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.

Friday, August 24, 2018

Source Material

The Queen has been out on her annual fall trek through the thrift stores hunting clothing and other apparel for our upcoming trip (hopefully Haweewee if it doesn't get blown off the map by the hurricane currently spinning up in the Pacific). So, she sends me a text at the office with the a photo of the following t-shirt:

She allowed as how it was the perfect shirt for me...since I typically refuse to accept much of anything without critically assessing the facts and source material.

I can't help it. I come by my flaw honestly as I was trained that way by a wise, old, Jesuit priest turned history professor in my history methodology class. The man had to be in his 70s at least at the time, and that was...more than a few years ago. Let's just say, if that man is still creeping around this old mud ball, I'm shooting him in the head on general principle. You can't be too careful to prevent a zombie outbreak.

God will sort it out.

Anyspeculation, there was a point to this post. I'm sure of it.

Oh yes...critical assessment of facts and source material.

That old Jesuit had all us wannabe history majors do a project (a research paper really) the main point of which was an annotated bibliography. He didn't really care what the subject of the paper was as long as the bibliography was annotated with a critical assessment of the source material including whether it was primary, secondary, tertiary, etc. He also wanted us to take it a step further and assess whether the source material exhibited any bias (this came back to bite me in the butt with my African history professor, but that's a story for another time).

Fast forward mumble, mumble years, and that is one the lessons that has stuck with me to this day. Unfortunately, I think this lesson has been lost on an entire generation (or more) of people.

Case on point. The other night, I come home from work to find two, brand new, freshly purchased boxes of Cheerios (M&M's preferred breakfast cereal) on a pile of stuff being gathered for donation. I queried The Queen as to the reason suspecting something was afoot.

The Queen informed me that my father-in-law, Opa, had told her that he had read an article somewhere that claimed Cheerios contained dangerous levels of a particular pesticide residue. Opa is one of those people for whom a little information is a dangerous thing (no, seriously, he's never met an internet scare of conspiracy theory that he hasn't latched onto). He really should not be let loose with an internet connection without a minder.

This revelation, as one would expect, caused my eyebrows to raise and set off my facial tics just a touch.

I set about investigating the claim du juor. Opa was questioned regarding the source of the Cheerios Challenge. After much fumbling about the dustier corners of his memory, we were able to tease out the source of the pesticide proposition. It was a news article from the Detroit Free Press linked to from the Natural News website referring to a study done by a group called Environmental Working Group.

Now we were getting somewhere. I start doing my due diligence on EWG. EWG claims to be a non-profit, non-partisan organization dedicated to protecting human health and the environment. A laudable goal to be sure. Funding is primarily from grants and individuals. Notable names among the donor list is the Walton Family Foundation (think Sam Walton of Wal-Mart fame) and The Turner Foundation (Ted Turner - CNN Founder). They also have corporate partnerships with many of the bigger names in organic foods.

Nothing about this is particularly alarming. It's not like George Soros or the Koch Brothers are involved. Having said that, did I mention EWG has a lobbying arm? Silly me. That must have slipped my mind. And regarding what issues do they lobby? Environmental, agricultural, food, toxic chemicals, etc.

So, they are environmental advocates. Again, nothing particularly wrong with that, but it could color their findings on certain topics or influence their reporting of facts. We'll get back to that in a minute.

I tracked down the article EWG posted about glysophate levels in foods. Glysophate, for the uninitiated, is the evil active ingredient in RoundUp (created by the nefarious mega corporation Monsanto...yes, I'm being a tad tongue in cheek). It seems that EWG commissioned a laboratory study of glysophate levels in common breakfast cereals. The article published by EWG reporting the results of the lab study started with a link to a recent California jury verdict in which Monsanto was ordered to pay $289 million to a plaintiff dying of cancer allegedly caused by exposure to glysophate. They then get into a discussion of the levels of glysophate in food allowed by the California Office of Environmental Health Hazard Assessment (1.1 milligrams per day for a 154 pound average person), the EPA (not specifically noted by referenced to be 60 times higher than the CA state allowable level) and the EWG's calculated "one in a million" cancer risk of 0.01 milligrams per day.

The original article I read did not "show their work" on the math, but it seems to have been corrected as they now report that a person would have to eat a 60 gram serving of food exceeding 160 parts per billion glysophate concentration to reach their calculated risk level of 0.01 millgrams per day (which, by the way, is 110 times lower than the  level the state of California says is too much which in turn is 60 times lower than what the EPA says is too much). So, just to put a bow on the math, EWG is saying that the safe level of glysophate in foods SHOULD be 6600 times lower than the level currently allowed by the EPA. They don't make a convincing case for why the level should be 6600 times lower than the EPA or 110 times lower than the state of California. Instead, they seem content to make the argument that it is a chemical linked to cancer and is therefore bad in any quantity.

For the record, I'm not volunteering to drink or otherwise consume 1.056 million parts per billion (that's 160 parts per billion times 6600) concentrations of glysophate in my daily Cheerios; and, truthfully, EWG may not be wrong in their conclusion. I just take issue with the manner in which they are presenting their information.

Back to the report on the study results. First off, the article currently on their website has been drastically revised from the version I read a few days ago, and I really wish I had a screen capture or PDF copy of the original to compare and contrast. The current version shows that EWG took samples of 45 conventional breakfast cereals and 16 organic breakfast cereals and tested them for glysophate concentration. They then report the test results in concentration parts per billion for each sample. All fine and dandy so far. Where things really went off the rails in the original article was that samples results were grouped according to which ones had unsafe levels (color coded in red...for contrast I'm sure). The thing that really bugged me in the original was that  they did not make it clear that the table of results categorized each product according to EWG's much lower concentration level.

To clarify further, the report starts out talking about concentration levels in milligrams per weight before  shifting to parts per billion in the lab results table. The revised article does now provide a brief conversion from milligrams per serving to parts per billions, but the original article did not.

Even in the revised article, if someone is not reading carefully, they might miss that critical distinction. The skeptic in me suspects that was EWG's intent in order to advocate for a new, lower standard for safe concentration levels.

Another, in my opinion, glaring omission from EWG's article is the results of other scientific testing on glysophate, a discussion of the MSDS sheet on the chemical, etc. For instance, it took me literally seconds to find out that the WHO and UN studies on glysophate determined that mammal animal models suggest that concentrations as high as 2000 milligrams per kilogram of  body weight was not associated with genotoxic effects. There's more detail out there than I'm willing to transcribe or cut and paste here. Bottom line is that you would probably have to ingest enough to drown yourself before you'd be at a legitimate risk of getting cancer, and you'd probably puke it up before you got close to those dosage levels.

After I pointed out these little details, the Cheerios mysteriously reappeared in the pantry.

Now, this is just one little drop of questionable information in a practical galactic ocean of information floating around the internet. Why should you care? Well, the president attacks CNN almost daily accusing them of being fake news. Fox News claims to be fair & balanced. Alex Jones gets banned from social media for making wild claims reported as news. For every EWG, there is a company or interest group lobbying for the opposite position. And let's not forget all those companies out there trying to make a buck selling snake oil and legitimate products.

Everyone, it seems, is publishing information at the speed of light. The incredible quantity of information being published everyday makes it impossible to fact check it all. That is why it is so incredibly important to learn to critically assess source material.

So, the next time you hear someone ranting about the latest scandal, conspiracy theory, social justice melt down...etc. Take a step back and dig into the source material with a critical eye. I'd bet that, more often than not, you'll find discrepancies in the reporting that will be most illuminating.

Thursday, August 23, 2018

I'd Be Pissed Too...

So, a few nights ago, The Queen and I went out for a lovely evening stroll as we are want to do from time to time. Theoretically, the intent of the walk was to get some exercise and enjoy the evening. We wound up strolling to a little hole in the wall tiki bar that opened up near the house tucked away in an industrial area where you'd never guess there was a bar much less a tiki bar.

We perused the drink menu of island themed alcoholic mixed drinks and made our choices. The Queen ordered something called the Headhunter which was advertised as " Dark rum, cinnamon and banana liqueurs, blended until frozen.

The drink arrived at our table decked out thusly:

Now, I'm not one to be impressed by presentation, but this got my attention. I love the look on the poor buggers face. I'd be pissed too if I had to wear a dolphin hat made out of a banana.

The Queen reported that the drink did not measure up to her expectations passing the palette with very little in the way of flavor. Disappointing. We agreed that we would stick to rum and coke there in the future.

Advice for M&M

1. "Murphy hates you. Personally." - LawDog 

See Murphy's Law. Most people don't know this, but there really was a Murphy. According to the generally accepted story, he was an engineer working on the program to develop the first jet aircraft ejection seats. While he never uttered the infamous and eponymous law in it's currently accepted form, he did say something that evoked the spirit of the law which was later paraphrased and attributed to him. 

2. Gravity sucks. Corollary - it's not just a good idea, it's a law.

3. Treat electricity with respect. See #1. Remind me one of these days to tell you the story of why I never trusted Granddaddy Aubrey. If anyone ever asks you to hold a spark plug wire, the answer is an emphatic "NO!!!" unless they agree that you will be holding it against their most sensitive anatomy.

4. Behind every warning label is an idiot with a lawyer. As the saying goes, I'm not advocating killing all the stupid people. I'm just saying let's remove all the warnings and let nature take its course. 

5. "Be nice until it's time to not be nice" Patrick Swayze as John Dalton in Roadhouse. The United States Marine Corps General John Mattis version is also instructive: "Be polite, be professional, but have a plan to kill everybody you meet."

6. There is no moral superiority in being a dead victim. God makes allowances for self defense, and turning the other cheek has nothing to do with meekly waiting for a bullet or a knife. If attacked, fight like you are the third monkey in line for the ark...and brother it's starting to rain. 

7. "It is easy to critique in leisure what a person had to do in haste." YouTuber/Firearms Trainer Paul Harrell

The longer version of this quote in the same video discussing the 1986 Miami FBI Shootout is: "It's very easy with the leisure of years to think about it what others did when they had seconds to decide on a course of action." Corollary: Hindsight is 20/20. Learn from the mistakes of other, and be thankful you didn't have to make that mistake yourself. However, don't fall into the trap of thinking you could/would have done better under the same circumstances. 

8. Napoleon Bonaparte's maxim, "Never interrupt your enemy when he is making a mistake". 

Saturday, August 18, 2018

Huh...9 Years of This And Counting

According to my blog archives, I started this little train wreck 9 years ago today. Thank you to all that are still lurking in the shadows and those brave enough to admit they read my infrequent ramblings.

I can't say what the next 9 years holds, but I'll give it my best shot.

Friday, August 10, 2018

Friday Funnies

For those not mechanically inclined, this is a front disc brake assembly that has been seriously abused.