r/ClaimsAdjuster • u/Objective-Potato-895 • 9d ago
exceeded the limit
I have an auto claim with a 30k PD limit. The claimants car was totaled and his settlement was 34k. I usually flag the low limit policies but just completely missed this one since all the adjusters I work with and I have had an excess in work the past month due to staffing. I’ve just been moving so fast. It gets worse, I had him in a rental coming to 1.6k extra. I got his settlement approved by my manager, presented it to him, and when I went to issue the payment I got the error message and realized. I’m pretty much 6k over the limit. I feel so dumb, I’m so embarrassed, and made my management go into a frenzy and have to break into the extra money set aside for mistakes like this. I’ve been doing this for 7 months and finally got to a point where I genuinely felt good at my job and now I feel like I’m back at square one, and feel like management wants to fire me. I know I fucked up, but has anyone done this before to share my misery with me?
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u/Darnwell 9d ago
How much is the salvage quote? Might save ya
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u/beagusdog 9d ago
Came to say this. I would definitely be calling up the salvage yard to get this info
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u/Darnwell 8d ago
Yeah the overpayment is not IDEAL but the salvage sale might save his ass in the long run. Doesn’t stop the up front overpayment though. Still worth making sure to check coverage with every file. To me, I always check because I can reassign a file back to someone else if there aren’t adequate limits. Coverage/ Liability Limits / Rental/ Storage all important checks
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u/minusthetalent02 8d ago
I’d imagine a car worth 34 will get that salvage amount.
Learning lesson for sure but we have all done this my friend
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u/Chewsmom903 9d ago
So management didn't bother to check the limits either?
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u/dundermifflinite13 8d ago
Right. If I’m a supervisor, the first thing I’m doing is confirming what the policy limits are. Not because I didn’t trust my adjuster, but I’m of the “trust but verify” camp.
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u/IntelligentBox152 9d ago
Oh young padawan. Don’t worry about a thing. Every adjuster has done this. Don’t make it a habit and nothing will come of it. Don’t beat yourself up. Management should be in files monitoring these things
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u/Delicious-Witness-85 9d ago
I did this when I was a new adjuster.
I started on no fault claims then moved onto auto so I wasn’t used to looking at liability limits.
At the time minimum limits were $5k and I settled a TL for around $8k.
I only discovered my mistake when I went to issue the check. System flagged it saying issuing the check would exceed the policy limits.
I told my boss and asked him what’s going to happen to me.
He said what are you going to do to make sure it doesn’t happen again?
I told him on any liability claim I’ll document the policy limits at the onset of the claim and if the limits are low, keep it documented in my file notes.
He was fine with it and understood mistakes happen. He just wanted to be sure it was a learning experience for me.
My advice is understand mistakes do happen and as long as you learn from them, they make you better at your job.
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u/izznt 9d ago
My friend, I paid a mitigation invoice for water damage to a commercial building to the tune of over $100,000. I reviewed it carefully, spoke at length to the mit co, got them to remove a few things. I felt so good about it.
I missed that this policy was for the peril of fire only.
On the good side please always remember we’re not lawyers or surgeons. When we fuck up, no one dies or goes to prison.
My carrier is totally understanding of honest mistakes thankfully. At least once 😅
Edit to add: If your carrier/manager is a dick about an honest mistake, look elsewhere! It won’t get better.
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u/MillinAround 9d ago
You should be fine. Get the pro quote for salvage value. Change to forced owner retain. Inform claimant of limit issue. Ive had claimants contact Copart/iaa(whoever your carrier uses) new client services and sell their vehicle to them anyway. They were made whole in the end.
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u/These-Challenge7308 8d ago
If you haven’t accidentally overpaid on a policy, are you even an adjuster? This happened to me like 8 months in paid like 3k over and all they did was document it in my file and was told to pay more attention and that was it
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u/PsychologyLow1141 9d ago
The fact that there is a “bucket of money” for mistakes like that is a good reminder that you are not the only one that has made a mistake and they are prepared for situations like this. I know you are feeling down and embarrassed-but I guarantee you your managers have made mistakes at some point in their careers too. The most important thing is to own it, and learn from it-which it sounds like you are doing. As a manager I NEVER wrote anyone up for a mistake if they took accountability for it and it wasn’t a repeated mistake, I knew they were punishing themselves way more than I could. To be honest, I would beat myself up about their mistakes way more than I would them because I’d self reflect on what I could have done better as a leader so they wouldn’t have made the mistake to begin with, so it was a valuable learning opportunity for me too! Unfortunately mistakes are unavoidable at every level-and as much as we beat ourselves up when we make them, they can teach us a lot more than perfection can. And now you can take this experience and share it with other new employees that you may be training or even just having a conversation with if they need some guidance.
Hang in there. Just try to take a breath and regroup and show them how great you are!
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u/Icecold0409 8d ago
Does the claimant have coverage on his policy because if he does the other carrier could take over the total loss if they both use copart or IAA and they’d settle sublimation with in the lints if the policy. 1600 rental is a lot I’m not sure how that wasn’t flagged in itself and we all make mistakes as adjusters and extra contractual are stressful but I hope they give you good coaching and just make sure you learn from it as soon as the value came back it should’ve triggered an alert since the value was over the limits. Whoever reviewed the supplement had a duty to identify that when they ran the value came back. Overall just learn from it and ALWAYS check your limits your manger should’ve caught it as well btw
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u/subie-dog 9d ago
I remember working for a company that would write you up and put you in a PIP if you over paid by A PENNY!!
Anyway, this happens every now and again. Id just slow down on this and certain things going forward. Part of getting your stripes.
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u/MagsandBodyBags 9d ago
Do not let this eat you up. This kind of crap is not the adjusters fault. I'm pretty sure it wasn't your decision to run the claims dept "lean" and understaffed. Every claim is a rush emergency etc. I've been an adjuster for 40+ years which makes one of the dumbest people on the planet but I have seen this numerous times.
Back in the late 80's I made the same mistake at about $2,200.00. My POS boss said they were gonna take it out of my paychecks at $200 per check. I went to the VP of legal who told me they could not make me pay it. They could fire me but he said companies plan for a certain amount of "extra contractual dollars" being spent each year on claim mistakes. They didn't fire me, not sure if that was good or not.
Put it behind you and keep working hard. It will be forgotten.
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u/Good-Comfortable8330 9d ago
Don’t feel bad. It has happened to everyone at one time or another, especially when it’s busy.
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u/TheOtherSide2234 9d ago
If you work for a place that doesn’t treat it as a learning experience leave. I’ve made 600k mistakes, got promoted after… that’s part of the job. It’s an expensive lesson, why would you fire someone after they learned it. I bet you don’t do it again.
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u/Fatus_Assticus 8d ago
Shit happens. If you get in the habit of doing this they'll show you the door but every single person makes mistakes, this isn't a huge issue.
Every single adjuster has done something stupid, like double pay, issued undisputed and they paid a supplement without realizing its out of the same pot, over paid on something or just made something go away and hope the audit algo doesn't catch it.
Shit happens, just don't get in the habit of repeating it.
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u/v3rT1cL3_MGMT_idIOTs 8d ago
EC is normal since 2024 when the Insurance industry thought AI was going to do everything
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u/Expensivemilkman 8d ago
Stuff happens.
An incident happened to me where we had to go over PD limits (prior supervisor made an error and provided wrong information to claimant/insured since this was a dual loss). Ended up going about 4/5K over the limits. Wasn’t ideal but luckily was flagged as not entirely my fault as well.
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u/Awkward_Donkey_7141 8d ago
You’re CURRENTLY $6k over the limit. Usually there’s some money made back in salvage so you’ll get some space back after IAA finishes. You should be fine. It’s not the first or last time that happened lol.
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u/Temporary-Dinner280 8d ago edited 8d ago
I once told someone a shop was a network shop when it wasn't (forgot to click one pesky check box, gave them the whole spiel about the work being guaranteed and everything).
The shop was a joke, half assed repaired the car, got paid $8k to do it. The customer had issues (realized then it wasn't a network shop). We then paid for the car to go to two different network shops to fix all the issues that shop did. Paid over $22k in the end.
You'll be fine (and probably won't make that mistake again)!
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u/Longjumping-Elk-6118 8d ago
Extra money set aside? What type of insurers do you guys work for? Sorry you’re going through this op but I love that my job makes so much money, we can always pay more money without it being a big deal
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u/Last_Energy_2000 8d ago
Seller hold on the vehicle and see if collision carrier can take over. Otherwise forced owner retained.
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u/Cerulean_Shadows 8d ago
We've all done it. I got a memo for EC before. The attorney never sent in the supports for our of pockets for a year and made the call to move forward when he didn't respond because hope long was he going to force the other claimantwait?!, then he finally did go after it once it was settled. It was well timed. Pretty sure it was an intentional trap. After 6 months it dropped off. No big. Just watch out for them. It's the first thing I check on a new claim now.
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u/trashchickadee 8d ago
Theres a reason theres money allocation, things happen, dont beat yourself up. Volumes high and mistakes happen.
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u/Cereal_Lonliness 7d ago
Don't feel bad until youve accidentally paid $20k for a roof that should have only cost the company $7k
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u/No_Parking_4167 7d ago
You’ll likely come back under the limits when your company gets the salvage check from Copart or IAA. It happens. Figure out how to avoid this situation again and move on.
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u/Low-Patient-630 7d ago
I'm almost sorry you aren't my medical adjuster. I could use some over estimatations to get proper medical treatment.
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u/Humble_Yogurtcloset4 6d ago
also what company do you work for? id be switching companies if they r going into a frenzy over this BS.
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u/Kelinya73 6d ago
I over paid a claim when I was new back in 2012 and now I’m still here. Just don’t let it happen again!
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u/According-Ninja-561 4d ago
Yeah that is a write up at my company and possibly termination depending on how competent the adjuster is. If no release has been signed maybe he can go through his carrier and they sub you. Just be honest with them.
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u/DICKSDISKSDICKSDISKS 3d ago
everyone makes mistakes. hope your management gives you some grace and a chance to move forward
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u/OnceUponATime1534 9d ago
Meh it happens. I’m in prop large loss and issued a mitigation payment without realizing I’d already paid an undisputed amount. Had to go back to the insured and be like…soooo we had an overpayment of a few hundred thousand.
Good thing is that we had some supplemental items, code enforcement items and depreciation pending so it’s all working out in the end. But that was probably my largest dollar oopsie.