Monday, August 27, 2018

An Insider's Guide To Claims Adjusting - Crazy Stuff

My best friend, Number One Follower, made the comment not too long ago that it would be good blog fodder to write about some of the more interesting things I deal with on a regular basis as a claims adjuster. Coincidentally, the company I work for (that has a very well known and popular ad campaign centered around..."interesting" claims) sent out a request for interesting claim stories from the casualty claims organization (think bodily injury as opposed to homeowner property claims) for consideration to be included in the ad campaign. There were several restrictions on things you could submit: Nothing involving severe bodily injury or death, it had to be "safe for work", etc.

After a 20 plus year career of handling high exposure and litigated third party liability claims, I've seen a lot of crazy stuff. When I stepped back and thought about the "interesting" claims I've handled, all of them would have been rejected for one reason or another. So, I'll just have to inflict some of that stuff on you poor souls here rather than have the glory of my claims being immortalized in a TV commercial.

How crazy is crazy you ask?

Well, let's start with the photos. The vast majority of claims files have photos in them. Most are pretty mundane....dented bumpers, wet floor signs and the like. But, some They'd give a normal person nightmares. And, no, before you ask, I'm not going to post copies of them mother reads this blog and I don't keep copies if I don't have to.

Back in the day, when dinosaurs roamed the earth and adjusters had actual paper files, we would get snail mail delivered to our desks. Depending on when the clerical staff got to your desk, it was better than even odds that you'd get your mail after lunch. Even if you did get your mail before lunch, chances were that you wouldn't get to it until after lunch.

Let me tell you...nothing quite makes the hair on the back of intestines stand up like dead body photos after a tasty lunch of pasta or barbecue (Brigid...I'm looking forward to your commentary from the secret squirrel forensic scientist gallery).

Nowadays, everyone has an electronic claims file and mail magically appears in your file after being scanned by some faceless clerical worker in another city (sometimes another country). Those documents show up sans description at all hours of the day and night. You have to go in and look at and label each one. One minute, you're looking at dry medical reports, and the next minute you're getting an eyeful of some guy's scrotum or some dearly departed's autopsy photos. Sometimes those are one and the same. 

Like I said, it'll get your attention. You don't last long in this business unless you develop a thick skin and a strong stomach.

So, what are some of the crazy photos I've seen?

The all time winner for "brain bleach" craziest photo award goes to the autopsy photo of the "gentleman" (and I'm using that term as loosely as possible in this case) who died in an auto accident. What made his autopsy photos unforgettable was his tattoo. Specifically, the location and subject matter of his tattoo. This grade A specimen of masculinity had tattooed his manhood to look like a candy cane.

Let that sink in for a moment. To this day, I am convinced he was a child molester.

Runner up for the "brain bleach" award was the scorching hot hoohah claim. Seems a lady was getting ready for her day; and, as many women are inclined to do, she flipped her freshly washed locks of hair in front of her body so she could blow dry her hair from the bottom up. Allegedly, her hair dryer suddenly turned into a flame thrower and she inflicted second degree burns upon her nether regions. Her attorney felt the need to send me unsolicited photos of her injuries. Call me a sexist pig if you wish, but she was not that attractive before she received second degree burns to her naughty bits.

The winner of the "how in the hell did that happen" award goes to the drunk driver who managed to incinerate himself and 2 of 3 closest friends while motoring down 410 in San Antonio (contestant number 4 got launched out of the pickup bed and died of blunt force trauma after he failed to learn how to fly before impacting the road about 100 yards away from the crash site), in a construction zone, at speeds in excess of 90 miles per hour. Apparently, a solid concrete construction barrier, in a clear attempt to commit suicide by drunk driver, jumped into the right lane of traffic when our intrepid Mario failed to zig when he was zagging. For the record, Dodge pickups will burst into flames when they are split in half down the middle of the engine block.

What made this claim a puzzler was the photos of the engine compartment. The fact that the engine block was severely damaged was not nearly as surprising as the charred leg that was nestled in amongst the remains of the heater hoses and other assorted engine components. What was even more surprising was that the leg was still attached to its owner who was still in the cab of the pickup. Somehow, superman had managed to put his foot and leg through the firewall of the truck into the engine compartment. We never did figure out how that happened exactly.

Most of the other photos that have found a permanent home in my memory are pretty gruesome. I'll save those memories for a dedicated gruesome post.

Crazy doesn't always come in the form of photos though.

Once upon a time, I had a copy of the driving record of a drunk that was pretty interesting. He had six DWIs in a pretty short period of time. What made it remarkable was the two DWIs in 1 day. We actually called him to clarify that one expecting it to be a mistake. Nope. He was arrested shortly after midnight for number 1, bailed out in the morning, got soused again and was arrested again before midnight.

To borrow Ron White's famous line: You can't fix stupid.

Deposition testimony is generally pretty boring. Every once in a great while, things get a Once upon a time, I handled a car wreck claim involving a woman making claim for TMJ (temporomandibular joint disorder). Basically, she hurt her jaw. I'm not sure how since we never found bite marks on the steering wheel, but what do I know? Any way, the reason this claim earned a place in long term storage was the derivative claim for loss of consortium (the fancy legal term for loss of "family relationship") made by her husband.

When my defense attorney took her deposition, he asked her about the claim for loss of consortium. Now, loss of consortium generally, but not always, refers to the loss of intimacy between a married couple. So, in response to my attorney's question about how the accident and her injuries affected her marriage, the plaintiff testified that she could no longer "...give her husband [oral sex]...."

Her husband later showed up at my office, and he had to be escorted from the premises by the local police department after he exhibited some uncouth, demanding behavior.

That's all for now. More to follow as time and memory allows.


  1. I've joked before about situations that when they go wrong I'm going to need more than just the quarter page they give you on the incident report to explain. Take care and stay sane.

  2. Odysseus, if you ever get the chance, use as many pages as necessary and take photos and video if possible. Your adjuster will thank you.


I am not easily offended. Please feel free to express your opinions: good, bad or indifferent. Basically, the "Golden Rule" applies. You get what you give. Treat others like trash here, and your comments will be trashed accordingly. Rudeness and vulgarity will not be tolerated.