In recent years, the art of the back-and-forth has been drained to near extinction. A concept that has become mythical to most. However, for the more seasoned restorer, let’s take a nostalgic trip down memory lane to a simpler time. A time centered around collaboration, education, and growth. A time when contractors and adjusters worked together. A time when collaborating on scopes, to agree upon fair and reasonable pricing for the insured, took priority. A time when both parties educated one other, as well as the customer, to ensure understanding and growth within the industry. A time when mutual respect for position and expertise was freely given. A time centered around cooperation, not opposition. A time that not only welcomed the art of the back-and-forth but thrived upon its use.
These concepts are foreign to the times we are currently experiencing. Nowadays, scopes are scrubbed by TPAs, or third-party reviewers. Insurance carriers are frequently using third-party reviewers for estimates that aren’t included on programs. These trends are mere examples of a dynamic which is drastically different than the traditional, mutually beneficial back-and-forth banter. The very art and culture that framed this industry has all but disappeared. In my experience, adjusters and contractors alike prefer the latter. A common goal between all parties is for the insured to have the best possible experience during difficult, often even tragic circumstances. Unfortunately, the current culture does not deliver on that common goal. The back-and-forth was much more efficient— delays weren’t as common; processes were more seamlessly executed— things were just simpler when collaboration took precedence. Precisely why I correlate the back-and-forth banter as a lost artform.
Frame it as A Question
In Episode 82 of The DYOJO Podcast, “The Power & Practice of Questions,” host Jon Isaacson welcomed a guest Steven Patrick. Steven, co-founder of Level the Playing Field, posed a good point regarding the framework of mutual discussions. More specifically, he emphasized that when working directly with an adjuster, or when directing conversations with potential customers, to frame everything as a question.
Hearing this reminded me of a specific interaction I recently had with an adjuster regarding a scope for structural cleaning. This adjuster went back-and-forth with me regarding what is considered ‘the norm’ for structural cleaning, the differences on heavy versus light cleaning, etc. Now reflecting on this interaction, there was a particular line item that we could not see eye to eye on. Neither of us were willing to concede. He didn’t understand my logic regarding the unit of measurement I had used on the line item in question. For context, I used the volume of the room in this instance because it involved fogging. In this situation, the adjuster asked questions so that he could better understand my point of view. I was able to successfully articulate the validity of my reasoning. However, he then went on to explain how this scenario was not actually the right usage of that line item, per its description. As a result, I did the unthinkable— I conceded. This back-and-forth interaction proved invaluable. An error was corrected, but something much more occurred as a result of this interaction; it incited growth within me and the adjuster. I was able to learn the proper usage and description of a line item and grow as an estimator, while he was able to further understand my reasoning regarding usage of specific line items and grow as an adjuster. A testament to the art of the back-and-forth– validating the benefit, the importance, the relevance, and the present need for these respectful discussions between parties.
Exception, NOT the Rule
Obviously, the above does not always occur. Quite the contrary because often, the common response given is the infamous, “Well, we don’t pay for that.” To which, I find myself wondering; “Well, why not”? “Why won’t you pay for it, exactly”? “Is it a policy or coverage issue”? “Is this loss afforded by the coverage”? “Is this because your assigned Service Level Agreements say you don’t”? “Well, this isn’t a program loss, so SLA guidelines don’t pertain to this instance.” Regardless of the circumstance or what the issue may be, I encourage you to go there. Initiate the conversation. Be respectful and well prepared in your conviction. Frame it as a question. Sometimes we must detach from our ego. Leaving behind any personal attachments we have developed towards our work is required.
We need to look at things from the other persons’ perspective. We must afford them the same courtesy we expect them to extend us. The guiding principle for all parties should be:
- What is in the best interest of the insured?
- What scope is an accurate and fair representation of the work required to make the loss whole again for the insured?
All too often, I think everyone gets too wrapped up in the cliché mentalities ‘us vs them’ or ‘light vs. dark’. Contrary to popular belief and opinion, what I believe we need is to compromise. We need to adapt a ‘Win-Win-Win’ mentality. All parties involved should be benefiting: The contractor should win (right scope); the adjuster should win (policy applied); the insured should win (loss made whole).
As contractors, we need to ask ourselves:
- Is the estimate an accurate and fair representation of the scope of work you performed (will perform)?
- Is the scope itself fair and accurate?
- Does the mitigation plan reflect industry standards/reconstruction plan up to code?
- If the loss is an assignment from a program, does the scope reflect the Service Level Agreement (SLA) signed with that TPA?
I have found communication is truly key to accomplishing the desired Win-Win-Win result. When a contractor keeps an open line of communication regarding a loss via phone, email, or in person at the job site, adjusters are typically more receptive to receiving input. The COVID pandemic has made it more difficult to conduct business on job sites but advances in available technology still afford similar results. Ensuring proper documentation is submitted using 3D scans, such as Matterport or DocuSketch, every contractor can now bring job sites to the carrier. Even still, there will be the occasional adjuster who sticks to their guns with no intention of compromise regardless of experience, expertise, or documentation. However, in MY experience, this has been the exception— not the rule.
Why a Lost Art
The back-and-forth is becoming a lost art because of current trends in business models. Contractors are more reliant on TPA programs than ever before. Unfortunately, with TPAs come reviewers. These reviewers are part of the TPA program; their sole purpose is to scrub estimates based upon the SLAs agreed upon by insurance carriers and the TPA. Contractors must also abide by these SLAs to ensure they continue meeting the requirements they agreed on to receive continued assignments. It’s a constant cycle that bypasses the back-and-forth banter with rejection after rejection until SLAs are satisfied. I would be remiss if I didn’t also mention how much this cycle tends to slow the entire claim process down. Essentially, these TPA reviewers are practically eliminating the role of the adjuster in this cycle. Once the estimate is approved by the TPA reviewer, it moves to the carrier. Very rarely does an adjuster reject an estimate submitted from a program due to the binding SLA agreement— they just pay whatever amount was accepted by the TPA.
However, there is an alternative business model within the industry. Ideally, a contractor takes a bill-direct-to-customer approach, thus eliminating the need for TPAs altogether. This business model allows the classic back-and-forth banter to exist and remain relevant. Even so, adjusters are now beginning to frequent the use of third-party reviewers or having vendors write comparative scopes.
Unfortunately, I don’t think they realize the consequence of this is essentially they are just slowly putting themselves out of a job— with all the reviews, comparative scopes, and even the TPAs, the need for adjusters in the traditional sense, will become less and less. Companies who use the bill-direct approach have already eliminated their interactions with adjusters altogether. These contractors bill their customer directly. Thus, having the customer deal with their insurance carrier themselves. After submitting payment in full to the contractor, the customer is then responsible for submitting a claim for reimbursement. The back-and-forth in this instance is between the customer and their insurance carrier; still a far cry from the art of the traditional back-and-forth banter this industry was founded upon. Even with this model, I believe it is still beneficial to speak to the adjuster. Developing, building, and strengthening relationships within this industry is so important… You never know where it may lead.
A Possible Solution
It would be tragic if the back-and-forth disappeared into extinction. In order to prevent this from occurring, everyone must be willing to do their part— working together for the good of the industry. One possible solution, or at least a step in the right direction moving forward, is to focus on relationships. Currently, every claim has an adjuster assigned. Some claims have an outside adjuster, while others are assigned a desk adjuster. Regardless of title, an opportunity exists on every claim to reach out. Start a conversation. Frame it as a question. Bare minimum, you are building and cultivating a relationship that will certainly prove to be mutually beneficial at some point in your careers. Potentially, you are enlarging your pool of lead sources, trusting industry contacts, and making the claims process much smoother for all parties involved. A benefit of having a win-win-win mentality!
The leading process one does when seeking a service, they want to use whether it is a restaurant, store or I don’t know a service/restoration company. The consumer is going to look for reviews online, the most current I might add. According to “Search Engine Journal” December 6, 2018, 85 percent of consumers think reviews older than 3 months aren’t relevant, but I digress. The sole purpose of leaving a review is to share an experience. In a review, you are given a glimpse into the experience someone else had, usually someone in a similar circumstance you find yourself in. Hence, why consumers search for and read reviews before making decisions. A review, whether positive or negative will have a significant impact on the longevity of your business, not to mention the amount of business you receive. Most of the time, a customer doesn’t know all the specifics that occur behind the scenes. The reviews left by customers tend to be a direct reflection of how the claim process was handled overall. How the claims go for them is the most important at the end of the day. Also, probably your leading source for leads in the future.
While the mainstream understanding is that adjusters can’t give referrals, I think you would hear otherwise from a lot of contractors who practice this two-way communication concept. If you aren’t getting these kinds of referrals, you must ask yourself why? Why is it that ABC Restoration seems to get 90% of claims from Good Hands Insurance in my area, while my company XYZ Restoration always lose out? “Well, it’s because they are a vendor, that’s why, and I refuse to be a vendor” – Is what the common answer is to that. There is nothing wrong with that, but that’s not always the case. It’s a relationship ABC Restoration made and cultivated with that adjuster. By doing good work with that adjuster and making the insureds happy at the same time. That’s not saying XYZ Restoration doesn’t do great work, maybe better than ABC, but because ABC cultivated that relationship in the ways I previously mentioned, did the claim go as it was supposed to, was the insured happy and made whole and was it done right? What is boils down to is, what do you want your company to be? What is your business model, what are your standards, everyone gets the chance to make an impression, you only get one first impression, what is that impression going to be? One of complete opposition, or one of healthy debate where you all learn and give the insured an awesome experience and make them whole after a loss.
Isaacson, Jon, host. “The Power and Practice of Questions.” The DYOJO Podcast, Season 3, Episode 82, 5 May 2022, thedyojo.com/podcast.html.
Southern, Matt G. “85% of Consumers Think Local Reviews Older Than 3 Months Aren’t Relevant” December 6, 2018,
Pittman, Jamie. “Local Consumer Review Survey 2022.” BrightLocal. Insights, Research, 26 January 2022,