CIS Group Scoop

Complaint Triage - Know the right steps

Posted by Morgan Cassady on Mar 10, 2015 10:00:00 AM

The sales engine at your organization is running smoothly and you have new policies coming in the door. Your rating algorithm works its magic and suggests that you should inspect the property. 

After a homeowner’s insurance policy has been issued, it is not uncommon in to have an insurance field underwriting inspection completed on the property. A property inspection is a great tool to determine the current condition of the property, identify certain types of conditions or hazards and if requested, receive an estimated reconstruction cost estimate.

Not only is the inspection a valuable tool to accurately determine the risk associated with a property, it is also a process that requires interaction between the homeowner, the agent, and the inspector. While our goal is to provide the perfect customer experience, occasionally a challenge will arise between any or all of the parties involved.  This may result in a complaint. Let’s discuss the steps and processes to evaluate and resolve complaints.

In this post, I will discuss the initial evaluation of a complaint and the fact-finding steps we use to resolve the issue. My hope is that you and your team find this information useful to supplement your own customer experience.

Validity of Complaint -

First, you must determine the validity of the complaint. The three key elements are the same, whether the complaint originates from the insured, agent or underwriter. The initial pieces of information needed are:

  • Date of Complaint
  • Date of Inspection
  • What action was taken by underwriting?

The following chart illustrates how the number of days between the date of the inspection and the date of the complaint can impact the validity.

Validity of Complaint, Probability

The Y-axis (vertical line) represents the probability percentage of a valid complaint and the X-Axis (horizontal line) represents the number of days between the date the complaint was submitted and the date the property was inspected.

There is a noticeable decrease in complaint validity as each day passes.  

The regression source data is pulled from Navigator (CISGOC’s Inspection ERP) over the course of the past two years, and approximately 4 million inspections performed in that period.

Memory Fades - 

The greater time between the date the property was inspected and the date of the complaint, the more impact it has on our ability to conduct accurate research. As each day passes, the ability for the inspector to recall specific information about a property or incident declines. A typical inspector may look at several hundred properties in a month. As time passes, their ability to remember relevant information about an interaction is greatly reduced.

Action Taken by Underwriting -

Was action taken by the underwriting team? Was coverage dropped?  Did Coverage A increase, resulting in a higher premium rating? Was a recommendation letter sent requiring the insured to repair or mediate a risk that produced out of pocket costs to the insured? 


Upon review of an inspection after a complaint is filed, have you ever seen something like this?

Property Hazard, Roof Hazard, Insurance Inspection, Property Inspection

Property Inspection, Hazard Inspection, Property Hazard, Insurance Inspection


Roof Inspection, Roof Hazard, Insurance Inspection, ITV Inspection, Property Inspection

Roof Hazard

Property Inspection, Hazard Inspection, ITV Inspection, Insurance Inspection, Property Inspection


When conditions like these are observed and noted on the inspection, underwriting may take action. If an insured receives a letter from their insurance carrier stating that they are taking action on a policy to mitigate or reduce risk, it likely comes at a cost to the insured. In some cases, the policyholder will immediately file a complaint regarding the inspection process hoping to defer or reverse the underwriting action taken by the insurance company.

In summary, when you receive a complaint regarding an inspection, take a moment to review the 3 key elements suggested. You may find that the data provided requires further vetting and research. 

Insurance Inspections, Property Inspection, Insurance Underwriting Inspection


At any time during the process that you determine further action is needed, reach out to our customer service at our HQ office so that our group can continue our never-ending quest to provide the Perfect Customer Experience




Until next time,


Morgan Cassady


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Topics: Perfect Customer Experience, Customer Satisfaction, Complaints, Problem Resolution