By Kevin Jones
One of the most frustrating things for the restorer is to respond to a job, do the work in a professional manner that follows industry standards and training, and leave the policyholder happy only to then watch the invoice get shredded by an insurance company or third party administrator (TPA). The restorer can try to fight the cuts, but chances are the insurer or TPA won’t budge, and in franchise systems, you often find the corporate body is of little help since their goal is to keep the contract intact.
It is no secret that insurers came up with vendor programs in order to attempt to get the best service for their policyholders, and there’s nothing wrong with that. The question remains, though, if you are fortunate enough and considered high quality enough to be in a vendor program, then why do insurers/TPAs:
- Seem not to trust your professional judgment
- Hold you to the IICRC S500 (when it suits them)
- Cut your invoice when you’re already providing them discounted services in order to serve them on their vendor program?
It doesn’t make sense, does it?
Sometimes it seems as if these restoration partners are nothing more than school bullies in the hallway. The difference is they have the deep pockets, much more-so than your average restoration contractor or franchise location, making it hard to fight them. In all fairness, the vendor programs are understandable, given the amount of scam artists that come out of the woodwork during storm events. Still, it seems that if they trust you enough to make you a vendor, then they should trust you enough to pay you what you’ve earned. It almost seems as if there’s just nothing that you can do to fight this uneven battle; or is there?
As “lame” as this may sound, one of the things you can do to strengthen your side of the battle is to take the best notes that you can imagine. As a 22-year industry professional, with the last 12 on the training and consulting side, one of the weakest points I see with restorers is their abilities to create proper documentation on restoration jobs.
I have seen days when no monitoring occurs, with no notation as to why. I have seen psychrometric numbers that make no sense and times when humidity ratio or grain depression increases with no explanation. These are the types of things that insurers and TPAs look for to argue against paying you for certain monitoring trips or to justify reducing your invoice. (Side note: Even more frustrating is the number of contractors, auditors, data specialists, desk adjusters, and TPA adjusters who either aren’t aware of the S500, or don’t understand its implications.)
You, as a restorer, need to vow to ensure you and/or your employees write the best notes possible on every job you do, every day, including every action and every interaction with someone, at a minimum. You need to tell a story, a story of a restoration job. You need to make this job so clear that anyone reading it can decipher what happened on that job and what was discussed. You need to document everything you do, whether it’s based on the standard or whether you’ve used your professional judgment to act outside the standard—anyone who reads your explanation should have no doubt why you did something and whether or not it worked.
I spent over 10 years in law enforcement, where I learned to write extremely detailed reports. I testified dozens of times in district court and lost very few cases. In superior court, I won every case in which I testified before a jury. Why? Because when I got on that stand, my notes were clear and concise, and I testified from my notes, not from memory.
You and your employees do dozens, sometimes hundreds of restoration jobs a year. To try and defend your invoice with inadequate notes and other documentation makes you look unprofessional and unprepared. This translates into giving an insurer or TPA (in their minds) every right to cut your bill.
Take good notes. Answer who, what, when, and where at a minimum. Make your notes so detailed so that anyone who questions them looks foolish. Taking good notes will help get TPAs where they need to be—out of the industry.
Kevin L. Jones is a restoration consultant and instructor with I-40 Structural Drying Academy and Consulting and an IICRC-approved WRT/ASD instructor. Visit his website at www.i40structuraldrying.com for 2 IICRC approved continuing education credits on note taking and report writing.