The Independent Insurance Claim Adjuster Resource

Scenario: Even before I began working with Peak Claims 5 years ago something was on the forefront of my mind and now more than ever seems like a great time to bring it up.

Why now? Primarily because Peak and other adjusting companies are being asked to handle files at the same fee schedule rates for 5 years; with an expanded list of responsibilities for each claim. The mere thought of such a request is disgusting; are insurers paying the same rates for roofing repairs they were 5 years ago?  What about paint?  Even the clean-up guy has seen a raise.  Unless I missed my last rate decrease , insurers have certainly given themselves some lee-way with rate increases.

The reason for this is simple:  Independent Adjusting Associations and companies have failed to put any pressure on insurers or produce any real efforts to mitigate this situation; mostly because they fear their clients.

Independent Adjusters are not dispensable and deserve to be treated with respect and dignity for their experience.  Based on the foregoing information and experience it’s quite clear that I need to drop this client like a hot box of rocks, not only for the 5 year inflation that I’m eating but also for the lost time that would likely be better spent marketing to other businesses.

Have you been in this situation before as an adjuster or adjusting company? We would love to know your thoughts on unionizing Independent Adjusters – feel free to leave a comment…

If you have worked with more than ten claims resulting from any kind of hail storm you’ve probably been exposed to what is commonly known as “neighboritis”.  Neighboritis is practically like a bad case of the flu; it spreads easily. The only logical cure is awareness of this costly and time consuming problem.

Neighboritis is a serious condition that needs to be addressed because it is damaging to independent adjusting companies and independent adjusters. The effects of neighboritis in relation to independent adjusting companies are discussed in this separate post.

Neighboritis happens in following stages:

1. A roofing sales person claims to be a hail expert and finds a neighborhood that was never really exposed to hail damage, or was exposed to hail that did not caused damages.  The sales person knocks on a door and claims to be a roofing expert, explaining to the homeowner / insured that they were exposed to hail and that they have damages on their roof.  The roofing sales person then offers the homeowner a new roof at NO COST, but only if he can inspect their roof right away and usually before the insurer is even notified of any potential claim.
2. The roofing sales person then works to smooth out any skepticism the property owner has by explaining the various values of a new roof in relation to property value.  Homeowners catch on to the concept that they could end up with a new roof at no cost and it takes little convincing that hail may have fallen and damaged their roof when they weren’t aware.
3. The salesman convinces the homeowner that they need to conduct a brief roof inspection to see the hail damages.
4. The salesman pushes the homeowner to sign a “contingency agreement”, although usually unenforceable by law.
5. The roofing sales person gives the property owner incentives to “spread the word” (neighboritis) by offering $500.00, $1,000.00 and larger referrals if neighbors sign on for their roof at no cost.
6. In the worst case scenario, the roofing salesman tells a story of his or her working with neighbor John Doe on his roof for hail related damages; all of which are a result of only having a contingency agreement.
7. One or two inexperienced property insurers pay for roof replacement when it was completely not necessary or by having mistaken mechanical damages for those caused by hail, thereby initiating one roofing salesman to claim that other roofs were replaced because of hail damage.  In extreme circumstances, a roofing company may have been hired outside of an insurance settlement to replace an aged roof and the same company comes back several months later, after hail occurred in a remote area, advertising that a nearby neighbor had their roof replaced (not indicating why) and thereby starting a frenzy in the area.

As you can imagine, the question has and continues to remain about what happens when said roofing salesperson is up on the that roof with no supervision? What is the viewpoint of a profitable insurance adjusting company on neighboritis?

Eight years ago I was on a roof with a roofing salesman named Mike who would bend down towards the shingles every time I turned around to take a photo or put my eye up to the viewfinder.  I couldn’t help but notice the little yellow lighter Mike was clutching from the corner of my eye.  Just as I suspected he was making his own damages hoping I would mistake them as those caused by hail.  Mike wasn’t the first nor the last but these salesman have wised up to creating false damages in front on insurance claim professionals.  Since then I’ve personally witnessed and documents familiar conditions on 8 other occasions; most of which occurred prior to the times we were expected to meet for a survey.

So, to answer the question of what could happen when a roofing sales person is on a roof with no supervision or oversight – let’s just say the potential for mechanical damages not caused by hail exists.  Neighboritis is a deceiving tactic used by roofing sales persons and companies to extract money for claims that do not legitimately exist.

Neighboritis can be prevented with awareness.  One way to help prevent this condition is for insurers to notify their clients in high-hail areas that roofing salesmen are out and to be aware of their sales-roof inspection tactics.  The general population in hail and storm chasing contractor areas can get used to the idea of joint roofing surveys prior to allowing a financially motivated roofing salesman on a roof.

What do you think about changing the ways that insurers and property owners work with roofing companies?  We’d love to hear your input – leave a comment!

by Phillip Crimaldi – Editor & Insurance Claim Analyst – May 19th, 2010

On any given day my office is prepared to remind inland residential property owners how much worse their $5,000 claim for water damage could have been.  While we are sympathetic to the average homeowners property claim, one mention of Hurricane Katrina will usually save us several minutes of ranting from the common property owner.  I always tell them “it could have been much worse”.

It is easy to remind these these folks about how much worse it could have been because I was there in Slidell, Marrero, Chalmette and dozens of other cities and towns for the months following Hurricane Katrina.  Witnessing the interiors of people’s homes and lives is an image that will be permanently etched in my mind forever.

That’s exactly why I think this oil spill poses a serious threat to all property owners along the Gulf Coast.


If you’re not following my thoughts just yet, let me drop this one on you:

“Wind Driven Oil”

Just in case you’re out of the loop, dozens of insurers had Civil and Regulatory Complaints filed against them for failing to recognize that some interior water damage was caused by rain;  we’ll have to spare you the details of these cases for another post.

Wind driven oil might become a reality for insurers, property owners and every living thing on the Gulf Coast line.

We’re not talking about requiring the heartless destruction that Mother Nature rained down on the Gulf in late summer of 2005, but rather only needing ~70 mph gusts to drive that oil right off the coast line and up into the air.  How far it travels likely depends on how fast the wind is moving and several other factors, but one thing is for sure; if cinder-block buildings couldn’t stand the wind, neither will the oil.  It’s true that we’re here attempting to calculate the potential risk to property late on a Wednesday night, but what about the rest of the Gulf?  We’ll just have to leave that up to the scientists and engineers, but if our calculations are correct it could be devastating to vegetation, nature and property.



While the news headlines, scientists, meteorologists and everyone else is talking about how hurricane season might carry the oil around the Gulf, it seems almost foolish to doubt that mother nature couldn’t put an unpredictable amount of that oil on land.  Even if Hurricane season doesn’t make a full on strike against the Gulf. I’m willing to bet insurers will have a hard time denying the window cleaning bill, at minimum. Leave a comment!

Phillip Crimaldi is the Director and majority shareholder of Peak Claims, Inc. -  A Denver, Colorado based cargo damage surveying and claim services company.

In this second part of Loss Notification for Independent Adjusters we’re going to discuss what you might consider when writing a loss notification letter to an insured. We’ll get to claimants in another post.  Please read Part I if you haven’t already because it sets some background up for the whole concept of writing these important documents.

The most important part of writing to an insured is to keep the all knowing and ever important independent adjuster mantra in the back of your mind, which is “I’m an independent adjuster conducting an investigation on behalf of said carrier.” Notice the period at the end of that sentence?  It’s there for a reason.

We’re not trying to hide anything from the insured, rather there is nothing to tell or speak with the insured about at this point because independents rarely receive settlement authority without at least one brief report to our client with some form of evidence attached.

Bad faith lawsuits and claims against carriers, independents, and others happen far too frequently for the simple reason that the adjuster couldn’t keep quiet.  This happens most often when an adjuster feels sorry for a person and thinks it would help to try and ease the insured’s concern by saying something aligned with a payment for coverage.  This can damage the reputation of independent and staff adjusters alike because promising a coverage that doesn’t exist is bound to upset any insured or claimant.  Sometimes, when there is clear coverage an insurer may have good reason to deny a claim such as information that responsibility rests with another party’s applicable coverage.  This is information you may not be privy to in a loss assignment or something that the insured is hiding intentionally.  Even then, it is not completely unheard of for an insurers to deny a claim for no good reason, which is exactly why you need to keep an emphasis on your impartial and non-biased view that relates strictly to the facts. Read more…

Most independent insurance adjusting offices utilize some very common practices upon acceptance of an assignment.  The adjusting firm is usually required to make  contact with some combination of insured, claimant(s) and or witnesses, if any.

For your typical “common loss peril” such as hail or wind it’s generally acceptable to handle the loss acceptance via email and the loss notification to the insured with a phone call.  It seems perfectly normal that this is the standard for most every adjusting firm, but what about larger losses? What is acceptable to the client and their insured?  What provides for an adequate amount of protection without sparking the insured’s interest in retaining counsel or a public adjuster?

Though it’s the insured’s every right to have counsel, it is no secret that attorneys and public adjusters drive the claim dollar “through the roof”, and more often than not out of the adjuster’s hands.

Let’s get one thing straight out of the box here:  If you have been assigned a file with an expected loss of $50,000 in the property & casualty or liability fields, and aren’t working under a third party administrator then you need to consider writing a claim acknowledgement letter to the parties involved, for the protection of the insured, your client and your own self. Read more…