The End of the Rainbow: Working with Adjusters
May 11, 2011
Most of us have been exposed to the Golden Rule: Do unto others as you would have others do unto you. Most of us think this to be a good idea, and most of us practice it in one form or another.
When you think about it, you’ll realize that treating others as you would like to be treated actually allows you to both help another feel good, and make yourself feel good at the same time. There is also a variation on the Golden Rule, one with a somewhat more sardonic tone: He who has the gold, wins.
Let’s revisit the players in the total loss relationship:
- The Policyholder
- The Agent
- The Adjuster or Program
- The Contractor and, on a lesser note, but rising…
- The Public Adjuster.
The agent is called by the policyholder to assist them. Their help can include suggesting who to use as a contractor, listing the steps to getting them restored to their previous condition, and how to get things paid for. The agent’s two prime directives are to help their client and to keep them as a client in the future, after the loss is taken care of.
The adjuster or program is called by the agent to meet with the policyholder and determine what the insurance company is going to pay for and what they are not going to pay for. The contractor – you – is called by the adjuster or program during their fact gathering process, to assist the adjuster in determining what needs to be done and what will and will not be paid for. Once the policyholder selects you as the contractor, you then restore their property back to its pre-loss condition.
The public adjuster is called by the policyholder to assist them in receiving all that they are suppose to receive from the policy that was in force at the time of the loss.
The replacement cost is determined by an estimate that is usually determined using an industry database, hearing opinions from all five entities regarding the estimate, and then reaching a group consensus as to what the price will be to complete the work.
So who is the client in this scenario? I would like to suggest that all the entities are clients in different ways. The policyholder is the client for their job, the one who you sign with to do their work and, as a result, the check from the insurance company will have their name on it. The policyholder will probably not have another loss and so, to you, they are probably going to be a one-time client, but a client nonetheless.
The agent is also a client, as they will be able to refer additional work to you based on how you handle their policyholder. The adjuster or program, however, work with policyholders everyday, and have a need for contractor services on a regular basis. The public adjuster is usually only representing the interests of the policyholder, as it affects their compensation on the policyholder’s loss.
So who is the boss, the person you need to pay the most attention to? That would be the adjuster. The adjuster is usually given very strict instructions by the company they work for as to how they do their job. Their company sees them as responsible for getting the policyholder restored to their pre-loss condition. This usually results in the adjuster thinking that they need to be listened to regarding all aspects of the job when it comes to their dealings with you as the contractor.
Their only boss, as they see it, is the policyholder. The adjuster has the power to issue the check when they feel it is time to do so, and issue it to whom they so choose. We all know full well the issues of the check having only the policyholder’s name on it, and what can happen when that action is taken.
Many times, I see contractors take what the adjuster says to them personally. What the contractor fails to realize is that the adjuster has his or her own set of requirements, placed upon them by their company, that they are required to follow. If they do not follow the company requirements, the adjuster can be disciplined and/or terminated as a result of their job performance.
So what do you do when the adjuster asks you to do something that you are opposed to, or that you feel is in conflict with the job goals? I would suggest that, first, you determine what all of your options are, based on what the adjuster is requesting of you. Once you have determined your various choices, determine what position each course of action would put you in.
I believe that you should not knowingly do anything illegal, immoral, unethical or dishonest, the premise being that you would not do what is being asked of you if you were doing the work for yourself in your own home.
If the adjuster is interested in hearing what you have to say regarding what has asked of you, keep it firmly in mind that you are not the final authority in this situation. The adjuster is. Keep in mind that you always have at least three choices in any situation you find yourself in.
- You can choose to do what is being asked of you.
- You can choose to do what is being asked of you, but with disclaimers and documentation as to the part or parts that you do not agree with, or
- You can respectfully decline to do the work that the adjuster is requesting you to do.