A recent New york collision center’s complaint to the state’s Department of Insurance led to forcing the insurance coverage carrier to agree with a completely independent appraiser’s repair estimate.
Kyle Bradshaw, with K&M Collision in Hickory, filed a complaint to the DOI via email in February after discovering in the independent appraiser, John DiBella, that The General insurance company disputed his estimate and amended it under his license number before sending it on to K&M.
“What has been happening is the insurer will hire a completely independent appraiser; the independent appraiser will come out, inspect the vehicle, go over the repairs and submit their are accountable to the carrier, and then what’s happening is the carrier’s been doing an interior audit or an internal review according to their ‘guidelines’ and it is then reducing what the independent appraiser’s written,” Bradshaw said. “Oftentimes, it may be 40 or 50%. It’s becoming a lot more popular. The majority of carriers that have started to eliminate their staff [adjusters] it’s increasingly prevalent in.”
At the same time that Bradshaw filed a complaint using the DOI, he disputed The General’s actions directly with the carrier to Material Damage Specialist Lori Finn.
“I've reached out to the appraiser that physically inspected the vehicle and that he stated he did not create this negative supplement and the figure was for $11,361.37…,” Bradshaw wrote in an email. “I'd certainly hope that you are aware that in accordance with North Carolina Administrative Code every licensed motor vehicle damage appraiser is required to prepare a completely independent appraisal of the damages. It's abundantly clear in speaking with Mr. Dibella that someone at The General received Mr. DiBella's appraisal back coupled with a problem with it and altered it under Mr. DiBella's name. Are you able to or anyone at the general show me the reason for hiring an independent appraiser if you plan to control his appraisal afterwards?”
K&M requested an actual inspection of the damaged vehicle following the General issued an estimate based on photos of the damage. The General then hired Auto Damage Appraisers to accomplish a completely independent appraisal, that was for $11,361.37, based on Bradshaw. An authorized internal appraiser for The General “found numerous charges that were in question,” based on an answer from the carrier to the DOI.
Auto Damage Appraisers’ COO “reviewed the data and adjusted the estimate. Once received, it had been approved and released to the shop. The payment for that repairs was issued to [redacted] for $7,063.89,” wrote The General Claims Compliance Advisor Hannah Bunch.
The General’s estimate was for $1,754.11, according to Bunch. “The appraiser indicated around the estimate that the initial estimate was written for that visible damage which there was hidden damage having a possible large supplement expected.”
An Auto Damage Appraisers supervisor told K&M “that invoice or photo documentation was required for the following: paint mixing for match, scanning of the vehicle for diagnostic codes, and any required additional steps needed during the diagnostic process. The supervisor also discussed the non-customer charges, which included washing of the vehicle, searching for OEM procedures, battery tending labor, and support functions,” based on Bunch’s reaction to the DOI.
The supervisor also stated an “estimate can't be manipulated without the independent appraiser knowing. The supervisor explained the independent appraiser completed the changes which PGAC's desk appraiser is licensed, and reviews claims every day for shops across North Carolina. The store confirmed the independent appraiser employed by PGAC for that supplement did not commit to payment for the initial supplement that was written, nor would be a copy presented to the shop.”
Ultimately, after coming to an impasse with The General and while waiting on DOI’s response, K&M recommended to the customer they file claims under their carrier to move forward with repairs sooner, which she did.
NC DOI P&C Complaint Analyst Adrienne Clark wrote within an email to Bradshaw, “For the records, our Department did advise the overall that our expectation was for the original appraisal done by John Di Bella, to become honored. However, Ms. [redacted] has elected to have her own insurance company handle this claim.”
Bradshaw said this claim shows the significance of filing complaints with departments of insurance for consumer protection. “It can be used as a benefit to the client in a few scenarios. Should you let stuff go, you’re not necessarily supporting your last of the bargain as a repair professional. If you know that something’s blatantly wrong, you’ve reached have that available.”
NC DOI Assistant Director of Public Affairs Barry Smith told Repairer Driven News the department has no discuss the complaint. When asked if the issue addressed happens often, he explained, “We don't code our complaints to identify the particular issue referenced in the complaint. So we are unable to figure out how many similar complaints we've. However, we don't see this type of complaint like a recurring issue. It is important for collision centers to know that their customers can file a complaint using the N.C. Department of Insurance should they have a problem with an insurance provider.”
Complaints with the DOI can be filed around the department’s website or perhaps a form obtainable to mail in.
The department states on its complaint webpage that it may:
- Forward a duplicate from the complaint towards the insurance company in question, and require the organization to supply a response/explanation;
- Review the company’s response for compliance with applicable North Carolina statutes, regulations, and policy requirements;
- Require the company to take corrective action when they determine that the company’s position does not adhere to applicable requirements;
- Help policyholders understand their insurance plans; and
- Recommend considerations that may be taken to reach a resolution if they don’t possess the regulatory authority to resolve it themselves.