The Claim Blame

I work at an independent insurance agency. One thing we are not allowed to do, by law, is telling people what to do. We can advise, but we cannot say, “Yes, file a claim,” or, “Make your coverage [amount].”

The phone rings.

Me: “Thank you for calling [Agency]. This is [My Name]; how can I help you?”

Client: “Hello, I need help with a claim.”

We don’t handle claims; that is handled directly with the carrier. But if the client has trouble getting a response or is confused about the process, we can reach out to the carrier ourselves and get them to call the client directly to explain or have the claim escalated.

Me: “We don’t actually handle claims here, but what do you need help with? I can get you to the right place.”

Client: “I had a tree fall and damage my gutters, but I don’t know if I should make a claim or not.”

Me: “Okay, what is your name and address? Let me take a look at your policy.”

The client provides his information and I pull his policy up.

Me: “Okay, I see here that you have a $5,000 deductible on your policy. What we recommend is getting an estimate done to see how much damage there is. Based on the estimate, you will be able to determine if you want to make a claim.”

Client: “What do you mean? Do I make a claim or not?”

Me: “Your deductible is $5,000, so you would be responsible for the first $5,000 of the claim. Once you know how much the repair will cost, you’ll be able to determine if it’s worth making a claim.”

Client: “So, if the estimate is $5,000 or more, I should make a claim?”

Me: “Not necessarily. You need to take into account that a claim is on your record for five years and it will impact your premium until it ages off.”

Client: “JUST TELL ME IF I SHOULD MAKE A CLAIM OR NOT!”

Me: “Please do not yell at me. Legally, we are not allowed to tell you what to do. The decision has to be yours.”

Client: “THEN WHAT GOOD ARE YOU? F****** USELESS, AREN’T YOU? JUST TELL ME WHAT THE F*** I SHOULD DO!”

Me: “I am disconnecting the call. Your agent will be in touch.”

I sent the recording to the agent and noted everything in the client’s file. The agent filled me in after he talked to the client. Apparently, the client was super friendly to the agent. The agent explained exactly what I did, in the exact same way.

The client tried to say I didn’t explain it to him. When the agent informed the client that he had listened to the call — the WHOLE call — the client went quiet. The agent let him know he was on notice; if there were any further issues, we would be firing him as a client.

I love being able to hang up on abusive clients and knowing that the agents and the owner have our backs.