I work for a vendor and we have had a good repour with the carrier adjusters because they know what it takes to settle a claim. The big issue is these outside providers who are out of state that I send my estimates to too review and they review them before they go to the carrier. The problem here is they are adjusting claims when they have never been to the loss and are not licensed. They are telling me what to remove and questions me when I have over 45 years in the insurance and contracting back ground. These are the ones who should be investigated. A lot of the times they will hold a claim in there system until I make corrections and I won’t make the correction because that line item is needed. So I call the adjuster to handle it and a lot of time they can’t because it first has to go though the system so the customer ends up waiting a lot longer then they should. Contractor connection – sedgwick — alacrity There the ones who need to be investigated. Plus if we get the job they get 6% of the total job and if we go out to write an estimate they also get 6% of the estimate fee and all they do is bust my balls and we have to pay them for that
Attorney Merlin points out extremely valid issues I have faced in my 30+ years as an insurance broker. I also agree the practice is, without a doubt, growing…even within at least one of the best known HNW carriers. Intentional or not, the practice of dispatching specialist vendors instead of claims adjusters circumvents fiduciary and good-faith duties owed to policyholders as well as the standard of care companies promise to them. It allows insurance companies to be plausibly “ignorant” of practices they cannot commit themselves, effectively undermining policies and procedures in place protect policyholders.
I’m not saying there aren’t situations when a specialist vendor makes sense, emergency water mitigation being an example. However, the vendor should never be the first point of contact. Neither should they “act” or allow themselves to be “perceived” as an adjuster or employee of the insurance company. If they are acting as “feet on the ground” they must be instructed to gather all information and possible damage. They should never be allowed to limit the scope of damage; as I have known to happen. This is denying coverage, which is an adjuster’s job and must be supported by specific policy language.
Kudos to Attorney Merlin and Claims Journal for bringing this matter to the forefront so all stakeholders can hold insurance companies accountable for laying their duties at the feet of vendors as well as keeping an eye out for vendors who step outside their role.
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I work for a vendor and we have had a good repour with the carrier adjusters because they know what it takes to settle a claim. The big issue is these outside providers who are out of state that I send my estimates to too review and they review them before they go to the carrier. The problem here is they are adjusting claims when they have never been to the loss and are not licensed. They are telling me what to remove and questions me when I have over 45 years in the insurance and contracting back ground. These are the ones who should be investigated. A lot of the times they will hold a claim in there system until I make corrections and I won’t make the correction because that line item is needed. So I call the adjuster to handle it and a lot of time they can’t because it first has to go though the system so the customer ends up waiting a lot longer then they should. Contractor connection – sedgwick — alacrity There the ones who need to be investigated. Plus if we get the job they get 6% of the total job and if we go out to write an estimate they also get 6% of the estimate fee and all they do is bust my balls and we have to pay them for that
Attorney Merlin points out extremely valid issues I have faced in my 30+ years as an insurance broker. I also agree the practice is, without a doubt, growing…even within at least one of the best known HNW carriers. Intentional or not, the practice of dispatching specialist vendors instead of claims adjusters circumvents fiduciary and good-faith duties owed to policyholders as well as the standard of care companies promise to them. It allows insurance companies to be plausibly “ignorant” of practices they cannot commit themselves, effectively undermining policies and procedures in place protect policyholders.
I’m not saying there aren’t situations when a specialist vendor makes sense, emergency water mitigation being an example. However, the vendor should never be the first point of contact. Neither should they “act” or allow themselves to be “perceived” as an adjuster or employee of the insurance company. If they are acting as “feet on the ground” they must be instructed to gather all information and possible damage. They should never be allowed to limit the scope of damage; as I have known to happen. This is denying coverage, which is an adjuster’s job and must be supported by specific policy language.
Kudos to Attorney Merlin and Claims Journal for bringing this matter to the forefront so all stakeholders can hold insurance companies accountable for laying their duties at the feet of vendors as well as keeping an eye out for vendors who step outside their role.