PRINCIPLES TO REMEMBER
Michael Sean Quinn*
applicable standards of care, when it comes to insurance adjusting. Policyholder should study them; they are quite malleable, within the range of the reasonable. Insurers already know them, and the policyholder is to find deviations; the function of those supervising adjusters and the adjusters thermselves is not to deviate from their central themes; and lawyers for either are to formulate descriptions and arguments either purportedly demonstrating that they have been observed, or–in the case of policyholders–the opposite. So, the most important incontrovertible components of
the relevant industry principles, customs, and traditions of adjustment are these:
First Axiom: Insurers are obligated to treat the interests
of their insured as at least equal to their own. Comment: Often this
obligation is taken to be a fundamental axiom of insurance theory and practice.
It is obvious that intermediaries have the same duties and level of duty as
legal agents of insurers. So long as intermediaries are also the legal agents
of a relevant person, I believe that intermediaries have an even higher duty.
Every insurer in adjusting every claim must look for coverage. Comment: The looking must include “vertical looking,” (“How deep does the injury go?”), “horizontal looking (“How many different things got damaged?”), and “coverage looking,” as well as”behaviorally looking.
Third Axiom: In handling a claim, an insurer has a duty to
be reasonable in all ways, at all times, with any claimant, with any claim and
any component of any claim. Comment:
To the extent an intermediary is involved in an adjustment process, the same
principle and standard of care applies to them. This is true, even if the
insurer is the decision maker and the intermediary plays no direct role in the
making of that decision.
significant axioms and principles involved in analyses like the one here, but
these are always involved, at least to some degree.