Ask an Expert: Insurers can’t change rules in middle of a claim

by  John and Theresa Kightlinger

Just because an insurer states something, does not mean it’s true.

In this article, we’ll address the real-life issue of outright lies and deceit committed by some individuals involved in the collision repair industry…and in this article, it does not pertain to collision repairers.

As much as they might like to, insurers cannot change the rules in the middle of a claim any more than the policyholder can. Insurance policies are legal and binding contracts that clearly convey the obligations of each party.

Licensed claims adjusters are supposedly trained and vetted to take on a position of public trust. They are bound to tell the truth and conduct themselves in a fair manner to the benefit
of the insurer they represent and the policyholder who paid for insurance and expects the company to honor its promises.

In a perfect world, everyone would conduct themselves in an honest and ethical manner and live the old axiom, “Do unto others as you would have them do unto you.” However, as of late, this is all too often not the case when it comes to insurers.

For example, a policyholder recently received an email about fees from one of his insurer’s claims managers. To many, this likely would carry some weight and draw concern for both the customer and repairer. However, there really is no reason for concern, as the comments are nothing more than baseless warnings and threats to their policyholder.

Here are portions of the email, followed by a policyholder’s correct response.

• We have no problem inspecting your vehicle and working with ABC Body Shop.

There are some items that you will want to discuss with (the shop’s owner) prior to

having him start the estimate of repair. Policyholder’s response: There shouldn’t

be a problem as the choice of repairer is the customer’s and the insurer has the right

to inspect it or not. Please advise me, in writing, within 24 hours, if you wish to

inspect my vehicle. If I do not hear from you within 24 hours, I will instruct my

shop to proceed with my repair so as to avoid any unnecessary delays and related

storage costs.

• Cleaning — This fee is not paid, it’s a cost of doing business. Policyholder’s
  response: Show me where in my policy where this is a cost of doing business.
• Storage — This will not be a fee paid unless the vehicle is deemed a total loss by
  (insurer’s name). Storage will be paid from the time the vehicle is deemed a total
  loss and not prior. Policyholder’s response: I’ve been assured that the only time this fee will be assessed is if and when the repairer is unable to proceed with the repair due to my failure to provide them direction to proceed with the repair. The only time that will happen is if and when I’m not provided what I’m entitled by your insurance company, so I would encourage you and your staff to respond to my repairer and me in an efficient and expeditious manner. Also, please provide me a copy of my policy where it states this loss-related expense is specifically excluded.
• Seat belt inspection — This is a fee that will not be paid. Policyholder’s response:
  Show me where this is not necessary.
• Sand and polish — Will not be paid, unnecessary procedure. Policyholder’s response: Show me where in my policy that this is excluded.

• Air bag inspection — This is a fee that will not be paid. Policyholder’s response:

How is this not a necessary procedure? Show me where it says it’s not.

• Test drive — Not paid, considered a cost of doing business. Policyholder’s

response: Show me where it says that this is a cost of doing business.

In summary,  it’s not uncommon for some insurers and/or claims people to lie to consumers in their ongoing efforts to contain claims-related costs/expenses. It is rare, however, that insurers will do this in writing.

Not all repairers know how to combat such behavior on behalf of their customers. The ability to recognize such issues and help customers defend themselves against such conduct is an added advantage to using a quality-oriented repairer. It’s knowledge like this that makes quality repairers good for customers, the community and the industry.

John and Theresa Kightlinger own My Body Shop at 401 N. Clinton St., Stockbridge. The couple have lived in the area and raised their children here over the past 20 years. John has been in the auto body business since 1985, and Theresa began work at General Motors after high school. Between the two, they have been working on cars for more than 75 years.