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My Claims Advisor ::

Story: Claims Adjuster Musings
Three Strikes You're Out?
When I was a young college graduate, I was hired by GAB Robins as an independent adjuster. In the first spring on the job in 1975 after I had completed my adjuster training and estimating schools, I was excited to get out and handle claims and prove what I could do. I was given a hail claim on a homeowners policy in an area that had very little hail. After inspecting the roof, I sat down at the kitchen table with the insured—a petite elderly widow. She offered me a glass of tea and I advised her there was no hail damage. She proceeded to order me out of her house using profanity, as they say, "like a sailor." The file was closed.

The following spring I received another hail claim that sounded familiar. When I visited the home, it was the same little old widow. This time she had a policy with a different carrier. The same scenario occurred and I received the same cursing and eviction from her home.

The following spring, I received a hail claim from a familiar address. Well, you guessed it! For the third year in a row, and with yet another carrier, I visited the home of the same lady. This time she met me at the screen door. We recognized one another immediately and I prepared myself for the cussing. When she came to the door, she simply waved at me with both arms and exclaimed, "Oh, just forget it!"

—Sandy S., Independent Claims Adjuster/Appraiser
Nacagdoches, TX
Kill 'Em With Kindness
I denied the claim of an older lady and she started in on me. I put the phone down and, after twenty minutes, I picked it up again only to find she was still cursing me out. I interrupted her, thanked her for her understanding in the matter and hoped she would consider my firm for her insurance needs. She did not know what to say and hung up the phone!

—Alan O., Staff Claims Adjuster/Appraiser
Hickory, NC
Thanks for the Tip
After a knee surgery, I was in a brace and on crutches but returned to work within days. I was scheduled to attend a hearing at the Department of Insurance. When I went into the meeting room, I was the only one there so I sat down. Along came the Hearing Officer who came in and started talking about the case—how I should be getting benefits, that I'd probably have a lot of pain and can expect impairment, etc. I then introduced myself as the carrier representative, thanked him for the evaluation of my case and for the tips on how I will argue against the claimant's case. He was a little embarrassed and we both had a good laugh. We remained friends for many years thereafter.

—Lesley T., Staff Claims Manager/Supervisor
San Antonio, TX
Fraud and Restitution
I participated in having a person sentenced to jail for 10 years for fraudulently claiming unrepaired damage to his auto. He would pay people to rent vehicles, hit his vehicle, and then collect for the damages. He committed the act 30 times prior to being arrested. I was able to submit a victim's statement and get restitution for the claimant.

—Michael D., All Lines Licensed Florida Adjuster, Specialized Paralegal
Margate, FL
Sometimes You've Just Got To Laugh
I was photographing the scene of an accident next to a canal in rural Ft. Lauderdale, FL. On the bank of the canal was a 12 to 14 foot alligator. I took a photo of the gator, placed it on a photo mounting sheet and put it in my report with the label, "Photo of claimant's attorney." The claim was a large exposure BI and the file, with my report in it, had to go through several layers of supervision all the way to the home office. Everyone who saw the photo got a big laugh out of it.

—Mike R., Independent Claims Manager/Supervisor
Norcross, GA

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