Thursday, 23 August 2012 16:16

Research, Documentation is Ammunition in Battles with Insurers

John Borek didn’t just acquiesce to putting reconditioned wheels—which he had serious concerns about—on his customers’ cars when that’s what insurers insisted on. Instead he found a way to determine and demonstrate whether those wheels were fit to be used.

That’s a pattern that Borek, owner of Autocraft Bodywerks in Austin, TX, has demonstrated over and over again: Gathering the information he needs to successfully prove his argument.

“I never imagined when I started in this business that I would have to be more of a lawyer and use my brain rather than use my hands,” Borek said. “But if you don’t, you can’t fix the car correctly and get paid for doing so.”

When it came to the reconditioned wheels, for example, Borek’s shop invested in a Hunter Engineering Road Force GSP-9700 machine. More than just a tire balancer, the equipment measures the wheel inside and out, identifying high and low spots. When an insurer insisted on a reconditioned wheel and a customer signed off on it, Borek said, they tested the wheel to determine if it was bent.

“You can balance a wheel that’s crooked, but just because it’s balanced doesn’t mean it’s going to be true,” Borek said. “This machine helps us avoid using reconditioned wheels that are out of round.”

Borek acknowledges that pay-back on the equipment is not necessarily quick.

“But even if we never get our money back, it helps us do the right thing,” he said.

Another way Borek has fought successfully for what he knows is right hasn’t cost him a dime. He’s frequently turned for free help offered through the Database Enhancement Gateway (DEG). Funded largely by three national repairer associations, the DEG offers a simple way to submit an inquiry to any of the Big Three estimating database providers.

Several years ago, for example, Borek took a class taught by consultant Mike Anderson of CollisionAdvice in which Anderson pointed out that labor times to paint a quarter panel are only for painting the outside the panel. Grinding of pinchwelds and the welding of the new quarter panel make painting of the underside necessary as well.
“You can get another hour or two to paint the backside, and it’s got to be painted,” Borek said.

That concept came to his mind shortly thereafter when his shop was installing a floor in a 2009 Honda Accord, and the insurance appraiser refused to pay for painting both the top and bottom of the floor pan.

“There’s paint on both sides, and you have to put the vehicle on a lift to paint the underside,” Borek said. “And not only that, it was a different color, a green e-coat.”

He submitted DEG Inquiry No. 1787, and received confirmation from Audatex that its paint labor allowance is for only the interior surface of the floor pan.

“I basically said to the adjuster, ‘Which side of the floor do you want me to paint because you’re only paying me to do one side,’” Borek said.

The documentation supplied through the DEG was enough to convince the insurer to pay for the additional paint labor, two-tone materials and the needed replacement sound-deadener.

“So that’s an example of something we got paid for by using the DEG,” Borek said.

Borek said he’s used the Audatex system long enough that he usually knows the answer to the question he submits to the DEG, but the process provides the authoritative documentation he needs to prove his point.

More recently, for example, Borek received a document that American National Property and Casualty Company (ANPAC) that the claims services company said was from Audatex and indicating that color sand and buff is included in Audatex refinish times.

Borek knew this wasn’t the case and submitted it to the DEG. Within 24 hours, not only had Audatex responded that its labor times did not include color sand and buff, but also that it had searched its reference manual back to 1993 and could not find the document that ANPAC was using to defend its position.

“Color sand and buff has been a pet-peeve of mine since 1998, and I know it’s not included in any paint time,” Borek said. “But how many shops are being sent incorrect information about things like this and not knowing any better?”

ANPAC later told the Texas Department of Insurance that the appraiser used “an outdated document.” Borek still contends the document was “fraudulent” given that Audatex concluded that the document is “most certainly not from ADP/Audatex.”

“But in any case, those are just two examples where the DEG helped us. And very quickly, I might add,” Borek said. “I think the reason some people don’t use it is they think it might only help on the next one, and when am I going to have that exact same vehicle and procedure in my shop? But it can help you right now if you just send it in. It doesn’t cost anything, and you can sometimes have a response in 24 hours. And once you’ve done the research, you always have it. We still get paid for painting both sides of those floors.”

John Yoswick, a freelance writer based in Portland, Oregon, who has been writing about the automotive industry since 1988, is also the editor of the weekly CRASH Network (for a free 4-week trial subscription, visit www.CrashNetwork.com). He can be contacted by email at jyoswick@SpiritOne.com.