The occupational hazards of the claims adjuster
On December 6, 2004, a tragic story in the National Underwriter
resounded throughout the insurance industry's corps of claims adjusters. With a headline that read, "Man Charged With Killing Field Adjuster," the article described the murder of a claims adjuster, who was inspecting reported hurricane damage inside a rented Tampa, Florida, house.
For years, claims adjusters have been swapping stories about the risks they face in fulfilling their job responsibilities. Under reported by the media and professional organizations, threats to adjusters, including physical assault, road rage, hostage-taking, stalking, verbal abuse, menacing e-mails and identity theft, are established risks. Prevailing health concerns, such as stress disorders, depression and exposure to environmental contaminants, are alarming short- and long-term issues.
Managing personal safety should be a key concern to claims adjusters as well as the companies for which they work. Many companies do a terrific job of outfitting their adjusters with the latest safety equipment, and they are cognizant of the signs of stress disorder; however, the adjusters themselves are ultimately responsible for their own personal safety. There are specific measures that can be taken to minimize incidences of physical and emotional harm and prevent an adjuster from becoming a victim, whether a field adjuster or an inside adjuster.
Hurricanes Katrina, Rita and Wilma raised awareness of the emotional and physical hazards faced by claims adjusters and catastrophe (CAT) team members, many of whom were victims of the storms themselves and had constant worries about their own families while helping policyholders cope with the consequences of the storms. On its Web site, the American Psychiatric Association states, "The number and scope of disaster-affected persons may be larger than realized and may include not only the individuals trapped in the immediate disaster situation but, also their family and close friends, peers and other acquaintances, rescue workers, disaster relief (e.g., Red Cross, mental health volunteers) and agency personnel (e.g., insurance adjusters), if not to some degree the entire community."
Dennis Potter, MSW, BCSCR, an advisor to crisis response teams, writes in an article for the American Academy of Experts in Traumatic Stress, "One classification of the most neglected people in the aftermath of a traumatic incident is often the team who went in to work with all the survivors. They often fail to recognize the full impact the event has on their own lives."
Adjusters must be proactive in recognizing how exposure to certain traumatic events in the field can affect their emotional and physical well-being, both to themselves and their coworkers. Some studies have shown that post-traumatic anxiety can produce immune system deficiencies in certain individuals who are then more prone to disease. Also, being part of a disaster response team can trigger a form of post-traumatic stress disorder (PTSD). On its Web site, the American Psychological Association describes PTSD as "an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human caused disasters, [and] motor vehicle accidents …."
Those suffering from PTSD can have trouble functioning in their jobs or personal relationships. Many people with PTSD repeatedly experience the ordeal (especially when they are exposed to events or objects that remind them of the trauma) in the form of flashback episodes, unpleasant memories, nightmares or frightening thoughts. According to the American Psychological Association, "The good news is research has shown that psychological interventions can help prevent these long term, chronic psychological consequences."
Potter teamed with clinical psychologist Paul LaBerteaux to develop a structured debriefing process for members of disaster response teams so that they are prepared for "re-entry into the world" after working with trauma survivors. Debriefing techniques might be especially useful to claims adjusters and members of CAT teams who work directly with victims of loss. Human resource departments might take debriefing strategies and techniques, as well as individual and group intervention sessions, into account when developing employee assistance programs specifically for adjusters and CAT teams returning from disaster response assignments.
Beyond the disaster-related stress and emotional trauma faced by adjusters are the health concerns presented by environmental conditions. On its Web site, the Restoration Industry Association (RIA), an international trade association in the cleaning and restoration industry, notes that adjusters and disaster team volunteers returning from the Gulf Coast began "to develop a number of different, and in some cases, unexplainable health symptoms, ranging from what some have called the 'Katrina Cough' or 'mold cold' to antibiotic-resistant injuries, [and] meningitis."
To take it one step further, according to The New York Times, New York City's Chief Medical Examiner, Dr. Charles S. Hirsch, recently amended the death certificate of a civil rights attorney, who developed significant respiratory problems after 9/11 and died five months later, to reflect that exposure to dust at Ground Zero "beyond a reasonable doubt" was "contributory to her death." The National Institute for Occupational Safety and Health continues to study the deaths of rescue workers, volunteers, and others who worked in the area of the World Trade Center after the 9/11 attack.
Adjusters are routinely called upon to enter buildings that may contain substances detrimental to their health. There is the obvious mold and mildew in basements and fiberglass insulation in attics, but what about the unseen dangers? Douglas Jackson, president of the Society of Registered Professional Adjusters, recalls a court ordered reinspection program that had adjusters inspecting attics and crawlspaces during the time of the hantavirus outbreak in southwestern portions of the U.S. in the 1990s. In those instances, protective breathing apparatus were given to adjusters; however, think about how often adjusters go into buildings without consideration of what hazards may be contained within.
To help adjusters and response team members do their work safely, the RIA developed the following hurricane cleanup guidelines, which are applicable to all types of losses:
- Understand the dangers -unstable materials, possible gas leaks, high levels of bacterial growth, and airborne particles
- Be aware of physical and emotional health hazards -antibiotic-resistant infections; rise in sinus infections, skin rashes, upper-airway irritations; increase in pests and parasites; psychological shock; physical exhaustion; secondary PTSD ( "compassion fatigue")
- Prepare and prevent-be prepared with the basics; partner with local organizations in navigating the area, securing resources, and identifying hazards; have appropriate current immunizations, such as tetanus boosters and meningitis and Hepatitis vaccines
- Be cognizant of personal hygiene-be reminded of the nature of the area (e.g. avoid scratching uncovered skin, rubbing eyes); carry first aid kits, antibiotic ointment, mosquito repellent, bottled water, etc.
- Wear protective gear and practical tools-safety shoes, eye protection, rubber gloves, hard hats, and appropriate respiratory protection
- Stay safe- working in any hurricane damaged area involves real dangers for all involved. Education and proper preparation can help reduce the chances of injury or illness.
In addition to the environmental exposures, adjusters who work in the field also can be at risk for threats and incidences of confrontational exchanges, sexual assault, physical injury, car-jacking, road rage, verbal abuse and so forth.
Adjusters are often put in the position of having to deny claims, which may lead to verbal or physical conflict. Training to raise awareness of the potential dangers is crucial. Role play, which would help an adjuster become familiar with responding to menacing situations or individuals, should be practiced, and case studies about past company incidents should be reviewed. Precautionary measures to follow when working in the field include the following:
- Share your day's schedule with someone from the office or a family member. Schedule appointments for early in the day, as crime increases after nightfall. Call in or text message after each appointment. (This is especially important when you are inspecting premises alone in an unstable environment, a remote location or a cramped space.)
- If you do not feel safe-for any reason-take a photo of the area and leave immediately. Always trust your instincts and intuition. Never put yourself at risk. You can always make alternate arrangements, such as returning with a partner or security officer.
- If you are unfamiliar with a specific location, stop by the local police department and ask about the area. Find out prior to the visit if you are going into a rural area, a high crime area, or an area with poor cell phone reception.
- Always be alert to your surroundings and the actions of the individuals with whom you are working, as well as others who may be spectators. Always have an exit strategy, whether on the street or in a building. Don't deny a claim from a roof top where the unhappy insured can remove the ladder. (You know that this has happened!)
- Learn to read verbal and nonverbal signals. This is especially true when venturing into the home of an insured or claimant. Behavioral signs and vocal tone can be indicators of potential problems.
- Make sure your cell phone is fully charged, quickly accessible and programmed to make 911 calls. Invest in a car charger for your phone. Again, it's important to know the locations of limited cell phone areas.
- Make sure your car is fully gassed and is working properly. Have your car keys readily accessible as you approach your car. Check the car's interior before opening the door to make sure no one is hidden in the back. Check under tires to see if debris has been placed there to puncture your tire and make you a sitting duck.
- Keep equipment, such as your computer, in the trunk. Don't remove the computer or your briefcase until you are satisfied the area is safe.
- Keep only the bare minimum of identification, cash and credit cards in your wallet. If possible, find a place in your vehicle to hide a small amount of cash and a credit card. Keep a few coins available in case your cell phone dies or is unusable in an area.
- Protect your personal information. Don't put a home telephone number on your business card. Don't use your personal cell phone to make business calls. Don't use your personal e-mail address to send business-related messages. And Google your name to see what's on the Internet about you.
- Beware of the dog. Even dogs that appear friendly can bite. Carry some dog biscuits to distract a dog that comes at you suddenly. Don't trust an owner who says the dog is tethered. One adjuster tells the story of needing to go into the backyard to inspect the garage. A large barking dog was tethered there. The dog owner said the dog was secure. But as the adjuster opened the back door, the TV antenna wire that was supposedly securing the dog to the rear of the property snapped and the dog came lunging at the adjuster. Fortunately, the adjuster was able to retreat to the safety of the house before the dog reached him.
- Learn basic self-defense techniques. Be prepared to use your briefcase as a shield or to throw it at an attacker.
- Avoid using your cell phone and laptop while driving. Accidents occur when drivers are distracted.
- Secure your laptop, briefcase and other equipment when driving. Loose equipment can become dangerous projectiles during a panic stop or accident.
- Don't cut corners when performing roof inspections. Make sure your footwear is appropriate. Secure the ladder according to your company guidelines. Ladders have slid out from underneath adjusters while coming off of roofs, causing fractured ribs, punctured lungs and fractured vertebrae.
No one should take personal health and safety for granted. During catastrophic disasters, inside adjusters are also under a lot of stress because they typically handle the caseloads of adjusters dispatched to the field. Because of the nature of claims handling, those who work inside an office can also become targets and victims of emotional and physical assaults, including verbal abuse, physical injury, harassment, identity theft, property loss and so forth. Unhappy insureds and claimants have been able to gain entry into claim departments, sometimes with tragic consequences. Some key reminders about office safety include the following:
- Make sure your company has security measures in place for the protection of its staff. Always follow company safety guidelines.
- Do not let someone you do not know into the building without first confirming the visitor's credentials.
- Always take down a caller's phone information. If something doesn't seem right, verify the information.
- If you are working late at night, do not walk alone to your car, including parking lots and garages. If you park on the street, try and park under a street light. Always have your car keys readily accessible.
- Before getting in the car, check the car's interior and under tires.
- Protect your personal information. Don't put a home telephone number on your business card. Google your name to see what's on the Internet about you.
- Shred documents containing personal information.
- Make sure your computer has a security password installed. Also, log out when you leave your computer. There have been instances where disgruntled employees have used unattended computers to alter claim reserves and issue bogus payments.
- Use care when reading e-mails and opening attachments. Make sure virus protection has been installed on your computer. Avoid using instant messaging.
- Know who you are dealing with online.
Responsibilities of the Company
In addition to the personal safety measures taken by adjusters, companies need to regularly reassess their role in ensuring a safe working environment for employees:
- Evaluate the risk factors associated with company policies, procedures and guidelines
- Mandate training programs for all claim staff, especially for new and inexperienced staff members in the field
- Insist on communication protocols
- Initiate predisaster planning; develop effective policies and procedures
- Train managers and supervisors to recognize and identify indicators of acute stress and anxiety
- Provide staff with necessary equipment, including cell phones, pagers, GPS systems and protective gear
- Establish reasonable claim handling standards so that adjusters are not forced to cut corners
Adjuster safety is a shared responsibility between employer and employee. Companies have to establish reasonable workplace safety guidelines, provide personnel with training and appropriate safety equipment, preplan for natural and man-made disasters and be cognizant of the stress related to CAT duty. Adjusters need to act reasonably and responsibly and always take necessary precautions, whether they work inside or outside. To quote Sgt. Phil Esterhaus of Hill Street Blues, NBC's highly acclaimed police drama of the 1980s, "Let's be careful out there!"
Donna Popow is senior director of knowledge resources and ethics counsel for the American Institute for CPCU and the Insurance Institute of America (the Institutes). She has responsibility for all aspects of claims education including the Associate in Claims designation program and the Introduction to Claims certificate program. Ms. Popow can be reached at email@example.com.