The Malaise of Mid-Phase Delays - Part 1

By Mark Goldwich

In my last blog, I talked about early phase delays, which one would hope would end once the insurance company provides you with an adjuster – just as one spending eternity in a very hot place would hope for a glass of ice water.

Once you hear back from the adjuster, you might imagine that the process would finally start to speed up. Unfortunately, you’d probably be wrong.  It’s during this middle phase that people usually conclude that something other than the immediate aftermath of the disaster is holding up the processing of their claim. That “something” could well be the greed of insurance companies.

Then again, it could be some systemic problem having to do with the institutional nature of any insurance-related bureaucracy. Maybe greed is not the best explanation for the strange “holding pattern” affecting mainly independent adjusters and insurance companies. This pattern that seems to kick in around about the time the other institutions in the affected community – the post office, the hospital, the businesses that weren’t physically damaged -- have all started to bounce back from tragedy. But a debilitating malaise seems, predictably, to grip the insurance sector at exactly this point.

It’s certainly possible that greed has nothing to do with this malaise. Mid-phase delays in processing your claim might not have anything to do with insurance company greed. Then again, they just might.

Q&A: What will happen?

• Once I get some kind of contact from the adjuster, how high a priority is my specific claim likely to be for this person?

It’s likely to be extremely low.

• Why?

Because catastrophe adjusters tend to have unconscionably high workloads.

• How heavy a workload are we talking about, exactly?

The adjuster may well be given fifty, one hundred, or two hundred claims. In considering those numbers, bear in mind that he or she could probably only assess between three and five in any given day for a typical disaster.

• Is that because insurance companies can’t afford to hire enough adjusters?

Given the record earnings reported by the industry, this really does not seem to be a plausible explanation.

• What other explanation could there possibly be for the industry’s decision to pile so much work on a single adjuster?

It may have something to do with extraterrestrial intelligence sabotaging a critical Earthling recovery pattern so as to lay the groundwork for a future assault on our planet. On the other hand, if the insurance industry isn’t under the covert control of off-world civilizations far more advanced than ours, the impossibly high workload of adjusters may have something to do with corporate greed. By a singular coincidence, a fleet of surrealistically overloaded adjusters tends to reduce the speed at which valid claims are evaluated and processed. (Take me to your leader is not spoken here.)

• What has to happen before the adjuster can actually come out and inspect my property?

Typically, the adjuster only has to make some kind of voice-to-voice contact with you over the phone.

• That can’t take all that long, can it?

If you’re one of the very first people on the list, and you happen to be sitting by the phone waiting for it to ring, no, it won’t take long at all. But remember: the adjuster may have fifty, one hundred, or two hundred claimants to contact; he or she must sort those claims into some kind of geographic order. The overloaded adjuster can’t be expected to drive all around, based on the order the claims were filed – he or she is much more likely to make calls within a small territory before moving on to contact the next area.

And remember this: Adjusters usually prioritize by severity…In other words, they try to see the most severely damaged – usually uninhabitable – homes first. This appears to be the most compassionate thing to do, but – by another extraordinary coincidence – it is also the most frugal from the insurance company’s point of view. You see, these uninhabitable homes usually require the insurance company to pay “loss of use” expenses. These can be extremely high. But if you get to these claims right away, you can “lock in” time frames and dollar amounts owed to the policyholder, greatly reducing the overall costs.

The aftermath of Hurricane Andrew in the Miami area (Photo credit: Wikipedia)

In some settings, though, the adjuster may be required to call on each policyholder before conducting any inspection. That alone could take quite some time. Either way, it starts with a phone call from the adjuster to you. And if you’re not sitting by the phone when the call comes, you can then expect to wait. You may wait while you and the adjuster play phone tag. You may wait while the adjuster’s schedule takes him or her out of your area. You may wait because your file is reassigned to someone else. You may wait because the adjuster gets sick, gets injured, has legal troubles, or simply quits. Whatever happens, though, the odds are that...You WILL wait.

• Suppose I’m unlucky enough to land at or near the bottom of the adjuster’s territory/priority list – what does that really mean to me?

It means that you may well have to wait for every person, in every other territory identified by the adjuster, to talk with the adjuster by phone, schedule a visit, and actually have their property inspected. In other words, your own perceived “place in line,” which you probably assume will be based on the point in time that you filed your claim, could end up being pretty much meaningless, since you are now waiting for the adjuster to meet with people who filed claims much later than you did. They get to meet the adjuster before you do simply because they’re closer to the area where the adjuster is already working.

• Are there any other ways people could “jump ahead of me” in line?

Yes. They could move up higher on the adjuster’s priority list if they get their insurance agent to report the damage as being more severe than it really is. Mind you, the insurance agent would probably never admit to engaging in such a callous and self-serving practice, but, back when I was working as an adjuster for a major insurance company, I got the distinct impression this took place. In fact, it seemed to happen so frequently that I couldn’t begin to estimate the total number of times I made my way to a supposedly devastated property, only to learn that it had sustained considerably less damage than I had been led to believe.

The bitter truth....is that the system is probably going to make you wait for a period that is much longer than any rational person would consider acceptable. After a major disaster, that’s simply what happens, given the manpower, workload, and logistical hurdles that independent adjusters are forced to deal with. So let’s face it: It’s going to take a while to get to everyone. Some people will jump ahead, and some will fall to the rear, but the overwhelming majority of policyholders are going to be waiting for a whole lot longer than they’d like.

After all that, you might think we’d be done exploring mid-phase delays, but alas there’s more…which we’ll learn about next time.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.