Insurance & Legal Matters

So how did we get here? Why do third-party or negotiated scope? The TPA would manage contractor administrators (TPAs) exist in our industry? Why do TPAs even get a say on who does what and how? Well, it may be prudent to give a little background on the emergence of TPAs. Long before the TPA term was applied to our industry, there was this idea of a “Managed Repair Network” among several insurance carriers. The repair networks were originally developed to bring high-performing insurance restoration contractors together to service pre-qualified claims from financially stable

Can the world of insurance claims and structural restoration get any more unfair and difficult than it already is? The answer is yes, and insurance companies appear to be pleased to bring you this new experience. Rather than deal directly with well-qualified restoration professionals who compellingly explain the processes executed in the repairs to the insured’s property, they simply hand the file review process to an auditor or Repair Contractor Network generally referred to as a Third Party Administrator (TPA). Generally speaking, TPA representatives frequently fail to possess any significant field experience and possess

In my last column, I laid a foundation for the changing dynamics in the insurance industry. These radical changes will no doubt influence our industry. Previously we covered the idea of predictive analytics, robotics, virtual reality, and cloud computing. While this sounds like the script for a sci-fi movie, technology is predicted to impact almost every aspect of our lives and business in the near future. Recently I visited a large insurance broker in Florida, and the conversation turned to the future of their business. They told me about the feeling they had that

RIA published an open letter to the mortgage industry penned by then- executive director, Tim Shaw. It was a no-holds-barred challenge to the industry to treat restorers with fairness and stop abusing power it acquired where “he who holds the money holds the power.” It posed the question to the banks: “If you don’t want us to get paid for restoring the property, please tell us where we can put the water back.” I don’t recall seeing a response from the mortgage industry. Maybe it simply got lost in the mail. In this author’s

  It was a standing room only in the hotel banquet hall filled with angry mitigation contractors. They were small mom-and-pop firms mixed with mid-sized regional franchise players. The speaker, a burly man in overalls sporting a restoration logo, approached the podium. He started his speech by raising a fist and saying something to the degree of, “I am sick and tired of insurance adjusters thinking they know more than us; they’re trying to tell us how to do our jobs!” The room erupted in raised fists and shouts of solidarity. As an adjuster,

Be it an effort to control wildlife, livestock or even immigrants, contentious views surround the idea of controlling a problem with the erection of a wall. Perhaps a more civil way of dealing with a problem is to build a bridge by attempting to improve relationships rather than eliminate them. Over the last two decades, the restoration industry has seen an obtrusive figurative “wall” erected that effectively silences all communication between restoration contractors and insurance adjusters. This wall is the insurance industry’s latest solution to avoid dealing directly with restoration companies and is called

An insurance adjustor’s take on closing the gap between restoration contractors and insurers ace it, restoration professionals, the insurance industry considers you neither friend nor ally. The motivation behind the concepts of unit cost estimating, 10 percent overhead, 10 percent profit and even estimating software was to reduce the cost of a claim and damper your profits. The reason they study remediation methodology is not to be more knowledgeable to extend better service. It’s to better identify differences in scoping and price and minimize what they perceive to be excessive or exaggerated costs. The

I’ve been an independent adjuster for more than 30 years. During that time, I’ve studied how contractors interact with insurance adjusters. In recent years, I’ve consulted or presented workshops for the restoration industry to help these professionals increase the market share of insurance claims work. You might say I’m a friend of the restoration industry, but I am still a practicing independent adjuster. Many contractors who do business or hope to do business with insurance adjusters have misconceptions about the insurance claims industry and this affects their efforts to penetrate this fruitful market. Whenever