Stop the Bleeding from Estimate Rejections

Estimate reviews are part of the process in property restoration, how do we minimize our losses?

Rejections sucking the blood from your estimates

Time is invaluable. It’s the only thing that we cannot purchase more of. In business when we are able to reduce wasted time we are able to increase our efforts in profitable endeavors. Wasted time is money bleeding out of your organization.

For those who have written estimates for an insurance claim, you know what it feels like to have your line items questioned by adjusters or your estimate picked apart by claims reviewers. Property restoration contractors often perceive the claims review process as a constant bleeding out of effort, energy and sanity.

It’s hard to produce for clients when you feel like you are always treating the wounded in your estimator bullpen.

How often have do restoration estimators say:

• “They’ve shredded my estimate!”
• “How do they expect us to make any money?”
• “I give up, there is no winning this battle with these made up rules.”
• “&#@$%”

Maybe this hasn’t happened to you but you’ve heard your peers complaining. Just wait, every estimator knows that their estimate will soon be the next victim of the insurance review gauntlet. The next time you send an estimate to a reviewer or hit upload in Xactimate, the process will run its vicious cycle with you.

For those willing to admit it, are your bruises still turning purple or are your wounds still bleeding? We all have choices to make. We can play the status quo game and complain about the system or we can work to find answers.

What would the typical response be as this scenario plays itself out?

• “Who are they to question me?”
• “They have no idea what it takes to run a business.”
• “This claims review ‘professional’ has never been to this job – they’ve probably never been to any job site ever.”
• “*&?^$”

Funny enough, this is both one of the issues as well as one of the keys to resolution as well. The person reviewing you claim has never been to this job. They typical claims reviewer works from a claims center half-way across the country. You are correct, they likely haven’t been to any job and possibly never will. It’s not their job.

This is a fact of the process and it does no good to complain about it.

Your roles should not put you at odds. One of you writes an estimate for the claim and the other reviews the estimate for the claim. Either of you may view your responsibilities to be at odds with each other but that is not inherent to the task at hand. The presiding principle should be to restore the client to pre-loss conditions and both parties should be working together to make this as expedient as possible.

The difference between what should be and what is leaves a lot of room for us to work towards a process that is clear and consistent.

As restoration professionals we can start by asking better questions.

• “What are the objections of the claims review?”
• “It appears that the claims reviewer has composed a detailed list of their reasons for the rejection of your estimate. What is the next objection?”
• “Did we utilize the correct line items?”
• “Did you call the adjuster to discuss the rejections?”

As an estimator you have the responsibility to learn how to tell the story of the loss through the estimating tool. The estimate has a language.

Whether you like it or not, for the majority of insurance claims, Xactimate has become the recognized story delivery tool. When your story does not resonate with our audience you need to learn how to communicate more clearly. In serving your client, it is necessary to use the resources in your tool bag to assist them in achieving a well executed outcome.

If your estimate is not compliant with basic carrier requirements, rejection is not the result of sadism its self-sabotage.

How do contractors gain ground in the claims review process?

• Develop your process intentionally.
• Do some research.
• Tap into your peer network.
• Communicate with the adjuster.
• Make progress in your process.

Start the process of reviewing your rejections for trends.
You can do this as a team or you can do this as an individual estimator. To assist you with collecting data we have developed a FREE PDF download -Tracking Claims Review Worksheet. Gathering this information will help you to make informed decisions about your process, adjustments for your team’s approach as well data to discuss with adjusters, claims reviewers or carriers.

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Resources for estimators, managers and adjusters composing estimates in Xactimate:

• READ: This article is excerpted from a broader discussion on thinking through the claims review process to achieve better outcomes – Help, Claims Review Shredded My Estimate.
• VIDEO: Claims Review Shredded My Estimate
• ARTICLE: Habits of Xactimate Estimating Success
• ​FREE E BOOK: The 10 Commandments of Xactimate Estimating Success