InSurOp-Ed: On Policyholder Attorneys and Public Adjusters

This coming June marks the beginning of my 54th year in the insurance industry. I’ve enjoyed something of a 3-phase career. The first 7 years was spent largely as a fire protection engineering graduate providing loss control and underwriting services to insurers. The next 8 years I spent in management with highly successful, if unfulfilling, results. But my real passion has always been research and education.

Before stumbling into an engineering college scholarship, my plan had been to become a high school math and/or science teacher. It took me almost 20 years to get into the education side of the insurance industry when I left a management position at ISO to join the Insurors of Tennessee, the state affiliate of the Independent Insurance Agents & Brokers of America (the Big “I”). I moved to the Big “I” national 11 years later to build their Virtual University and retired 17 years after that as Assoc. VP of Education and Research. For the past 5 years, I’ve been blogging, writing books, and doing some speaking (not to mention gigging with my band The Spyders).

So, for over 30 years now I’ve been involved in researching, writing, and speaking (aka “educating”) on insurance and risk management. Much of my work during that time has been in assisting independent insurance agents with coverage and claims issues. As you might guess, these activities, especially when the agent was unable to resolve a denied claim with a carrier, frequently brought me in contact with attorneys and adjusters responding to disputed claims from the policyholder side.

It is probably no secret that policyholder attorneys and public adjusters are not especially highly regarded within the industry by insurers and the claims personnel they employ. To a lesser degree, that’s probably generally true of many agents who feel that the claims process works better as a private party among friends (insurers and insureds) where a disagreement breaks out that is best resolved, when possible, by the agent as a mediator and, in many cases, an advocate for the insured. (That being said, it’s not unusual for an agent to refer a customer to a public adjuster or policyholder attorney if they strongly believe a claim is covered but they’ve hit a brick wall with the insurer’s adjuster.)

Frankly, with a very few expert witness experiences, most of my dealings with policyholder attorneys had been adversarial and most of my knowledge about public adjusters was second hand. Like most people, my general knowledge of policyholder attorneys came from the handful that advertised during shows like Jerry Springer (not, in my defense, that I ever watched a lot of Jerry Springer shows…at least that’s my story and I’m sticking to it) that portray insurance companies largely as tools of Satan. In other words, at least within the insurance industry, policyholder attorneys and public adjusters have not historically been held in the highest esteem.

However….

What I’ve discovered over the past five years is that this view is largely as invalid as the general public negative view of insurance agents and companies. Yes, there are attorneys and adjusters who really have no business in ‘our’ business. But the same can be said about those operating within the carrier side of the industry.

One of the first policyholder attorneys I’ve gotten to know is Chip Merlin who heads up the Merlin Law Group, based in Florida, but with offices around the country. I first became aware of Chip when he reached out to me after the publication of my first insurance book “When Words Collide: Resolving Insurance Coverage and Claims Disputes.” Presenting largely a pro-policyholder view of insurance contracts (that is, the premise that the purpose of insurance is to insure, not look for a way out of a claim), it’s not unexpected that a policyholder attorney would receive a book like this in a positive way.

But I was surprised at what a vocal and public advocate Chip has been for the book. My guess is that he’s probably responsible for the sale of at least a couple thousand books to a market I never fully realized. I became a daily reader of his law group’s blog and found it different from what I expected. He and his staff often blog about court cases that an insured loses. One would expect them to tout predominantly policyholder wins, but just the opposite is generally true. The point of this approach is that not everything is covered and a particular adverse court case is a lesson learned in preventing uncovered losses. That’s exactly the point of my “When Words Collide” book.

I met Chip in person not long before the pandemic hit when he arranged for me to speak at a public adjusters conference in Orlando. My experience there and since went a long way towards dispelling some of the myths about public adjusters. I was impressed by the enthusiasm and earnest commitment of the attendees to doing the right thing, as well as their knowledge about insurance contracts and industry operations. It was a group of individuals every bit as professional as what I’ve found in decades of attending CPCU conventions.

Since that time, I’ve gotten to know remotely several public adjusters whose qualifications, knowledge and professionalism rival most any of the agents and adjusters I’ve known within the industry. One such individual is David Princeton of Advocate Claim Service, LLC. David is a highly intelligent and knowledgeable public adjuster working on a law degree. We have had some enlightening discussions and debates on LinkedIn and, while we don’t always agree on coverage issues, his opinions and interpretations are always well reasoned and passionately and professionally articulated in a sincere and compelling way.

Most recently, I was contacted by a public adjuster who told me he had read my “When Words Collide” book multiple times. Nathan Ortiz of Bravura Claims Negotiation, LLC emailed me about a rather complicated claim he was attempting to resolve involving water damage and fungus remediation. He presented his coverage opinion in a very well thought out, logical and structured approach. His focus seemed to be on doing what’s right and what is unambiguously called for in the insurance contract. Like Chip Merlin, I also noted that his LinkedIn page included even-handed information like how to work with and not against agents.

Policyholder attorneys and public adjusters are not the enemy. Like Coach Dale of the Hickory Huskers, give them a chance.

P.S. After posting this article on LinkedIn, I heard from some individuals in the industry that their experience with public adjusters was largely unfavorable. The only point I’d make about that is to consider that, if your only interaction with public adjusters is adversarial, don’t make the mistake of presuming that all or most interactions with public adjusters are unfavorable. I believe psychologists refer to this as the “Halo Effect” or something like that…ascribing characteristics to a larger group based on observations of a very small contingency of that group. That, in part, may be why some policyholder attorneys advertise in a way that implies (or worse) that insurance companies act only in their own self-interest. Given that the vast majority of direct interactions between policyholder attorneys and insurance company representatives are adversarial, they may attribute their perceptions to, for example, all carrier insurance adjusters even though the majority of claims are likely resolved to the mutual satisfaction of all parties.

Bill Wilson, CPCU, ARM, AIM, AAM

Founder at InsuranceCommentary.com

Mr. Wilson retired from the Independent Insurance Agents & Brokers of America in December 2016 where he served as Assoc. VP of Education and Research and was the founder and director of the Big “I” Virtual University for over 17 years.

He is the former Director of Education & Technical Affairs for the Insurers of Tennessee and, prior to that time, he was employed by Insurance Services Office, Inc. He is a graduate of the Illinois Institute of Technology with a B.S. degree in Fire Protection & Safety Engineering.