When I read the definition for insurance adjusting it seems clear that Safelite is indeed adjusting claims. Your thoughts?

simple answer YES.

And it is not just sgc it is ALL networks. 1 is not better than another they are all playing a dangerous game. soon to be taken down.

They're not investigating, negotiating or settling claims, so I'd argue no.


I can understand why shops would see it differently though.

When they call non-network shops and discuss pricing and tell the insured they will only pay a specific dollar amount how is that not negotiating? And when they send a check for a lesser amount than the invoice how is that not settling a claim?

As a spectator to all the litigation that Safelite’s is and has been involved in over the past decade or so, it appears to me that the soft underbelly that’s been previously neglected may be the question of whether they are adjusting claims or not. Each state clearly defines what an adjuster is and is not. In my home state of Texas, the law says an adjuster is... “an individual, firm, company, association, organization, partnership, limited liability company, or corporation who, for direct, indirect, or any other compensation acts on behalf of an insured in negotiating for or effecting the settlement of a claim or claims for loss or damage under any policy of insurance covering real or personal property; or on behalf of any other public insurance adjuster, investigates, settles, or adjusts or advises or assists an insured with a claim or claims for loss or damage under any policy of insurance covering real or personal property; or one who advertises, solicits business, or holds himself or herself out to the public as an adjuster of claims for loss or damage under any policy of insurance covering real or personal property.” Most states have similar definitions.
If state regulators were to determine that Safelite is, in fact, acting as an adjuster while they slyly pose themselves as such to insureds, they would suddenly be subject to licensing and a whole host of new rules and regulations as promulgated by the states’ Code of Ethics with regard to those companies and individuals involved in the business of insurance. Flying under the radar, as they have for two decades, would be impossible. Their already suspect business model couldn’t survive that level of scrutiny and oversight. It would be nice if it were that easy, huh? Maybe I'll call TDI in Austin and find out. Just a thought...

In most states an agency has to license all of their employees who answer the phone and assist customers with claims, coverage questions, or quotes for coverage. Seems like what's fair for the goose is fair for the gander.

IS SAFELITE ADJUSTING CLAIMS? Lets use DOI's post. First, just what are you trying to portray DOI? Are you really from the Dept. of Insurance? I think NOT. Who are you really? who do you serve and bow down to? Anyway lets Break it down:

1. they are not investigating. REALLY? you think that? Well lets see... When a customer needs my services for repairs to their vehicle, we first establish form of payment. Ok so far? If they want to use an insurance policy they paid $$$$$$$ to cover their loss we contact agent or Ins Co, and verify coverage, and deductible. If we are FORCED into any contact with SGC, or network, we put the customer on line to initiate the claim process. At this time SGC gathers information, Ins co, Policy #, Date of loss, and MANY other questions for my customer to answer. Gathering of information is exactly investigative. Any judge, court or arbitrator will agree. SO major fail on your part. For any network to set up a claim they Have to investigate the circumstances to set up a claim. They are acting as adjusters.

2. Negotiating. WOW you fail again. When SGC or any network asks the shop that is preferred by the customer, "will you accept the following rates", then they are trying to "NEGOTIATE". And by the way They are basically "price fixing". FAIL AGAIN! They are acting as adjusters.

3.Settling claims. WHAT THE HECK? You really can not be that stupid. well maybe, dept of ignorance? ah this one is just way out there. When SGC pays a claim or short pays a claim they are trying to "SETTLE" the claim. Really you cannot be that stupid. your actions are not just misinformed but are actually malicious in nature to defraud service providers. Again the network is acting as an adjuster to adjust, and control the claim process.

We really don't see it "differently" we see it for what it is and you are trying Not to see it for what it is.

I am not sure what planet you are on but I bet it starts with a "U". Figure it out DOI! Just like Mark1 says "you just can't make this stuff up!

The legal loopholes...TX law.
Adjuster's License Exemptions:
...
(10) an individual who:
(A) collects claim information from, or furnishes claim information to, an insured or claimant and enters data into an automated claims adjudication system; and
(B) is employed by a licensed independent adjuster or its affiliate under circumstances in which no more than 25 individuals performing duties described by Paragraph (A) are supervised by a single licensed independent adjuster or a single licensed agent.

FYI. Lynx Services is licensed with the California Department of Insurance as an adjuster. Safelite Solutions is not.

Really? ok so find that document and please post it. I would love to read it. Not doubting you just curious to see it.

When the claim is filed & the customer has a specific shop, if SGC net can find them in their data base (wink wink) and SGC then calls the shop to assign the claim,how is asking the shop if they will accept the approved rate NOT acting as a claims adjuster?

No document, go into CDI's website and check license status by typing in company name. If they are licensed it will show their number. No license no records.

Even worse is when the chosen shop does not accept the insurer's offer and then Safelite refuses to give the name of the policyholder and lies to the policyholder about whether they can still use the shop and whether they will have any out of pocket expenses over and above their deductible. Safelite should never be in the position to lord over their competition in such a way.

So they paid us out one amount and charge the policyholder and insurance another? Like taking the icing off the cake?

Well it could be in their contract with the insurance company, I don know.

As a shop owner with a broken w/s & full glass coverage, I have to go through my competition in order to report my claim. I then have to bill my Insurance Co. via my competitor who is making $$$ off the process of my glass replacement.

sglass, you should know better by now.
As a shop owner with a broken windshield and full glass coverage, you can submit your invoice directly to your insurance company without going through your competitor and use said invoice as the first notice of loss. It would behoove you to take and have available digital photos on file in case your insurance company wanted damage verification.

THERE IS NO NEED TO CONTACT A DIRECT COMPETITOR DURING THE CLAIMS PROCESS.
THERE IS NO NEED TO CONTACT A THIRD PARTY ADMINISTRATOR DURING THE CLAIMS PROCESS.

As soon as shopowners come to this realization, the better off we will all be.

Davey by billing direct bypassing the TPA.s what is the turnaround time

to get paid?

Also when billing direct do you find out what the fax # or email address

is for each ins. co. and have a assignment of benefits on invoice?

Simply fax or email with Date of loss policy # and customer signature correct?

You can expect payment in 30 days on average and mostly only what they offer. Shortpays need to be collected and will take more time but they are worth pursuing.

Absolutely keep records of fax numbers and email addresses that work.

Signed assignments do not have to be on the invoice but they must accompany the invoice.

1.) Verify coverage. use the agent or customer service number.
2.) Document the loss with digital pictures clearly depicting the damage.
3.) Have customer sign the AOP (make sure he/she is policyowner or at least insured on the policy.)
4.) Send invoice with reasonable charges along with AOP and cover letter indicating your intent to sue for anything less than full payment via some form of confirmed receipt i.e. certified return receipt, request for delivery receipt, etc.
5.) Give them 2-3 weeks to respond, then call for status. Use customers name and their phone number (the one that was listed on your invoice) to get the status.
6.) Follow-up until paid in full.

Is AOP assignment of proceeds?

So is all this why there seems to be a new method of really lowball offers, secondary pricing if they ever actually call back whan you refuse the lowball, bit still won't pay sales tax because they say they're subcontracting and you have to resale it to them? I wonder if they're marking these lowball offers up in the middle? Can that be legal?