A latest dialog on LinkedIn has sparked severe questions concerning the objectivity of engineering studies utilized by insurance coverage firms. Our agency is now taking step one to seek out out whether or not the claims of systemic bias maintain water.
It began when a public adjuster responded to a thread involving lawyer Steven Badger. The assertion was, “I truthfully can’t keep in mind an engineer report within the final 15 years that was favorable to the insured.” I then posed the next easy query in a submit:
“Is it potential that no insurance coverage firm engineer report has favored a policyholder in 15 years?”
The response, if true, was a robust assertion deserving of follow-up. A 15-year run of engineer studies, all unfavorable to policyholders, would counsel one thing much more troubling than occasional errors or outlier habits. It will suggest a systemic observe that undermines equity in claims decision and damages belief in your entire course of.
However as I admitted in my submit, I approached that declare with skepticism. I don’t doubt the frustrations many public adjusters, restoration contractors, and policyholders really feel as a result of I’ve seen sufficient engineering studies to put in writing posts on the subject, together with Beauty Harm Hail Points—Biased Engineering Experiences and Dangerous Religion, Why Ought to Policyholders Be Compelled to Settle for Engineering Opinions From Companies Owned By Impartial Adjusters, and Adjusters Can’t in Good Religion Rely Upon Biased or End result Oriented Opinions. In my function, nevertheless, I don’t sometimes obtain engineering studies until the matter turns into a dispute. My view is, admittedly, incomplete.
Nonetheless, I used to be intrigued sufficient to behave. I supplied to have a paralegal overview the engineering studies offered by any public adjuster prepared to take part. To my shock, a seasoned public adjuster took me up on the provide. He despatched us a thumb drive with a considerable variety of studies generated over a few years, all from insurance coverage company-retained engineers.
Our overview is now underway. We’ll be wanting on the studies from a impartial standpoint, categorizing every as:
- Favorable to the insured
- Unfavorable to the insured
- Impartial or inconclusive
One fascinating speculation got here from a litigation specialist who commented that the majority engineering studies he has seen don’t outright deny claims however as a substitute provide a restore protocol. That is typically far lower than what’s demanded, however not a complete rejection. That’s one thing we’ll be testing as nicely. Are most studies true denials, or just scope reductions? I’m not sure the way to decide from simply the report how typically insurance coverage firm studies align with or contradict the details on the bottom.
Whatever the end result, the method issues. As I wrote earlier than:
If it’s even near 100% unfavorable, it might be astonishing proof of bias.
If it’s not, it reminds us how simple it’s to slide into exaggeration once we’ve seen too many unhealthy circumstances.
Both means, the train promotes readability, transparency, and knowledgeable dialogue, which we want extra of on this business.
Nevertheless, a phrase of warning, which insurance coverage educator Invoice Wilson not too long ago reminded us, “All generalizations are false, together with this one.” That quote, typically attributed to Descartes, is especially related right here. We must be cautious of portray with too broad a brush, even once we really feel strongly, as a result of feeling will not be the identical as realizing and truthful accuracy.
Within the meantime, those that suspect manipulated or deceptive engineering studies mustn’t simply vent about it on-line. Take motion.
Ship them to Doug Quinn and the American Policyholder Affiliation, who’re actively monitoring and dealing to cease this type of misconduct. The Engineering Accountability Mission is doing actual work on this area. Here’s a weblog with hyperlinks about the way to go about sending studies: What To Do About End result-Oriented Engineering Experiences? Add the Experiences Into the Sport-Changer Engineering Report Evaluation Instrument of the APA.
We’ll share what we discover in our overview as soon as it’s full. Till then, I welcome your ideas, your information, and your experiences. The extra transparency is positioned on this challenge, the higher it’s for everybody within the insurance coverage declare neighborhood.
Thought For The Day
“Generalizations are the demise of thought.”
—Marya Mannes
