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Monthly Archives: April 2017

Typical Insurance Adjuster

The mere mention of a complaint to the State Department of Insurance may bring the adjuster around to making a better offer. Adjusters would rather not have to deal with a complaint and they positively don’t want copies of them ending up in their personnel file !

Your complaint to the State Insurance Department will accomplish several things. First, his boss will now become aware that there’s a claimant who intends to do whatever it takes to obtain some positive settlement dollars. That will often inspire that person to take a closer look at your case and come up with a better offer. Also, if indeed you write to the Consumer Complaints Division, it will evolve into what’s always a costly effort because a complaint with the State Insurance Department will add an additionallayer of work, supervised by an extra contingent of personnel. When it’s realized this will likely come to pass they’ll try harder to get rid of you and settle your claim.

The vast majority of insurance adjusters dream of one day being promoted to a higher position within the company they work for. They’re acutely aware of the fact if their personnel file has correspondence flowing into it from claimants they’ve handled(plus copies of the letters which have been sent to the insurance commissioner) and those will, somewhere down the line, be read by one of his companies executives. In many instances this will be a man who doesn’t want a “Problem” claims employee spluttering, splashing and crashing about his office area causing headaches and extra work within the framework of that particular executive’s command. The adjuster is fully aware that such complaints will keep him, out on the road forever,and will surely prevent him from moving up the corporate ladder.


When it comes to the reality of the way things work in the actual, daily, experience of personal injury claim negotiations and settlement, is often vastly different from the stipulations found in the “Formal law”. That is, legal theory, as it’s written and allegedly supposed to work. What this means, simply stated, is: Adjusters can settle a case, whether their decision to do so is based on “The Law”, or not.

In the real world of Personal Injury settlements a “Compromise” (one which often has little and often nothing to do with “The Law”) is the order of the day. It’s commonly accepted among those is the business (because that’s what makes their work life so much easier) that in any given case there’s almost always a likelihood of negligence on both sides, rather than just one. What this boils down to in practical terms, is this: Irregardless of the law practically no claim is without merit or totally lacking in value – – especially if the “Value” is simply to “get rid of it”. QUESTION: “How does Dan Baldyga know this to be true?” ANSWER: “Because he was an Insurance Adjuster, Supervisor, Manager and then Trial Assistant for over 30 years. He’s been there, and observed that.”

Although it’s never expressed to him “officially” every adjuster quickly learns, should your case go to trail, compromise will usually be the order of the day, even in cases of questionable liability . This fact alone gives him plenty of room to make a compromise settlement before your case ends up in his Defense Attorney’s hands where such a move will usually take place anyways! Why will this come to pass? Because the costs of preparing for(and then proceeding into)a courtroom battle will skyrocket.

Being aware of this is always bubbling and boiling in the gray matter between every adjusters ears. If there’s any question whatsoever (regarding who was at fault in the accident you were involved in) don’t ever give up. Keep pounding away! When faced with a determined claimant who’s willing to wait and haggle and refuses to go away, the chances are the adjuster will eventually make an offer.

This comes to pass because the adjuster(especially if your claim has some value) doesn’t want it to end up as a complaint at the State Department Of Insurance. Plus he knows you’ll be made, a settlement offer, somewhere down the line, anyway! So, better he settle it now, before the cost of defending it gets blown out of proportion, later.

Insurance Fraud

The Insurance Research Council revealed some alarming information obtained from a recent survey regarding types of insurance crime that is considered “acceptable” by an unusually high percentage of the public. These types of insurance fraud include the following followed by the percentage of those surveyed who felt that it was acceptable:

o Increasing the claim to cover the deductible – 40%

o Increasing the claim to cover the premiums paid – 36%

o Including defective or obsolete appliances on a lightning claim – 29%

o Listing adults as main driver of a car being driven by an under age driver – 20%

o Omitting accidents/tickets from an insurance application – 14%

o Continuing medical treatment to increase the value of a claim – 11%

o Pretending a hit-and-run accident occurred to submit a claim – 7%

o Abandoning a car and reporting it stolen to the insurance company – 6%

o Reporting an injury at home as work related in order to collect workers’ compensation benefits – 10%

o Cooperating with lawyers, doctors or chiropractors to file false or exaggerated workers’ compensation claims to get money from insurers – 17%

Insurance fraud typically consists of the following types or instruments of fraud:

o Workers’ compensation premium fraud occurs when an employer provides false information in order to obtain a lower insurance rating.

o Workers’ compensation fraud occurs when an employee files an inflated or false injury claim in order to receive benefits or increase benefits.

o Staged accident fraud occurs when a person intentionally causes or is involved in an accident, or walks in and reports an accident in order to compensation or false or intentional damages and injuries. This could include automobiles or fake “slip and fall” claims.

o Property fraud is the falsification or inflation of a claim for the loss of personal or commercial property in order to obtain benefits. This includes losses due to the theft, disaster, or arson of insured property and vehicles.

o Benefits fraud occurs when an uninsured person receives benefits reserved for an insured person as it relates to his or her policy. A typical example of benefits fraud includes a non-covered dependent receiving medical or dental treatment by using a parent’s name or identity. Similarly, we have seen friends and roommates commit benefits fraud as well.

Condo Rental Insurance

1. Comparison shopping is the most obvious way of cutting costs on insurance as well as everything. It takes a bit of time and effort but if comparison shopping on line it’s easy to access quotes from companies and ascertain which offers the lowest.

2. Increasing you deductible works with condo rental insurance just as with any other type of insurance. The higher the deductible the lower the insurance premium will be. Just keep one thing in mind when trying to lower fees by increasing your deductible. Should the eventuality of having to file a claim arise you will have to pay that deductible before the insurance company will pay out. Make sure you will be able to comfortably pay whatever that deductible amount is or it’s not worth the lowered insurance rate.

3. If you’re thinking of getting a dog find out what breeds-if any-your insurance company won’t cover. There have been more and more instances of dog attacks in past years and certain breeds are considered more dangerous than others.

4. If you’re over 55 or retired some insurers offer discounts. Now granted this isn’t a variable you have much control over but it is a factor that may lower your fees.

5. A multi-line discount can be obtained when an insurance company offers a discount to its clients who buy more than one insurance policy through them. An example of this type of coupling is insuring both a car and the condo.

Online Insurance

Then during the nineties big firms latched on to the idea of “direct” which is a handy abbreviation for cutting out the middle man. Just watch tv or listen to the radio toady and you are sure to observe this direct and that direct. The purpose of this in the world of insurance is to cut out the traditional high street broker and the percentage paid to them wherever possible.

The advent of the Internet and its increasing usage in most homes up and down Britain has accelerated the “direct” phenomenon. The big boys have quickly realised that websites are cheap to build and in addition there is a small army of privately owned websites on the World Wild Web that are more than happy to promote their insurance products for a commission – this commission usually being a lot less than a typical shop front broker is currently paid.

This all sounds very good………for the PLC that is. From the consumer’s point of view the casualty in all this is usually the level and quality of service. It’s fine when you are arranging your policy on the phone or on the net and you can even have the privilege of paying there and then by credit card. What will the “direct” experience be like when it comes to making ac claim? Just how “direct” is a call-centre located in India?
While you the consumer are no doubt seeing some of the savings by skipping the broker don’t think for one minute that all the savings are being passed on.