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Catastrophe Claims Management Manual
Property Loss Research Bureau
3025 Highland Parkway, Suite 800
Downers Grove, Illinois 60515-1291
Contact Information
Peter Balingit, AVP, 630-724-2231; pbalingit@plrb.org
Andrew Louchios, IT – Geospatial Specialist, 630-724-2233; alouchios@plrb.org
Copyright 2016 Property & Liability Resource Bureau
Property & Liability Resource Bureau members may reproduce this publication or any portion of it for the exclusive use of their employees. Any other reproduction or distribution of this publication or any portion of it without the express written consent of the Property & Liability Resource Bureau is strictly prohibited. Article IV, Rules and Regulations, of the PLRB Bylaws state:
Section 1: Members shall hold all information including publications, educational materials, and opinions received from the Bureau in strict confidence. Every communication from this Bureau is confidential unless it is specifically stated therein that it is not.
Section 2: Members shall not divulge any information furnished to them by the Bureau to any person who is not an officer or employee of the member without specific permission of the Bureau. No member may furnish information originally received from the Bureau to any organization affiliated with the member, unless the member possesses a letter from the chairman, written on authority of resolution of the Governing Board, specifically authorizing the member to furnish information to a certain organization.
- Section One – Home Office Catastrophe Manual
- Home Office Checklist – After the Catastrophe Strikes
- Section Two – Branch Office Catastrophe Supervisor’s Guide
- Branch Office Checklist – Planning Duties
- Branch Office Checklist – After the Catastrophe Strikes
- Section Three – Catastrophe Adjuster’s Guide
- Catastrophe Adjuster’s Checklist – Responding to the Catastrophe
- Section Four – Appendix A – Sample News Releases
- Insurer Expedites Claims following Tornado
- Insurer Expedites Claims following Hurricane
- Section Four – Appendix B – Policyholder Claims Information Packet
Introduction
June 2016
Careful planning and creative implementation of well-thought-out, experience-based, and scalable catastrophe claims response plans has made it possible for the property and casualty insurance industry to effectively manage enormous catastrophes. At the same time the claims departments are able to maintain the day-to-day claims services. This is a core competency for the property and casualty insurance industry.
The PLRB Catastrophe Claims Management Manual summarizes many of the lessons-learned over decades of the property insurance industry meeting catastrophe claims challenges. These lessons have been discussed in depth at the Claims Conference. Many of the ideas shared have been incorporated into this never-finished manual.
The manual is divided into four sections:
– Home Office;
– Branch Office;
– The Adjuster; and
– Sample News Releases & Policyholder Kit Information
This division will provide planning and response guidance for your company’s catastrophe plan development. Each section can stand alone, serving the audience for which it was written.
Hugh O. Strawn, AIC
Vice President, Catastrophe Services
Property & Liability Resource Bureau
630-724-2230
Section One Home Office Catastrophe Manual
Model Catastrophe Plan Outline
Introduction
A general outline of a catastrophe plan should include the following:
- Your company’s definition of a catastrophe.
- A statement of the company philosophy on the importance of quick, accurate, and friendly satisfaction of claims following a catastrophe.
- An explanation of why the company feels there is a major need for having a specially designed set of claims procedures for catastrophes.
- A statement of need for all company personnel to intensify their service to policyholders during a time of increased claims activity following a catastrophe.
- A statement of recognition and appreciation of the company staff who continually “go the extra mile” over and over again.
Purpose
- Explanation of why the plan:
– Has been written;
– Is distributed;
– Is continually updated; and
– How it benefits the employees.
Responsibility and Administration
- A designation of a company employee with the responsibility to coordinate the updating of the claims department catastrophe manual.
- A designation of a company employee responsible for periodically checkinghttps://www.plrb.org, PLRB’s password-secured Web site, for occurrence information, as well as coverage information contained in PLRB Catastrophe Bulletins [From Home Page hover over “Coverage Research,” click on the “PLRB Search” hyperlink, click on the “Bulletins” hyperlink, click on the “Catastrophe Bulletins” hyperlink, and select the needed bulletin.]
- Designation of a company employee who has the responsibility to start the catastrophe operations.
- Designation of company employee who is to establish liaison with the insurance department(s) in the affected state(s).
- Designation of company employee who is to serve as the coordinator with the local/state emergency management agency, and/or the Federal Emergency Management Agency (FEMA).
- Designation of who is to organize a team of experts to assist with claims.
- A definition of the various personnel positions within the catastrophe group.
- A summary of important administrative issues
Who is responsible for maintaining the pre-catastrophe-assembled catastrophe team response supplies, as well as keeping the “just in time” suppliers ready to go?
Who is responsible for operational expenses incurred while handling the catastrophe?
Who is responsible for assuring adequate support personnel are assigned?
- Clerical
- Telecommunications
- Data processing
- Medical
- Logistics & Supply
Who is responsible for coordinating catastrophe activities?
Who is responsible for receiving and managing catastrophe complaints, agency communiqués, insurance department directives, and other catastrophe-specific communication?
Who is responsible for coordinating housing needs for the catastrophe adjusters?
Catastrophe Team Make-up
Include an explanation of:
- How the catastrophe team will be staffed;
- How the personnel staffing the team are selected;
- How often the staffing will be reviewed and updated;
- The need for team members to be available on short notice;
- How quickly they are expected to respond;
- How the company’s alerting system is implemented and functions;
- How the on-call roster is maintained;
- Individual’s responsibility to be ready for catastrophe duty or to be sure back up person is available at all times;
- How long the team is expected to work at a catastrophe;
- What the specific office hours are to be for catastrophe office operations;
- How productivity is to be measured;
- How complaints will be handled;
- The company policy regarding reporting of illness or injury; and
- The company policy on reporting damages caused to property by company personnel.
Travel
- A statement of company travel requirements and expectations for catastrophe team members.
Compensation
- A statement of company policy on compensation for members of the catastrophe team for salaried and hourly employees.
Expense Allowance
- A summary of company policy on reimbursement for expenses incurred in specified categories during a catastrophe operation.
Planning Duties
- A statement of who is responsible for completion of specified duties, such as:
Periodically reviewing personnel to identify those capable of managing functions of a catastrophe operation;
Periodically reviewing personnel to identify those technically qualified to adjust various sizes of catastrophe losses;
Publicizing the catastrophe team and determine if identified personnel are willing to participate;
Submitting the names of recruits to the catastrophe team coordinator;
Issuing current company catastrophe identification cards for individuals;
Assuring local claims supervisors prepare a price guide for company use at the catastrophe site;
Assuring local claims supervisors prepare lists of contractors, roofers, glass repair firms, electricians, plumbers, suppliers, and have available at the catastrophe site;
Assuring local claims supervisors prepare lists of experts whose services may be needed during a catastrophe, such as engineers, architects, accountants, salvors, etc., and have available at catastrophe site;
Assuring local claims supervisors maintain a list of temporary clerical help or temporary employment agencies that could provide trained help during a catastrophe;
Developing a plan for maintaining normal operations during the catastrophe;
Developing plans for the equipping of a catastrophe office with the necessary inventory of furniture and supplies;
Establishing continuing liaison with phone service companies to install toll-free phone numbers, additional local hard-wired voice and data lines, cellular phone service, as well as long distance service, to include satellite up-links if necessary;
Maintaining current maps that locate and display policyholders by address;
Maintaining current road maps, printed and electronic, in areas of responsibility;
Maintaining current policy forms in use in the areas of responsibility;
Maintaining current antitrust guidelines per company counsel;
Preparing and maintaining the company’s policyholder and public information materials;
Keeping company senior executives informed of developments;
Modifying and maintaining the company’s Internet Home Page site, and social media sites if desired, to accommodate communication with the policyholders who survived the catastrophe; and
Maintaining liaison with agents to facilitate agent/adjuster matching.
- Provide a summary of post-catastrophe preliminary activities that should be undertaken and identify who is responsible for assuring their completion. These preliminary activities might include:
Estimating the volume, location, and types of claims expected;
Arranging for enough people, who are familiar with company telephone procedure, to answer the expected in-coming phone calls;
Estimating the probable dollar loss;
Arranging extension of office hours as necessary to handle catastrophe claims reports;
Inventorying the available supplies and getting the anticipated additional supplies needed for the catastrophe operation;
Assigning a coordinator to review the reports coming in from the field;
Establishing a coverage desk, staffed by personnel with the proper authority to:
– Review PLRB Catastrophe Bulletins [From Home Page hover over “Coverage Research,” click on the “PLRB Search” hyperlink, click on the “Bulletins” hyperlink, click on the “Catastrophe Bulletins” hyperlink, and select the needed bulletin.];
– Answer field adjuster’s questions; and
– Maintain continuity in company coverage decisions.
Preparing important insurance information for release through the primary communications media in affected areas, and social media if desired;
Preparing catastrophe-specific insurance information and claims packets for distribution to policyholders affected by the occurrence;
Assigning a person to develop a catastrophe-specific policyholder satisfaction follow-up survey which can be sent by US Postal Service mail, delivery service, or e-mail to your policyholders at some time following settlement of the claim;
Notifying the area claims supervisor to prepare a detailed briefing, for arriving catastrophe adjusters on:
– Extent of damage;
– Areas of damage;
– Geographic obstacles (provide current maps);
– State insurance rules re: Unfair Claims Practices; Valued Policy; Catastrophe adjuster registration/licensing; Deadlines for contacting policyholders; Adjuster and vehicle identification, and so on;
– Company policy regarding antitrust law (adjusters sharing information with adjusters from other companies).
– Company guidelines regarding any waivers or exceptions on:
- Filing a proof of loss following a catastrophe
- Preparing an inventory on the total loss.
Clarifying company guidelines regarding:
– Time frame for
– A quality contact with the policyholder;
– Completing the first inspection;
– Delivering the ACV payment.
– Claims settlement on replacement cost coverages;
Will proof of replacement be required in a catastrophe?
Will depreciation be withheld on all, or some, of the losses?
– Additional Living Expenses;
Will bills be required?
Will an advance against future costs be provided with no proof of current expenditures?
– Additional authority for claims settlement that may be given to local agents;
– File documentation following a catastrophe;
Will it be changed in a catastrophe?
What shortcuts will be permitted?
Any changes in the procedures for the total loss?
– Mortgagee’s name on settlement checks; and
– Fraud control.
How is it implemented during the catastrophe?
Are there any additional indicators to be aware of during a catastrophe operation?
Will referrals be handled in any special manner?
What role is the insurance commissioner playing in fraud control during the catastrophe period?
Having catastrophe supervisor:
– Determine how much additional staff may be needed to manage the catastrophe operations;
– Determine where the catastrophe office(s) should be located;
– Determine what additional supplies will be needed to operate a catastrophe claims office;
– Arrange for additional telecommunication lines and equipment;
– Reserve living space for adjusting and administrative personnel;
– Reserve the necessary rental cars for the catastrophe team;
– Make banking arrangements for catastrophe adjusters, as well as for policyholders who may have to cash checks without proper identification;
– Provide for cash advances to catastrophe team members;
– Review company procedures for contacts with the media ;
– Prepare orientation for arriving adjusters;
– Plan to conduct frequent, regularly scheduled briefing sessions with adjusters; and
– Prepare the necessary data for periodic reports on claims received and claims settled.
- Develop a policy stating:
– What equipment the company will provide the catastrophe adjuster; and
– What equipment the catastrophe adjuster is expected to personally provide.
The following tools and equipment contains basic items often needed to accomplish the job:
– Road maps;
GPS
Printed
– Cameras
– Chargers, and
– Extra digital memory sticks;
– Flashlight
– Lantern
– Batteries & charger
– Calculators
– Voice recorder
– Ladder
– Report forms
– Laptop computer
– Tablet
– Checks
– Cash
– Special protective clothing
Steel toed & steel soled work boots
Warm coats
Rain coats
Hard hats
Ear muffs
Heavy-duty work gloves
Soft-soled shoes for roofs
Other items for the catastrophe work environment
– Cellular phone
– Pager
– First Aid kit
- A checklist should be developed for home office personnel to follow after the catastrophe has occurred. The list will serve as a reminder to complete each responsibility, as identified in the company’s plan. A sample checklist is on the following page.
Home Office Catastrophe Operations Procedures Checklist
After the Catastrophe Strikes
Assign staff to:
Determine number of claims expected
Answer anticipated telephone calls
Determine probable dollar loss
Inventory the available supplies
Obtain supplies, as necessary
Establish a coverage desk to maintain continuity in company coverage decisions.
Contact policyholders via the primary media with insurance information releases.
Prepare catastrophe-specific policyholder information kits.
¨ Extend office hours as necessary to handle the anticipated claims load
¨ Assign staff coordinator to review reports sent in from the field
¨ Notify catastrophe area claims supervisor to prepare a detailed briefing for arriving catastrophe adjusters on:
Extent of damage
Areas of damage
Geographic obstacles that will be encountered
State insurance rules such as:
- Unfair Claims Practices Act
- Valued Policy Laws
- Catastrophe Adjuster registration/licensing
- Deadlines for contacting policyholders
- Adjuster and vehicle identification
Company guidelines on:
- filing a proof of loss
- anti-trust
- preparation of an inventory for the total loss
- replacement cost coverages in catastrophes
- ALE advances
- additional claims settlement authority given to local agents
- file documentation of each claim
- fraud control
¨ Have catastrophe supervisor:
determine how much additional staff will be needed to manage the operations
site the catastrophe office(s)
coordinate the supply needs
secure living quarters for adjusters and administrative personnel
arrange for the necessary rental cars
make banking arrangements for catastrophe adjusters and policyholders without identification
review the company policy on media relations
plan to conduct frequent, regularly scheduled meetings with adjusters
plan to submit weekly progress reports to the home office
Managing Work Flow
- Define how the company determines if a claim has priority and how it is to be serviced. Consider integrating a procedure into the claims assignment process that prioritizes claims at the time an adjuster receives an assignment.
- Include step-by-step directions on the requirements for smooth work flow, as set down by the company.
- It is recommended the following information be included:
– Review catastrophe office hours of operation;
– Review how the company receives claims;
– Review how priority claims are determined and serviced;
– Reminder to screen losses for complete coverage information;
– Review the basics of aggressive good faith in handling catastrophe claims;
– Review the company rules on immediate contact of insured;
– Review company procedures for the handling of telephone messages;
– Review of company estimating guidelines under catastrophe conditions;
– Review guidelines for advance payments;
– Review the rules of file documentation; and
– Review the rules and procedures for reopening closed files; and
– Responsibilities for catastrophe claim manager such as:
- Map the affected loss territory into zones for adjuster assignment;
- Start a loss log to keep track of claim status and reserves;
- Implement assignment records for all claim files, open and closed; and
- Assess workload of adjusters frequently to determine if additional resources are necessary.
Training and Preparedness
Staff Adjusters
- The catastrophe plan should be a “living” plan that is constantly reviewed and updated. All staff adjusters should be familiar with the basics of the plan, the quality of work expected of them, and how their productivity will be monitored.
- Periodic pre-occurrence refresher training is crucial to the smooth implementation of the plan. Periodic refresher training, to include reviewing standard operating procedures for inspecting losses, should be implemented for specific catastrophe adjusting challenges.
- Pre-occurrence drills of a catastrophe operation are an excellent and proven method of staff training. They serve to help identify portions of the plan needing change.
- Post Catastrophe refresher training to help adjusters familiarize themselves with specific skills, such as accurately inspecting hail damaged roofing, may be offered.
Independent Adjusters
- State the company policy on how they are to be used following a catastrophe.
– Will they be used on the catastrophe work?
– How will they be supervised?
– Will they be used on the routine claims, while staff adjusters deal with the catastrophe?
– What are the company’s catastrophe claim documentation and service time-frames expected of independents?
– What is their claim settlement authority?
- Keep independent adjusters used by the company briefed on the performance expectations during catastrophe operations. The independent adjusters must be familiar with the plan.
- Ask for right-of-review of the independent adjuster’s catastrophe operations plans. This will provide advance knowledge of the independent adjuster’s capabilities. Educational assistance and suggestions may also be offered to help the independent adjuster meet the company’s needs.
Non-Claims Staff for Emergency Claims Duty
- Determine which staff people in the company might be trained to assist with catastrophe claims settlements. Underwriting staff people are familiar with coverages and can benefit from the catastrophe claims experience.
- They should be familiar with the catastrophe plan. This will permit advance preparation to meet company expectations.
- Consider providing pre-occurrence training which will give staff the basics for accomplishing the post-catastrophe jobs.
- Develop a post-catastrophe refresher training course to bring the non-claims staff up-to-speed quickly.
- Develop a post-catastrophe crash-training course for the untrained non-claims people who may be used. They’ll need the basics in a hurry.
Estimating Property Damages
- Consider including the company’s training program on estimating property damage. This program could be utilized in both pre-catastrophe and post occurrence training plans.
Public Information
The Media
- Provide a summary of company policy on answering inquiries from the news media following a catastrophe.
- Provide basic guidelines for answering questions from the media.
- Some suggestions:
– Directly answer all questions;
– If you don’t know the answer to a question, say so;
– If you must refer the reporter to another source, say so and provide the source’s name e-mail address, and phone numbers;
– Frame all answers with the company’s policy on claims payment;
– If a reporter is seeking information, but does not know what questions to ask, offer information on how to report insurance claims, how to prepare an inventory, how to keep proper records, how to expedite the claim, and types of losses typically covered by a homeowners policy; and
– It is recommended news releases be sent to the media in the area affected by the catastrophe. It is also recommended the news releases be posted on the company’s Web site in an accessible News Release or Media folder. The files should be identified with key words in a metafile in order to be located by search engines used by reporters. These news releases can supplement any advertising your company may choose to place in the local media. See Appendix A for samples.
The Public
- Provide the staff a statement of company policy about appearances before public meetings and forums following a catastrophe.
- Provide the staff a list of subjects to be discussed at a public meeting.
- Some suggestions:
– Assurance that claims are being handled;
– A description of types of losses normally covered in such a catastrophe;
– How to file a claim;
– How to prepare an inventory; and
– Identifying and addressing unique claims issues in the catastrophe to head off confrontation, for example identifying that flood insurance is purchased in addition to Homeowners coverage.
- Provide a detailed list of contact numbers the catastrophe adjuster may call day or night for assistance in dealing with a public relations issue.
- Remember, media and public inquiries require an immediate response. You cannot wait until the office opens on Monday to get the answer.
- Distributing printed information following a catastrophe can be helpful to the policyholder. PLRB has prepared information on filing claims. Companies may consider using the following Catastrophe Services templates:
When You File Your Insurance Claim
Filing Your Insurance Claim after the Tornado
Hiring a Contractor after the Disaster
Filing Your Business Insurance Claims after a Disaster
Training and Preparedness
Staff Adjusters
- The catastrophe plan should be a “living” plan that is constantly reviewed and updated. All staff adjusters should be familiar with the basics of the plan, the quality of work expected of them, and how their productivity will be monitored.
- Periodic pre-occurrence refresher training is crucial to the smooth implementation of the plan. Periodic refresher training, to include reviewing standard operating procedures for inspecting losses, should be implemented for specific catastrophe adjusting challenges.
- Pre-occurrence drills of a catastrophe operation are an excellent and proven method of staff training. They serve to help identify portions of the plan needing change.
- Post Catastrophe refresher training to help adjusters familiarize themselves with specific skills, such as accurately inspecting hail damaged roofing, may be offered.
Independent Adjusters
- State the company policy on how they are to be used following a catastrophe.
– Will they be used on the catastrophe work?
– How will they be supervised?
– Will they be used on the routine claims, while staff adjusters deal with the catastrophe?
– What are the company’s catastrophe claim documentation and service time-frames expected of independents?
– What is their claim settlement authority?
- Keep independent adjusters used by the company briefed on the performance expectations during catastrophe operations. The independent adjusters must be familiar with the plan.
- Ask for right-of-review of the independent adjuster’s catastrophe operations plans. This will provide advance knowledge of the independent adjuster’s capabilities. Educational assistance and suggestions may also be offered to help the independent adjuster meet the company’s needs.
Non-Claims Staff for Emergency Claims Duty
- Determine which staff people in the company might be trained to assist with catastrophe claims settlements. Underwriting staff people are familiar with coverages and can benefit from the catastrophe claims experience.
- They should be familiar with the catastrophe plan. This will permit advance preparation to meet company expectations.
- Consider providing pre-occurrence training which will give staff the basics for accomplishing the post-catastrophe jobs.
- Develop a post-catastrophe refresher training course to bring the non-claims staff up-to-speed quickly.
- Develop a post-catastrophe crash-training course for the untrained non-claims people who may be used. They’ll need the basics in a hurry.
Estimating Property Damages
- Consider including the company’s training program on estimating property damage. This program could be utilized in both pre-catastrophe and post occurrence training plans.
Public Information
The Media
- Provide a summary of company policy on answering inquiries from the news media following a catastrophe.
- Provide basic guidelines for answering questions from the media.
- Some suggestions:
– Directly answer all questions;
– If you don’t know the answer to a question, say so;
– If you must refer the reporter to another source, say so and provide the source’s name e-mail address, and phone numbers;
– Frame all answers with the company’s policy on claims payment;
– If a reporter is seeking information, but does not know what questions to ask, offer information on how to report insurance claims, how to prepare an inventory, how to keep proper records, how to expedite the claim, and types of losses typically covered by a homeowners policy; and
– It is recommended news releases be sent to the media in the area affected by the catastrophe. It is also recommended the news releases be posted on the company’s Web site in an accessible News Release or Media folder. The files should be identified with key words in a metafile in order to be located by search engines used by reporters. These news releases can supplement any advertising your company may choose to place in the local media. See Appendix A for samples.
The Public
- Provide the staff a statement of company policy about appearances before public meetings and forums following a catastrophe.
- Provide the staff a list of subjects to be discussed at a public meeting.
- Some suggestions:
– Assurance that claims are being handled;
– A description of types of losses normally covered in such a catastrophe;
– How to file a claim;
– How to prepare an inventory; and
– Identifying and addressing unique claims issues in the catastrophe to head off confrontation, for example identifying that flood insurance is purchased in addition to Homeowners coverage.
- Provide a detailed list of contact numbers the catastrophe adjuster may call day or night for assistance in dealing with a public relations issue.
- Remember, media and public inquiries require an immediate response. You cannot wait until the office opens on Monday to get the answer.
- Distributing printed information following a catastrophe can be helpful to the policyholder. PLRB has prepared information on filing claims. Companies may consider using the following Catastrophe Services templates:
When You File Your Insurance Claim
Filing Your Insurance Claim after the Tornado
Hiring a Contractor after the Disaster
Filing Your Business Insurance Claims after a Disaster
Section Two
Branch Office Catastrophe Supervisor’s Guide
Model Catastrophe Plan Outline
Introduction
This should include:
- The company’s definition of a catastrophe
- A statement of the company’s philosophy of catastrophe claims handling and the critical role played in the process by the catastrophe claims supervisor.
- A statement that supervisors play an important motivational role in encouraging company personnel to intensify their service to policyholders during a time of increased claims activity following a catastrophe.
Purpose of a Catastrophe Plan
- An explanation of why the plan has been written, distributed, and the role of the supervisor in continuously looking for methods to improve the plan.
Responsibility and Administration
- Describe the requirements of the supervisor to help the plan’s author keep the document updated.
- Describe the supervisor’s responsibility to take the appropriate and necessary steps to implement the company’s catastrophe claims plan.
- Define where the supervisor is positioned within the catastrophe group.
- Supervisor’s responsibilities
– For expenses incurred during the catastrophe operation?
– To assure adequate support personnel are available to help with the additional workload imposed by catastrophe adjusting?
– In helping company maintain its policy concerning replacement personnel?
– In coordinating and managing catastrophe activities?
Catastrophe Team Make-Up
An explanation of:
- How the catastrophe team will be staffed;
- The role the supervisor plays in selecting the personnel who are chosen for the catastrophe team;
- How often the staffing be reviewed and updated;
- The need for all team members to be available on short notice;
- The criteria for the supervisor establishing and maintaining an alerting system to assemble the team for duty;
- How long the team will be expected to work at a catastrophe;
- The hours the supervisor must keep the catastrophe office open for business;
- How the supervisor shall measure the team member’s productivity;
- How claim file reviews will be conducted;
- How the supervisor’s productivity will be measured;
- How the payment authorization procedure will be executed;
- How complaints will be handled in a catastrophe;
- How injury and illness is to be handled during the catastrophe operation; and
- The supervisor’s responsibility in handling damages caused to property by catastrophe team members.
Travel
- A statement of company travel requirements, expectations for catastrophe team members, and the supervisor’s responsibilities in managing travel.
Compensation
- A statement of company policy on compensation for members of the catastrophe team for salaried and hourly employees.
Expense Allowance
- A summary of the company policy on reimbursement for expenses incurred in specified categories during catastrophe operations.
- A statement of the supervisor’s responsibilities in managing expenses during the catastrophe.
Planning Duties
- A statement of the supervisor’s responsibility for catastrophe operations preparedness and planning, such as:
– Keeping identification cards current;
– Periodic review of personnel to identify those capable of sustaining the rigors of a catastrophe operation;
– Periodic review of personnel to identify those technically qualified to adjust catastrophe losses of various sizes;
– Recruiting team members through promotional activities;
– Submitting the names of recruits to the catastrophe team coordinator;
– Developing a current local price guide for use by the catastrophe adjusters;
– Develop an outline for an “intelligence briefing” which can be given to arriving catastrophe adjusters;
The outline might include this Information for the adjusters
- A copy of the price guide.
- A description of damage areas.
- A summary of state insurance regulations.
- A summary of local laws or regulations, such as curfew hours, etc.
- Copies of current road maps or map software for notebook computers.
- Review forms that will be used.
- Review the company’s antitrust guidelines.
- Other items of importance as determined by the supervisor.
– Developing lists of contractors, roofers, glass repair firms, electricians, plumbers, suppliers, and so on for use by the catastrophe adjusters.
– Developing lists of experts whose services may be needed during a catastrophe, such as engineers, architects, accountants, salvors, etc.
– Developing lists of temporary clerical help or temporary employment agencies that could provide trained help during a catastrophe.
– Prepare an inventory of equipment needed to furnish a separate catastrophe office, if necessary. List suppliers with such equipment, including after-hours contact information.
– Prepare an inventory of supplies necessary for a catastrophe claims operation.
- Include all the usual supplies such as pencils, paper pads, forms, stationary, and so on, in sufficient quantity to meet demands for a minimum of two weeks without re-supply.
- Consider adding specialized supplies such as special catastrophe acknowledgment-of-claim cards, special door-knob hanger adjuster calling cards, additional battery packs for notebook computers and cellular telephones, and so on.
– Establish liaison with the telecommunication service companies to install hard-wired, cellular, and satellite telecommunications service.
- It is recommended a checklist be included to serve as a reminder of important tasks needing attention. A sample checklist appears on the following page.
Branch Office Catastrophe Supervisor’s Guide Checklist
Planning Duties
¨ Is the personnel alerting roster current?
¨ Do personnel know what is expected once they’re alerted?
¨ Identification Cards
Current cards issued to all necessary staff?
Additional card forms available for use if needed?
¨ Are there any other likely catastrophe team candidates who have not as yet been contacted?
¨ Is the local price guide current?
¨ Is the information assembled for a catastrophe team “intelligence” briefing?
Copies of the current price guide available in sufficient quantity
A summary of pertinent state insurance regulations
A summary of policy modifications or variations effective in that state
Copies of current road maps or map software for notebook computers
Copies of pertinent forms to be used after the catastrophe
A statement of the company’s anti-trust policy for review with adjusters
Contacts made to quickly gather damage reports
Contacts made to quickly gather information on local emergency laws or regulations, such as curfew
¨ Are the lists of contractors, roofers, glass repair firms, electricians, plumbers, suppliers, etc. current?
¨ Are the lists of experts such as engineers, architects, accountants, salvors, etc, current?
¨ Are the contacts for hiring temporary clerical help aware of a potential need following the catastrophe?
¨ Is the inventory of equipment and supplies needed to operate a separate catastrophe office current? Are the after-hours numbers of those suppliers listed with the inventory?
¨ Is liaison established with the local telecommunication suppliers for equipment, land lines, cellular service, and satellite service?
After the Catastrophe Strikes, Response Duties
- Provide a summary of preliminary activities the supervisor should monitor to assure completion.
- Preliminary activities might include:
– Estimating the number of claims expected.
– Estimating the probable dollar loss.
– Determining how much additional staff may be needed to manage the catastrophe operation.
- Adjusters
- Administrative
- Clerical
- Telephone
– Arranging for enough people, familiar with the company telephone procedures, to answer the expected in-coming phone calls.
– Extending office hours as necessary to handle catastrophe claims reports.
– Assignment of a coordinator to review claims arriving from the field.
– Verify inventory of supplies necessary for a catastrophe claims operation complies with company plan.
– Obtain a supply of detailed printed road maps for adjusters and supervisors.
– Issue important insurance information for release to the mass media, as well as seek assistance from agents in utilizing materials in the Communicating with Catastrophe Survivors manual, in affected areas. Refer to the public information section of the plan.
- Zone the catastrophe area for adjuster assignments.
– Note any geographic obstructions to adjuster movement.
– Note areas by degree of damage, if possible.
– Consider adjuster assignments based on:
- Degree of loss difficulty.
Suggestion: Give the simple losses to the less experienced adjuster. Assign the more complex losses to the more experienced adjuster.
- Degree of hazard.
Suggestion: Assign the more demanding claims, such as those involving climbing about a roof, to the more physically fit and agile adjusters.
- Experience and talent.
Suggestion: Assign the claims on the basis of specialized knowledge or skills.
- Excellent communications and people skills to be able to handle traumatic losses, such as deaths and injuries to family members
- Ability to easily get from assignment to assignment.
Suggestion: Bundle the assignments in an area of easy movement. Avoid assigning only by address, as you may be able to see the next address, but you can’t get to it because there is a river valley in the way.
- Prepare an intelligence briefing for arriving adjusters. It might include:
– Catastrophe office hours;
– Adjuster telephone availability hours;
– An outline of the areas damaged;
– A summary of local prices;
– Proof of Loss requirements following the catastrophe;
– Special file and reporting requirements following the catastrophe;
– Special legal information, such as curfews; and
– Review
- Local rules or statutes involving adjuster registration or licensing, valued policy laws, and other important legal data;
- Company antitrust guidelines;
Recommendation: Adjusters should be cautioned against sharing information with competitors.
- How priority claims are determined and are to be handled;
- Complaint handling procedures;
- Procedures in the event of illness or injury;
- Company policy on authorizing temporary repairs to protect the building and contents;
- Company’s list of appropriate, safe, and secure storage facilities for the insured’s to place their possessions until the structure is rebuilt or repaired;
- Procedures in the event the adjuster damages property; and
- Work expectations.
- It is recommended a checklist be prepared to refresh the supervisor’s memory on tasks to be accomplished. On the following page is a sample checklist.
Branch Office Catastrophe Supervisor’s Guide Checklist
After the Catastrophe Strikes
¨ Alert personnel for duty in accordance with the plan.
¨ Develop an estimate on the number of claims expected.
¨ Develop an estimate on the probable dollar loss.
¨ Determine what additional staff will be needed to deal with the catastrophe claims.
Adjusters
Administrative
Clerical
Telephone operators
¨ Determine the catastrophe office hours.
¨ Choose an experienced coordinator to review claims received from the field.
¨ Check the inventory of office supplies to assure sufficient quantity for at least a two-week operation.
¨ Are special catastrophe supplies available
Catastrophe specific receipt of claims letters
Door-knob hanger calling cards
Detailed road maps for arriving adjusters
¨ Zone the catastrophe area for adjuster assignments
Take into account geographical obstructions to movement.
Identify the areas by degree of damage.
¨ Assignment of adjusters considerations
Degree of difficulty based on extent of loss
Degree of hazard posed by the claim site conditions
Experience of the adjuster
Ease of movement from assignment to assignment
¨ Prepare an intelligence briefing for arriving adjusters.
Outline the damaged areas
Provide special information about the areas, such as curfew regulations
Review state insurance laws and regulations pertinent to the area
Review company’s anti-trust guidelines
Review company’s guidelines for determining a priority claim and how such claims shall be handled
Review the company procedures to be followed in the event of employee illness or injury
Review the company procedures to be followed if an adjuster damages property
Review work expectations
Review how the company receives claims
Review the importance of screening losses for complete coverage information
Review the basics of aggressive good faith in handling catastrophe claims
Review the company policy on immediate contact with the insured
Review company estimating procedures used in a catastrophe
Review company guidelines on advance payments
Review company procedures on issuing drafts
Review company procedures for catastrophe claim file documentation
¨ Begin a loss log to track claim file status and reserves.
¨ Implement assignment records for all claim files, open and closed.
¨ Assess adjuster workload frequently to determine if additional resources may be necessary.
¨ Prepare public information releases for distribution to the mass media as necessary.
¨ Review and implement company’s reinspection policy for catastrophe claims.
Managing Work Flow
- Include step-by-step directions on the requirements for smooth work flow, as established by the company, and how the role of the supervisor in achieving a smooth operation.
- It is recommended the supervisor conduct an initial briefing for newly arrived adjusters and staff to:
– Review how the company receives claims.
– Review the importance of screening losses for complete coverage information.
– Review the basics of aggressive good faith in handling catastrophe claims.
– Review the company policy on immediate contact with the insured.
– Review company estimating procedures.
Suggestion: The company should establish a policy on when the adjuster will write an estimate sheet after a catastrophe to clarify if it will it be on every loss or only some losses.
– Review the company guidelines on advance payments.
– Review company procedures on issuing drafts.
– Review company procedures for catastrophe claim file documentation.
- Suggestions for catastrophe claim management the supervisor may consider:
– Start a loss log to keep track of claim status and reserves.
– Implement assignment records for all claim files, open and closed.
– Assess the workload of adjusters frequently to determine if additional resources are necessary.
– Prepare weekly reports for the home office on the numbers of claims reported and the number of settlements.
– Conduct meetings at least weekly with the adjusters to:
- Share information of use in settling the catastrophe claims.
- Reward outstanding work by the staff.
- Motivate staff to do their best.
- Gain information on field conditions.
- Assess stress levels of staff.
– Establish procedures to comply with company policy regarding reinspection of catastrophe losses.
Training
Staff Adjusters
- The catastrophe plan should be a “living” plan that is constantly reviewed and updated. All staff adjusters should be familiar with the basics of the plan.
- The supervisor’s role in staff training to implement the plan should be identified.
- Pre-catastrophe training is best if it is:
– Catastrophe specific, such as how a catastrophe adjuster should separate wind damage from water damage following a hurricane.
– Action oriented, such as employing table-top exercises, simulations, group sessions, and so on.
– Sticks to a basic theme, focusing on teaching a specific point.
- Periodic refresher training is crucial to the smooth implementation of the plan.
- Scheduled periodic refresher training keeps the staff in shape for action. It also helps identify weaknesses in the plan which may not be noticed until a crisis develops.
Independent Adjusters
- Training of this resource will depend on how the company intends to use the independent adjusters during a catastrophe operation. Will they be used on the catastrophe? Will they be primarily assigned the routine claims that will continue in the areas not involved in the catastrophe?
- Keep the independent adjusters used by the company briefed on the performance expectations during the catastrophe operations. The independent adjusters must be familiar with the plan.
- Procedural training for the independent adjusters regarding company reporting requirements would help achieve a smooth work flow following the catastrophe.
– It is recommended independent adjusters be required to report to the supervisor:
- The number of losses they are adjusting.
- The number of adjusters working the catastrophe.
- The number of inspections completed.
- The number of files closed.
– Ask for right-of-review of the independent adjusters’ catastrophe operations plans. This will provide advance knowledge of the independent adjuster’s capabilities.
Non-Claims Staff for Emergency Claims Duty
- Company people who might be used in a catastrophe to complete assignments normally handled by an adjuster. This group could include underwriters, actuaries, loss control, clerical, and so on.
- If possible, the supervisor should seek to identify potential candidates for training prior to a catastrophe. If chosen in advance, the non-claims people can become familiar with the catastrophe plan and be prepared to respond when asked.
- It would be best if these identified candidates could be trained prior to the catastrophe. A core of trained people will permit a faster implementation of the plan to use non-claims people in certain functions after a catastrophe.
- The supervisor should develop a refresher training course to help the previously trained non-claims people prepare for their new duties following the catastrophe.
- The supervisor should develop a post-catastrophe training course for the non-claims people who will not be selected until after the catastrophe occurrence. This should be a simple, job-specific, training plan that will quickly give the person basic skills.
Estimating Property Losses
- The supervisor should be prepared to provide refresher training as necessary on the company’s estimating procedures.
- Any modifications of the company program, necessary because of the catastrophe conditions, should be included in the post-catastrophe training program.
- It is recommended the catastrophe adjusters be provided with a copy of the estimating guidelines during their initial catastrophe briefing.
Public Information
The Media
- Review the company policy for answering inquiries from the news media.
The Public
- Review company policy for appearances before public meetings.
Section Three
Catastrophe Adjuster’s Guide
Introduction
A disaster may occur anywhere in America. It may take many forms: hurricane, tornado, flood, conflagration, blizzard, or earthquake. Whatever the type of disaster, it will affect insurance policyholders who will file claims for indemnification. They will expect, and will have the right to, fast, courteous, complete, and accurate claims adjustment.
You, as a catastrophe adjuster, will play a key role in meeting and fulfilling those policyholder expectations. Your professional skills will be used to the maximum extent during the recovery process and the rebuilding period. How well you do your job will be closely watched by the policyholders, the insurance regulators, and your company. There is little room for error in today’s catastrophe adjusting environment.
The job of a catastrophe adjuster is vitally important to the business of insurance. Properly handled, a catastrophe claim can demonstrate to the policyholders the true value of insurance. You are one of two insurance industry contact people the policyholder will probably ever meet. The other person is the agent. A great deal depends on your work habits, appearance, personality, competence, and professional ability. The Catastrophe Adjuster’s Guide is designed to help you deliver first class service to the ultimate consumer of insurance, the policyholder.
Preparing for a Catastrophe
What to Expect
The catastrophe can be divided into two general categories:
– The physical environment of the disaster; and
– The psychological state of the policyholder.
Both are extremely important for the catastrophe adjuster to understand and appreciate.
The physical environment will present a professional technical challenge to the adjuster. The damages to property will be many and varied, requiring skill and ingenuity in many instances to estimate the scope of the loss and negotiate a settlement. The greatest challenge to the adjuster will come in determining if structures, which haven’t been destroyed in the disaster, may be repaired. Assessment of damage is a skill which a catastrophe adjuster can polish to a high sheen of proficiency during catastrophe operations.
Your physical environment is going to be changed also. Work hours and procedures will not be routine until the crisis has passed. Residential and office conditions may be primitive during the early stages of a catastrophe claim operation. Communication systems may have been so disrupted that you will have some difficulty in establishing voice and data communications early in the operation. You may even have to rely on pencil and paper once again in those early hours.
The psychological state of the policyholder will require your patience following a disaster. Their first concern will be for the safety and welfare of their immediate and extended family. The secondary concern, early in the catastrophe, will be for the restoration of their home and possessions. You will play a vital role in helping assure the survivors’ safety and welfare is of concern and is addressed by the policy in the form of additional living expenses. Dealing with the survivors’ secondary concern of reorganizing their life and rebuilding their home or business will be no less challenging.
Depending on the severity of the catastrophe, your psychological state can also be affected. It is well documented that people who help others following a disaster are affected by the experience. It is a stressful time for the adjuster too. Always keep in mind that you, as a catastrophe adjuster, are one of the most important players in the recovery process for the victim. You will be the one providing the funds for them to put their life back in order. And you will do it quickly. It is a personally satisfying experience.
Stresses and Pressures
- Survivors
A sudden and unexpected event has damaged or destroyed property essential to the life of the survivor. It might be a home. It might be a business. It represented order and stability, but now it’s damaged or destroyed.
The survivor will feel shock at first that such an evil event could hurt them. They will probably next feel anger. They will likely next become depressed, thinking the situation is hopeless and they will never recover. Finally, they will decide to push on and recover as best they can.
A sense of urgency will likely affect the insured to get things quickly back to normal. They will feel pressure to take care of the family, or the business and its employees, as soon as possible.
- Civil Authorities
The sudden event usually can’t be predicted as to time and place of arrival. But any competent civil authority will lay contingency plans for the management of the disaster. Those plans normally involve emergency response to the event with emphasis on preservation of life and containment of property damage in the initial stages of the disaster. In later phases they will include plans for the recovery of the community, primarily in removal of debris, restoration of essential utilities, maintenance of law and order, and so on.
Rebuilding the community is hardly ever addressed in civil authority contingency plans. That is not considered an emergency operation. Obviously, rebuilding following the disaster is critical to the survival of the community.
Most well organized communities have a variety of codes and ordinances dealing with zoning and building. In many major disasters, where destruction is general and widespread, there have been pressures on the civil authorities to rebuild to a new “master plan.”
In disasters where there hasn’t been pressure to “right old wrongs”, the process of assuring compliance with zoning regulations and building code issues has generally been time consuming. The civil authorities are often under great pressure to hasten the process by one group of constituents, while under pressure by another group demanding careful plan review and deliberation to assure everything is done correctly.
**PLRB’s Building Code Division can assist with coverage questions that are related to state and local building codes. It can be contacted on-line at www.plrb.org. On the Home Page hover over “Coverage Research”, click on the “Building Codes” hyperlink. State and local building codes are available on-line.**
- Adjusters
You will face pressure and stress from a variety of sources. Not all will be negative stress. Many will be positive pressures that will assist in delivering excellent service to the affected policyholder.
As a professional you have a commitment to do your job well. Serving the needs of your policyholders under catastrophe conditions presents a real challenge. Many people are expecting fast service. You have the responsibility of providing that service.
The policyholder’s immediate needs of food, shelter, and clothing will have to be addressed. The victim may vent anger at you, not because you have done anything wrong, but because you’re a convenient target. Giving the policyholder instructions to reach clear and attainable short-term goals, and establishing realistic follow-up dates, will help productively channel the person’s energy.
Repair or replacement of the property will put pressure and stress on the catastrophe adjuster. Both the policyholder and the civil authorities may place demands on the adjuster that will be stressful.
Operating under such conditions would be a challenge under any circumstances. But the adjuster may also have the additional stress of primitive living conditions and rudimentary working conditions.
Understanding the stresses and pressures you may face in advance of the catastrophe operation should help you emotionally brace for the assault.
Crisis Public Relations Basics
Following a catastrophe, the adjusters may find themselves in the position of insurance industry public relations representative. The only difference between being a P. R. representative in a normal claim situation and in a catastrophe claim situation, is that the latter is a crisis. Your every action and comment are being carefully watched and noted.
A catastrophe presents a golden opportunity for an adjuster to show the public how well the insurance system works for its policyholders. Relating to the public is a very important aspect of catastrophe adjusting.
Public relations activity does not always mean talking with the media. That will likely be handled by a P. R. person from your company. The most critical public relations assignment will be executed by you the catastrophe adjuster. To the average policyholder you are the insurance company. You are likely to be the only person from the insurance company they will ever meet. What you do and say, and how you do it and say it, will leave a lasting impression with that policyholder.
Effectively Communicate in a Crisis
- Dress professionally, but appropriately for the conditions. It has been said what the listener sees is often more important in forming an opinion than what is heard. If you look professional, you communicate the message, “I am competent.”
- Show respect for the survivor and the circumstances in which he or she find them self. Speak quietly, seriously, and directly. Remember they have experienced a severe trauma and need strong support. You, as the adjuster, can provide some of that support.
- Listen to what they have to say to you. While it may not deal directly with the claim, the fact that you have just taken the time to listen transmits the message, “I care.” Remember, just talking about the experience is a form of recovery from the disaster. The policyholder may assume that you as an adjuster are familiar with catastrophes and can offer guidance, so they tell you their story.
- Take time with people. Catastrophe victims sometimes complain that the adjuster was abrupt and rude. Follow-up usually shows the adjuster was anxious to get to the next claim. A fine balance should be achieved between treating the victim with care and providing fast service.
- Talk in plain language. Most people are mystified by “insurance-ese.” A good communicator will avoid the jargon and speak in language the policyholder can understand. The essence of all communication is formulating the message in an understandable form. If the policyholder has no idea of what you’re talking about, misunderstanding will surely follow.
- If you have made any specific suggestions to the policyholder, consider leaving a written copy. This will avoid a later misunderstanding over what is to be done. Pre-printed checklists, thoroughly reviewed with the insured, can compliment your efforts.
- Follow up with the policyholder during the recovery process. While it may not be absolutely necessary, a simple follow up call to see how they are doing effectively communicates the message, “This company cares.”
In a normal claims situation, the home office usually deals with the media. Since you are a catastrophe adjuster, you may find yourself talking with a reporter. Be familiar with your company’s policy regarding media contact.
Tips to help you communicate well when talking with a reporter
- Be relaxed, pleasant, professional.
- Speak to the reporter as if you were talking one-on-one with an associate.
- Answer the questions directly and honestly.
- Speak only to known facts. Do not speculate on anything.
- Do not comment on other companies, their adjusters, or their practices.
- Never answer for someone else or speculate on what others are thinking or why they did something.
- If the reporter is asking you questions in areas beyond your knowledge or experience, say so. You should never attempt to fake your way through an answer.
- Speak plain English. Avoid insurance jargon. Remember, you are communicating with the viewer/listener/reader, possibly one of your policyholders.
- Emphasize the positive, such as:
– How your organization is geared up to handle the large number of claims;
– How people can expedite the claims process; and
– How people can best get in touch with an adjuster.
- Be sure to let people know early on what might not be covered.
- Make your answers short, information filled, and to the point.
Negotiation Guidelines to Fix Value/Loss
- Be sure to review the company’s policy and guidelines on negotiations.
- Check with the catastrophe supervisor to determine if there have been any modifications to those guidelines, because of the catastrophic conditions.
- If disputes arise, segment problems and negotiate separate solutions. Do not make sweeping agreements under duress.
Estimating Losses
- Review the company’s guideline for estimating losses to refresh your memory on claim situations which you may not have recently encountered.
- Ask the catastrophe supervisor if there are any modifications to the company’s estimating procedures because of the catastrophe.
- Make sure the insured understands your estimate to avoid problems later-on in the claim process.
Potential Problems
- “Neighboritis”
This phenomena usually occurs after your policy holder has been talking with the neighbor and discovers the neighbor has received something that your insured hasn’t received. “If my neighbor gets it, I want it too,” your insured reasons.
Solution
Take the time to carefully explain to your policyholder, in plain language, the coverage of their policy, how policies may vary between competitive insurers, and how the coverage purchased by the insured will determine what may be recovered.
Be patient. Be polite.
- “Competitoritis”
Similar to “neighboritis” this problem might surface when your policyholder perceives a difference in how you’re settling the claim compared to what your competitors are doing. The reasoning goes, “If their insurance company is doing that, so should my insurance company.”
Solution
Explain the competitive nature of the insurance industry. Show how policies might be different or how the coverage could be greater or lesser than your company’s policy. Speak in plain language and be patient.
Always remember that your insured is under great stress!
Tools/Equipment Needed for the Job
- Cellular phone, Smart phone, pager
- Laptop
- GPS & printed road maps
- Cameras
- Flashlight, lantern, extra batteries
- Calculators
- Audio & video recorders, extra batteries
- Ladder
- Report Forms
- Checks
- Cash
- Special protective clothing appropriate for the type of event and the weather conditions. Items should include: boots, warm coats, rain coats, hard hats, ear muffs, gloves, soft-soled shoes for roofs, and so on.
- First Aid kit
Special Arrangements
- Activate a voice mail account or forward your phone to a predetermined location where your calls may be answered.
- If you live alone, you might want to arrange for someone to:
– Monitor your residence
– Pick up mail/deliveries/paycheck
– Water plants
– Feed pets
– Water yard
– Cut the grass
– Shovel snow
– Forward bills and other important mail
After The Catastrophe
Access to the Area
Access will undoubtedly be limited for a period of time by the civil authorities during the emergency phase of the disaster. To gain access to the area during this time you should:
- Locate the emergency operations command post. This would most likely be a vehicle of some sort. It may also be a building. It will likely be marked by a distinctive sign or a “CP” flag.
- Show your company identification card and ask for access to the area.
- You will likely be issued distinctive tags you must wear on your person and/or display on your vehicle.
- You will also likely receive any special curfew instructions.
- Mark your vehicle with a distinctive window sign with company logo and identification, so the police patrols will recognize you as an insurance adjuster.
Safety for the Adjuster
- Your greatest chance of being injured on a catastrophe operation is in a traffic accident. That is no different than any other day of the year. But traffic safety hazards are compounded by the effects of the disaster. People are not paying close attention to their driving. Traffic control signs and street identification signs may be damaged or destroyed. Roads and bridges may be weakened. Keep alert. Drive defensively.
- Bring protective clothing, appropriate to the season, to prevent environmental injuries such as sunburn, frostbite, etc.
- Bring protective clothing to prevent physical injuries. Items such as safety shoes or boots, water-proof boots for work in mud and water, hard hat, leather work gloves, safety glasses, etc., should be considered.
- Assure all equipment is in good repair. For example, your ladders should be in good repair, flashlights should have extra batteries, etc.
- Assure all equipment is appropriate for the job. For example, ladders should be the correct length for needed reach.
- Bring your own smoke detector for use in your hotel room.
- Keep rested so you will be alert. Most accidents occur when the victim is fatigued. Know your pace.
- Bring medicine prescriptions with you so they may be filled if needed in the catastrophe area. Do the same thing with your glasses or contact lens prescriptions.
Contacting Policyholders
- Be pleasant, but businesslike.
- Be sympathetic.
- Present your business card.
- Explain who you are, why you’re there, what you will do for them.
- Encourage the insured to accompany you as you scope the loss.
- Explain how you arrive at your scope figures.
- Answer all questions to the satisfaction of the insured.
- If company policy permits, leave a copy of your scope with the policyholder.
- If company policy permits, let the policyholder use your cellular phone to make adjusting-related calls, if their phone is out-of-service.
Inventory
- Get the insured participating in the claims process early with the preparation of an inventory.
- Ask them to list room-by-room contents damaged and contents destroyed.
- Ask them to list when purchased, where purchased, and purchase price.
- Ask them to look for any photos showing the room and its contents before the disaster.
- Ask them to save damaged contents for your inspection before removing to a land-fill area.
- Assist them by suggesting use of catalogs and websites to refresh their memory and obtain prices.
- Remember to provide any company forms or booklets, and to refer them to company websites that may help them complete this important job.
Salvage
- The insured claimant will likely see only debris following the disaster, while the claims professional will see not only debris, but salvage potential.
- It is important to look at all salvage possibilities, as outlined by your company, to help speed recovery, control claim costs, and ultimately control costs for the policyholders.
Protection of Property/Damage Mitigation
- The insured hopefully will have taken emergency action to preserve and protect the insured property after the loss. If not, provide written instructions detailing these necessary activities and keep a copy for the file. But, be aware that material shortages may hinder the process.
- Be especially aware of the need to provide a more permanent solution to the protection of the claimant’s property. This helps set the insured’s mind at ease, as well as control potential expansion of the claim, if further damage should occur.
- Plan to meet company policy on authorizing temporary repairs to protect the building and contents.
- Check with your supervisor for a list of appropriate, safe, and secure storage facilities for the insured’s to place their possessions until the structure is rebuilt or repaired.
Additional Living Expense Guidelines
- Review your company policy on Additional Living Expense.
- Thoroughly explain to the policyholder what is covered and what documentation is required for the A.L.E. claim.
- If your company does not have an arrangement with a claim service provider for emergency housing services, begin assembling a list of realtors to aid you in finding appropriate property for long term displacement cases. Remember, competition may be fierce for quality rental properties following a catastrophe.
- Maintain communication with your supervisor regarding any changes in the A.L.E. “climate”.
- If consistent with your company policy, consider negotiating a blanket monthly or weekly rate, and allow the insured to make his or her own arrangements.
List of Reminders
- As soon as possible begin putting together lists of people with services you might need during the course of the catastrophe operation.
- Check with the catastrophe supervisor for the company’s list of:
– Experts
– Consultants
– Government Agencies
– Others
Catastrophe Adjuster’s Guide Checklist
Responding to the CatastropheThings to Remember When You are Leaving on a Catastrophe Assignment
¨ If you live alone you might want to arrange for someone to be responsible to:
Monitor your residence
Pick up the mail and deliveries
Forward bills and other important mail
Water the plants
Feed and exercise pets
Water the yard & plants
Cut the grass
Shovel snow
Deposit paychecks in your bank account
¨ Obtain copies of any necessary prescriptions that may have to be filled while you are away. Be sure to include any prescriptions for eyeglasses.
¨ Gather the equipment/supplies you will need, such as:
Cell phone
Tablet
Laptop
Pager
Magnetic car signs
GPS unit as well as paper road maps
Cameras
Flashlight, lantern, extra batteries
Calculator
Audio & video recorders, extra batteries
Extension cords
Surge protector
Ladder
Tape measure
Business card supply
Paper pads
Pencils, pens, paper clips, etc.
Report forms
Drafts
Company identification card
Cash
Special protective equipment
- Safety glasses
- Hard hat
- Safety shoes
- Water proof boots
- Leather work gloves
- Rain gear
- Cold weather gear
- Smoke detector
¨ Review company guidelines for use in catastrophes regarding:
Inventory
Estimates
Proof of loss
Salvage
Additional Living Expenses
Cash advances
Issuing checks
Replacement cost provisions
Reports
Section Four – Appendix A
Sample Tornado News Release
Insurer Expedites Claims Following TornadoRelease Date:
Contact: (Person’s name, position, e-mail, and telephone numbers – cell & office)
Insurance claims of homeowners and businesses are being quickly handled by (name of company) claims people following the tornado on (date of the storm) at (location).
“Insurance policyholders who have suffered damage should immediately contact (include the name of the appropriate contact person),” said (name of source, position, and company name). “Their agent can set the claims process into motion and help with emergency needs as well.”
The insurance policy requires policyholders do the following as part of the claims process:
- Notify your agent or the company, immediately.
- Protect the property against further damage. Do the best you can under the circumstances. Protect your possessions which are not destroyed by getting them under cover. You want to minimize damage from wind and rain, as well as guard against theft.
- Make any reasonable and necessary repairs to help safeguard the property.
- Keep accurate records of your repair expenses. Save receipts for any supplies you have to buy to board up the building or protect your personal property. These receipts will become part of your claim.
- Prepare a detailed inventory of damaged personal property. Be sure to include: make, model, actual cash value (what it was worth if you were to try and sell it at a garage sale the day before the storm), and the total amount of loss.
Some suggestions that will help you speed up the claims process are:
- Photograph or video the damaged area for a permanent record.
- Save everything that is damaged or destroyed until the insurance adjuster has seen it and verified its existence. As a protection to the policyholders, insurance policies require you to prove you owned any item claimed.
- Be sure to leave a forwarding address, your e-mail address, and telephone numbers with your agent and the adjuster, so you can be quickly contacted during the settlement of your claim.
- You may be entitled to a partial advance payment of your claim. This is to help you pay for emergency needs such as clothing, food, shelter, and so on. This advance payment is part of the total claim.
The (name of company) has established a special office at (location & telephone number) to assist policyholders with their claims. (Name of company) policyholders may call the special claims office at (telephone number) between the hours of (hours of operation) on (days of operation).
Sample Hurricane News ReleaseInsurer Expedites Claims Following Hurricane (name of storm)
Release Date:
Contact: (Person’s name, position, e-mail, and telephone numbers – Cell & Office)
Insurance claims of homeowners and businesses are being quickly handled by (name of company) claims people following Hurricane (name of storm).
“Insurance policyholders who have suffered damage should immediately contact (name the appropriate contact person and telephone number),” said (name of source, position, and company name). “The agent can set the claims process into motion and help with emergency needs as well.”
Hurricanes generally cause damages through flooding of property and wind. Flooding and wind damages are covered under separate policies.
FloodingFlood insurance must be purchased separately from Homeowners insurance. If you have flood insurance, your damages caused by wave, tidal action, or other flooding may be covered. If you do not have flood insurance, those damages will not be covered by your homeowners insurance policy.
WindHomeowners insurance will cover damages to your home and contents caused by the hurricane’s wind.
The insurance policy requires policyholders do the following as part of the claims process:
- Notify your agent or the company, immediately.
- Protect the property against further damage. Do the best you can under the circumstances. Protect your possessions which are not destroyed by getting them under cover. You want to minimize damage from wind and rain, as well as guard against theft.
- Make any reasonable and necessary repairs to help safeguard the property.
- Keep accurate records of your repair expenses. Save receipts for any supplies you have to buy to board up the building or protect your personal property. These receipts will become part of your claim.
- Prepare a detailed inventory of damaged personal property. Be sure to include: make, model, date of purchase, and cost to replace.
Some suggestions that will help you speed up the claims process are:
- Photograph or video the damaged area for a permanent record.
- Save everything that is damaged or destroyed until the insurance adjuster has seen it and verified its existence.
- Be sure to leave a forwarding address, email address, and telephone number with your agent and the adjuster, so you can be quickly contacted during the settlement of your claim.
- Your company may make a partial advance payment of your claim. This is to help you pay for emergency needs such as clothing, food, shelter, and so on. This advance payment is part of the total claim.
Your home and property which were once so familiar to you, and probably quite safe, have no doubt been altered by the hurricane. Be very cautious when re-entering your hurricane damaged home. Remember, it may be days before the area may be considered safe by the emergency management officials. Use caution.
ElectricityTreat all downed wires as if they were energized electrical lines. Stay away and let professionals from your local electrical utility check to make sure they’re safe. If your house was flooded, assume the water got into the electrical system and that it is unsafe. Have an electrician check to assure its safety.
Natural or Propane GasSometimes hurricanes will break gas pipes and cause gas to leak into the house. If you smell the “rotten egg” smell of natural or propane gas, leave the house and call your local fire department immediately. Wait until they or the gas utility gives you the “all clear” before going back into the house.
Structural StabilityHurricanes are violent storms that exert great force on structures. If the house is “listing” or leaning over, assume it isn’t safe to enter. A listing structure could collapse. Have the building’s stability checked by your local building official, an engineer, or a competent contractor.
SanitationIt is quite possible your drinking water may be contaminated because of the storm. Food products stored in the home may also be contaminated. The same can be said for medicines which might have been in the house. A rule-of-thumb you might follow is to treat anything you will eat or swallow with extreme caution, if it has gotten wet or flooded in the storm. Your local government emergency management agency or the local county extension agent’s office will have information about health related issues. Please contact them for advice.
The (name of company) has established a special office at (location and phone number) to assist policyholders with their claims. (Name of company) policyholders may call the special claims office at (phone number) between the hours of (hours of operation) on (days of operation).
Section Four – Appendix B
Policyholder Claims Information PacketYour policyholders may depend on the knowledge, skill, and expertise of your company to help them recover from the disaster. They need information about many areas that are related to recovery, but are actually beyond the discipline of insurance. Development of a Policyholder Claims Information Kit that can be given to the policyholder by the catastrophe adjuster on the first visit will help smooth the recovery process by empowering the policyholder with information on a series of subjects that they will have to understand in order to begin rebuilding.
The kit might include the following information:
- Introductory letter explaining the purpose of the adjuster and briefly outlining the steps that will be followed in adjusting the claim and getting the policyholder back on his or her feet, as well as the policyholder’s and the insurance company’s responsibilities during rebuilding.
- Telephone numbers and e-mail addresses of adjuster(s)
- Rebuilding To Do list pad to help policyholder organize their recovery efforts
- Household inventory links, book, or sheets
- Rebuilding/repairing the house information sheets such as:
– Getting bids, sources to verify a contractor’s references, and selecting a reputable contractor
– Common disputes property owners have with contractors and their resolution
– Explanation of building codes and the importance of adhering to them
– Building permits and inspections
– Glossary of construction terms and materials
– Schematic drawing of the parts of a structure
– Information about types of building materials
– Loss mitigation hints