A Day Of Reckoning

You Reckon So?

by Antone P. Braga


Knowledge is leverage. The more you know, the more you have adjusting power. The real trick in adjusting is to get a good result as quickly as possible, with as little trouble as possible. It is the continued fate of unknowing, unprepared policyholders to deal ineffectively. Their lack of ability, I am sure, is due in part to attitude. However, lack of information and understanding are the real culprits. It is difficult to imagine doing something in an area of which you know little or nothing, no matter how simple the task. This scenario has repeated itself down through the ages.

In today’s typical property insurance claim business: the independent or company adjuster represents the insurance company, and also happens to prepare, file and settle claims for policyholders. However, it is a blatant conflict of interest for the payer to represent the payee in a payment transaction (reference), and can lead to all sorts of problems and litigation.

Reckoning: policyholders themselves, or independent companies that prepare claims for policyholders (policyholder adjusting firms already exist for large claims), prepare all sized policyholders’ losses, much the same as the HR Blocks of the world, or the public prepares its own taxes. Initially, forms, instructions, claim rights, and recovery rules are made available to the insured public or policyholder representative, as a basic guide. The policyholder, or policyholder representative then presents a prepared statement of loss to the insurance company for consideration, and a statement for services rendered. If additional adjustment is needed it should be handled between a company adjuster and a policyholder adjuster, or between a company adjuster and a prepared policyholder.

In the end: the insurance company is alleviated from conflict of interest, and can reduce it’s claim force dramatically to handle day to day business, giving attention to only those claims that need audit or further adjustment, the insuring public is protected and represented properly, the insurance company savings in adjusting expense offsets the added cost of loss preparation, and it can cite insurance consumer protection—gaining good will and market share.