Wouldn’t you know it? As soon as I posted a comment on fraud online recently, I got a call from a source in the Midwest who told me he had a conversation with an adjuster who said, “My supervisor told me from now on that if a repair is not scheduled, we are not to write any R&Is or blends.”
I have talked about these kind of incidents many times at many industry events. When insurance companies are confronted with adjusters saying such things, many claim this is “not our company policy” or it’s an “isolated incident” or, my personal favorite, it’s just a “rogue adjuster – we can’t watch everyone all the time.”
Give us a break! This adjuster got the idea from his supervisor, and his supervisor got the idea from someone else, either intentionally or unintentionally. The repair industry is held to a standard where it isn’t allowed to have any “rogue” employee mess-ups, so why are the insurers not?
Okay, I can now see my friends in the insurance industry running down the road with the rope and boards, but they have to face up to the fact, just as we do, that there are instances where adjusters are carrying out company policy while mahogany row is trying to maintain plausible deniability. This really puts the kibosh on the good that some companies are trying to do.
Yes, insurance industry, after spending many years on your side, I’ll defend you where needed, but those whose policies of operation may differ from what they speak have to face up to the reality that there is no defense for “short sheeting.” It’s called unfair claims practice…and the statement the appraiser made is blatant unfair claims practice. In his expertise, he knows the items are needed in the repair, and he’s taking advantage of a consumer who in all likelihood has no idea that these items are needed.
What compounds the matter is that if a shop goes along with it, it becomes involved in the same conspiracy whether or not it’s a DRP for the insurance company in question. It also puts the shop in a position of lying to its customer and technically committing a fraudulent act. If you don’t believe me, look up the definition of fraud listed on various industry and legal websites. The one biggie in this scenario is “intent.”
Back to my friends in the insurance industry running with the rope (I hope it’s good quality nylon). I’ll stand beside you on the fact that not all companies take an approach like this and try to be fair when preparing estimates and figuring out what they pay for. From time to time, we may disagree on certain items, but that’s the nature of the beast. In the end, these bumps get worked out because it’s part of being in the industry.
As a businessperson, you, the repairer, must make the final decision how to handle these matters. But remember, according to the spokesperson for the Property Casualty Insurers Association of America, “The repairer is the final authority on the parts and labor it takes to fix the vehicle.”
Repairer, this means that the reason you do something is not the important thing – it is that you do it, or not. You are the one responsible.
Bob Smith is the owner of Storm Appraisal & Management Service and has 44 years of combined experience as both an appraiser and a collision industry and legislative consultant. He can be reached at (816) 519-5858 or [email protected].
