Managing the Large Loss

I. What are we dealing with:
Where do we start?
Are we reactive or proactive?
Control of the claim begins pre-loss.
II. What controls are we dealing with?
a. Policy holder
1. P.H confidence in the adjuster.
b. Policy language
c. Damages
d. Liability
e. Civil
III. Are we reactive or proactive?
a. Company claim philosophy
b. What are the reactive aspects in large loss scenarios
1. Fear
2. Uncertainty
3. Delays
4. Over reacting
5. Over spending
c. Repercussion = increased indemnity expense

IV. What happens in a pro-active roll?
a. Company may experience a paradigm shift
b. What are the proactive affects on a large loss
1. Pre-loss plan and team – adjusting staff, investigators, restoration vendors, construction consultants, engineers
2. Confidence
a. Adjuster
b. Policy holder
3. Timely response:
a. How will we employ and deploy?
b. What are the rolls?
c. What are the authority limits?
d. What are costs?
4. Controlled costs
5. Controlled Claim Strategy
a. Policy language
b. Proper investigation
c. Timely response
d. Controlled costs
6. Customer service orientation
a. Customer needs vs.cost
7. How to build a pre-loss plan
a. Know your company claim philosophy
1. Paradigm shift due to changes in:
a. Handling P.H
b. Insurance industry perception
c. Litigation
d. Restoration / Reconstruction Techniques
b. What are your team requirements?
1. Adjusting staff
2. Investigators
3. Restoration providers
4. Construction consultants
5. Engineers
6. Legal staff

c. Developing your team
1. Qualifications standards
a. Capacity
b. Credibility
c. Financial responsibility
d. Structure
e. e-commerce availability
d. Establish “operational / pricing guidelines”
a. Response time management
b. Authority guideline
c. Reporting guidelines
d. Costs
1. Consulting- IA / experts
2. Damage mitigation –
e. Employing your team
1. Time is of the essence
a. As time passes costs go up
1. Employ a recall roster.
a. Cause Origin
b. Independent adjusters
c. Restoration provider
d. Construction professional
e. Engineering forensic
2. Set first onsite meeting with the team
a. Reinforce scope & authority of each member
b. Address immediate needs
1. Policy holder
2. Carrier
c. Establish a report back deadline
d. Evaluate findings
1. If necessary – non waiver

3. Set first meeting with policy holder
a. Outline your team
1. Introduce team
2. Share their role
b. Thoroughly review policy language c. Discuss immediate needs
1. Employ the team to satisfy the needs
d. Establish a claim time line
1. Provides a road map of the claim for the P.H
e. Bringing it all together
1. Reporting from members
a. Coverage
b. Initial reserving
c. Defined scope
d. Final damage assessment
e. Business interruption
1. Temporary locations
2. Other solutions
2. Evaluation process
a. Policy holder needs
b. Cost effectiveness
c. Coverage
d. Recovery plans
3. Decisions and Employment processes
a. Defined Coverage
b. Defined scope
c. Defined damages
d. End game plan
4. End game plan final notes
a. Communication
b. Attitude
c. Satisfaction
d. Reduced indemnity expense
f. Policy holder retention