10.4.09

CHAPTER 1 – (Part 2)


Your Agent –v- The Adjust

Many Americans have Insurance Agents that they feel warmly towards, and may even feel a bond of friendship with their Agent. Agents generally present themselves to the Insured in a friendly and professional manner, which builds a bond of thrust between the two individuals. In small townships it is quite conceivable that such bonds of friendship are indeed genuine; the members of their families may enjoy mutual ties and associations. But for the most part, throughout our nation, no matter how friendly the Agent, the truth remains that the relationship is that of buyer to seller, and little more.

What you must understand is that Insurance Agents are Company Sales Representatives who make his or her living on a commission, and that commission comes from selling you Insurance, comes out of your monthly Premium payments. Point of fact: Your Agent has been trained to present themselves to you in this manner. That is not to say that all Agents are phony’s; no. I have met many Agents who are truly forthright people who genuinely care about the people they serve. Point here is that your Agent’s job is to sell you Insurance; their job is not servicing the Policy in your time of loss and need.


Generally speaking, Agents have no authority or even input into the claims handling process. It is true that some Insurance Company’s, primarily the larger Company’s, give their Agents a limited scope of authority to handle claims and issue settlement checks. However, their authority for handling claims extends only to small losses, and is limited to a dollar amount of loss, commonly not to exceed $2500.oo.
I have met many Insured’s who have received such settlements from their Agent’s who thought their Agent could help them with large storm related losses. But this is never the case. --- As an Adjuster doing everything allowable to help the Insured, I have had Agents that were trying to make themselves look like the hero in the eyes of their customers by trying to get me to pay for things that were not damaged by the event, or that are not covered by the Policy. But this highly inappropriate approach never bears fruit for the Insured. The work of the Adjuster is to service a binding contract. Even if the Adjuster did try to pay out money for illegitimate items, the Adjusters files are examined by Supervisors, photographs are taken and studied. In the end, all the Agent who has forced him or her self onto the claims process has accomplished is to make the Insured mad, and make a good Adjuster look like the bad guy.

When a claim has been assigned to an Adjuster, that Adjuster holds controlling authority over your claim until such time as the Adjuster has turned your claim file back in to the Company for processing.
When you have a claim that has been assigned to an Adjuster, my advice is that you work closely, patiently and courteously with that Adjuster throughout the process. Most all Adjusters are stressed out, overworked, and worn out from being on the receiving end of every conceivable manner of abuse. (The stories I could tell). By being pleasant and courteous with your Adjuster, you are in fact helping them help you.

If in the end you are not satisfied with the final outcome of how the Adjuster has handled your claim, or with the claim settlement, you do have recourse, which I will discuss at length in a proceeding Chapter.