ETHICS AND THE PUBLIC INSURANCE ADJUSTER

Read the full article at https://www.linkedin.com/pulse/keeping-public-adjusters-professional-barry-zalma-esq-cfe and at https://zalma.com/blog plus more than 3800 posts.

When insured’s are busy professionals they simply do not have the time or patience to deal with the details of a first party property claim. The public insurance adjuster exists to assist insureds in the presentation of a claim to the insurer. The public insurance adjuster is, in most states, licensed by the state insurance department. The insurer’s adjuster is often asked to deal with a public insurance adjuster. The contact between the public insurance adjuster and the insurer’s adjuster is often adversarial since the public insurance adjuster wishes to justify his or her contingency fee to the insured. Both should be working toward the same goal: the payment of proper and complete indemnity to the insured.

Public Adjusters claim they are, mostly with good cause, professionals who are employed exclusively by a policyholder who has sustained an insured first party property loss. The public adjuster handles every detail of the claim, working closely with the insured to provide the most equitable and prompt settlement possible. A public adjuster should inspect the loss site immediately, analyze the damages, assemble claim support data, review the insured’s coverage, determine current replacement costs and exclusively serve the client, not the insurance company while working ethically with the insurer’s adjuster.

The National Association of Public Insurance Adjusters (NAPIA) publishes a code of conduct which sets forth the ethical standards that all public insurance adjusters should follow. 

Scottsdale properly took an aggressive stand against a lawyer and public adjuster who it believed blatantly abused the process of the court and maliciously forced Scottsdale to defend a lawsuit that could not possibly succeed. That it gave Zelig and Kapilow the opportunity to avoid the suit by informing them of the true nature of the policy, its effective dates and that it would be impossible for it to respond with indemnity to a claim for damages occurring before the policy came into effect, was kind. Kindness was returned with aggression.

Scottsdale’s reasonable conduct and attempt to resolve the situation in a non-confrontational manner was rewarded by abuse and a refusal by Zelig to be confused with facts. The Court of Appeal was neither confused nor cowed. The results of the trial would have been interesting but the defendants settled. Another appeal resulted when the settlement amount was not paid to Scottsdale.

Adapted from Insurance Fraud – Volume I by Barry Zalma, Volume One available as a Kindle book and a paperback at amazon.com.