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Adjuster Licensing and Timelines for Processing Your Damage Claims

This post is part of a series sponsored by AgentSync.

Hurricanes. Forest fires. Earthquakes. What do they have in common? If you are in the insurance industry, the answer is that they are all guaranteed to trigger weather and catastrophe claims from those with catastrophe coverage.

For carriers and adjusters, this ultimately means activating an emergency response among their staff. This could mean a tsunami of hundreds of adjusters being deployed in an affected state or region. Whether these are staff adjusters or independent contractors hired just for a single emergency response, onboarding and license compliance are critical to ensuring claims can be processed and submitted in a timely manner.

Before we jump into the meat of the blog, it’s important to remember that we are not lawyers, and we present this information for general education and industry discussion – you are responsible for doing your own due diligence.

Processing of complaints in time

Many states—especially those with robust weather disaster cycles—have specific timelines for processing claims. Insurance companies that want to be able to sort the wheat from the chaff of legitimate versus fraudulent claims must act quickly.

There are a number of reasons why insurance companies want to be quick on the scene in the aftermath of a natural disaster or weather event such as a hurricane or wildfire:

  • The law. Legally, most states have set deadlines of days or weeks to process and pay “clean claims,” ​​or claims that are clearly covered by the policy and have all relevant information available. We are committed to following the law.
  • Speed ​​equals satisfaction. Customers with faster claim resolution and response times scored their insurers higher. In a word-of-mouth industry like insurance, having adjusters in place to file and process claims quickly is key to growing and retaining business.
  • Like a crime scene, evidence deteriorates over time. Adjusters are your eyes on the ground to spot insurance fraud and determine what qualifies as a legitimate claim. If an adjuster can’t check out a claims site for days, weeks, or even months, it becomes much more difficult to root out fraud.
  • Unaddressed, the damages (and the corresponding amount of damages) can rise. Think of some Kansas retiree whose shingles are blowing the house off. The damage is covered and the insurer agrees to fix the roof. But the insurer’s preferred roofer will take a while to get around to it. Meanwhile, each subsequent drizzle or storm pours more onto the exposed roof. Even with tarps, running water starts to cause damage inside the home. Now the insurer has to pay to replace a ceiling in a bathroom in addition to the ceiling. (See how this can spiral?)
  • The longer you wait, the longer fraudsters and scammers have to move in. Nature abhors a vacuum. So does your dog. And so does the insurance. In the wake of a natural disaster, if you don’t act quickly to connect with your affected customers, there are more opportunities for a fraudster with a generic “submit your claim” scheme to confuse your policyholders.

Adjustment license affecting claim processing times

You might be thinking, “Surely that’s what all apps and AI are for, right? I’ve seen a million instant claim app ads on Snapchat, so the instant claim problem is SOLVED.”

Unfortunately, many claims are not “clean” and therefore human adjusters with their human need for licensing must get involved, either by being physically on site or by virtually managing the claims process via photos, videos and other digital data collection. The problem is definitely not solved.

Similar to insurance producers, insurance adjusters must also maintain licenses in most states, with continuing education and license renewals and the whole shebang. For casualty insurers who handle this manually, a natural disaster can also equal paperwork. Perhaps you assign an adjuster to a set of claims only to realize that they are not properly licensed for that state, or they do not have a home state listed. Then you have to reposition the adjuster and find a stand-in to meet the customers’ needs.

Churning adjusters either because the insurer’s staff disappears or because they are improperly licensed is so common that Louisiana introduced a law this session to prohibit insurers from churning more than three adjusters through a claim assignment within a given period. According to Louisiana Insurance Commissioner Jim Donelon, the rule “addresses the most frequent concern raised in the 4,000 complaints [the Louisiana Department of Insurance] received from consumers in the aftermath of Ida.” It turns out that insurance consumers don’t like being handed over to multiple adjusters any more than insurance companies like finding and replacing them. Speed ​​dating is simply not an attractive business model for any corner of the insurance industry.

Right now, many carriers and adjusters rely on manual processes that use self-reported information from adjusters. It’s a gas-and-brake game of compliance management while trying to have enough staff to man the phones in the aftermath of a disaster. But imagine doing business differently.

Imagine knowing where an adjuster is licensed and authorized to do business—no ifs, ands, and buts—and being able to properly route claims accordingly. Imagine connecting with a new adjuster and knowing on the first day of the relationship which states you would need to schedule an appointment with. How much can the frenzy of adjustment missions be reduced?

Quick introduction for claims adjusters

Claims processing is cyclical – sometimes you can’t find enough people to take phone calls, and other times the entire staff can take a long lunch. It’s easier said than done to stay compliant while gearing up for a disaster season, and we all know that Mother Nature doesn’t wait for insurance companies to tick and cross t.

With AgentSync Manage, operators can onboard adjusters in as little as hours, giving carriers and adjusters the knowledge that their adjusters are up-to-date on licensing and licensed in the states they need.

Instead of searching for background checks, license verification and other required documentation, Manage can provide a single portal for adjuster self-service and easily integrates with digital background check providers.

When having a licensed adjuster is critical to a fast and compliant claims process—which in turn delivers results for the bottom line—manual errors and spreadsheet tracking simply won’t slow you down.

Going outside of these adjusters once disaster season is over can also be a pain point when using manual processes. But with AgentSync Manage’s automations and integrations, you can set adjuster licenses to “inactive” status – in bulk, if needed! – and start workflows to send a legal notice to an adjuster via email that you have terminated their contract.

At AgentSync, we can help you lock in your adjusters’ licensing and compliance requirements so you can reduce churn and increase your team and customer satisfaction. See how; check out our Solutions page.

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