The Malaise of Mid-Phase Delays - Part 2

By Mark Goldwich

Last time we started talking about mid-phase delays – let’s pick up the conversation from where the adjuster is finally assigned and is ready to see you…

English: (Photo credit: Wikipedia)

• Once the adjuster actually arrives in a given area, things do start to move forward briskly in that geographical area, don’t they?

Sometimes. Other times, things go mysteriously wrong in ways that cause substantial delays. The insurance companies – buffered as they are by the companies they are outsourcing an ever-increasing amount of their work to – benefit financially from delays that they (technically) have nothing to do with. Call it another in a long list of extraordinary coincidences that benefit their bottom line.

• It all sounds very fishy – but are there events that can “legitimately” delay an adjuster?

Sure. As we’ve seen, a claim can be reassigned. It’s also quite possible that the adjuster will have to deal with an honest-to-goodness family emergency; we all have those from time to time. Very often, this emergency is disaster-related; some of these people are picked because they’re local, and local people have local ties of their own to think of after a hurricane, tornado, earthquake, fire, or flood. 

Other adjusters come from out of state, which means that they may need to go home when things go wrong there. And, as we’ve already noted, the adjuster could get into an accident, get sick, get reassigned to another region, or “burn out” and quit the profession – not an uncommon outcome.

• When an adjuster is reassigned, what happens to all the claims that adjuster was responsible for, but now leaves behind?

All the files have to go to someone entirely new, and…The whole process starts again.

Damage in Pensacola after the 1906 hurricane. Retrieved from the Monthly Weather Review for September 1906. (Photo credit: Wikipedia)

• Is that a big deal?

Absolutely. Let’s say you’ve been called by Adjuster A, and Adjuster A has set up an inspection time for two weeks from today. The appointment comes and goes. No one shows up. You call the insurance company, get transferred to the call center, spend a whole lot of time on hold, and then, if you’re lucky, get the news that that adjuster is no longer handling that file. At that point, you may be given the name and phone number of Adjuster B … or you may simply be told that you will need to wait for the new adjuster to contact you.

• Okay, but that’s only likely to happen to me once, right?

In my experience, it’s not unheard-of for a claim to be reassigned in this way two, three, or more times in succession. Some people end up with a dozen or more adjusters by the time the claim is paid.

• Once the adjuster actually inspects my property, what happens then?

After the adjuster inspects the claim, he or she must write up an estimate, a process that sometimes takes quite a while to complete.

• Why?

First, understand that you are likely to be dealing with an (outsourced) independent adjuster. The independent adjusters are typically hoping to physically inspect a whole bunch of claims first … and then, having done that inspection write up all the estimates later. Why? Because they are afraid that if they don’t get out and at least inspect the claims, the claims will be taken away from them and given to somebody else, which means they will lose out on billing for that claim. The independent adjusting industry can be a bit cutthroat. After all, qualifications are minimal, prior experience is not required, and the financial potential is tremendous.

Some are paid $1,000 per day just to make themselves “available” (i.e., sit and wait) from the time the storm strikes to the day they begin working on the storm claims. Some independents can make over $200,000 per year. Just about everybody would like to be at that level. Out of fear of losing money and access to future claims, they want to keep as many claims as possible. So they may put off writing up your estimate so they can go out and inspect more claims.

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This is unfortunate for two reasons: first, it delays your payment (there’s a surprise), and second, the quality of the estimate drops with the passage of time, because the estimator’s memory of your property fades. Even with inspection notes and photos, the passage of time means that there is a greater likelihood of ambiguity, error, and a resulting challenge from the insurance company.

• Who is ultimately accountable for customer complaints during this process?

Excellent question. If such a person exists, you have my heartiest wishes in locating him or her. As a practical matter, all you can do is call the message center. When you do, the person who answers the phone will tell you repeatedly that he or she can do nothing more than take a message for you. As I pointed out earlier: There are really two disasters to deal with: one that everybody knows about because they see it on the news, and one that you only know about if you yourself actually experience it. That second disaster has to do with actually getting money from your insurance policy.

• Do policyholders ever go crazy as a result of dealing with this stuff?

Not being a qualified mental health professional, I am in no position to say. But the question has certainly crossed my mind. Imagine the level of frustration that somebody will feel after having suffered damage from a hurricane, fire, flood or other calamity – then waiting for weeks to hear from an adjuster -- and then having new adjuster after new adjuster delay, then leave a message, and another, then set up a time to meet, and fail to materialize. I wouldn’t be surprised to learn that some people do in fact need counseling, therapy, and/or medication as a result of dealing with the claims process. I do know that, as a public adjuster, I deal with these kinds of problems constantly, and they are extremely frustrating -- even for me. And I’m already familiar with this process of ongoing, systemic delay. Dealing with it is what I choose to do for a living!

• Is that all I have to worry about when it comes to delays?

I wish it were. Stay tuned for next week’s blog where I’ll tell you all about late-phase delays.

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.