I am an experienced restoration contractor. So, what would I have to offer a new independent adjuster who is launching their career in the rapid waters of property claims estimating? We can learn from each other. While we may be on opposite sides of the process, there are many aspects of our roles and responsibilities that overlap. I believe that the majority of our success in claims estimating relates to the development of our mindset and habits.
If you work with insurance claims, you will need to develop your skills for writing and reading Xactimate estimates. This is true whether you are an adjuster or a restoration professional. Xactimate has become the standard for the majority of insurance carriers and third-party administrators (TPAs). If you are new to Xactimate, I have three tips that will help you master best practices for this estimating platform. Producing an estimate that reflects a scope of work that can be agreed upon is a process of establishing this scope through thorough data capture and accurate data input.
Tip #1 for Intentional Adjusters - You must learn from rejection
As you learn to write estimates in Xactimate and upload them to claims review (internal, external, or TPA), you are going to get rejected. It’s part of the process. Pay attention to what you are getting rejected for. Try to not repeat the same mistakes with the same carriers. Every carrier has their general rules as well as their idiosyncrasies. For example, one carrier will want contents written as CON LAB and another will want to see it as CON ROOM. It should only take one rejection for you to understand and remember which carrier prefers the line item one way or the other.
To help shorten your learning curve:
- Develop a process to help you consistently capture thorough data relevant to the claim.
- Create and/or refer to a database of carrier guidelines (most adjusting firms have these resources).
- Internal review can help you to get ahead of rejections. Especially for larger or higher end claims, have people in your network that you can utilize to get a second set of eyes on your estimate.
- There are third party services that can provide you with an instant review and suggestions for items you may have missed, and may also provide carrier profiles which help you identify common items specific to that organization.
Tip #2 for Intentional Adjusters - You must learn from repetition
Xactimate is designed for the straightforward losses. While we may disagree on the percentage of claims that are “typical”, there are going to be losses that break with the norm. For the majority of your losses, once you have a scope format that has been accepted, you can either create a macro or cut and paste that format. In my opinion, macros can be more work than they are worth, but there are plenty of YouTube videos on how to construct these. Memorize the codes and line items that you utilize most frequently and reference prior approved estimates as standards for future claims.
To help shorten your learning curve:
- Develop a consistent approach to how you capture and input data.
- Develop a reference database of information related to commonly questioned line items.
- Develop your macros and/or reference estimates, especially if you are seeing a lot of similar claims.
Tip #3 for Intentional Adjusters - You must learn from relationships
Get to know your local peers, partners, and vendors. For those losses that break from the normal in-and-out claim, make contact early and often with your local providers. You will learn what they see as simple agreed-upon scopes of work and what the idiosyncrasies are for the carriers you commonly work for. A simple key to advancement in any role is to make your supervisor's job easier. As an adjuster this may be your internal claims reviewers, desk adjusters for the carrier, or a third party administrator (TPA). Don’t contact them for every little change; have your items in order so that you can discuss the claim and make expedient revisions that are consistent with the data capture, policy language, and the guidelines of the carrier.
To help you shorten your learning curve:
- Some people, on either side, want to paint the picture that insurance claims have to be contentious. Depending on which “side” you are on, you have to follow a scripted narrative of negativity. I want to encourage you to form your own opinions and to work to develop good professional relationships. The standard that governs all parties in the claim should be to restore the property to pre-loss conditions, no more and no less.
- Do yourself, your client, and the contractor a favor by making this standard clear at the outset of every claim. Your introduction could be something to the effect of, “My job is to perform thorough data capture of the site conditions so that I can accurately input data to generate an estimate for an agreed-upon scope to restore your property to pre-loss conditions.”
- Contractors who understand this standard can be a great resource. Often contractors arrive at the worksite prior to the adjuster. They may be able to provide the ESX file for their estimate, which could help you with the sketch and details needed to understand how they are approaching the loss.
- While your company may not pay for tools such as DocuSketch or Matterport, these three dimensional data capture tools can be incredibly valuable for helping with your claims efficiency.
Xactimate best practices for success in claims estimating
It is helpful to have a consultant or mentor, whether this is an internal resource or someone you pursue from outside your company. There are helpful YouTube videos, and independent training courses that you can take. Don’t let fear prevent you from reaching out to someone through email, LinkedIn, or for coffee. For most professionals in the industry, mastery has come through trial and error.
If you want to survive and succeed in the insurance property claims industry, you must learn from the Three R’s of Rejection, Repetition, and Relationships.
Jon Isaacson is a freelance writer, business coach, speaker and 17-year veteran of the property restoration industry. His organization, The DYOJO
- The Do Your Job Dojo
, specializes in helping individuals, teams and organizations to Develop Intentionally.
Jon also hosts the DYOJO Podcast which features discussions with insurance entrepreneurs and is available on Apple, Spotify, Anchor and Google.