Category: Adjuster Tips

5 Insights to Achieve Effective Policyholder Communication

Effective communication and superior customer service can be just as important as the claim result to a policyholder. While it sounds easy, a lack of communication is a common complaint among insureds against their property insurance carriers. Adjusters can help in the effort to close that gap by following these tips while handling claims.

Whether in person, on the phone, or through electronic means, it’s important insurance professionals explain claims thoroughly while still maintaining empathy and superior customer service. Photo Credit: “Workplace” by Free-Photos / CC BY 4.0

1. Maintain an Empathetic Tone

It doesn’t matter if the claimed item is something small or very costly. If your policyholder contacted you, that means it’s important enough to them and worth the time, effort, and resources to file a claim. Showing and maintaining empathy – regardless of whether the incident winds up resulting in a settlement – is critical. This demonstrates to the policyholder that you genuinely care for them as a customer.

Empathy can go a long way. Make sure it isn’t forced like it came from a script or so over the top that it seems fake. If the claim doesn’t merit a settlement, it’s important to relay the news in a caring way but still firm enough that the policyholder understands this decision was necessary.

2. Keep an Open Line of Communication with a Variety of Options

Adjusters should provide multiple methods for insureds to obtain an answer. Make sure to give policyholders email addresses, phone numbers, and other information for who to contact if they have questions. If they do reach out to you, make sure to be responsive and follow up quickly, even if there aren’t any updates, so your clients know you’re working on it.

Effective communication doesn’t mean insureds have to be able to talk to adjusters at any given moment. A frequently asked questions page on a website can give a general overview. Phone apps and personal logins can give policyholders access to their account to check on updates, see progress of their claim, or receive messages.

3. Avoid Jargon – But Provide Education as Needed

Your role shouldn’t stop at reporting coverage amounts. It’s important to educate policyholders about how things work, what the damages include, and why a decision was made without using terminology that goes over their heads. Answer questions and keep details clear and concise without unnecessarily confusing them or acting like they wouldn’t understand.

Policyholders shouldn’t need a dictionary or an equipment manual to be able to understand what you are talking about, but feel free to educate them if they ask questions. Photo Credit: “Girl” by Наталия Когут/ CC BY 4.0

Not every policyholder will want an explanation or as in-depth a description as others. Figure out their interest level and go from there.

4. Don’t Make the Policyholder’s Contractor the Enemy

When explaining a claim resolution keep to the facts and leave the policyholder’s contractor out of it. Making the contractor out to be the enemy could cause insureds to lose trust in you if they believed the contractor, and it could leave a negative impression on the conversation.

Keep the discussion related to data-based testing results and manufacturer pricing to explain findings and resolutions. It would be inappropriate to make it personal.

Stick to the facts when reviewing claims, both before a settlement decision is made and after, to eliminate speculation and doubt. Photo Credit: “Mimi-Thian” by Mimi Thian / CC BY 4.0

5. Leave Speculation and Doubt Out of the Conversation

Keeping only to the facts is also important so as not to leave room for speculation or doubt. If the policyholder thinks you aren’t sure about the claim findings or resolution, they may question it, too. Go through the process both when the claim is filed so insureds know what to expect and review it again to explain how the results were found. It maintains credibility and makes it more understandable even if the solution isn’t in the policyholder’s favor.

Close the Communication Gap

Ensuring questions are readily answered, that insureds are kept in the loop, and that discussions are fact-based is critical to a more positive policyholder experience.

When adjusters assign our experts an onsite assessment or a desktop review for a claim with HVAC equipment, we are quick to jump on it and not keep anyone waiting. Insureds are contacted through a variety of methods, and adjusters can track progress and maintain communication through the portal. Adjusters who submit a claim to HVACi can use our comprehensive, actionable reports to explain findings to policyholders in clear and understandable terms. Close the communication gap to keep superior customer service levels.

4 Times Squirrels Caused HVAC System Claims

Are squirrels as innocent as they look? Photo Credit: “Squirrel” by Alastair Newton / CC BY 4.0

This squirrel looks cute, but underneath those innocent eyes is a mouth with 22 teeth that have caused major problems for policyholders. We at HVACi reviewed dozens of HVAC system claims that linked back to these rodents and picked out a few that left us feeling a little squirrelly about what all these animals are capable of.

1. Power Struggle

Squirrels seem to find wires tempting to bite. Photo Credit: “Squirrel” by ImageFile / CC BY 4.0

Power lines seem to be especially enticing because several claims assigned to us involved a squirrel chewing through them. For this claim, the squirrel’s action caused arcing and mini fires, according to the commercial policyholder. Five package units on two connected buildings were reported malfunctioning. It would cost an estimated $122,899 to replace the systems.

HVACi’s comprehensive evaluation found that four of the five systems were damaged, though the fifth was working properly at the time of assessment. Among the failed components were compressors and refrigerant circuit compressors. One of the system’s compressors was “shorted to (the) ground.” A fan motor and blower motor also failed from high voltage surge. Despite the damages, no full replacements were required. New compressors, blower motors, and a fan motor would return the policyholder to pre-loss condition, but it still proved to be a costly incident caused by a squirrel encounter.

Recommended Settlement: $30,270

2. Not Guilty on All Charges

Squirrels often get onto the roof and then into attics, causing damages. Photo Credit: “Brown Squirrel on Brown Wooden Roof” by Muhil Mohan / CC BY 4.0

The squirrel in this claim also found wires appealing, but this time they were in a policyholder’s attic. After the utility company made the necessary repairs and restored power, a high voltage surge was claimed to have damaged the HVAC system. A contractor recommended the insured replace the split system at an estimated $16,000 cost.

However, we can’t entirely blame a squirrel for this one. The policyholder had the contractor make the full replacement prior to the HVAC system assessment. Though it wasn’t connected to the power source during the evaluation, the old system didn’t have any visual or measured evidence of surge-related damages. If the system malfunctioned when powered on, it would have been because of internal mechanical failures from normal wear and tear. The system was also very dirty with a significant amount of rust and corrosion.

Recommended Settlement: If coverage was afforded, the settlement was $369 to clean up the system.

3. A Surge of Damages

In this next claim, the squirrel kept a distance from the policyholder’s property but proved to be the source of the peril. According to the policyholder, a squirrel damaged a transformer and knocked out power. When it returned, the 2-part heat pump no longer functioned properly. The customer had the system inspected and was recommended to get a full replacement.

This time, there was evidence of damage to the air handler disconnect box caused by a high voltage surge. Otherwise, the system condition and wiring were typical for its age and use, and the outdoor components were operational during HVACi’s assessment. Switching out the disconnect box and having the system retested were among the recommendations to return the policyholder back to pre-loss condition. A full replacement wasn’t necessary, but the squirrel still caused a repair that hadn’t previously been required.

Recommended settlement: $208

4. Fired Up During a Power Outage

Transformers are another popular place for squirrels to cause problems. Photo Credit: “Electrician” by alcangel144 / CC BY 4.0

The squirrels in the previous claims all did something that resulted in an HVAC system needing repairs. But for this last one, this squirrel caused enough trouble to require a full replacement.

Like another policyholder’s story on our list, the squirrel in this claim took a trip up a transformer that led to a power outage. When the wood-burning boiler lost power water circulation stopped, but the wood kept burning. This caused the boiler to overheat and compromised the integrity of the entire system. Because of that, the assessment determined a replacement boiler was needed to return the insured to pre-loss condition because repairs would meet or exceed the cost of replacement.

Recommended Settlement: $15,193

If you suspect a squirrel may have caused mayhem for your policyholder’s HVAC system, submit a claim to HVACi. We’ll complete a comprehensive onsite assessment to determine the actual cause of loss and scope of damage and recommend repairs or replacements to return your policyholder to pre-loss condition.

A Step-by-Step Guide to Settling Residential and Commercial HVAC Claims

You go through your claims that need to be settled, and there it is – an HVAC system that’s different than the type you are familiar with. Now what?

Adjusters won’t be concerned about whether they’ll make an accurate settlement decision for claims with HVAC equipment if they abide by the following simple steps.

1. Contact the insured immediately.

Reach out to the insured as soon after receiving the claim as possible. It seems simple, but it’s the best way to get the process officially started and to begin obtaining necessary information. Plus, it’s good customer service. Your policyholders know you’re aware of the claim and are going to do whatever it takes within the confines of the policy to return them to pre-loss condition.

2. Gather the details of the claimed equipment.

Knowing the age, brand, and other characteristics of the damaged equipment will be important while settling an HVAC claim.

You’ve made a connection with the policyholder. Take the time to get the details of the equipment that’s being claimed. Having information such as its brand, estimated age, and system type will be necessary further in the process when verifying that the repair or replacement options are compatible to the rest of the components and are of Like Kind and Quality (LKQ).

If your insured doesn’t know those details, don’t worry just yet. These can be obtained during the testing phase.

3. Review what the contractor and policyholder submitted to have a better handle on potential damages and what settlement is being requested.

Contractors may recommend full replacements of HVAC systems without first proving cause of loss and scope of damage – both of which affect settlements.

Policyholders and contractors may provide more information for some claims than others. Key elements to note are if your policyholders are claiming a full HVAC system replacement, if they provided a cause of loss, if the damage is typical for the age of the equipment, or if there really isn’t a lot for you to go on. You wouldn’t want to settle a claim without doing your own assessments first, but it’s good to know what you or an equipment assessor may be walking into.

4. Choose a qualified expert to evaluate the HVAC equipment.

Whether your policyholder submitted little information or provided a book, it’s important you get the claimed systems checked out for yourself. You don’t have to be an expert on HVAC equipment to be able to make accurate settlements – but the third-party HVAC company you have doing the work should have the experience and knowledge to fully evaluate the components in an objective and timely manner.

Making accurate settlements starts with choosing the right HVAC assessment vendor. For guidance, watch the What to Look for in an HVAC Claims Vendor video.

5. Ensure all HVAC systems and components are assessed.

Make sure no shortcuts are taken when assessing the equipment. Every system, regardless of how many are included on the claim, should be tested. Comprehensive evaluations will determine what components are damaged and the scope of the problem. Sometimes a policyholder won’t know that a different component is causing the issue, or some of the claimed systems will be non-damaged.

It’s important that extra effort is spent to determine the cause of loss and scope of damage so that you are only settling for equipment that is actually damaged and covered by the policy. This will lessen the chance that the claim gets reopened for additional damages in the future.

6. If covered, confirm recommended repairs and replacements are compatible and LKQ.

HVAC systems have different types of refrigerant that aren’t interchangeable and have varying constraints, such as the pressure requirements shown here. All equipment needs to be compatible for the policyholder’s system.

HVAC systems may be functioning properly at the time of the assessment, which could lead to a finding of non-damaged. But because of their exposure to the elements and how long some of the components can last, wear and tear is also a common cause of loss, which may not be covered by the policy. Both scenarios could end the claim settlement process.

If the cause of loss is covered, the assessment should have provided recommended next steps, including repair and replacement options. Pull out that information about the policyholder’s current HVAC system. Some components aren’t compatible with certain systems based on the refrigerant used or other factors. Sometimes the replacement options included in the claim, either by a contractor or the policyholder, are unnecessarily better than what was there before. Verify all recommended repair and replacement options are in line with what the policyholder currently has and that it’s LKQ.

7. Confirm the recommended components are available and in line with regulations.

Having a plan of action with recommended repairs and replacements is only as good as how well it can be executed. Make sure items that are needed can be readily purchased by the contractor or policyholder. If your third-party vendor didn’t do this, which it should have, have someone perform a desktop review that can check manufacturer databases for product availability.

The recommended repairs and replacements should be aligned with local and federal regulations. But make sure you clearly understand what they are, even if your policyholder or the contractor doesn’t. One topic that frequently gets misunderstood is the use of R-22 following the phase-out. For a clear understanding of how that comes into play, check out 6 Truths You Should Know About the R-22 Phase-Out When Handling HVAC Claims.

8. Confirm repair and replacement costs are market value.

Sometimes replacements have already been made or you are confident the scope of repairs is appropriate. However, costs can fluctuate depending on the contractor, location, or equipment, and it’s important adjusters confirm they’re in line with market value.

A desktop review can help check for available equipment and verify manufacturer pricing and local labor costs. This ensures the policyholder – and the carrier – is settling for the applicable amount.

9. Keep the policyholder informed about what is happening with the claim at each step.

Each claim has a lot of moving parts, but it’s critical policyholders are kept in the loop about where it is in the process. This makes for a better insured experience and shows you care about your customer and their claim.

More importantly, don’t shy away from telling them news you don’t think they want to hear. Do it quickly and be upfront so your policyholder can figure out next steps.

10. Make sure you settle the claim quickly while staying accurate and objective and providing a good policyholder experience.

That sounds like an impossible task – accuracy, objectivity, speed, and a good policyholder experience? Your policyholder shouldn’t have to choose which they get. Following these steps will guarantee that happens, but you don’t have to do them alone. HVACi can help. We provide comprehensive assessments for all HVAC system types with reports that include repair and replacement recommendations with available components priced at market value.

Trust the nation’s leading HVAC and Refrigeration assessment company to keep you one step ahead in making faster and accurate decisions without sacrificing on quality or policyholder experience. Submit a claim to HVACi to find out how it works.

Customer Service and a Good Policyholder Experience Go Hand in Hand

You’re still waiting for your pizza after 45 minutes despite there being only a handful of other diners. The server has barely said two words to you, and the decorative chairs feel like you’re sitting on bricks. When your food arrives, the crust and toppings are what you wanted, but was the overall experience worth another visit?

Emphasizing customer experience while completing the service may not seem as important for insurance as it is for restaurants. But as with pizzerias, your policyholders choose their carriers and decide what feedback they give friends, social outlets, and business review websites.

Global management consulting firm McKinsey & Company studied insurance customer experience through U.S. repairable auto claims. Qualities determined to drive customer satisfaction include speed of the claim settlement, ease of communicating with the insured, employee knowledge and professionalism, employee courtesy, and process transparency.

These should also be the foundation for a good property and casualty insurance claim experience.

 

Efficient Processes Reduce Time and Frustration for Policyholders and You

Your policyholders may be waiting to make repairs or replacements until their claim is resolved, and they want it completed as quickly as possible. Time is money not only for you but also your policyholder, particularly if it’s a commercial client.

Use, maintain, and upgrade procedures for efficiency to reduce the wait time for your policyholder. Technology can automate the claims process to decrease how often data is entered, or technology can move the claim along to the next stage, such as preparing it for onsite assessments or desktop review services.

As insured needs change, so should your response. Enhance your technical skills and capabilities to better fit your customer and provide prompt resolutions.

 

Regular Communication Should Be Maintained Through All Platforms

If 2020 taught us anything, it’s that communication can take place over a variety of platforms and there’s no excuse for being inaccessible.

Face-to-face appointments or phone calls should offer positivity and professionalism. Empathy and helpfulness can go a long way in times of stress or crisis. Your policyholders should feel like they’re your primary focus and know that you’ll do everything to determine a fair and accurate resolution.

Those sentiments can be conveyed by maintaining open lines of communication through other outlets. Keep policyholders in the loop about service progress and answer their questions through all platforms, including email, phone calls, website chats, and company apps.

 

Employee Courtesy and Transparency Includes Earning Their Trust

In the same vein as communication, courtesy and transparency are important. Whoever is on the other end of the line, chat, or email should know how to have professional tones, responses, and attitudes while communicating with customers. Your insured may not notice it – but they’ll remember a negative experience.

The positive tones your policyholders are receiving – if they’re genuine – will also increase their trust in you and your carrier. They want to know you’re going to resolve a claim accurately and appropriately.

It’s important to be open with them – even if it’s not the news they were wanting to hear. Delaying communication or not being transparent can make matters worse going forward.

 

Show You’re Knowledgeable and Experienced to Handle Your Policyholder’s Situation

Part of providing a good customer experience is demonstrating your knowledge about the insurance industry and each claim. Have the details readily available without your policyholder repeating them.

Don’t simply tell your insureds the final result. If they prefer, be able to educate them about why that decision was made, provide inspection documentation, and be prepared to answer their questions or know who to ask.

Clear, detailed information shows you’re knowledgeable about what’s filed in the claim and the individual situation, that you care about your customer, and that you want them to understand the process.

 

HVACi Is in Line with Your Customer Service Model

The HVACi team knows what your policyholder seeks in a customer service experience because it’s what we provide to our own clients – you.

Our quick cycle times and innovative technology keep the claim on track to not delay the process for you or your insured. The comprehensive reports are formatted and written to ensure we provide detailed damage and next step options while not confusing anyone with industry jargon. Our team is trained to speak with insurance personnel and your insureds in a professional and courteous way throughout the process, whether you contact us by calling, submitting a claim through the website, or accessing the adjuster portal.

Let your partnership with us enhance your policyholders’ experience with you.

Adjusters, Ensure Accurate HVAC Claims Settlements By…

Settling claims fairly and accurately begins with making sure you as an adjuster have all the necessary information from the start and that it’s verified. This includes determining cause of loss, scope of damage, and appropriate repair or replacement recommendations priced at market value. Anything less means the claim settlements could be for an inaccurate amount.

Adjusters, ensure your claims with HVAC systems are settled as accurately as possible by:

1. Considering all repair options rather than only full replacements

The percentage of residential HVAC systems that required a full system replacement totaled less than a quarter of all the systems HVACi assessed last year.

Contractors often like to tell your insureds that a full HVAC replacement is required to return them to pre-loss condition. They might use reasons such as, “Repairing an HVAC only extends its lifetime by a year or two” or that “Replacements will save you money in the long run.” Justifications exist for why a replacement may be necessary, including if there is a safety hazard or if the cost of repairs is more expensive than installing a new system. But full replacements are usually not the best solution, and most settlements don’t require one.

Repairs, including swapping out a major component and leaving the rest as it is, are more likely than replacements. The HVACi 2020 Annual Claims Report states only 24% – less than a quarter – of residential HVAC systems were determined to need a full replacement. It’s important adjusters have an equipment evaluation completed to see if an alternative is available that would be a more accurate and appropriate solution.

If you’re settling for more replacements than repairs, you’re likely adding unnecessary claims leakage.

2. Confirming cause of loss

HVACi’s assessments determined these were the actual causes of loss for residential split systems. Policyholders more often had them claimed as a different peril, which could have resulted in settlements for damages that shouldn’t have been covered. 

Lightning, hail, and water are all perils that affect HVAC systems and were the most claimed causes of loss outside of “unknown” on residential HVAC claims last year. However, HVACi assessments determined these perils were not actually the most common causes of loss impacting residential split systems, as shown by the graph above. It’s important adjusters determine why the equipment sustained damage to ensure they’re making accurate settlements for only the perils covered by the policy.

More than half of the residential systems HVACi assessed were recategorized to a peril other than what was claimed after evaluation. For residential split systems, more than a third were determined to be damaged because of age-related wear and tear.

If you’re settling most HVAC claims without verifying cause of loss first, you likely have had inaccurate settlement results.

3. Assessing each unit in claims with multiple HVAC systems

Thorough testing should be completed on all equipment, regardless of how many systems are included in each claim.

Commercial and large loss claims frequently have multiple systems included in them with a costly claimed amount. To get the most accurate results, adjusters should have thorough evaluations of each item – even if there are hundreds.

Nearly 20% of the commercial HVAC systems evaluated last year were determined to be non-damaged at the time of assessment. One-third of all commercial systems didn’t sustain covered losses and shouldn’t have been included in the claim.

If you’re not assessing every HVAC system included in claims, you’re probably settling for equipment that wasn’t damaged or was damaged by a peril that isn’t covered by the policy.

4. Verifying market pricing and availability

Not double-checking equipment estimates could result in settlements that are higher than they should be. Photo Credit: “Accountant” by Shutterbug 75 / CC BY 4.0

Contractors provide policyholders estimates based on their company’s pricing, which may not be in line with market costs. An adjuster should verify scope of damage and the cost of equipment and labor to make the most accurate settlement.

Real facts should be the foundation for a settlement cost – not overinflated equipment estimates. The expense for materials should be based on market value pricing. Labor costs should be consistent with the loss location.

If you aren’t verifying market pricing, you might be settling for more than necessary.

5. Being up to date on regulations and exactly what they mean

Policyholders, contractors, and adjusters may misunderstand changing regulations or believe untrue or misleading information about them. It’s important to know exactly what they entail to make accurate settlements.

January 1, 2020, was an important date in the HVAC industry. That’s when the phase-out of new production of R-22 ceased entirely and only reclaimed R-22 became available on the market. The news of the deadline came years in advance and so did the start of myths surrounding the phase-out. An adjuster who isn’t up to date on regulations could fall victim to a contractor who doesn’t fully understand the rules or is banking on no one else knowing them and unnecessarily approving a full replacement “in order to comply.”

Energy efficiency regulations, including SEER standards, and other federal and local codes impact how equipment may be manufactured, repaired, or replaced. It’s important adjusters stay familiar with how their policyholders and their claims could be impacted.

If you aren’t up to date on regulations and what they mean, you may not be settling claims accurately.

6. Using a knowledgeable, objective third-party assessor

Many adjusters rely on third-party assessment companies to evaluate their policyholders’ HVAC systems. This is a good idea if it’s a company you know will offer objective, comprehensive, and accurate assessments based on just the facts.

HVACi is the nation’s leading provider of HVAC and Refrigeration damage assessments thanks to its thorough investigations, swift cycle times, and actionable reports that enable insurance carriers to settle claims quickly and accurately. Our experienced and knowledgeable professionals verify cause of loss, assess every HVAC system and component listed on the claim, and provide replacement and repair recommendations. Each report also includes market pricing and equipment availability to ensure you are settling for the appropriate component at a fair and accurate price. Plus, HVACi’s subject matter experts not only stay up to date on trends and industry news, they also offer continuing education training and educational resources for adjusters.

Don’t run the risk of settling any claims inaccurately because it could lead to a negative customer experience or unnecessary claims leakage. Submit a claim to HVACi to receive an accurate claims assessment that will lead to better settlements and resolutions.