The Claim Clinic

The adjuster describes how attempting to force an insurer into admitting fault or setting a precedent can backfire, leading to claim denials and litigation. The lesson emphasizes the importance of understanding insurer motivations and strategically shifting negotiation tactics towards compromise.

The "Cornering" Effect and Insurer Resistance:

• The central idea is that insurance companies will resist agreeing to arguments that could implicate them in "bad faith" or set unfavorable precedents for future claims.
• As the adjuster explains, "sometimes we make arguments and we put them in a position where if they agree with us they implicate themselves in bad faith or they set a precedent for future claims."
• This happens when adjusters try to force insurers to define ambiguous policy language, admit to past errors, or concede on coverage issues that aren't clearly defined.

The "Our Position Stands" Response:

• When faced with arguments that could lead to precedent-setting or admissions of wrongdoing, insurers often resort to the response, "Our position stands."
• The adjuster points out, "if you ever hit a brick wall like that you need to understand that you have just put them in a position where they're going to set a precedent or implicate themselves."
• This response is a strategy to avoid admitting fault and triggering potential ripple effects on other claims.

Litigation as a Strategic Ploy:

• Insurers may intentionally push cases towards litigation to create an opportunity for a "compromised settlement."
• The reasoning for this is, "once the suit is filed they can make a offer that is a compromised settlement and that compromised settlement gets rid of all the arguments that were made previously."
• This allows them to avoid admitting wrongdoing or creating precedents, settling the case purely on financial terms rather than principle.

Compromise as a More Effective Strategy:

• Instead of attempting to "prove them wrong," the adjuster advocates for a shift toward a compromise settlement approach, especially after encountering resistance.
• The key tactic is for the public adjuster to say to the insurance company, "we have discussed it and we are willing to accept a compromised settlement offer in the amount of X and if you'll agree to that we'll sign off on a release."
• This allows both parties to move forward without a costly and protracted legal battle and avoid setting precedent.

Public Adjusters Can Initiate Compromise Settlement:

• Public adjusters can directly negotiate a compromise settlement on behalf of their clients without the need for an attorney.
• The adjuster states, "For you Public Adjusters out there you're allowed to do that hey I talk to my client and we have agreed to accept a compromise settlement in the amount of X..."
• This tactic can help resolve claims faster and avoid a lot of legal expense, as long as the client has agreed to the settlement amount.

Focus on Client Needs:

• Ultimately, the adjuster emphasizes that the primary goal should be to get the client's needs met: "ultimately I just need to help my client be able to make repairs."
• The focus then shifts from winning an argument to achieving a fair resolution that allows the client to move forward.

Conclusion:

The most important lesson from this source is that successful negotiation with insurance companies requires understanding their motivations and avoiding confrontational approaches that can lead to resistance. Instead of trying to force admissions of wrongdoing, a focus on compromise settlements and client needs can be more effective for achieving favorable outcomes.

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