METHODOLOGY
In resolving a claim we follow industry-upheld best practice protocols for property inspection, and refer to standard databases when assessing the value of a loss. We find that this helps build trust by bringing insurers and policy holders onto the same page, enabling both to more easily navigate any possible challenges or disputes.
assess the damage
Here we use in-person photo inspections, drone technology, moisture reading of structures, as well as other industry-accepted methods to determine WHAT has been damaged and to what EXTENT has it been damaged.
establish causation
Taking into account all the data collected in the assessment stage, we compare this with broadly accepted theories and evidence in engineering, meteorology, material sciences, and other relevant fields to establish a forensic understanding of what CAUSED the damage, and WHEN it likely occurred.
review coverage
After understanding what is damaged and how it was damaged, we compare this to the provisions in the policy, taking into account the exclusions, additional coverages, and any other fine print that might alter the coverage. We will then have a clearer picture of if, and how much might be covered under the policy.
Our Rationale and Work Philosophy
While resolving a claim is, on the surface a purely technical process, we acknowledge that there are "big picture" ideas and principles which underlie everything we do, and which silently shape the landscape of property insurance. In our daily operations we may not be able to change the facts of what was damaged and when, but much can be said about HOW the claim is handled. In our Work Philosophy we attempt to integrate these two often discordant spheres: the cold, rational sphere of facts (of both policy and physics), and the warm, irrational sphere of people, who, in the final analysis are the only ones who make any insurance meaningful at all.
The claims experience
One of our driving ideas is that of the “claims experience”. This idea is based on the fact that most homeowners will pay for home insurance for their whole lives, and will need to claim major coverage only once in their lives. For this reason, life-long loyalty of insureds to their insurer is paramount, and the claims handler has a major role to play in this. The claims department (unlike the insurance agents) only interacts with the homeowners in their moment of crisis. The nature of this interaction can radically enhance trust and faith in the company, or horribly erode it. We believe that we are representing your company at this most delicate and crucial juncture, and we aim to make as much of a positive impact as possible in these times of distress by offering effective solutions and smooth restoration to the homeowners.
Empirical observation
In handling the vast majority of claims a good rapport and transparent dealings are enough to facilitate an agreement and close out a settlement. However there are cases when the claims adjuster needs to deal with extraordinary circumstances. In these cases, we have discovered the importance of de-personalizing the interactions. When challenges arise in the negotiations, we have found it effective to rely on facts and data, so that no one’s word or reputation need be called into question. This entails collecting ample evidence in the early stages of claim handling. This evidence will be used to arrive at a coverage decision, and this can be revisited in later stages to substantiate that decision if problems or questions arise.
Finding the humanity
Aside from viewing situations through a contractual/empirical lens, we also want to view them through a humane lens. All of our interactions are with people, not things. Many of the people we deal with are in a state of distress and disorientation. Home is a sacred space for each of us, and their homes have been upset. They are experiencing a loss far deeper than merely a financial one: a loss of stability, a loss of control over their lives. The tone, attitude and approach of the insurance adjuster in these vulnerable moments is just as important as the cold hard facts of the contract.