Adjusting

The Most Common Estimating Mistakes

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September 21, 2020

There’s nothing more frustrating for an adjuster than completing a claim file for submission only to have it returned for corrections.

Some of the most common estimating errors are simple errors that can be easily overlooked. Take, for instance, depreciation. Adjusters often overlook simple depreciation when replacing items. Other instances of depreciation errors are depreciating labor or repair items and applying non-recoverable depreciation to recoverable depreciation items and visa-versa.

Another very common estimating error is including duplicate labor, as well as not including a damaged item in the estimate, mis-identifying materials, wrong material amounts, and allowance for labor minimums. Make sure to do a QC of your own file before submitting, even if it takes a few extra minutes.

Less common but still significant errors in the estimating portion of a claim include:

  • Area deductions not taken
  • Numbers not matching the POL or CAP amounts
  • Advance payment that exceeds the damage
  • O&P issues
  • Tax issues
  • Paying for items we shouldn’t
  • Not auditing contractor estimates
  • Lump sum allowances
  • Deductible issues
  • Writing the estimate in the wrong software

Concerning other basic errors, the number one error is coverage issues or wrong coverage applied. Make sure to read the policy thoroughly and focus on the claim as you go, to avoid making this mistake.  Pay special attention to the narrative reports as well. These reports are crucial to providing a clear picture of the damage, yet poorly written narratives are a common mistake. Another piece of advice—make sure to do a thorough check of all paperwork before turning it in to ensure nothing is missing, as missing documents are a common mistake but easily corrected. And, if you think you may miss your 60-day deadline, it is your duty to provide an explanation.

Other mistakes that we see often are, in general, poor investigations and not properly explaining denials. This is another mistake that can be easily remedied by slowing down and taking time to read your own report before submitting. Less common basic errors include not fixing the file the first time, revising items that were not requested, administration issues, not reviewing expert reports, not reviewing contractor and/or remediation estimates and reports, adjuster not certified to handle a particular loss, priors not addressed, and poorly labeled or missing photos.

Coverage issues

Within the basic errors are coverage issues. Here are some of the most common coverage issues:

  1. Including a building item as contents and visa-versa
  2. Inclusion of non-covered contents items, such as auto parts, marine parts, and other specialty items
  3. Improperly including an item as ACV or RCV
  4. No direct physical damage by or from flood
  5. PFE restrictions not adhered to
  6. Covering items in a basement where there is no coverage
  7. Loss avoidance not covered
  8. Estimating item not covered
  9. APS not covered

Legitimate returns

Legitimate returns also cause anguish for the adjuster but can be easily avoided. The overwhelming reasons for a legitimate return are not clarifying what you mean in a line item note or narrative report.  Following this error are a need for additional investigation and/or additional photos. Less common reasons for legitimate returns are not confirming GCF, requests for price adjustments by the examiner, waiting on expert reports, and waiting on NFIP or carrier clarification.

Takeaway

Always QC your own file before turning it in. Pay special attention to your narrative and line item notes in the estimate, add those extra photos, perform a thorough investigation, check your policy twice before making a determination of coverage, write a clear, concise, and thorough narrative, watch for depreciation issues, and remember to include all damage in the estimate. For specific training, visit our class schedule, or email our VP of Quality Assurance and Training, Craig Fowler (craigfowler@cnc-resource.com), if you would like to request a class.


Chris Fowler — Thanks for reading! What did you think of this post? Email us.