The Outcome Oriented Claims Culture Is Pervasive and Killing Any Good Will Towards the Insurance Industry

Seek Now (fka Ladder Now) is a third-party vendor to insurance companies. It has non-licensed inspectors do work that historically was accomplished by company or independent adjusters. Here is a memo from a Seek Now manager to his field inspection team:

I was showing this message to a number of adjusters at the First Party Claims Conference. This conference has an emphasis on Artificial Intelligence. So, I put the message into ChatGPT for analysis, and here are the results:

The text you’ve provided appears to be a communication from a manager or supervisor named Steve Wilson to a team, likely involved in insurance claims inspections, specifically regarding State Farm claims. Here’s an analysis of the key points:

Increase in State Farm Volume: The message begins by acknowledging a significant increase in the volume of State Farm claims, which now comprises about 50% of the team’s total workload. This is an important context, as it indicates a heavy reliance on State Farm for business.

Issue with Reinspections: The message highlights a problem with reinspections due to some team members conducting assessments loosely. Reinspections usually occur if an initial inspection is deemed inadequate or inaccurate, indicating a potential issue with the quality of work.

Strict Standards and Consequences: Steve emphasizes that State Farm adheres to strict HAAG standards for damage assessments. He warns that continued reinspections, particularly from the same technicians, may lead to financial penalties (deducting the inspection cost from the technician) or even barring them from handling State Farm claims. This is significant as it could impact their workload by approximately 50%.

Urgency and Risk of Losing Business: There’s a sense of urgency in the message. Steve is concerned about the risk of losing State Farm as a client due to substandard inspections. He urges the team to improve their assessment quality and align with the required standards.

Open Communication: The message concludes with an invitation for team members to reach out if they have questions, indicating a willingness to assist and provide guidance.

Response from Patrick Spivey: Patrick’s response, though brief and somewhat humorous (‘lol’), suggests a readiness to assist or provide expertise in ‘calling it tight’, i.e., making accurate and strict damage assessments.

Overall, the message conveys a serious concern about the quality of work and its implications on business relationships and revenue. It stresses the need for adherence to standards and quality control to maintain a crucial business relationship with State Farm.

To me, the message was clear. Make your opinions about damage lower or face getting reduced wages. How do you think State Farm policyholders would feel if they had an inspector from Seek Now making determinations on their claim? How would you feed if it were your claim?

Policyholders, insurance regulators, and the public need to understand that many in the insurance claims industry are driven to reduce the amount paid on claims. While everybody acknowledges that good faith with full and prompt payment is the standard, the current claims culture is to pay as little as possible. Many third-party vendors will sell out to help insurance companies do this.

This is why so many professional and ethical claims adjusters are leaving the insurance claims industry. They cannot legitimately answer “why” they are participating in a business that is not playing by the rules and standards of conduct, which give way to the culture demonstrated in this memo. What happened to the industry that promised the highest of integrity, ethics, and business dealings with policyholders at their greatest time of need?

I know many residential property insurance adjusters at Chubb and AMICA would be embarrassed by this memo. However, the claims culture at those two insurance companies is very different than the rest of the claims industry. For much of the rest of the property insurance claims industry, these types of memos and cultural attitudes are why our law firm attorneys are quite busy.

Thought For The Day

Always do right. This will gratify some people and astonish the rest.

—Mark Twain