essentials but many that take my class online after taking many very good field classes advise that much of this material was not covered. Mind you these are new adjusters who have taken and passed adjusters license exams, estimate software classes, and in many cases have passed atleast 1 carrier certification exam. They usually have the 3 basics at minium (license, software, and 1 carrier certification ) and tests that cover basic estimating but not the majority of these other important topics. Is it any wonder we have files often mishandled due to a lack of training?

https://dimechimes.wordpress.com/2009/02/13/have-license-ready-to-go-not-so-quick-take-this-self-assessment-test/

Carriers should not complain about needing inexperienced independent adjusters not trained on claim file requirements if they are not willing to let them take their training. They pick up the expense as independents. Follow the example of NFIP who allows them to attend their workshops but will not certify them without 4 years experience….but sometimes make exceptions during major disasters IF they took the current year’s workshop.

My many heartfelt thanks go out to the now hundreds of experienced adjusters who participate on ClaimSmentor to help answer trainee questions without any hassle in our forums and even join us sometimes stopping by in our live online classes for trainee adjusters as well as thanks to the claim managers who also do the same. Our site would not be possible without their partipation and willingness to support our e-mentor project.

**Update 2/28/09 10:45 AM: I had not been following the claim statistics that often recently and today ran across an Insurance Journal article form August 08 about the TWIA losses already depleting funds when two other minor hurricanes came in before Ike. Read this link for the information:

http://www.insurancejournal.com/news/southcentral/2008/08/26/93100.htm


Branch Consultants Whistleblower Case Reinstated- Appeal Court Decision February 2009/Also links to info on the Rigsby Whistleblower cases

February 23, 2009

We had previously written on this blog about the Branch Consultants case being dismissed in this prior blog entry on 10/17/07:

https://dimechimes.wordpress.com/2007/10/17/branch-consultants-vs-multiple-insurers-whistleblower-case-thrown-out-by-judge-today/

Here is another blog  on 3/28/08 we wrote about the appeal filed with links to many other blogs and news articles:

https://dimechimes.wordpress.com/2008/03/28/branch-consultants-whistleblower-case-appeal-filed-on-the-dismissed-case/

We have now learned the Appeal Court decision of February 09 has reinstated the case.

We have located some news coverage giving many more details to include a news link at State Farm who was now dismissed from the case commenting about the case. Some of these articles do include the names of which companies have been dismissed from the case and which insurance companies, adjusting firms, and software estimating companies are still named in this case.

 Here is a link to the news on State Farm’s Katrina news link:

http://www.statefarm.com/about/hurricane/dismiss_qui_tam.asp

Attorney Kanner who represents Branch Consultants has information up on the Qui Tam section of his website that contains information about numerous news articles that have been published on this case here:

http://www.kanner-law.com/CM/LeadingCases/LeadingCases88.html

For those who remember this case with the 4 unnamed whistleblower cases  (the news says they are PA’ s (public adjusters) filed under “Branch Consultants” who we never could find a website for, the Court of Appeals reopened the case this week. We did locate the name of one of the adjusters in a news article linked to in the first blog above (Max Johnson named in a news article):

Here is a blog post over at http://www.slabbed.wordpress.com with links to the court documents from this week:

http://slabbed.wordpress.com/2009/02/19/allan-kanner-can-just-evermore-kiss-my-ex-rel/

To see lots of blogs Slabbed has posted updating the status on the EA Renfroe/State Farm/Rigsby cases you can also view these- there are so many I don’t even try to post them all but many are interested in these cases:

http://slabbed.wordpress.com/legal-qui-tam/qui-tam/

And here is the news story with a good summary and update on the Branch Consultants RICO suit: (Note this names the carriers, 3 adjusting firms and software firms involved in this whistleblower case):

http://blog.nola.com/tpmoney/2009/02/new_orleans_whistleblower_laws.html

**Update 2/25/09:

http://slabbed.wordpress.com/2009/02/24/adjusting-the-adjuster-defendants-in-katrina-qui-tam-litigation/

***Update 3/1/09

Great article at National Underwriters P & C with information about State Farm and Allstate being dismissed from this case.

http://www.propertyandcasualtyinsurancenews.com/cms/nupc/Breaking%20News/2009/02/23-APPEAL-mr?origin=Auto%20and%20Homeowners