A latest dialog on LinkedIn has sparked severe questions concerning the objectivity of engineering stories utilized by insurance coverage firms. Our agency is now taking step one to seek out out whether or not the claims of systemic bias maintain water.
It began when a public adjuster responded to a thread involving legal professional Steven Badger. The assertion was, “I actually can’t bear in mind an engineer report within the final 15 years that was favorable to the insured.” I then posed the next easy query in a publish:
“Is it potential that no insurance coverage firm engineer report has favored a policyholder in 15 years?”
The response, if true, was a strong assertion deserving of follow-up. A 15-year run of engineer stories, all unfavorable to policyholders, would counsel one thing way more troubling than occasional errors or outlier habits. It might indicate a systemic observe that undermines equity in claims decision and damages belief in your entire course of.
However as I admitted in my publish, I approached that declare with skepticism. I don’t doubt the frustrations many public adjusters, restoration contractors, and policyholders really feel as a result of I’ve seen sufficient engineering stories to write down posts on the subject, together with Beauty Injury Hail Points—Biased Engineering Reviews and Unhealthy Religion, Why Ought to Policyholders Be Compelled to Settle for Engineering Opinions From Corporations Owned By Unbiased Adjusters, and Adjusters Can’t in Good Religion Rely Upon Biased or End result Oriented Opinions. In my position, nevertheless, I don’t usually obtain engineering stories except the matter turns into a dispute. My view is, admittedly, incomplete.
Nonetheless, I used to be intrigued sufficient to behave. I provided to have a paralegal evaluation the engineering stories supplied by any public adjuster prepared to take part. To my shock, a seasoned public adjuster took me up on the supply. He despatched us a thumb drive with a considerable variety of stories generated over a few years, all from insurance coverage company-retained engineers.
Our evaluation is now underway. We’ll be wanting on the stories from a impartial standpoint, categorizing every as:
- Favorable to the insured
- Unfavorable to the insured
- Impartial or inconclusive
One attention-grabbing speculation got here from a litigation specialist who commented that almost all engineering stories he has seen don’t outright deny claims however as an alternative supply a restore protocol. That is typically far lower than what’s demanded, however not a complete rejection. That’s one thing we’ll be testing as effectively. Are most stories true denials, or just scope reductions? I’m not sure methods to decide from simply the report how typically insurance coverage firm stories align with or contradict the details on the bottom.
Whatever the consequence, the method issues. As I wrote earlier than:
If it’s even near 100% unfavorable, it will be astonishing proof of bias.
If it’s not, it reminds us how simple it’s to slide into exaggeration after we’ve seen too many dangerous instances.
Both approach, the train promotes readability, transparency, and knowledgeable dialogue, which we’d like extra of on this business.
Nonetheless, a phrase of warning, which insurance coverage educator Invoice Wilson not too long ago reminded us, “All generalizations are false, together with this one.” That quote, typically attributed to Descartes, is especially related right here. We ought to be cautious of portray with too broad a brush, even after we really feel strongly, as a result of feeling isn’t the identical as realizing and truthful accuracy.
Within the meantime, those that suspect manipulated or deceptive engineering stories mustn’t simply vent about it on-line. Take motion.
Ship them to Doug Quinn and the American Policyholder Affiliation, who’re actively monitoring and dealing to cease this type of misconduct. The Engineering Accountability Challenge is doing actual work on this area. Here’s a weblog with hyperlinks about methods to go about sending stories: What To Do About End result-Oriented Engineering Reviews? Add the Reviews Into the Sport-Changer Engineering Report Evaluation Instrument of the APA.
We’ll share what we discover in our evaluation as soon as it’s full. Till then, I welcome your ideas, your information, and your experiences. The extra transparency is positioned on this difficulty, the higher it’s for everybody within the insurance coverage declare neighborhood.
Thought For The Day
“Generalizations are the dying of thought.”
—Marya Mannes
