Canadian Underwriter

Pinnacle Position

May 31, 2015   by Craig Harris, Freelance Writer|Craig Harris, Freelance Writer

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When asked about his adjusting firm’s approach to business, Pinnacle Adjusters Group’s managing partner Ray Proctor cites an adage from Ronald Reagan: Trust, but verify.

“We treat our client’s customers with respect and offer professional service, but we still verify and validate,” says Proctor. “You can conduct a thorough fraud investigation, but still treat the person with fairness and courtesy.”

Pinnacle Adjusters Group has existed in its current form since 2005, when it was rebranded from Sobel Adamson Clements; however, it has roots in Adamsons Limited that date back to 1897. Marc Newburgh, who joined the firm in 1995, continues in his role as principal owner, but dedicates much of his time to community service. Day-to-day management of the company rests with Proctor, who took on the role of chief operating officer in 2013.

Today, Proctor heads up a team of three veteran adjusters – Chris Gullison, Michael Lander and John Scott – and two longstanding support staff – Sue Lewis and Mina Pallotta – at Pinnacle Adjusters Group.

“As a boutique adjuster, we do a lot of CGL claims, especially personal injury with general liability exposure, and we are also specialists in Auto AB/BI,” says Proctor, who adds that Pinnacle was one of a select few adjusters accredited to handle claims for the upcoming Pan Am Games, July 10-26, and the Parapan Am Games, August 7-15, in Toronto.

For Proctor, the success of the firm comes down to the quality of the staff he manages. “If you look at our team of adjusters, we are diversified and well-versed in many areas, particularly personal injury, coverage issues, investigations and litigation issues,” Proctor comments of the firm, which services the GTA and other regions in Ontario on demand. “We have more than 100 years of combined experience between our adjusters and principals and because of that we are often called on to handle unique or complex losses. And we have a team of support staff who are the heartbeat of the company. People know what they are getting when they call us.”

Proctor understands this first-hand. As a former director of claims operations for a large p&c insurance company, he used to rely on Pinnacle Adjusters Group as a preferred vendor for independent adjusting services.

In fact, Proctor’s career in claims dates back to 1993, when he moved into personal and commercial claims handling for some of the country’s top insurers. For close to two decades, he developed extensive experience in accident benefits, bodily injury, general liability and commercial property claims, serving in several senior claims management positions. He made the transition to the independent adjusting side of the business in 2010, and opened his own firm, which was amalgamated with Pinnacle Adjusters Group in 2013.

“There was something about the dynamics of claims that I found interesting,” Proctor notes. “More than 20 years later, I still find it so -sometimes the nature of this job can frustrate you, but it is never boring.”

Curiosity and knowledge about diverse industries and professions are key parts of what makes an independent adjuster’s life stimulating, according to Proctor. “As an adjuster you need to know a bit about everything – from legal to medical to engineering. When you get to a loss site, you have to get up to speed pretty quickly.”

This widespread interest certainly applies to Proctor himself, who, in addition to experience in commercial/personal property, liability and auto claims, also has expertise in alternative dispute resolution and fraud detection. He is accredited with a handful of convictions, one of which was an industry adjuster. However, he believes his role as a litigation specialist stands out.

“You learn so much when you are subject to discovery or when you are cross examined as a witness,” he says. “You understand why you are being asked certain questions by a lawyer, and you can relate that back to why you need to gather certain information and ask questions in your investigation that must be answered in your loss report. It really ties it back to what you have to learn and uncover in your role as an adjuster.”

Pinnacle’s business approach is to provide a wide array of adjusting services in return for reasonable fees. “We don’t have a desire to be the cheapest adjuster,” Proctor observes. “As someone who has worked on the company and independent side, I have seen how the low rate adjusting fee competition can erode the quality of claims handling.”

The balance between quality and cost has to be struck by every insurance company and client, Proctor acknowledges. But he adds that an excessive emphasis on productivity targets, short-term financial goals and efficiency measurements can have unintended consequences on loss payouts.

“Claims examiners are relying on an adjuster’s expertise and ability to gather information and deliver an accurate report,” he says. “What if there is a coverage issue or other information not picked up on due to a lack of experience? That could unnecessarily add tens of thousands of dollars to the loss payout? Is that worth saving a few dollars on an eight-hour assignment? If you think hiring a professional is expensive, try going with an amateur.”

“If it is all about getting as much productivity out of people for the lowest cost, I suggest that comes at a price,” Proctor adds. “Insurers may save on the expense side, but they are sure to be losing far more than those savings in loss payments.”

As an expert in reviewing files and conducting claims audits, Proctor has an interesting vantage point on how an inexperienced investigation can sometimes fall short of the mark.

“I have done thousands of audits and I see it all the time,” he says. “There is hard leakage that is easy to find, such as ‘this invoice was overpaid.’ But leakage from overlooked opportunities that only experience catches is usually about much more significant loss dollars. For example, look at loss transfer, subrogation, priority, change in coverage or possible misrepresentation. These are the things that have a greater likelihood of getting overlooked by the inexperience that low-rate adjusting fees often buy. They only get picked up in audits after the fact.”

“The gap in industry experience is a concern to me; there aren’t as many companies willing to make the investment in training young adjusters anymore. We are soon to lose a number of experienced veterans to retirement,” he says. “There are a lot of junior adjusters who are eager to learn, however it seems like the approach now is training by fire – ‘here are a bunch of files, go to it.”

Proctor adds that “if you don’t invest in training and your people don’t get the experience, it can affect corporate governance, corporate responsibility and bad faith claims – it all ties together.”

A prime antidote to the training gap is the role of industry associations like the OIAA and CIAA, where Proctor says like-minded adjusters can gather for seminars, discussions and continuing education.

“That is one of the reasons why our associations are so important, they can provide some of that training – that is the mandate,” notes Proctor, who is the OIAA Kawartha/Durham Chapter delegate for the provincial OIAA Executive. “I have met so many people through the association that I would not have if I was only behind my desk or out on the road.”

For Proctor, this type of informal networking and information gathering is critical, and may become even more significant in the years ahead.

“You can ask them (fellow adjusters): how do they approach certain issues in the market? What are the hot topics? Who can organize a good seminar or training session on a key issue? That is the real value you get out of it. Ultimately, we learn from each other,” he observes.

For Pinnacle Adjusters Group, Proctor says the firm will stay the course and stick to its fundamental premise of thorough, quality adjusting services for fair rates. This is a chosen business model in the face of consolidation
, trends to in-house adjusting and more national flat-fee contracts for independent adjusting services.

“We have a broad spectrum of clients, including insurance companies and corporate clients,” Proctor concludes. “In the past couple of years, we have been able to keep very busy, even in times of general industry downturns. We have loyal clients who know our philosophy and value our experience. I don’t expect that to change.”