Mr. Stool

"I stooled myself, stooled all down my legs, even on my shoes."

"How ???"

" I stopped at the farm store and locked my doors and went inside. While I was there, somebody broke into my car, and sprayed a chemical that made me stool." 

"What chemical"

" I don't know, but as soon as I smelt it, I stooled"

" can you just stop saying stool, please?"

This wasn't my claim, but I heard a lot about it. No evidence was ever found that somebody broke into the car and sprayed this magic stool producer, but we paid the 1200 for clean up anyway. Why? Because when you do stupid shit (or take one) chances are we'll pay for it. Welcome to comprehensive claims!

Collision coverage is when you hit somebody or get hit with a vehicle. Comprehensive (here on: comp) is all the other worldly bullshit that can happen to you and your vehicle. Honestly this is where the good stories, and the most difficult people and the limits of the policy all merge together into a clusterfuck. 

So let's return to Mr.Stools. He claimed an unknown assailant broke into his car, sprayed a high-tech James Bond like spray so powerful, he pooped his pants. A chemical agent that the mere smell instantly causes a bowel movement. Of course, no pile of poop was found outside the vehicle, as surely an attacker must have gotten a slight wiff, right? No chemical stain found inside. No broken glass or forced entry. What the fuck right? Well, if you look up Mr. Stool on the Maryland Judiciary site, you can see he's had several recent DWI's and a history of booze related issues, chances are he was a bit lit, mistook a fart for the real deal, and boom: stool city.  Clearly, he's lying, but that's ok. The guy already had quite a day, the adjuster isn't going to push the story, he is up to date with payments, so here comes the check.

Of course, if you have the same insurance company as Mr.Stools, you will help cover the cost of his shitty drawers. No matter what he said, that check was on the way. I don't know why people just make up stuff. Just say you shit your pants. Who cares?

Comp also covers animal strikes. I've seen every type of critter you can think of accused of damaging vehicles. You would be shocked at how much damage a squirrel or hedgehog can do at 85 MPH. Birds shattering windshields, deer running into stopped vehicles trying to ram them, even a church van that was infested with rats. I had an old lady insured once that kept a 70's cargo van full of feral cats, but more on that another time.

This coverage also allows for an exceptional amount of fraud. People claim animal strikes or a tree fell on their vehicle, when in fact it was an accident .With the age of the Internet, these claims are quickly dismissed. If you back into a pole, and then say a deer hit your rear, and no evidence of deer hair ( those fuckers explode on impact and leave bits everywhere) and a dent that is 5 inches and cylindrical...chances are there will be some serious follow-up questions. 

Mr. Stool eventually tried to claim so old, rusty damage as part of his attack, and opened up a medical claim hoping to collect for " pain and suffering". When advised those will not be paid for, he threatened the adjuster and told him he would come to our office, and beat the stool out of him. Lovely. Just another claim out of 50 that week. Move on to the next. 

Playing with my Ding-Dong: A day in the life of an adjuster

“I know you are just sitting there, scratching your ass and playing with your ding-dong” - voicemail message

Voicemail is a great passive/ aggressive tool to verbally assault somebody, without having a retort thrown back at you. More on that later.

So you decided to file a claim. Good for you! Maybe you were in a legit accident, or maybe you need rent money and backed into a pole. Either way, you're in for a treat!

Let's start with the claim intake or as it's jargonly known: FNOL (First Notice Of Loss). I like to call them Fucking Numbskulls On Loan, because industry wide, this position is usually filled by temps who give zero fucks. It's a revolving door call-center job , usually out of state and because of volume/staffing issues, is sloppily done at best. At worst, it is a nightmare. These reps have zero claim or legal knowledge, and basically type out the answers to a list of questions to set up the claim. Some companies actually have their adjusters perform this role, in an effort to burn them out and make them jump off the nearest bridge. Average length of employment of an FNOL is about 3 months, no education is required, and the worse your spelling and grammar the better. Sometimes they get ambitious, and type up a horribly worded description of the accident.

For example: ‘insured car hit another car, need rental.’ Or ‘vehicle is damaged after unknown accident'. No shit. FNOL has periodically given people bad legal advice, made promises adjusters can't keep, or bungled the claim so bad it takes hours or days to correct. There is no accountability, no way to contact this mysterious group of employees, you just have to deal with it.

After the customer service train wreck of FNOL, your claim (with any luck) gets sent to an adjuster for investigation. After correcting the spelling, names and phone numbers in the claim, the assigned adjuster will begin to ‘work’ the file.

  1. Call the goddamn policy holder. You gotta talk to your guy first. You may not know who or what was driving the vehicle, if they had permission to do so, or what's going on. Young Johnny had a fender bender while away at school, so calling his mother to ask if she was aware of an accident is on par with telling her that her son was beheaded by Isis. 99% of the time, it's a fender bender with nothing to worry about. Good luck telling Momma bear that. You can also get a cheating spouse or separated couple, just finding out the new boyfriend/girlfriend is driving the BMW. Good times. Once that's done, throw on your recorder and take a detailed statement from the driver. More on this process later...

  2. Call the Claimant. In the world of insurance there are two groups: insured and claimant. Insured is your customer, the policy holder and the one you have to butter up, console, and smooch the cheeks of, or else the dreaded ‘I wanna speak to your manager’ is uttered. Claimants are the other guy, the one you may or may not pay. The one you don't have to return their endless calls and can send them a letter they will never read, telling them you aren't paying. The next step is contacting this person, find out who was driving, and take a recorded statement.

  3. Police reports, witnesses statements, and setting up an inspection of the vehicle follow, plus any announcement of ‘injury’ needs to be considered.

  4. After you have the recorded statements, police reports, inspection photos and any other evidence (witness statements, video footage, other insurance companies payment demands) you can make a decision on liability based on the law. Whew. Generally, this can take a day or two, or 2 years, every accident is different.

  5. Pay everybody that needs to be paid and close that mofo up. It's finally over.

That's the aerial, big-picture view of the process. We will delve into these topics more in future blogs. For the layperson, I wanted to give you an overview, for the adjuster...well you probably skipped over it because you do it so much,  it's pure agony to see it written out.

Adjusters get about 5-7 claims on average, every day. Monday's are the worst, as weekend claims mount up to create a wall of doom. Monday it's not uncommon to get 12+ claims on your desk before lunch. Not much time for ding-dong playing, sadly. Tuesday-Thursday you get a little reprieve maybe only 2 or 3 claims on those days. Friday is just another Monday.

Now toss in a few hours on the phone with an interpreter for non-English speakers, a few crazy people and a meeting or two about how you need to ‘smile through your voice!’  or on the latest corporate buzzword, and there you have it. Your phone never stops ringing. If it's a new loss, or a 17 month old claim, your voicemail is blinking all day. ‘Why doesn't he answer the phone?’ Because that's all I would be able to do, I get voicemails from 9pm screaming for me to answer the phone, even if my outgoing message says my office hours end at 5. All day the phone rings. All fucking day. Go take a tinkle and come back to 7 angry voicemails.

One hell of a day. Multiply by 5, and boy do you need a weekend. Luckily Saturday duty is once a month! Nothing beats a 6 day, 50 hour week followed by a single day to relax and do all the other things in life. Stressed? Fuck off. You can be replaced instantly by an eager beaver recent university grad who will do your job for a fraction of what they are paying you. That is, until they burn out. Industry wide, burn out rate for adjusters is about 3 years. Does your ding-dong hurt yet?

Next time: ‘My car smells like a bag of farts’: the world of comprehensive claims.




 

In the beginning...

So here it is, my first blog. Everything starts somewhere (trust me when I say to start this took quite some time) and it's always fun to look back at the start and cringe….

This blog is a documentary on the world of auto insurance claims. How insurance companies work, what being an adjuster is like, the complex absurdity of the ‘personal injury’ cottage industry, funny stories, and by proxy: the nature of human beings. Dealing with people at their worst moments in a stressful time is an illuminating look into the workings of not only the human experience but of our own culture and society in a larger sense. I also want to let people know exactly how the sausage is made: bad faith, word vs word, the waste of government and the claims process in total. I want this blog to be Upton Sinclair's ‘The Jungle’ for insurance.  

So a bit about me. I worked in auto claims for seven years. I worked for a large multinational company, a small ‘mom and pop’ operation, and a quasi-government insurance company, catering to those who cannot get coverage anywhere else and should not be on the road. I worked in departments that only handled vehicle damage, as well as injury units and attorney represented clients. I've argued, explained, comforted, yelled, helped, screwed over, (and been threatened) by every class, race, gender and language available. In short: I've seen a lot, and I have even more to say.

So join me on a fantastic voyage of discovery and depression! Let me share with you the insight I've gathered without having to actually do one of the worst jobs in America…. Or just laugh at my pain, whatever you're into.