A current dialog on LinkedIn has sparked critical questions in regards to the objectivity of engineering stories utilized by insurance coverage corporations. Our agency is now taking step one to search 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 truthfully can’t keep 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 submit:
“Is it doable 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 apply that undermines equity in claims decision and damages belief in your complete course of.
However as I admitted in my submit, 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 put in writing 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 Companies Owned By Impartial Adjusters, and Adjusters Can not in Good Religion Rely Upon Biased or Consequence Oriented Opinions. In my function, nonetheless, 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 supplied to have a paralegal assessment 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 assessment is now underway. We’ll be trying on the stories from a impartial standpoint, categorizing every as:
- Favorable to the insured
- Unfavorable to the insured
- Impartial or inconclusive
One fascinating speculation got here from a litigation specialist who commented that the majority engineering stories he has seen don’t outright deny claims however as a substitute supply a restore protocol. That is usually far lower than what’s demanded, however not a complete rejection. That’s one thing we’ll be testing as properly. Are most stories true denials, or just scope reductions? I’m not sure find out how to decide from simply the report how usually insurance coverage firm stories align with or contradict the info on the bottom.
Whatever the end result, the method issues. As I wrote earlier than:
If it’s even near 100% unfavorable, it might be astonishing proof of bias.
If it’s not, it reminds us how simple it’s to slide into exaggeration once we’ve seen too many unhealthy circumstances.
Both manner, the train promotes readability, transparency, and knowledgeable dialogue, which we’d like extra of on this business.
Nevertheless, a phrase of warning, which insurance coverage educator Invoice Wilson lately reminded us, “All generalizations are false, together with this one.” That quote, usually attributed to Descartes, is especially related right here. We ought to be cautious of portray with too broad a brush, even once we really feel strongly, as a result of feeling isn’t the identical as figuring out 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 sort of misconduct. The Engineering Accountability Mission is doing actual work on this house. Here’s a weblog with hyperlinks about find out how to go about sending stories: What To Do About Consequence-Oriented Engineering Reviews? Add the Reviews Into the Recreation-Changer Engineering Report Evaluation Device of the APA.
We’ll share what we discover in our assessment as soon as it’s full. Till then, I welcome your ideas, your knowledge, 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
