You see, nothing changed, but the way I presented it...

You see, nothing changed, but the way I presented it...

Author: Cal Spoon
Date: January 2, 2022

There is no greater conflict of interest than the one between a carrier and the insured they owe. A Texas Supreme Court Justice put it best. "We note at the outset that the insurance claim process is inherently adversarial. The adversarial process begins as soon as a claim is filed and ends only when the resolution of the claim is finally determined and accepted by the parties.” found here: https://cases.justia.com/.../supreme.../2019-17-0640.pdf...

Why the bad faith, prompt payment, and any other consumer protection legislation in insurance, regardless of the title under which it is shrouded, exist.

There is a special relationship, but certainly not the one they are pushing. Which is, because they are the insurer, they must have their insured's best interest in mind.

No, the special relationship is the fact that you purchased a policy before an event, regardless of whether the event ever occurred.

That is the only special relationship that exists, and it is born from the contractual obligations of both sides, before the event, and after the event. No one gets to change that, unless the contract does.

Trust me, they have done a ton to get rid of verbiage they view detrimental to profits, and implement concepts rather than facts. For instance... Duties After a Loss has evolved over the years. Some of the Older policies say... "Requirements in the event of Loss."

To put it into perspective, a scenario I run into often. Insured has significant loss, I notify them that loss has been valued $250,000.. to which they really do not respond, especially in a way I would expect, so... I say the same thing in a slightly different way. Your loss has been valued at a quarter of a million dollars... Shock, awe, disbelief...

You see, nothing changed, but the way I presented it...The phrase, and thereby the perception that only a few things are required of the insured... are a bold face lie, that the policy, every single one I have ever read, proves in seconds.

We were not a response to them... they were the carriers response to us, and control.

Not only of our industry, but indirectly, because of their adjustment of the claim, MRP programs, preferred vendors... all the way to the manufacturers, of every industry they insure, which is... all of them.

This single lie has done more than anything else we can uncover to get us where we are today... everyone believing this is the way it has always been, and there is no changing it.

Yes.

There.

Is.

 

Stay tuned for part 2 of the "Origins of the Adjusters... All of them" series. We are waiting for someone, anyone... to claim that 10K reward. While we wait, we do not wait. We already are pretty certain that the reason it has not been claimed... is that it cannot be done.

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