Policyholders—-What Are the Four Questions Every Insurance Adjuster Should Be Asked and Then Required To Answer?

Chip Merlin | Property Insurance Coverage Law Blog | October 2, 2019

Speaking at the IAUA Conference in San Antonio yesterday, I suggested that every insurance company should be demanding from their field adjusters and claims managers that they deal with their customers who ask these four questions:

  1. How much am I fully entitled to?
  2. When am I going to get those benefits?
  3. Are you certain that I am not entitled to more, and what are those benefits?
  4. Is there anything you can do to speed up getting what I am owed?

Claims managers, insurance regulators, public adjusters, attorneys for policyholders, and the media should be asking these four questions. These are questions I am demanding our Merlin Law Group attorneys and staff answer to our clients. It is the same question insurance companies should be asking from their own employees serving their own customers.

Does this happen? I would suggest that often it does not. It is almost as if the insurance customer after making a claim is the enemy and the amount demanded is fraudulent.

Claims managers should be asked whether they agree these four questions are the basis for good faith claims handling and that they should be penalized for failing to adhere to them.

I bet a big waffle answers will happen.

Thought For The Day

Criticism in good faith is good. When it’s targeted solely to destruction, I’m not interested.
—Andrea Bocelli

California’s Insurance Adjuster Act of 2019 Is Coming

Derek Chalken | Property Insurance Coverage Law Blog | August 5, 2019

California’s Senate Bill 2401 is making its way through the legislature and will hopefully bring some important changes to the way insurance companies train their out of state adjusters who handle California based policyholder’s claims. The bill, also known as the Insurance Adjuster Act of 2019, was created by Senator Bill Dodd to eliminate confusion and delays caused by out-of-state or unaware adjusters.

Of significance, the bill will require the California Department of Insurance (DOI) to produce an annual notice describing the most significant California laws pertaining to property insurance policies (including those regarding declared states of emergency) and require the out-of-state adjusters to submit a signed certification, under penalty of perjury, that they have read the most recent notices issued by the DOI, as well as a handbook for adjusting claims prepared by the DOI.

Another part of the act requires that carriers assign a primary point of contact for insureds during a state of emergency. This law was drafted with the hope that it would limit confusion created when carriers assign multiple adjusters to a single claim. For example, insurers often have a desk adjuster, independent field adjusters, contents adjusters and even ALE adjusters working on a single claim. The new bill will require the DOI to provide training standards for these adjusters and require the carrier provide a single point of contact. Insureds simply do not know which person to contact. The new law aims to streamline these communications with the insurer through one person.

These guidelines will hopefully increase the accountability insurers have when they assigned out-of-state adjusters to deal with increased claims activities following catastrophic disasters. If you feel your carrier is not abiding by their obligations to you, contact a Merlin Law Group attorney for a consultation.
1 https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB240

3 Rules for the Claims Adjuster’s Tools

John O’Brien | AdjusterPro | April 16, 2019

In my earlier article for AdjusterPro, I discussed some of the biggest mistakes I see new adjusters make when they enter the claims industry. The formula for a successful career as an insurance claims adjuster is quite simple: more claims closed = more money. So it should come as no surprise that to close the maximum number of claims, you have to work quickly, efficiently, and accurately. Time spent figuring out Xactimate, or having to go back and fix mistakes or take photos you missed is time you aren’t closing claims and making money. And that’s where your adjusting tools come in.

Compared to other property-related careers, being an insurance claims adjuster doesn’t really require that many tools. But the tools you do need, including your technology and clothing, need to be good quality, accessible, and well maintained.

I’ve found that if you follow these three rules, you’ll avoid a lot of wasted time and needless stress. They may sound simple or seem obvious but I see adjusters struggling in the field all the time because they didn’t make a little extra effort to treat their equipment like a vital part of their job success.

Rule #1: The Single Point of Failure

If the loss of any single tool would make it impossible to do your job, perform an inspection, or complete a claim, have a backup or alternative method at the ready.

If you use a digital camera, you should have a spare SD card. But you also need a backup device to take photos, like a smartphone, in case your camera picks a mid-inspection time to die its final death. You should also have a vehicle charger as well as a juice pack or mobile way of charging the camera or phone. You never want to ask a policyholder if you can charge your phone or camera while on inspection. Have 2 tape measures, 2 laser measures, and 2 shingle gauges. Carry spare pads for you cougar paws.

To put it simply, never put yourself in a position to have to stop doing your job in order to replace any tool or device.

Rule #2: Have Dedicated Tools

Your adjusting tools will make you hundreds of thousands of dollars. So get good tools and take care of them. Most importantly, only use your claims adjusting tools FOR claims adjusting.

As soon as you start using your tools for other things, like personal projects around the house, you exponentially increase the likelihood that you’ll forget to put the thing back. You’ll find yourself on inspection, rifling through your truck and cursing the new picture you used the tape measure to hang because said tape measure is still on your kitchen table. This extends to family and friends as well. Don’t let others borrow your tools because the Law of Neighbors says you only get things back 50% of the time and when you do, there’s a 50% chance it’s broken. (Warning: that may not be an actual law but it’s been my experience.)

Of course, if you are following the single point of failure rule you will have a spare tool, but what if that one breaks or gets lost? Having dedicated tools that are always where they are supposed to be will make your life much less complicated, plain and simple.

If you’re interested in learning more about what specific tools an adjuster can’t live without, I’d love to see you at my Adjuster Success Method webinar. We cover tools, how to find employment, perform inspections, close claims, and so much more. It’s a great course for adjusters looking for a systematic way to set their careers up for immediate and long-term success.

Rule #3: Keep your Vehicle Clean & Organized

This may seem like the most obvious of my ‘rules’ but I can’t count the number of times I’ve seen an adjuster open his door and have Gatorade bottles fall out and napkins fly away. I’ve seen guys knee deep in stuff in their truck beds hunting for a shingle gauge. I’ve been asked to borrow batteries because the adjuster bought extras but couldn’t find them.

And it makes sense. We live our lives on the road, sometimes driving over a hundred miles a day. We eat, and sometimes even sleep in the car, rarely stopping except for necessary breaks. But it’s all the more reason to take proper care of your environment – in this case, your car.

Keep your tools organized and in a dedicated location within your vehicle. Everything needs a consistent place. This will reduce the possibility of losing a tool or wasting time trying to find something. Remember: time is money! Make the effort to organize your tools in your vehicle in a way that makes sense to you. And then always return things back to “their place.” Throwing your equipment in your truck bed because you’re in a hurry not only beats it up, you’ll just have to spend more time hunting for it later.

organized tools
Take a hint from the best – keep your tools organized and secure in your vehicle

Clean your car or throw away trash every time you have the chance: getting gas, using the facilities, grabbing a snack. Don’t let your vehicle become a trash can. In addition to making your job harder, claimants notice and it creates a poor impression about your abilities and professionalism.

Following these simple “rules for your tools” not only makes it easier to get the job done, it also subconsciously reduces your stress levels. Every day and every claim is different. Adjusters never really know what situation you are walking into so it’s important to control what you can. Time is money and as an adjuster, yours is precious.

Are There Ethical Conduct Standards Between Public Adjusters and Independent or Company Adjusters?

Chip Merlin | Property Insurance Coverage Law Blog | April 18, 2019

An excellent and successful insurance company defense attorney, Bill Berk and I were on a panel presentation at the 2019 Windstorm Insurance Conference earlier this year. Berk reminded the audience of adjusters that under Florida law, they should not be saying or implying bad things about each other. He noted this Florida regulation:

A public adjuster shall not represent or imply to any client or potential client that insurers, company adjusters, or independent adjusters routinely attempt to, or do in fact, deprive claimants of their full rights under an insurance policy. No insurer, independent adjuster, or company adjuster shall represent or imply to any claimant that public adjusters are unscrupulous, or that engaging a public adjuster will delay or have other adverse effect upon the settlement of a claim.

I can imagine how many public adjusters and company or independent adjusters reading this post are thinking about times they may have forgotten this ethical regulation.

I raise this regulation because a public adjuster wrote me about a regional independent adjustment firm, Residential Property Adjusting, Inc. from Connecticut, Rhode Island, and Massachusetts that expressly tells the public on its website:

Like most insurance specialists, we strongly recommend AGAINST hiring a public adjuster. However, should you choose to make that decision there are a few things you should know. First, understand that your insurance carrier is legally and ethically bound to handle your claim under the terms of your insurance policy and it is interested in resolving your claim as quickly and fairly as possible. In other words, give them a chance to do the right thing as they usually will.

Second, understand how a public adjuster is compensated. Public Adjusters charge a percentage of your final settlement, usually around 10%. So if your insurance company offers to pay you $100,000 then your hired public adjuster WILL TAKE $10,000 of that amount. Public adjusters will always tell you that this fee is offset by their skills in securing a larger settlement in excess of what the average insured can obtain for himself. In other words, if the damages can be repaired for $100,000 they will try and get the insurance company to settle at a much higher figure like $140,000. What they usually fail to tell you is that your insurance company is only obligated to pay you for either what costs you actually incur or what costs you will incur to have repairs done. It does not owe you any “excess,” and certainly will not agree to pay the bill you incur to hire the public adjuster.

Your insurance company will never object to your hiring of a public adjuster as legally they can’t. But most good insurance companies will assign experienced adjusters to handle the files where a public adjuster is involved. A good insurance adjuster can spot where the public adjuster is falsely inflating a claim or estimate and quickly put a stop to it. Just because a public adjuster creates a massive estimate, does not mean that the insurance company will honor it. In fact 99.9% of the time they will make payments based solely on the ‘insurance company’ estimate created by either their staff employee or an outside Independent Adjuster such as our firm. They will review the public adjusters estimate to see if additional line items are warranted, but that’s usually where it stops.

Also, remember that these outside contractual arrangements with a public adjuster will always be at your expense…..


It is also important to note that a public adjuster (PA) has no legal authority. They are not an attorney, nor can they act as one. Some public adjusters make the mistake of advising their client to sue an insurance carrier if they don’t get their way. Other than being poor advice, it’s also illegal advice, and the public adjuster (PA) is at risk of losing their license if it is reported to the State Department of Insurance of their violation.

If you ultimately decide to hire a public adjuster (PA) we recommend the following some simple strategies to narrow the selection. If they can’t meet these criteria then we really really really discourage you from hiring them. Here is the advice:


2. Ask for a timeline provision in your contract. Specifically, request that they settle your claim within 45 days from being hired or the contract is void and no payment is owed. Unfortunately, many public adjusters will drag out files for up to 6 months or a year (even more at times).

I have certainly stated incorrect opinions in the past and am not close to being perfect. Perhaps after reading this blog post, the managers of this independent adjusting company will have a change of heart and remove this position on the topic.

Until then, any attorney, public adjuster or policyholder dealing with this independent adjusting firm should keep this as evidence. It reads like a similar script which some insurers wrongfully teach adjusters how to dissuade policyholders from hiring public adjusters and shows a bias against the policyholder getting professional and licensed help in the adjustment of their property insurance claim.

Before cheering too loudly, I want to suggest that any public adjuster holding a Florida license should immediately audit their websites to make certain that they are not in violation of the regulation above. Some clever and unfriendly insurance attorneys and adjusters may be checking your public adjuster websites as soon as they finish reading this post.

I suggest those interested in this topic read, And Goodwill to All–Unless You Are a Public Adjuster, where it stated:

Dogs and cats. Oil and water. I predict the civility Dan Odess suggests in his article will not be acknowledged by many on the insurer side simply because it came from a public adjuster. For adjusters with a pre-determined attitude, no matter what the truth may be, their mind is already made up.

And remember, such acts in many states can result in fines and possibly cost one’s license or livelihood in the property adjustment business. So, let’s be nice to one another out there in the adjustment world. It is tough enough.

The 3 Biggest Mistakes New Adjusters Make

John O’Brien | AdjusterPro | March 29, 2019

Recently, my friends at AdjusterPro asked if I’d like to be a guest author for their blog page. Since I’ve been a successful claims adjuster now for a number of years, they felt my perspective on the biggest mistakes new adjusters make might be helpful for their readers.

My immediate response was, “That’s simple. They don’t know what they’re doing.” However, I was quickly told that I “wasn’t getting off that easy” and furthermore, my answer was “not helpful.”

Back to the drawing board.

But the fact is the biggest challenge facing new adjusters IS  that simple: they don’t know what to do. Now please don’t misunderstand. I don’t blame new adjusters. After all, we’ve all been there. And as the old saying goes: you don’t know what you don’t know.  Whether you’re an insurance claims adjuster just starting your career, a salesperson dealing with your first tough client, or a family with a newborn….you can’t very well fix unknown problems.

When it comes to insurance claims adjusting however, I do think there are areas where new adjusters could better prepare themselves for the job and set themselves up for real long-term success in this industry. I’ve broken them down into 3 main areas where I’ve seen new adjusters struggle the most.

It’s worth noting that independent insurance adjusting is a fantastic job with high pay and low barrier to entry. Pass your state license exam and boom – you are a licensed adjuster. But achieving the high pay part gets a little more complex. Independent adjusters get paid on each claim that they inspect, estimate, and close. So while the success formula is simple: more claims closed = more money, there are plenty of challenges standing in the way of the ‘more claims closed’ part of the equation.

MISTAKE #1: Insufficient (or no) preparation for estimate writing.

The easiest first step you can take but perhaps the most important is gaining a solid grasp of how to use Xactimate. This estimating software is used by the majority of all adjusters for most property-related claims in the US. I can not stress enough how important it is to be functional in Xactimate. This is partially related to a big misconception in the insurance claims industry. Many people think most of a claims adjuster’s work is in the inspections…but 75% of the work you will do as an adjuster is actually estimate writing.

So back to the equation more claims closed = more money.  Being able to write 5 claims in an evening will make you 5 times more successful than an adjuster who can only write one claim per evening. Not only will it earn you more money, it will increase your value to your employer – who will likely give you more claims and more opportunities whereby the cycle begins again.

Oh and by the way, please don’t be that guy/gal that thinks they can learn on the fly during their first big storm deployment. (AdjusterPro Co-Founder Adam Gardiner wrote a great article on his experience as an Xactimate newbie during Hurricane Charley. It’s worth a read.) First, nobody has time to help you because they are too busy writing their own claims. Taking 2 hours to help you could literally cost them thousands of dollars. Plus, two hours of frustrated help from a fellow adjuster won’t be nearly enough time to get you up to speed. The only other option is to go to your adjusting firm’s help center and wait patiently for one of the overworked help staff to walk you through. But again, time is money and time spent waiting is time you aren’t closing claims.

So first things first – get Xactimate training. AdjusterPro has a great Xactimate Tactical Training course to get you started. Then practice, practice, practice. Once you know the basics, there are a host of “tricks of the trade” that you can learn to cut your writing time down.

MISTAKE #2: Not having an ordered, systematic process for approaching your workload.

Insurance claims checklist

This one isn’t as cut and dry but it is every bit as important for new adjusters – and can truly make or break your career in claims. So what does this really mean? It means you need a system: a step-by-step, consistent approach you use for every claim, no matter the size or circumstance.

Whether you have 1 claim or 50, every single claim requires incredible attention to detail. Closing the claim means completing all of the necessary steps in the correct order. Miss one and it leads to additional mistakes or missed tasks, potentially resulting in a kicked back claim. If nothing else missed steps and tasks will cost you time. And, as we’ve discussed, time = money.

This was a huge challenge for me when I first deployed. I was proficient in Xactimate writing so I thought I’d do ok. Not so. I constantly found myself in a mental fog of chaos as I bounced from one task to another with no real organization. I became stressed which led to more mistakes I needed to fix which, of course, led to more stress.

Fortunately, I was able to identify my problem and make some changes. With a bit of trial and error, I was able to create a systematic approach to every claim. It’s allowed me to handle huge claims loads from multiple firms and multiple carriers at the same time. My Adjuster Success Method training course was really developed for this purpose. I wanted to share my experiences: the good, the bad, and the ugly, and help new adjusters get a leg up on this all-important part of a successful career in claims.

The bottom line? If you want to be successful you need to get organized and stay organized.

MISTAKE #3: Taking yourself out of the game.

Facing the daunting task of figuring out how to do their job while navigating a major catastrophe deployment is what sends many a new adjuster back to the safety and predictability of a normal 9-5 job. Most of the time, they would have made fine adjusters if they’d just had a little more guidance before facing that first CAT deployment. But I have seen so many become stressed, get overwhelmed, and pack it in and go home.

There isn’t a one size fits all solution here. But if you want to be successful in this field, you need to be prepared and you need the determination to stick it out, no matter how tough it gets. And it will get tough. But with the right training, the right mind frame, and a great system? You’ll be killing it in no time.