Chantal Roberts, Principal & CEO of CMR Consulting, joins the podcast to talk about litigation and the insurance industry. Chantal serves as an expert witness for claims handling standards and procedures and has a wealth of knowledge about the claims process. Chantal and Dr. Bill Kanasky, Jr. talk about the shortsightedness of the insurance defense industry and what the reasoning is behind how insurance companies approach litigation. They discuss how an investment earlier in the litigation process by insurance companies could manifest in significant cost savings. They talk about how claims departments adjust claims, the relationship between primary carriers and excess carriers and how they can, and should, work together and collaborate for better outcomes. Lastly, Chantal shares her perspective on the workload that adjusters manage, the burnout, and how that leads to the mishandling of files.
Full Episode Transcript
[0:05] Bill Good morning. Bill Kanasky with Courtroom Sciences. Welcome to the Litigation Psychology Podcast. Another episode coming your way from Courtroom Sciences. Please go to courtroomsciences.com. Brand new website. It rocks. It’s a badass website. My picture is not on the website, which is highly disappointing. Figured I’d be on the first page. No, they went with other things. I know, right? Uh, today, today, great guest: Chantal Roberts of CMR Consulting. Uh, we’ve been kind of following each other, um, on, on LinkedIn for a long time now. And, uh, I think what you post is great. And hopefully what I post doesn’t offend you too much. I’ve been trying to keep it real. At the same time, if you hold back, I think there’s something wrong with that. Uh, Chantal, how are you doing this morning?
[0:58] Chantal I’m doing well. How are you?
[1:00] Bill Good. Are you, are you in Kansas City?
[1:03] Chantal I, yeah. I’m—you, you can say Kansas City. I’m in Overland Park. I’m in the bougie suburbs, you know?
[1:08] Bill Okay. Well, um, the, um, the Kansas City Chiefs defeated the Cleveland Browns last night, which sent my father—my father went into full like kicking, screaming. 71 years old, acted like a, a five-year-old, um, after that.
[1:25] Chantal So, he’s not going to be listening to the podcast?
[1:27] Bill He’s not going to be listening to this podcast. He’s, he’s, he’s very, very upset. However, we’ve got, we’ve got better stuff than football, uh, to talk about, um, because yesterday was an absolute disaster for my picks. We’ll just leave it at that. Uh, we’re going to talk about—I mean, everybody loves to talk about insurance, right? It’s funny because when I talk—
[1:48] Chantal I don’t know why not—
[1:50] Bill I talk to people, there’s always profanity attached to insurance companies. Like, it’s always “blank blank” insurance companies, right? It’s never like, “I love insurance companies.”
[2:02] Chantal It’s usually “mother” something insurance company and “son of a, son of a.” It’s a whole family thing is what it is with insurance companies.
[2:09] Bill It’s really, it’s really incredible. Like, I’ve seen bumper stickers that say, “I love my dog.” You don’t have a bumper sticker that says, “I love my insurance adjuster.” Doesn’t exist. Although if you make it, you could get a little side gig going and make—
[2:21] Chantal I could. You know, I totally could.
[2:23] Bill I’m sure those would sell like hotcakes. Uh, Chantal, tell us, tell us about, tell us about CMR Consulting and what you do. Because, really, I don’t—I’m not sure I’ve met anybody else in the industry that actually does what you do. It’s highly specialized, but I find it very intriguing. Please educate our audience.
[2:44] Chantal Sure. So I am an expert witness for claims handling standards, practices, and procedures. And usually when I say that, attorneys know exactly what I’m talking about because they’re the ones who hire me. But for the laypeople, they’re like, “What?” So I say, “Okay, so you know when you have a claim and your adjuster like pisses you off and then you sue your adjuster?” Um, and then the, the attorneys hire me and then I say, “Oh yeah, the adjuster totally did something wrong and they owe you a billion trillion dollars.” Or I will say, “No, the adjuster didn’t do anything wrong and you just need to suck it up, buttercup.”
[3:23] Bill Is this bad faith litigation? Is it really bad? Is it bad faith litigation? By the way, the only thing—it’s funny enough, in 18 years of doing this, the only—and boy, I’m going to say some things about insurance companies today, it’s kind of going to rock the world, but I don’t think I’m, I’m wrong. I think I’m just stating factual things. The only thing that like actually wakes everybody up in the insurance—the two words: bad faith. You say that—oh. Oh, now we’re all on the same page. Oh, now we want to prepare. Oh, now we want to invest in our case. Whereas with your standard claim, it’s a completely different system, right?
[4:00] Chantal Yes. And I don’t, I don’t understand it because you should be, as an insurer and as an adjuster—at least this is the way that I was trained and this is the way that I had trained, I trained all of my adjusters when I was a claims manager—is you should always be looking at that. Like, what happens if you drop the ball and the insured turns around and sues you for bad faith? Is, is this—is this the hill you want to die on? And I know as an expert witness, I sit there and I look at some of these things and I go, “What in the world was the adjuster or his team leader thinking about?” Because in the grand scheme of things, we’re talking about twenty thousand dollars when they have—I know they have spent more than twenty thousand dollars on litigation expense. Even though the counsel is in-house counsel and you’re not paying, you know, “quote-unquote” you’re not paying defense costs or whatever, you’re still paying defense costs. It, it’s just all in the back, you know, envelopes of whatever. So yeah, anyway.
[5:13] Bill Yeah. And you—and we had mentioned before we came on, uh, the air here, um, my last podcast where I just—I lost my, I just lost my—because I guess you don’t—I get so, I get so aggravated because you have, you have a very aggressive plaintiff’s bar that has figured out this whole system. And they front-load their efforts on the, on the very safe assumption that the insurance company’s not going to invest in the same type of preparation. And then as that case moves forward, you know, the scoreboard is very, um, you know, you know, unbalanced. And they’re fully taking advantage of it and it absolutely makes me crazy. So I guess my question to you, Chantal, is why does the insurance industry suck so bad?
[6:04] Chantal I, I think it has to do with cost. And I totally agree with you. And it’s interesting because I find that I am hired more by plaintiff counsel, which makes me nervous because then I’m afraid of, of having that bias or perceived as having a bias. And, and I don’t really, uh, but I, I do, I do worry about it. Regardless, I, I think it has to do with cost because the, the plaintiffs don’t have an adjuster to tell them if something was done correctly or not correctly. The defense—or I don’t even think it’s the defense firms, actually. I don’t think it’s the defense attorney, quite frankly. I think it’s the insurers. I, I think the insurers are sitting there going, “Look, we’re going to have our 30(6)(b) witness and then we’re going to have our adjuster up there, we’re going to have the team leader up there, so they’re going to talk about good faith claims handling, you know, until the cows come home.” The, the issue is that with some of the cases that I’ve seen, I have looked at them and gone, “Oh my goodness, if defense had hired me, I would have told them to settle right then and there because of this one particular line right here.” Every insurance adjuster knows what that is. And, and, and let’s hope that the plaintiff doesn’t find out what that means or something. I mean, it’s, it’s just one line, usually. And I’ve had it happen in two cases, and um, it’s been the bomb that has broken the case open. So I get the fact that you want to save, but the funds—the loss adjustment expenses—uh, because everybody’s tightening their belts and, and where are you going to tighten your belt but the claims department? Because that’s where the money goes out, it’s not where the money comes in. That’s a whole other story.
[8:12] Bill That’s the problem. That’s the problem.
[8:14] Chantal Listen, we can talk about that in just a second. But, um, the, the issue is by spending, what, five thousand bucks on me? Uh, I can sit there, look over everything and go, “Yeah, you’re good. Go ahead and fight it,” or “No, you need to go ahead and settle it,” or you know, whatever. And I’ve just saved you five thousand dollars and you don’t have to go to court or get bad law made or, you know, whatever.
[8:41] Chantal Um, you may have just saved five million dollars.
[8:43] Bill Oh yeah. I mean, well, I don’t—exactly, yeah. I don’t tend to um, get pulled in on those bigger cases because I’m new still. So, uh, please call me, hire me, I’d love to. [Laughter]
[8:57] Bill But um, it’s all, it’s all, it’s all about, uh, the average. It’s, it’s so—we, we actually have a similar job in the fact that we are an investment, right? That has, that has, relatively speaking, extraordinarily low cost upfront for a massive cost savings. But let’s go back—follow the, follow the money, right? You got to follow the money. My dad always told me, he’s like, “You ever want to learn something, just follow the money. You’ll learn everything you need.” And that’s been really, really true. And when you follow the money, again, the claims depart—we’re talking about at the, on the other podcast—they don’t get to hold—I call it, “they don’t get to hold the trophy,” right? Right. So after the big win, right, big defense verdict, that trophy’s not like sitting on Susie’s desk for a week and then it goes on Joe’s desk, then goes on—no, no, no, no, no. They don’t see any of that. They’re just on to the next claim. And so they don’t—they just cognitively don’t have any, I guess for lack of a better term, appreciation for the economic outcome, right? They only have, they only see what’s going out. They don’t see the cost savings and that’s a real problem.
[10:11] Chantal And it’s the way that the claims, or it’s the way that insurers are set up. And it’s, it’s an easy fix, actually. Uh, in fact, we did it at the former company where I was a claims manager because we were expensive. We, we were expensive. But it’s—the claims manager, the owner, would say—the managing partner—he would say, “Look, you don’t get Nordstrom service at Kmart prices.”
[10:44] Bill No. That’s what they want, though.
[10:47] Chantal Yeah, that’s what they want, but you’re not gonna get it. Uh, and that’s again a whole nother issue with the, the consumer aspect, not the insurer aspect. But, so we decided to start keeping track of all of our adjustments. Because what is an adjuster? An adjuster is literally someone who adjusts a claim. So if you, if you have an estimate that’s a hundred dollars, but the insured or the claimant comes in and says, “My contractor says it’s going to cost 120 dollars to, you know, fix this roof or whatever,” well adjust the claim as long as that twenty dollars isn’t not covered—or it’s covered, in other words—you know, pay it. Or adjust it. Maybe give them 110 now and then give them 10 when the work is done if you’re worried that they’re going to pocket the money or make a profit, “quote-unquote,” from the, you know. And then what you do is you take that, uh, money that you saved from a defense cost—or I shouldn’t say saved because plaintiff attorneys are thinking, “Oh, you’ve saved money”—you’ve adjusted from a defense cost of ten thousand dollars and you put it in the adjustment thing and you’ve got plus ten thousand dollars. And that’s how your claims department has “quote saved end quote” the insurer money, um, so that you’re not spending it. Because otherwise you’re caught in a vicious circle that is a self-prophesizing kind of thing, you know?
[12:27] Bill No one talks about this and I’m kind of shocked because it comes up in every jury—in every jury deliberation. The word that’s not allowed to come up comes up every time. That’s the word “insurance.” The judge says, “Do not talk about…” Well, guess what comes up in every mock trial, every focus group, every real trial?
[12:47] Chantal Right. Because everybody knows that there’s insurance out there.
[12:49] Bill Thank you. Okay, so news flash—by the way, I live in Florida. I’m going to tell you a story here, okay? The general population, i.e., your jury pool, cannot stand insurance companies. Hate them. Like, this—that is lawyers. People don’t like insurance companies, but everybody hates them because here’s what happens: you get into a car accident, right, and you total your car and they’re like, “Well, here’s your check for twelve thousand dollars.” You’re like, “Whoa, whoa, whoa, whoa, whoa. Wait, wait, wait, wait, whoa, whoa. That was a twenty thousand dollar car!” “Well, here’s your check for twelve thousand.” When the hurricanes come through, right, and your roof gets ripped off and it’s a thirty-five thousand dollar roof and they come up to your door and they hand you a check for nine grand, you’re like, “You know…” You outta punch somebody in the face at that point. It’s not a popular industry. And so that’s where a lot of jurors like to tee off and increase damages saying, “Well, hey, you know, there’s insurance paying for this, screw them.” And they have no sympathy for the insurance company. I tell you the one insurance person I have sympathy for—I want you, I want to hear your feedback on this. And I’m going to tell more stories, by the way. I am addicted—do you, okay, at my local Publix—dark chocolate espresso beans. Beans, oh my god. I’m completely—I have them all day. Not very good for you.
[14:07] Chantal Oh my gosh. I just—you know, Target also has them.
[14:12] Bill Do they have—okay, well whether it be Target, I don’t care who has them, but if I don’t have them on my desk now, I just—I have to have them. Back to my story. So there’s one person I feel sympathy for in the insurance industry, right? And that’s the—that’s the excess claims specialist. So imagine this, right? So you have this pilot flying the plane and the mountain’s right in front of them, right? And he’s flying the plane towards the mountain. At the last second, he hands the controls over to the copilot, gets a parachute and says, “Hey, see, I’m out of here,” and jumps out. And then the next guy gets the—and, and the plane’s already crashing into the mountain. As this goes back to the bad faith, I have seen so many cases where I end up coming in on the back end, which is unfortunate. But the case has been so mishandled by the primary, right? The primary, uh, claims person. And then it falls on the lap of the excess and so much damage has been done up to that point, right? You know, it’s really, really hard to play catch up. How much do you see that? Because I unfortunately probably see it on at least a weekly, sometimes daily basis.
[15:22] Chantal That’s rough. I don’t see it that often. But what I do encourage the, the excess carrier to do is when they receive notice—and hopefully they receive notice before, you know, we’re headed into the mountain—is you need to ride herd over those cats. And as hard as that is—in fact, I don’t remember who I was talking about this before with, but that means you call on a monthly basis. You know, “Hey, uh, underlying adjuster, what’s going on? Send me your report. Send me the defense reports,” or whatever. And that way if you don’t like what’s going on… So I, I maybe don’t have as much sympathy for the excess carrier unless they did just get it over when it’s like, “Oh, hot potato.” Uh, and then in that instance, you, you can easily go back. And I’ve represented actually someone in this case because the defense counsel—in, in my world, since I am usually retained by plaintiff, I um, a lot of it, defense counsel, opposing counsel will be like, “Oh, so you only…” where and I’m like, “No, no. I have been hired by insurers who are suing other insurers either for subrogation issues, but one of them happened to be a, an excess issue where the, the allegation was the underlying didn’t turn it over soon enough so the overlying, the excess, got stuck with this three million dollar, yeah, you know, thing.” And so yeah, um, if that’s the case, then you can turn it right back around and, and sue for bad faith against the underlying carrier.
[17:09] Bill Yeah, yeah. I mean, there’s that. I’ve been stuck in the middle of so many of these. But you’re right, the quality of the reporting upstairs is really important. And then the other thing I’ve seen which is, again, it’s so frustrating—uh, again, from the excess point of view—is that, you know, so the primary is kind of getting to the end of their coverage, right? And so the excess—it’s like, “I need the controls now,” but I can’t have the controls now. It’s like, “Let’s do this mock trial now. Let’s do this focus group.” And the primary is like, “Well, I, you know, I still have some money here.” And the excess is like, “I know, but I don’t want this disaster when I take over this.” It’s really a, um—it’s a fascinating yet frustrating system which, you know, I’m not really sure if that’s, uh, uh, correctable. But, but the relationship is… Yeah, it’s weird.
[18:00] Chantal I don’t know. In fact, I don’t know why insurers don’t cooperate more. And in fact, I wrote about it. I wrote a, a book during quarantine and during COVID, um, and I wrote it for mid-level adjusters. And basically my theme was “stop messing around,” uh, for the most part.
[18:22] Bill Good theme. It should have been the title.
[18:25] Chantal But um, the, the part of the thing that I talked about in one of the chapters is the issue between the flood insurance and the wind insurance, especially when you get hurricanes, right? Because I handled Katrina claims. And during Katrina, the Department of Insurance in Louisiana changed the rules, honestly. Because you used to—you could just go, “That’s the flood line, so I’ll pay everything above there,” or I’ll just go 50% boom, 50% flood, 50% wind or whatever and, you know, let the pieces fall where they may. Well, the Department of Insurance said, “Yeah, you can’t do that anymore. You can’t just automatically say 50%. You actually have to adjust the loss.” Which, I mean, you’re just like, “Great, I don’t know how this works,” you know? Anyhoo, um, so in, in the book, The Art of Adjusting is the title—just my little plug—you know, you need to work with your other adjuster. You know, sometimes it’s going to be 75%—wind is going to pay for 75% of the loss and flood’s going to pay for 25%. Sometimes you can do 50/50. Sometimes you could do a 75% flood, 25% wind. But the issue is you need to be working as an adjuster with the other adjuster. And don’t make your insured do that because they, they’re laypeople, they don’t know how to do it. But it’s the same thing with the, the underlying and the excess carrier. If you want to have a mock trial go, “Great. Look, here’s the deal. Let’s split the cost.” I mean, there, there’s more than one way to get to the end. Why is everybody entrenched in this, “I’m not going to spend any money”? Well, I get the fact that you’re not going to spend any money, but if you don’t want to spend any money, split the cost. I mean, go Dutch. That’s the best way to do things.
[20:25] Bill You know, I, I totally agree and I think more cooperation is necessary. But it’s kind of like that—they mirror the defense bar. The defense bar doesn’t cooperate with each other. They don’t talk to each other. They don’t even like each other. It’s crazy.
[20:35] Chantal You say that, but I’m a member of DRI and they’re all like buddy-buddy, especially when you get them drunk. So I’m just saying it—
[20:45] Bill I will agree. I think you have to wait till the—yeah, you have to wait till the happy hour for that, yeah, to happen. And it’s, it’s, it’s, you know, one weekend, uh, a year. But you know, in, in, in reality, when you really compare it to what the plaintiffs bar is doing—
[21:02] Chantal They do share a lot more.
[21:04] Bill They have an exceptional communication network and they help each other literally on a daily, uh, basis. Whereas if someone in the defense needs help, it’s, you know, because they’re all competing. I, I mean, I get it. At the same time, so we’re trying to change that here at Courtroom Sciences to help the defense bar to be more proactive, communicate more, particularly in the trucking industry. Top target: nuclear verdicts.
[21:30] Chantal Yeah, the trucking issue. So you know, something to think about, too. Like I was thinking about this while I was riding my bike this morning—uh, trucking issues. When we were—because we were in Arkansas—and so there’s a lot of trucking going up and down, you know, Arkansas. And we would take truckers to the mall to buy them suits for their depositions or for trial or or whatever. Um, whether that’s a skirt and kitten heels, uh, or a suit and tie and either cowboy boots or, you know, Oxford penny loafer kind of deal. And, and you just chalk it up to the cost of defense. Yeah, it’s a, it’s a loss adjustment expense. And, and you don’t think about those sort of things. But that’s something that you need to do. So why not spend—if you’re going to do that to make sure that your trucker looks decent—I don’t want to say decent because I mean, they’re decent people anyway—um, you know, professional. Professional, or they’re, or they’re showing respect to the court or something. Then why not preload your claim and, and save some money by hiring you or me by going like, “Oh yeah, that witness is terrible. You don’t want to hire or you don’t want to put this witness up on the stand.” Or me going like, “Oh yeah, you totally need to settle. Oh yeah, settle. Uh, settle now. Ask how many zeros you want behind that number.” Or go, “Oh yeah, take it all the way up to the Supreme Court, I don’t care,” you know? That kind of thing.
[23:06] Bill I mean, so I—I mean, I wrote this down this—no, because this is—this is a fact, and I want your opinion on this, okay? Mishandled files cost a lot of money.
[23:17] Chantal Absolutely.
[23:19] Bill Okay, number one. Number two, what’s the proportion of mishandled files? I just want your honest opinion on this, because I’m not sure what the answer is. Because I’ve seen a lot of very hands-on insurance companies, I’ve seen a lot of very hands-off. How—what’s the proportion of—this is a completely unfair question, by the way—uh, proportion of mishandled files that are due to just having too many files? You talk about, “buckling your belt, saving money.” Another way to save money is to cut down on staff, multiply files amongst your staff. How many files just slip through the cracks and by the time they figure out they have a problem, it’s entirely too late because they’re just—the claims person is overwhelmed?
[24:01] Chantal Oh yeah, that is a huge, huge issue. And in fact, there is a book that I like to quote in some of my reports where we talk about the fact that having an adjuster who is overworked is actually unethical. Because we, as adjusters—not I think in 33 states or something like that—we have licenses just like doctors, just like attorneys, just like clinical psychologists, you know, just like anybody. So we are white-collar professional people and we’re expected to carry out that kind of, of work. And the issue again is cost. And I will say—and this is a bit controversial—that all the bean counters up in the ivory tower, they’re the ones who are going, “Oh, well, again, the claims department is where all the money is going out, so let’s tighten our belt there.” And that’s where the hiring freeze is—well, then you don’t have time as an adjuster to investigate the loss. So you either start paying everything that comes across your desk—which again is that self-fulfilling prophecy that claims just go out the door—or you expect your adjusters to still adjust the claim. You know, take out a fluff on the estimate or, you know, depreciation of labor, general contractor fees, and sales tax or whatever because it’s legal that you can do it and yada yada. And then the adjuster gets behind and so they get overworked. They miss deadlines and they get sued and they get frustrated because they have no support from anybody else. Uh, so they leave to another insurer who is in a different cycle. They’re in a hiring cycle and so then you split that adjuster’s claim load amongst everybody else. And, and so, yeah, it’s actually unethical. That’s when you are going to have a, an angry adjuster as a witness and say, “Well, I don’t give a hoot about what happens to my boss because they overwork me.” You know, so what are they gonna do, fire me? They can’t fire me. You know, I’m one of five adjusters handling five billion claims, or whatever. You know, whatever. Yeah. So it’s a, it’s a huge issue, which makes me always wonder why you don’t have claims people in charge of whole insurers. Because I, as I’ve always said, the claims department is the promise keepers of, of the insurer. You know, the underwriters write the promise, which is the policy; agents sell the promise; but it’s the claims department that keeps that promise. So if you want someone heading the company that keeps the promise—not someone who is trying to balance—not to say that they shouldn’t be, you know, for-profit, because insurers are for-profit. You mean—what, I know
[27:18] Bill I know exactly what you mean. All right, well this has been a fantastic podcast. Thank you so much for joining us.
[27:26] Chantal Yeah, absolutely. Thanks for having me.
[27:28] Bill It’s a topic that’s not going away, so I’m sure we’ll have you on soon. And I want to do more panel formats so we get two or three people on here and then we could, all we could all duke it out. But until that happens, um, Chantal, tell our audience if they need you, how do they find you? How do they get, how do they get a hold of you?
[27:47] Chantal Sure. They can reach me by telephone: 913-335-0612. Or email: cmroberts@cmrconsulting.net. And I also have theartofadjusting.com, so you can find me that way as well, because that was the name of the book.
[28:07] Bill Oh, and you’re on LinkedIn. You’re very active online.
[28:08] Chantal Yeah, LinkedIn, Insta, you know, all of those fun things.
[28:16] Bill I just do the LinkedIn. I don’t do no Twitter, no Facebook. I think it’s ruining our society. And, uh, I don’t even know what TikTok is. I—my kids—I’m like, “What the hell are you talking about?” I am—yeah, I guess I’m getting old.
[28:31] Chantal I am too. It’s crazy. Get off my lawn!
[28:34] Bill I know, I’m turning into my grandfather. Again, thank you so much for being on the podcast.
[28:37] Chantal Thanks for having me.
[28:39] Bill Really, really fun. To our audience members, thank you so much. We are approaching 100 episodes very quickly, so we’ll try to plan something special. But we will see you next time. Litigation Psychology Podcast, brought to you by Courtroom Sciences. See ya.
Be confident in achieving superior litigation outcomes. CSI has the expertise, track record, and capabilities to help you win.
Learn more about our Crisis Communications services
Go to Page
