The Claim Clinic

De: Andrew McCabe
  • Resumen

  • Insurance Claims and Restoration focused program. The Claim Clinic aims to educate the property damage restorers of the world through interviews with legendary Disaster Recovery experts.

    Become a member at https://plus.acast.com/s/the-claim-clinic.


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    © The Claim Clinic
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Episodios
  • A Rebel Call To Arms
    Feb 11 2025

    Ladies and gentlemen,


    I am here to deliver an urgent truth: the restoration industry is under attack, and the time to act is now. Unity is not optional. It is the only way forward. For years, I have watched as this industry has been taken from us, piece by piece. Now, the carriers are no longer content with nibbling away at what we’ve built. They are moving aggressively, driving independent restorers out of business, silencing the very voices that make this industry strong. In some parts of the country, this is already a reality. Appraisals are being weaponized. Payments are being delayed for months, even years. Outright denials have become the norm. In these markets, independent restoration businesses have been wiped out. This is not an isolated problem—it is spreading. And it will reach every corner of this country unless we stop it. But hear this: we are the ones who allow it to happen. Their programs and policies depend on our compliance. Their agenda succeeds only because we tolerate it. That ends today. The truth is simple: we win together, or we lose everything. There is no middle ground. Five years from now, if we fail to act, we will have no voice, no control, no choice in how we serve our clients. We will be at the mercy of systems designed to benefit carriers—not us, not our clients, and not the communities we serve. Anyone who thinks they’re above this fight is wrong. Anyone waiting for someone else to step in and fix this is mistaken. The responsibility to protect our industry falls on all of us. Every single one of us must decide, right here and right now, to fight back. Stop going along with their programs. Refuse to comply with systems designed to strip us of our power. Stand up for yourself, your business, and this industry. Together, we have the strength to reclaim what is ours. The time for waiting is over. The time for action is here. Fight for your livelihood. Fight for your clients. Fight for the future of restoration.

    Become a member at https://plus.acast.com/s/the-claim-clinic.


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    2 m
  • Painted Into A Corner
    Jan 27 2025

    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.

    Become a member at https://plus.acast.com/s/the-claim-clinic.


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    12 m
  • Don't Negotiate With Terrorists
    Jan 23 2023

    Negotiating your bill with adjusters is negotiating against yourself.

    I interviewed a new Restorer and expounded upon the importance of having solid contracts and understanding leverage in the claims environment.


    #ThickestFileWins #VirtualInspections #RemoteEstimating #Contractors #CustomerCentricClaims #InsuredFirst #TheStructureSpeaks #restoration #largeloss #claimslife #estimating #Xactimate #CoverThatOverhead #dothehardthings #InsuranceClaims #LitigationSupport #appraisal #Matterport #DroneMeBro #3dscanning #drones

    LARGE LOSS CONSULTING | APPRAISALS | XACTIMATE® | CLAIM SUPPORT

    Get Matterport: https://amzn.to/3WUZbKs

    I've included a "sample" CAT pricelist in my online course: FactorThatShit.com - 25% off code: CATTEAM

    PLX/pricelist files in course documents

    claimsdelegates.com/roofsketch


    ~ In 2012, Andy McCabe founded the property claim estimating and claims consultancy called Claims Delegates. Claims Delegates retains an army of dedicated professionals who write Xactimate® estimates for contractors, attorneys and adjusters across the country. They also consult on Large Loss and CAT events. They are currently accepting new client applications: WriteMySheet.com


    Xactimate Estimates: http://www.claimsdelegates.com/xactimateestimates/

    Schedule of Fees: https://www.claimsdelegates.com/feeschedule


    One-On-One Restoration/Estimating Advice & Coaching: ClaimsDelegates.com/consult https://clarity.fm/andrewmccabe


    The 24HR TECH mitigation documentation system: www.waterdamageprofit.com This training system and documentation package will help you train techs faster and get paid more for mitigation projects. The 24HR TECH on Amazon: https://amzn.to/2NVpZ9Y

    Become a member at https://plus.acast.com/s/the-claim-clinic.


    Hosted on Acast. See acast.com/privacy for more information.

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    44 m

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