Adjuster X

Caught in the Act

By: | September 15, 2014 • 3 min read

This column is based on the experiences of a group of long-time claims adjusters. The situations they describe are real, but the names and key details are kept confidential. Michelle Kerr is the editor of this column and can be reached at [email protected]

I was shaking the cobwebs out of my head. Some adjuster friends and I had closed the pub at 2 a.m. the night before. Thankfully, my first call was a simple activity check. I was feeling queasy as I parallel-parked my car in the neighborhood of the claimant, James Parson. I took two aspirins and a swig of coffee, and squinted at my paperwork.

James was claiming total disability. His case had not had been previously adjudicated as temporary total or permanent total disability, so I knew it was in active litigation.

Advertisement




I rang the doorbell at the nearest house, trying to collect myself so I was coherent when I introduced myself. But there was no answer. I rang again and waited. Still no answer.

At the next house, a woman in her fifties answered. I asked her if she knew her neighbor, James Parson. She said she wasn’t all that friendly with him and his wife, and knew nothing about his present activities.

At the next house, a young woman with two small, screaming children said she was too busy to talk. The aspirin hadn’t kicked in just yet — my headache was still pounding.

The woman at the next house said she’d seen Parson home a lot lately. She said she hadn’t seen him cut the lawn or do any work around the house in a while, which she said was quite unusual. I thanked her and moved on.

I decided to try just one more house. A man in his sixties greeted me, and invited me in for a cup of coffee. More coffee was sounding like an excellent idea right about then.

The man’s name was Bill. In the kitchen, he introduced me to his friend, Jim, who also had a cup of coffee.

“Thanks so much for your hospitality,” I said to Bill. “I need to ask you a few questions about your neighbor, Mr. Parson, and then I’ll get out of your hair.

“Do you know Mr. Parson well?” I asked.

“Fairly well,” he replied.

“I’m trying to determine what you may have observed about his level of activity around the house over the last several weeks,” I explained.

Bill thought for a minute, and said, “His level of activity appears to have declined over the last few weeks. In fact, I’d say he is pretty sedentary at this point.”

I asked if he had seen him driving. He said no, not much at all. I asked, “Do you know if Mr. Parson has any significant physical disability of any type?”

He looked at me, and then at his friend and said, “Jim, do you have any significant physical disability besides your work-related problems?”

Advertisement




I swiveled my head and stared at Jim, who was looking back at me wryly. “Oh, by the way,” Bill said, “This is Jim Parson.”

I almost fell out of the chair. “Ask me anything you like,” Jim said. But Jim was represented by counsel, and I was already in hot water.

Bill chuckled as I stammered, “I’m so sorry. I’ve got to go now. Thanks for the coffee.” I made a beeline for my car.

No surprise — by the time I returned to the office in the afternoon, there was already a call from Parson’s attorney, complaining about me speaking to his client without representation. Thankfully, he believed my explanation about the accidental meeting.

I left the office that afternoon ruing the beer-induced haze from the night before that deadened my senses and turned my easy assignment into a job-threatening tangle.

More from Risk & Insurance

More from Risk & Insurance

Risk Matrix: Presented by Liberty Mutual Insurance

10 Critical Risks Shaping the Liability Landscape Today

Litigation trends, including ever-rising jury awards, are amplifying new and emerging liability exposures across the board.
By: | June 3, 2019




The R&I Editorial Team can be reached at [email protected]