Adjuster Licensing and Your P&C Claims Processing Timelines

Hurricanes. Wildfires. Earthquakes. What do they have in common? If you’re in the insurance industry, the answer is that they’re all guaranteed to trigger weather and disaster claims from those with P&C insurance like home, business, and auto coverage.

For carriers and adjuster firms, a mass-claims event activates an emergency response amongst your administrative staff. This could involve deploying a tsunami of adjusters to an affected state or region. Whether these are staff adjusters or independent adjuster contractors brought on for a single emergency response, onboarding and license compliance are critical to processing claims in a timely manner.

Why do insurance carriers have to process claims quickly?

Many states—particularly those with robust weather disaster cycles—have specific timeline requirements for insurance carriers to process claims. Insurers that want to sort the wheat from the chaff of legitimate vs. fraudulent or padded claims need to act fast.

There are a number of reasons insurance carriers want to be quick to the scene in the aftermath of a natural disaster or weather event such as a hurricane or wildfire:

• The law. Legally, most states have set timelines of days or weeks for processing and paying “clean claims,” or claims that are clearly covered by the policy and have all relevant data available. We stand by following the law.
• Speed equals satisfaction. Clients with faster claims resolution and response times scored their insurers as more satisfactory. In a word-of-mouth industry like insurance, getting adjusters on the ground to file and process claims quickly is key to growing and retaining business.
• Like a crime scene, evidence deteriorates over time. Adjusters are your eyes on the ground to spot insurance fraud and determine what qualifies as a legitimate claim. If an adjuster can’t check out a claim site for days, weeks, or even months, then sussing out fraud gets a lot harder.
• When unaddressed, damages (and corresponding claim amounts) can rise. Consider a retiree whose shingles blow off the house in a storm. The damage is covered, and the insurer agrees to fix the roof. But the insurer decides to contract exclusively with a preferred roofer instead of paying out the claim for an outside vendor. The carrier-preferred roofer has multiple storm-related claims in the area, and takes a while to get to the retiree’s roof. Meanwhile, each subsequent drizzle or storm pours more onto the exposed roof. Even with tarps, trickling water begins to cause damage inside the home. Now the insurer has to pay to replace a ceiling in a bathroom in addition to the roof. (See how this can spiral?)
• The longer you wait, the longer schemers and scammers have to move in. Nature abhors a vacuum. So does your dog. And so does insurance. In the wake of a natural disaster, if you don’t act quickly to connect with your affected customers, there’s more opportunity for some scammer with a generic “file your claim” scheme to befuddle your policyholders. 

How does adjuster licensing affect claims processing?

Without enough adjusters whose licenses are fully compliant and up-to-date in relevant states, your claims-adjusting process will get dragged down, no question.

You may be thinking, “Surely that’s what all the apps and AIs are for, right? I’ve seen a million instant-claims-filing app advertisements on the Facebook, so, speedy claims problem SOLVED.”

Unfortunately, many claims aren’t “clean,” and thus human adjusters with their human need for licensing have to get involved, either by being physically on site or by virtually handling the claims process via photos, videos, and other digital data gathering. Problem decidedly not solved.

Similar to insurance producers, insurance adjusters have to maintain licenses in most states, with continuing education and license renewals and the whole shebang. For P&C insurers that are handling this manually, a natural disaster may also equal a paperwork disaster. Maybe you assign an adjuster to a set of claims only to realize they aren’t appropriately licensed for that state, or they don’t have a designated home state. Then you have to reassign the adjuster, and find a stand-in to meet the customers’ needs. 

Churning adjusters either because of insurer staff attrition or because they are inappropriately licensed is so common that Louisiana introduced a law to prohibit insurers from churning more than three adjusters through a claim assignment within a certain period. According to then–Louisiana Commissioner of Insurance Jim Donelon, the rule “addresses the most-frequent concern raised in the 4,000 complaints [the Louisiana Department of Insurance] received from consumers in the aftermath of Ida.” 

Turns out, insurance consumers don’t like getting handed off to multiple adjusters any more than insurance carriers like finding and replacing them. Speed dating is just not an attractive business model for any angle of the insurance industry.

Right now, a lot of carriers and adjuster firms are relying on manual processes that use self-reported information from adjusters. It’s a gas-and-brakes game of compliance management while also trying to have enough staff to work the phones in the aftermath of a disaster. But imagine doing business differently. 

Imagine knowing where an adjuster is licensed and authorized to do business—no ifs, ands, or buts—and being able to correctly route claims accordingly. Imagine connecting to a new adjuster and knowing the first day of the relationship which states they can work in or get a reciprocal license for. How much could the frenzy of adjuster assignments be reduced?

How to ramp your adjuster onboarding for the best speed-to-claim

P&C claims processing is cyclical—sometimes you can’t find enough people to take phone calls, and other times the whole staff can take a long lunch. Staying compliant while you ramp up for a disaster season is easier said than done, and we all know Mother Nature doesn’t wait for insurers to dot i’s and cross t’s.

With AgentSync Manage, carriers can onboard adjusters in as little as hours, and give carrier and adjuster firms the assurance that their adjusters are up-to-date on licensing, and licensed in the states they need. 

Instead of scrambling for background checks, license verification, and other required documentation, Manage can provide a single portal for adjuster self-servicing, and integrates easily with digital background check providers. 

When having a licensed adjuster is critical to a speedy, compliant, and fraud-free claims process—which in turn delivers for the bottom line—it just won’t do to have manual errors and spreadsheet tracking slow you down.

Offboarding those adjusters when disaster season is over can also be a pain point when you use manual processes. But, with AgentSync Manage’s automations and integrations, you can set adjuster licenses to “inactive” status and kick off workflows to email a legal notice to an adjuster when you’ve terminated their contract. 

At AgentSync, we can help you lock down your adjusters’ licensing and compliance requirements so you can reduce churn and increase your team and customer satisfaction. See how; check out our Solutions page.