The Claims Quagmire

The Claims Quagmire

The Claims Quagmire

The Claims Quagmire

We are going to assume that when you started your roofing company, or started working for a roofing company, that it was not because of an immense love of working on insurance claims. In fact, insurance claims management is probably one of your least favorite things to do.  At Balance, that is all we do.  We are insurance claims specialists and it is our goal to take on this administrative burden so that you can focus on the most important drivers of your business such as selling, building, and billing, along with the extensive responsibilities that come with running a business. We believe that it is in your best interest to work with an insurance claims specialist such as Balance, but we also believe that it is important for you to understand the claims quagmire so that you can decide for yourself.


The DNA of a Claim

An insurance claim has a few parts:

  • Sales/Project-Claim Acquisition
  • Field Data Services
    • Job-Project Damage Assessment and Documentation
  • Estimatics
    • Pricing and Scope
  • Supplementing/Claims Reconciliation
    • Appraisal Process
    • Public Adjusting
    • Legal Recourse
  • Invoicing/Collection


Who Are the Players Involved?

That’s a lot of moving pieces, so let’s account for some operational considerations. Should you manage the administration of your claims process internally or should you outsource?  To inform this decision, you should understand the cost, process, and variables associated with handling your supplementing efforts “in house”.  If you do decide to go this route, a thorough training program will be critical to ensure that you are effectively maintaining the balance between maximizing claims and staying in compliance. With outsourcing, you get proven, focused expertise.  As a result, training won’t be necessary, but there will be the added costs associated with outsourcing.  You just have to weigh all variables and decide for yourself.


Claims Best Practices

No matter if your claims team is internal or outsourced, here are some helpful tools and best practices to help accomplish your objectives:

  • Creating Standard Operating Procedures & Processes
  • Document Package/Presentation Solution
  • Compliant Dynamic Contract Documents
  • Vertical Integration
  • Management of PO and Expectations
  • Documentation (Photos, Video, Measurements, etc)
  • Branding Referral Program
  • Departmentalized Organization
  • Finance – Banking Resources
  • Effective Back Office Processes


That’s a lot to unpack. To keep it simple, decide and commit to how your business wants to handle the claims process, internally or externally. Document everything, stay organized, communicate effectively, have patience, and keep selling! We’re happy to help you in any way we can! – Check out the rest of our blog and contact us any time with questions.