On June 20, 2022, Wheeler, DiUlio & Barnabei hosted the sixth installment of their 12-part webinar series, The Perfect Claim. The goal of the series is to discuss the entire claims process from start to finish so people can learn how to resolve claims more efficiently.
This webinar, Proper Writing: Letters, Reports, and 3rd Party Experts, focused on what it takes to write a proper letter. Partner Anthony DiUlio discussed the essentials of letter writing and 3rd party reporting.
The Letter: Why It’s Important
“Letters” can be texts, emails, and letters that do everything from summarize phone calls to provide a position on a claim. These letters are important for many reasons:
- Sets the Tone
- Sets Expectations
- Shows Professionalism
- Provides Proof
- Puts You on Their Level in the Eyes of 3rd Parties
Sets the Tone
Letters set the tone for the entire adjustment to the claim. You want to use an appropriate tone when presenting yourself in writing. Think about the audience and the potential people who will be reading that letter and remember that it will be cemented in the file forever.
A letter gives you the opportunity to clearly outline what your expectations are for the claim. For example, when you’re doing your first notice of loss letter to the carrier, you can set your expectations appropriately.
If your readers recognize you as a professional, you will get better results in the long run.
Your documentation (letters, texts, emails, etc.) solidify exactly what communications occurred between two parties. Some of the most important letters you will ever write in an entire claim are letters that summarize inspections and phone calls. Every time you have a substantive conversation, you should be sending a letter out to the person who you had a conversation with and the carrier memorializing that conversation.
For instance, you should always type up a quick email after an inspection. You should include the insurance company and the inspector. Give a summary of what you discussed and say something along the lines of: “If any of the above is incorrect, please let me know with 10 business days. Otherwise, I’m going to assume we’re on the same page.”
Puts You On Their Level in the Eyes of 3rd Parties
If your letters follow the criteria listed above, the judges, the jury, and the lawyers will look at you much better than if you wrote a sloppy letter.
Insurance companies always have very similar professional letters that come out. They stick to a format and use a consistent layout. These formed letters set them aside from somebody who just throws something together in a word document without much thought.
If you want to be viewed in a better light when you’re ultimately disputing it, follow these guidelines!
Elements of a Good Letter
What does it take to write a good letter?
- Letterhead when possible (even if it’s just an email attachment)
- Format – remember the acronym CRAC:
- Analysis of Rule with Facts
Although it may seem insignificant, a letterhead changes the appearance of the letter to anyone that is reading from the outside. It looks far more professional and sets you on the same level as what the carriers are doing. You can also send your letterhead letter in an email as an attachment.
A good way to format all of these letters is by following the CRAC formula: Conclusion, Rule, Analysis of Rule with Facts, and Conclusion.
Start with a nice opening to get the pleasantry out of the way. Then start with your conclusion: “This letter is a request for you to overturn your denial based on the fact that the roofer found hail damage to the client’s roof.”
Rules are all of the hard evidence and backing for your position, such as the policy, building codes, manufacturer documents, etc.. You can cite all of the things that have to be true as part of your argument. In this part, you can outline all of the guidelines.
Analysis of Rule with Facts
This is where you combine the facts with rules. Go through the comparison and analysis of the facts of the claim with whatever policy rules you stated previously.
After following these steps, restate your conclusion again. State that “as a result of the above, we’re asking for x and are looking for a response in x days.”
Following this format is a convincing way to write your letters.
Do’s and Don’ts of Letter Writing
There are some general rules when it comes to letter writing that you’ll want to keep in mind. First, always present letters in full, complete thoughts. Avoid writing emotionally, using all caps, and writing in unprofessional language.
Furthermore, you should be polite, clear, and always cite to proof. Provide a call to action that you’re looking for from the carrier, whether it be questions, proofs, dispute to facts, or a second inspection/opinion.
3rd Party Reports
3rd party reports are incredibly important when it comes to trying to prove things that you may or may not have the most experience in. When you get 3rd party expert reports, you want to make sure they have the correct information. You’ll also want to review the insurance company’s expert reports to see if they’ve got the correct information too.
What Makes a Good 3rd Party Report?
- Using the CRAC Format
- A report should contain the following:
- Experience: What qualifications do they have?
- What They Saw: What did they physically see? No opinions.
- What It Means: What does what you saw mean to you?
- How They Know It: “I know because of the staining, the plumber’s reports, details from the insured, etc.”
- Summary: Summarize conclusions, and put them together in a succinct way.
All expert reports should have these details. Also, you should also be outlining it the same way when you do an expert report yourself. Following these steps will set you up for better results.
Have more questions about proper writing? Contact Wheeler, DiUlio & Barnabei to learn more.