April 19, 2019

“$#*! My Claims Manager Says: 10 Adjuster Pet Peeves”

“Raindrops on roses and whiskers on kittens” were some of Julie Andrews’ favorite things in “The Sound of Music.” Adjusters likely have their own favorite things, but that is not usually what claim professional’s grouse about to each other. More likely, adjusters compare notes about the stuff that drives them crazy. This has not only a cathartic effect. Knowing adjuster pet peeves and what drives them crazy can help those who work with adjusters. This includes the gamut of vendors and business partners such as defense lawyers, rehab specialists, surveillance firms and expert witnesses. Bosses – such a claim managers and supervisors – who are attuned to what sets adjusters off, may be able to avoid those things, thereby boosting morale and employee retention.

Pet Peeves

So what sets adjuster’s teeth on edge? What drives them crazy? Here is an informal and highly subjective list:

#1. Cheapskate insurance buyers. Policyholders who make insurance-buying decisions based on “the cheapest quote,” and then feign surprise when they don’t get platinum claim service. Duh!! Usually things are cheaper for a reason … If you check into a Motel 6 and pay a bargain basement price, please don’t whine because the hotel lacks concierge service and a mint on the pillow. When shopping for insurance, many accounts are “all about price.” When they have a claim, it’s all about service. Sorry, but those two usually go hand in hand – both in claims adjusting and in other realms.

#2. Instant claim experts. Culprits here: brokers on commercial accounts who become experts on reserves 30-days before renewal. Scenario: Broker Dopey pays scant attention to an account’s loss runs or claims history until the policy expiration looms. The underwriter quotes renewal terms, but at a 43% increase over the expiring policy. Startled and alarmed, the broker demands to know the reason. The underwriter points to a deteriorating trend of claim reserves. It dawns on the broker that incurred loss ratio actually does impact renewal terms and announces that the case is over-reserved. Suddenly galvanized, the broker becomes an expert on claims and reserve-setting, telling the adjuster that the number is too high. (Nothing like an impartial assessment!) The actuary looks at the same file and tells you it’s under-reserved. Go figure …

#3. Having to cover the actuary’s @$$. The problem here is claim management getting called on the carpet by The Corporate Gods to explain why actual loss trends did not align with the actuary’s projections. Huh? I guess that’s easier than suggesting that the $600/hour actuary who never soiled his hands by looking at a real-life claim file is out of touch. Plaintiffs and lawyers have the annoying habit of not checking with corporate actuaries before filing their lawsuits. A radical notion: go back to the actuaries and ask them to explain the reasons their projections deviated from actual loss patterns.

#4. Gasbag defense lawyers who phone, yak for 45-minutes on routine items and then close by saying, “I’ll put this in a letter to you …” Arghhhhhh! Thank you – you have just wasted my time two-fold! Fix: be sparing in initiating phone calls to adjusters. Be brief on the phone. Email a request for a block of phone time to let the adjuster schedule you in his or her calendar.

#5. Attorney evasiveness. Defense counsel who cannot give a straight answer to the question, “Based on all you know thus far, what is a fair compromise settlement value as to MY policyholder?” Instead, you get hemming and hawing, “One the one hand but . . . on the other hand.” (Get me a one-handed defense attorney – Stat!!) I know it’s a tough call to make, but that is why I’m paying you $250 an hour!

Related to this annoyance is defense counsel who cannot give a straight answer to the question, “What will the case cost to defend?” More hemming and hawing. I know that the answer often is, “It depends.” I also recognize that sometimes these costs can spiral due to factors beyond defense counsel’s control. (They can also plummet sometimes for no reason related to defense counsel’s efficiency.) If different scenarios will produce varying cost-of-defense numbers, give a budget for each scenario and I can take it from there. For example, “Budget A reflects the costs if we win our Motion for Summary judgment, Budget B reflect how things will unfold if we lose it, Budget C envisions taking the case to trial …” etc.

#6. Lame lawyer promotional pitches. Here we have defense counsel with lame-oh marketing pitches who cannot succinctly state what competitive advantage they have over the hundreds of other attorneys/firms in the same space. Or who reply with bromides such as, “We work hard” or “We are cost-effective.” Please be more creative than that! If this question catches you off-guard or only evokes platitudes, it tells me you have not done your homework. Solution: perfect your “elevator pitch” on why your firm really is different!

#7. Gasbag written reports from defense counsel that bury the important stuff on page eight, paragraph three. I don’t have time to search for a needle in the verbal haystack, that golden nugget tucked away. Better still, make your written product user-friendly. Give an up-front one-page Executive Summary highlighting your finding and recommendations. If I want to probe amongst the weeds, I can then delve into your more detailed memo behind the Executive Summary.

#8. Misleading service representations. Defense firms that assure you that your written guidelines are no problem but betray by their initial billing, reporting or handling that they haven’t the foggiest. Like bobble-head dolls, they nod as you explain the highlights of your guidelines. Remedy: lawyers who read and heed client guidelines! Conduct periodic in-house training refreshers on client guidelines. If anything is ambiguous or unclear, ask!

#9. Defense firm bait-and-switch. Defense firms who “court” you with a rainmaker senior partner when you are a prospect but who staff your case with an unknown newbie once you become an actual client. This smacks of bait and switch. Caveat: if they ask you to staff the case with a newbie or make a cogent case as to why it makes economic sense, be open-minded. It just may make sense, given the exposure and complexity of the case. Don’t assume that all newbie’s are incompetent.

#10. Useless attorney newsletters. Defense firms seem to think we have an innate fascination with how the Eight Circuit held on such and such case instead of offering is PRACTICE TIPS we can use or consider based on that ruling. Remedy: law firms who report on developments but who go the extra mile in explaining the practical take-aways for claims people. Where is the “news you can use”?

Well, this is the end of the rant. Thank you — I feel better now. Surely you have your own pet peeves as an adjuster. What are they? Share them here or email them to me at kevin@kevinquinley.com

Comments

  1. I couldn’t pass this up; even at 3:40 A>M> (don’t ask).

    I’m NOT an adjuster, but I’ve been around for long enough to have a few valid opinions. My number one complaint:
    You go to 8 hours of boring C.E. meetings and have “fraud is evil” hammered into your head. Then some manager decides that “settle, settle, settle” should be the credo.

    Failure of management to select and then follow through on appropriate training. Good training should never ever ever be overlooked.

    Failure of designated “go to” company people for certain cases. If you don’t have a clue what a spondololiothesis is (can’t even spell it), how can you rationally evaluate it?

    Paid whores — we all know exactly what those are, who they are, and we rely on them anyway. Too many carriers have nothing independent about an IME.

    Day old donuts and the cheapest crap coffee known to man in the break room. C’mon guys.

    BEAN COUNTERS.

    Out-dated inefficient “manuals.”

    Carriers who do not encourage interaction (of the work variety) between adjusters. Inidivdual knowledge may be limited, but combined knowledge is a plus-plus for everyone.

    “We’ve always done it that way before.” (Don’t even get me started ….)

    Out dated forms or formats that must be completed.

    The checklist mentality that must be followed USING those out-dated forms.

    Lack of ongoing educational materials. How does any astute investigator broaden his/her horizons if he does not have his own copy of JCFR?

    Companies that have never realized that an adjuster or an investigator IS HIS ROLODEX/ADDRESSBOOK/ OR KNOWN CONNECTIONS. Picking up the phone and getting to the right person instantly saves an incredible amount of time having to wade through a half dozen “little folks.” Forking over the money/time to attend a 2 hour monthly meeting and eat a $20 lunch among peers can save the company countless hours of wasted time.

    I suppose it all boils down to being able to think Big Picture, rather than Small picture.

    Okay, it’s almost 4 a.m. — how many more do you want? (I’m going to sleep, darn it!)

    Want more? The list is looooooooooooooooooooooooooooong.

    LK

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