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Independent Adjuster Things

Independent Adjuster: An independent person and/or company working to provide loss assessment and claim handling to an insurance carrier, attorney or self-employed entity; not working in a payroll but on an as needed basis.

There really is no easy definition that can be made because an Independent Adjuster is many things; but not always at the same time.  Looking at the phrase within we see “independent” and “adjuster”,  (I/A for short) meaning the latter half of the title only becomes active when making an adjustment to something.  What if there is no adjustment to be made?

We believe it is incorrect to reference a party as an “adjuster” when that person or entity is merely investigating a claim or surveying damages.  Those folks would respectively be called independent investigators or surveyors.  This theory is well evidenced as marine surveyors do not refer to themselves, or within their job community as “marine adjusters”. Read more…

In a brief review, we noticed that nearly all states have passed legislation that refer to “Unfair Claims Practices”.  Essentially, most states have set forth some bare bone guidelines that force insurers to fairly investigate and pay claims for damages that they are legally obligated to the liability for, or would be legally obligated.  The acts are much more in depth than what meets the eye though.  For example, Colorado’s statute on Unfair Claim Practices sets out several limitations that include, but are not limited to “Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies” see C.R.S. 10-3-1104(h)(3).

In nearly all cases, the legislature was clear in it’s intent to protect both first party insureds and third party claimants with these acts.  We’ll be expanding on this theory in another post but make the point that case law in nearly all states limit a third party claimant’s right to sue an insurer for bad faith as they are not a party to the contract or policy. This often leaves the Department of Insurance or Regulatory Agency responsible for the policing of insurers when they treat third party claimants unfairly.  A regulatory agency can fine insurers limited amounts, but this doesn’t necessarily prevent unfair claim practices to third party claimants.  If a claimant is forced to bring suit upon a tort-feasor he bears an expense for counsel and risk at trial.  None of the funds that are collected from regulatory agency action against insurers can be collected by a 3rd party claimant and most courts limit bringing administrative judicial records or findings into Civil litigation.  At best, a third party claimant is left to attempt recovery for the forced suit from the insurer through mis-guided attempts of negligence per se against the insurer, or the state.  Everyone knows that suing the state could take a decade. Read more…

By the Independent-Adjuster.com Staff – For immediate release – November 29th, 7:08pm MST.

Independent-Adjuster.com has recently learned through an anonymous source that a local Denver area independent claim professional is considering amending the Colorado Department of Regulatory Agency – Division of Insurance to an on-going legal battle stemming from a negligence based tort claim against a Denver property owner.  The claim professional feels strongly that the department failed to consider his DORA Complaint against the property owner’s insurer with any reasonable application of the law.

Colorado case law does not provide third party claimants with any remedy for claims against liability insurers representing property owners, thereby leaving the duty of policing up to the limited powers of the regulatory agency.

We have learned that the Plaintiff, who remains anonymous at this time, has filed his Complaint as a Plaintiff in Propria Persona or as a Pro Se litigant, meaning that he represents himself in the matter.  His legal education and background was not available at the time of this release.  We will provide updates on this story as they become available.

The appraisal clause is designed to be a simple and low cost form of mediation in the event of a disagreement on the value of damages; generally limited to property claims.  Much like mediation, there are few written rules governing the appraisal clause.  In the appraisal process each individual party (the insurer and the insured) select a competent appraiser and then the appraisers come together and select and umpire who, in the event the appraisers cannot reach an agreement, hears each appraiser’s findings and then makes a ruling on the matter.  When the appraisers cannot decide on an umpire they can petition a local court or judge to assign one at random

In most states an appraiser can be anyone including an engineer, an independent adjuster, a public adjuster, an attorney, or your best friend.  The appraiser should be independent and impartial from the claim process that preceded invocation of the appraisal clause.   It’s important that the appraiser understands the rules and processes through which Appraisal is completed, and have some background on how insurance polices work.  If an appraiser doesn’t properly understand the boundaries of appraisal Read more…

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