Fifty Shades of Claims Investigation - A New Book, Template for ...

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It will not give the latest hot seller, Fifty Shades of Grey, a run for its money on the bestseller list. I doubt that anyone will load this book on the Kindle and take it to ...

Claims Management . BY KEVIN QUINLEY, CPCU, AIC, ARM

FIFTY SHADES OF CLAIMS INVESTIGATION A New Book, Template for Evolving Demands New Claims Demands


est Publishing Company has just issued its eighth edition of Casualty, Fire and Marine Investigation Checklists (CF&MIC). It is co-authored by Pat Magarick (posthumously) and Ken Brownlee, our resident iconoclast. This is a book that no one—not even the most conscientious adjuster or insurance claims geek—would curl up with and read from cover to cover. Nor is it meant to be digested that way. It will not give the latest hot seller, Fifty Shades of Grey, a run for its money on the bestseller list. I doubt that anyone will load this book on the Kindle and take it to the beach for escapist summer reading. For starters, the book weighs in at almost 900 gut-busting pages. Nevertheless, CF&MIC is a useful and authoritative resource guide for claims professionals tasked with handling a multitude of claims. The book’s updated 29 chapters provide handy checklists on myriad property and casualty (P&C) claims investigations. For adjusters seeking blueprints to guide investigative efforts, this book is an invaluable resource. It should be part of the claim office library in any insurance company or third-party administrator (TPA) branch. Pat Magarick was once a dean and guru of claims handling. When I began my claims career in the late 1970s in Norfolk, Va., the adjusting industry viewed him as a towering figure. After a career as a claims executive at AIU, Magarick died in 1998. Nevertheless, his impact reverberates through textbooks he authored and which still enjoy multiple printings. Co-author Ken Brownlee, still very much alive, sustains Magarick’s impressive legacy and builds upon it. Brownlee is or should be well known to those within the claims community. A seasoned claims professional, he is a former corporate risk manager for Crawford & Company and is a prolific author. Among other things, Brownlee has written a monthly column for Claims Magazine for many years. 18 . SEPTEMBER 2012 Claims Magazine

Brownlee correctly notes that the legal and investigative landscape for the 21st century claims adjuster has changed radically since the book’s first edition in 1955. In 2012, adjusters face challenges handling files related to terrorism, cyber risks, computer hacking, global warming, nanotechnology, and environmental impairment liability. New types of coverages offered by insurance companies spawn new types of claims that merit customized, bespoke investigations with specialized investigative templates. This is the first update since 2008, and the authors have incorporated many refinements into the book to make it current and relevant to today’s claims adjusters charged with investigating losses. For example, Chapter 29 focuses on fraud investigation and is entirely new content. There is a new section on investigating dog- and animal-bite claims. Updated material also includes a chunk on contractor liability under general liability policies, day care center claims, and even a section on claims against colleges and universities. The latter seems prescient, given the backdrop of the Penn State Jerry Sandusky litigation, which will keep lawyers—both on the plaintiff and defense sides—busy for years. This is just a smattering of the updated content incorporated into the eighth edition of CF&MIC. Today’s stretched-thin-but-enterprising adjusters must investigate these claims. Some of these losses will be litigated. Discovery will train the spotlight on what adjusters did and did not do. One could easily see CF&MIC becoming used as a “standard of care” referenced by those attempting to compare what an adjuster did versus what an adjuster should have done on a given claim file.

Checklists: Cookbooks and Caveats Of course, CF&MIC is only a guide; it is not a cookbook. Sensible claims handling involves knowing when to occa-