claims adjuster

by Guest » Fri Jun 12, 2009 03:01 pm
Guest

I'm trying to find out if there is a law on how many business days an insurer can take to get a claim adjuster to appraise the damage to your vehicle. My claim is now five business days old and Geico is advising that the earliest they can get to my vehicle at the dealer would be Thursday, of next week!!! That would be 8-9 business days. Totally unacceptable. Anyone have any info on that? I would sure like to push them as much as possible.

Total Comments: 13

Posted: Fri Jun 12, 2009 04:50 pm Post Subject:

There are no laws that I know of... only state that have Fair Claims Practice Acts. Even these usually only talk about the resolution of the claim and this is typically 30 days unless additional information is needed.

Why is your vehicle at the shop... is it not driveable? Is GEICO your carrier or the other person's? if you vehicle is not driveable and GEICO is not your carrier then they should be paying for a rental in the meantime.

If GEICO is your carrier, call and speak to a supervisor. let them know that over a week to inspect a vehicle in unacceptable. Let them know that the usual time frame is 48-72 hours. Let them know if they cannot inspect within that time frame that you will be filing a complaint with your state's Dept of Ins office.

Posted: Fri Jun 12, 2009 05:30 pm Post Subject:

I ran my car off the road and sustained some under body damage however it is drivable although I am not comfortable with it and have brought it to the dealer where Geico can go and see it. Geico is my insurer and advised it “can take up to 5 days” for an adjuster to see the vehicle since I am having the dealer take care of necessary repairs and not using a Geico shop.
When I called today (Friday) and was advised that next Thursday, 9 business days since filing the claim, was the earliest they would be able to look at my car I told them it was unacceptable. That info came from “dispatch” which schedules the adjustors. I then proceeded to call Geico claims dept, spoke with a woman there who did call dispatch on my behalf but to no avail. They say there are overwhelmed she says, and suggests for me to call dispatch on Monday “in case they have a cancellation, maybe they can move you up”. Huh??????
After calling two days ago and being told they would be there this week and now to be told today that it’s next week is not right so I am taking your advise and am going to call them again and threaten to file a complaint.

Posted: Fri Jun 12, 2009 05:49 pm Post Subject:

Please speak to the supervisor of your claims adjuster.

My advice... call today.

Posted: Fri Jun 12, 2009 07:06 pm Post Subject:

I called however the supervisors are in a class today, how ironic. Another rep from geico was able to get my appt moved up a day since they had a cancellation, which is still not acceptable so i did file a complaint with the NYS Dept of Ins.
Interesting how everytime I call Geico they bring up their locations where I can bring my car for an estimate/repair, have it inspected immediately and how, unfortunately, it takes up to five days when their customer chooses their own body shop. Im starting to think that's where that cancellation came from. Someone may have become tired of wating.

Posted: Fri Jun 12, 2009 07:11 pm Post Subject:

Yup, I agree. Sounds like they are understaffing appraisers which would "push" people into using their preferred shops. That needs a DOI complaint.

Posted: Fri Jun 12, 2009 07:19 pm Post Subject:

i mentioned that in my DOI complaint.

Posted: Sat Jun 13, 2009 02:16 am Post Subject:

i mentioned that in my DOI complaint.



More people need to be doing this for these companies that drag their feet and promise prompt claims service. They just fail to tell you that if you want prompt service you have to use their shops or you'll linger in land of the lost claims unless you are constantly in touch pushing your claim. Always get an email of your claims person and try to communicate in writing. I am only aware of one major company that will not use email for claims responces as it bit them in the hiney once when something showed up in an email that embarrassed them terribly in court.

Here is an example of Missouri's unfair claims practices act with regard to timely communication and handling of claims.

20 CSR 100-1.030 Failure to Acknowledge
Pertinent Communication
PURPOSE: This rule effectuates or aids in
the interpretation of section 375.1007(2),
RSMo.
(1) Every insurer, upon receiving notification
of claim from any first-party claimant within
ten (10) working days, shall acknowledge the
receipt of the notification unless payment is
made within the period of time. If an
acknowledgment is made by means other than
writing, an appropriate notation of this
acknowledgment shall be made in the claim
file of the insurer and dated. Notification
given to an agent of an insurer shall be notification
to the insurer.
(2) An appropriate reply shall be made within
ten (10) working days on all communications
from any claimant which reasonably
suggests that a response is expected.
(3) Every insurer, upon receiving notification
of claim, promptly shall provide necessary
claim forms, instructions and reasonable
assistance so that first-party claimants can
comply with the policy conditions and the
insurer’s reasonable requirements. Compliance
with this section within ten (10) working
days of notification of a claim shall constitute
compliance with section (1) of this rule.



More rules that are routinely and often ignored I have found.

20 CSR 100-1.050 Standards for Prompt,
Fair and Equitable Settlement of Claims
PURPOSE: This rule effectuates or aids in
the interpretation of section 375.1007(4),
RSMo.
(1) Standards for Prompt, Fair and Equitable
Settlements Applicable to All Insurers.
(A) Within fifteen (15) working days after
the submission of all forms necessary to
establish the nature and extent of any claim,
the first-party claimant shall be advised of the
acceptance or denial of the claim by the
insurer. No insurer shall deny any claim on
the grounds of a specific policy provision,
condition or exclusion unless reference to
that provision, condition or exclusion is
included in the denial. The denial must be
given to the claimant in writing and the claim
file of the insurer shall contain a copy of the
denial.
(B) If a claim is denied for reasons other
than those described in subsection (1)(A), an
appropriate notation shall be made in the
claim file of the insurer.

(C) If the insurer needs more time to determine
whether a claim should be accepted or
denied, it shall so notify the first-party
claimant within the time otherwise allotted
for acceptance or denial, giving the reasons
more time is needed. If the investigation
remains incomplete, the insurer, within fortyfive
(45) days from the date of the initial notification
and every forty-five (45) days after,
shall send the claimant a letter setting forth
the reasons additional time is needed for
investigation
.



I currently have a customer that has been leaving messages on the answering machine of the adjuster which claims to have totaled the policy holder's vehicle. She leaves messages every couple of days and has not heard or had any written communication regarding the terms of settlement.
The last words from the mouth of the adjuster was, "your car's still driveable, right?" That was 3 weeks ago. They are at least in violation of faiure to return pertinent inquires regarding the claim.

I know of shop owners who locate phone numbers and email addresses for the board of directors or ceo's of some insurers and give them to their customers and that sometimes gets action. You can attempt to climb the claims ladder if you can get a name or number of supervisors and directors.

Posted: Tue Jun 16, 2009 03:27 pm Post Subject:

Interesting information, thanks.

I must have pushed the right buttons because Geico was out to look at my car Monday instead of Thursday. However today, when the car should be in the shop the dealer calls me this morning to say that because Geico wants to use three aftermarket parts they will not fix the car. I now have three choices: pay the difference out of pocket, another $400, fight with Geico, or take my car elsewhere to be fixed. Of course I picked the fight with Geico option. I spoke to the adjustor who said two of the parts are an $8.00 difference (mud flaps), and the other is the rim. They like to keep costs down. ARE THEY FREAKING KIDDING ME!!!!!!!!!!!!!. The damage so far is estimated at $1300 and my deductible is $1000.
Next step, adjustor will try to negotiate with dealer who says they don't negotiate. I am giving the adjustor until noon today to work this out or else I am back on the phone with geico.

Posted: Tue Jun 16, 2009 04:19 pm Post Subject:

You mention that the difference between OEM and AM parts was $400 but then that there is an $8 difference for mud flaps and the other part is a rim. Is the difference in price of the OEM rim and AM rim the $400? What is the price of this rim that the difference could be $400?

You state that the repair cost of $1300 and the difference in OEM vs AM parts is $400. This is a huge percentage of the over-all repair bill!

Of course the shop does not like to use AM parts (I can see some parts... but rims?)... the more OEM parts the buy, the better their sales figures with their franchise. Also, they make 25% on parts. If the OEM is $400 more, then just this one part will earn then an _extra_ $100! It does not cost them any more to use OEM parts so that is pure profit. If they use 1000 OEM parts vs AM... you do the math on the extra money that they make.

Are you sure this was not an LKQ rim and not aftermarket?

Posted: Tue Jun 16, 2009 04:57 pm Post Subject:

When I spoke with the dealer this morning he informed me that the three OEM parts (two mud flaps and one rim) would cost me approximately another $400 if I pay out of pocket and not fight with Geico. Afterward I spoke with the adjustor who said the difference between OEM mud flaps and AM is approx. $8 each so the major additional cost is due to the rim. The original estimate for OEM rim is $179 so probably the AM rim is around $400 and perhaps the dealer overestimated the additional cost.
The damage to my vehicle is solely undercarriage, having been forced off the road and over a concrete curb at highway speed. The vehicle sustained damage to the entire underbody covers, mud flaps, rim, and some nice scratches under the front bumper and along the underside painted areas, basically bumps and bruises.
The damaged rim is original BMW. Now I understand Geico wants to keep costs down and the adjustor had said the rim would be new but maybe it was blemished and refinished so it therefore could not be sold as new. Does the dealer want to make money, sure, we all do. Does it make a difference to me? I’m not so sure that it does. I want BMW to do the repairs, period. What bothers me the most is that dealer said last week they do not use OEM parts and the adjustors know this, and the adjustor says today dealer does all the time. So someone is lying while my car sits there another day. That is what bothers me.
Just called adjustor who has not been able to get to dealer yet today but says he will, first claims by 4, then says by 2. So call the dealer, why do you have to go there?????????????? I’m really getting annoyed.

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