Large-loss threshold triggers
Commercial vs. residential
- Residential: often $100K-$250K
- Commercial: often $500K-$1M+
Automatic triggers
- Total-loss designation
- Policy-limit exposure
- Complex coverage issues (commercial, specialty)
Discretionary triggers
- Complexity of loss
- Multiple policies involved
- High-profile or reputation-sensitive
Large-loss adjuster characteristics
- Senior adjuster, often 15+ years experience
- Specialty background (fire, commercial, specialty property)
- Higher authority limits ($500K+ often)
- Reduced caseload (more time per claim)
- Often CPCU or similar credentials
Enhanced documentation
- Forensic engineers retained
- Multiple inspections over time
- Detailed cause-and-origin analysis
- Commercial BI financial analysis
- Full photo and measurement documentation
Internal review intensity
- Multiple supervisor layers
- Legal review common
- Actuarial input on reserves
- Reinsurance notification (may trigger external review)
Reinsurance implications
Cedent carrier notifies reinsurer for:
- Losses above retention threshold
- Catastrophic events
- Unusual coverage issues
Reinsurer may:
- Request documentation review
- Influence claim handling
- Audit handling decisions
- Delay cedent's payment pending sign-off
Policyholder strategy
Match documentation intensity
- Forensic experts
- Detailed scope and pricing
- Professional representation (PA, attorney)
Expect longer timelines
- 6-12 months typical
- Reinsurance review adds time
- Legal review adds time
Leverage structure
- Appraisal often favorable on amount
- CRN on statutory breaches
- Litigation with first-party counsel