As we continue to solve the top insurance problem, this week bring us to: Required compliant notices and/or disclosures not being provided.
An adjuster has all kinds of disclosures to worry about: total loss settlements, salvage, and policy limit disclosure, just to name a few. So as of today, how do they keep track? Well, it seems that most aren’t which is why it’s a top problem!
At Claim Toolkit, we keep all our information up to date by staying in the know. One of the ways we do this is by looking at market conduct exams, talking with customers and reading articles. We’ve been seeing and hearing P&C insurance problems that have easy solutions to them so we want to help!
We are going to kick off with: Paying, investigating, acknowledging and/or denying claims outside of the specified time frames.
We’re sure that no is surprised that this is a top issue for insurers! As an adjuster, how many time frames do you need to keep track off? That’s why Claim Toolkit for Compliance create a Communication Time Limits chart.
This is one of our most popular charts as it outlines time frames for everything you need to know when handling a claim – in every state, plus DC.
How many days does the insured have to make proof of loss after a blank form is supplied by the insurer? For North Dakota, its 60 days
How many days does an insurer have to make a decision on claims/benefits within receipt of a valid and complete claim? In Colorado, 60 days
Claim Toolkit for Compliance can’t ensure that you meet these time frames, but we can give you all the information you need to try!
“You miss 100% of the shots you don’t take.”
When I don’t think my offer will settle the claim, I always remember that saying.
Take the shot. Make the offer.
If it is an auto case with a comp neg split, your offer effectively puts the claimant carrier on notice of your position: You’re not paying 100%. This really speeds the subrogation process because the other side is far less likely to ‘Just Say No’ when it is reported to them as having shared responsibility.
If it is a represented claimant, the attorneys have the duty to take the offer to their client. You never know people’s motivations. It has happened more times than I an count that the client overruled the attorney and took the money. Take the shot.
If it is a convoluted commercial question, your offer stakes your ground on where your coverage and liability applies.
Once I made a really low offer on a suspicious BI claim where there was clearly an accident – but not as clear was if the claimant was in the car at the time. Their immediate acceptance was proof enough for SIU involvement leading to two arrets.
Other good things happen when you put your position out there:
Challenges can fine tune your argument;
Adversaries are forced to respond; and
The first offer generally results in a stronger position to dictate the terms.
So, even if you are pretty darn sure the claimant won’t take it – make the offer.
You miss 100% of the shots you don’t take.
Mark’s Claims can be denied! Got a better way? Let us know!
Why would you NOT make an offer?