Over the years I have spent in the Claims Adjusting Profession, early on (1970's) Insurance companies were "cash" rich and looking for ways to not only pay claims, but to purchase whatever was needed to do the job. As time went on and the Stock Market started to decline, carriers were not making as much on their investments and they were not so "cash" rich any longer. What was once a ratio of for every dollar brought in you spent 1.20 or more was a way of the past. Now the carriers were looking for more like for every dollar in you spent .90 on claims.
Thus, the focus went from looking for coverage, to looking for exclusions or other ways to deny the claim.
My question would be is it Ethical when handling a claim for an Insured that is paying your company a premium for coverage, to teach the adjusters to look first for a way to deny.
The Spin of course is that the carriers are getting so many claims that they must use a filter to eliminate the ones that have no potential of coverage. Fact is that if the carriers hired more adjusters they would be able to handle ALL the claims in a fair and ethical way.
You be the Judge! Let me know your thoughts and answer the question "Is it Ethical?"
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