I guess the best ways are to go over some “dos and don’ts” and correlate it with claims that could occur to any PMP but would not be expected. We can choose from so many different types of pest control claims, but for the sake of this article's brevity, let’s focus on one dealing with a general pest. Other claims surrounding termite, WDIRs, fumigation or wildlife can be similar in nature, especially on how to deal with the customer. This article will mainly focus on a general pest situation(s) and the way customers should be treated when contacting your office to file a potential claim.
Let’s take a general pest situation dealing with an exposure/inhalation or insect bite claim.
Don't Play Ostrich
DON’T - Please do not stick you head in the ground hoping it will go away. Most of us who handle these types of claims know the vast majority of inhalation/insect bite claims or suits are questionable at best. With that stated, telling the claimant they are not sick and hanging up won’t work. Yes, I stated this because we have handled some suits where the insured did not say some very nice things and the next notice was a lawsuit being delivered to their front door.
DO - Talk to the claimant assuming their complaint is legitimate. The main reason for many of these types of claims is the claimant’s lack of education or knowledge about the product used or the service that was rendered. LISTEN. The most important thing the PMP should do especially at the start of the claim is listening to what the claimant has to say. Let them talk. Let them tell their whole story. If you know there are issues that were not mentioned by the claimant, ask a question or two afterwards to get their responses.
Example: One time our PCO was dealing with a situation surrounding a brown recluse spider bite. Spoke with the claimant and discussed the basics. Nothing really got resolved and the claimant got an attorney. When I spoke with our insured, we went over the facts and the discussion he had with the claimant. How he handled this situation and what steps did he make to control the claim. Again only the basics were discussed so I asked our insured if he considered asking a few of the following questions to obtain more information:
Go to the "Scene"
It is important to visualize what the claimant is telling you about the claim. Get the layout of how the alleged bite took place, where and under what circumstances. What time was the bite? What were you doing? Where you alone at the time? All of these questions should be asked (possibly again) but at the same time you get an idea of how the claimant was living and in what conditions. BRING A CAMERA! I would have to say the vast majority of the inhalation or insect bite claims, the conditions of the apartments or condos were not very good. As they say, a picture is worth a thousand words. For this spider bite exposure, our insured put some traps or boards around to see if any are found over the next few days to a week or so. This claimant allowed our insured to do this service (defense strategy really).
Educate the Claimant
This is only after you have received enough information of what allegedly occurred per the claimants allegations. You should have a copy of the agreement you have with the customer or the apartment complex. Discuss the target insects that you were contracted to service. Have the label and MSDS sheets also ready to verify how the application is to take place for that specific product used. Finally, your documentation is the main key to defending your service. Your treatment notices should reflect the product used, percentage, amount and type of treatment (crack and crevice, etc.). Now I realize that many states do not mandate PMPs keeping this type of information for general pest treatments. I understand but there is a difference between regulatory requirements and what is needed to defend a potential lawsuit.
Your documentation should reflect what is in the contract and how the property was serviced. Any ambiguity will kill a defense. To help with this type of documentation, the PMP should discuss ways to improve their paperwork by contacting their association, legal counsel or insurance representative that knows pest control exposures.
Make A Decision
If you noticed, at no time have I mentioned that you should state your company’s position on the claim. That is where most of the mistakes we have seen our insureds make causing the claim to fall to us. The claimant calls and says they are sick due to their application or they got bit by an insect you were supposed to control. Too many companies try to state right off the bat, “I am sorry this happened but we are not responsible.” Immediately the claimant if forced into a defensive position. They have no other choice but to go to an attorney and/or file suit.
Back to the spider bite example. After our insured told the claimant they were not liable, the claimant got an attorney and put them on notice by letter. No suit yet. The insured turned the claim over to us. We made contact with the attorney and went over the facts. Now one good thing about claims like these is plaintiff attorneys are usually very inexperienced on how to try these matters. That is good and bad. Some are too clueless to realize the claim they have is weak at best but the good side is other attorneys start to realize that they are in over their head and not worth the cost to go forward. On this spider bite claim we were lucky. With this attorney I did exactly what was discussed above. My position was tell me your story and afterwards I will ask the necessary questions to hopefully to really find out what happened.
Well we got the basic info and asked the same questions that I mentioned earlier the insured might have asked. After I got the answers I then educated the attorney about the habits of a brown recluse spider. They are nocturnal and do not like activity, etc. Attorney verified the husband’s job with the sofas. I asked how they knew it was a spider bite and that is when the husband's previous bite claim came up. The attorney mentioned the emergency room physician verifying the spider bite and I mentioned a document we had stating the misdiagnosis of a spider bite with a staff infection. Finally scanned and emailed a copy of the contract where the insured luckily had the target insects listed. No spiders. Then I mentioned that our insured put out traps and boards and after two weeks there was not one sign of a spider in the apartment. I told the attorney that after listening to him and with all the facts known to date, I do not see how our insured was liable or contractually obligated to pay this claim.
Bottom line after the discussion took place was the attorney stated he would get back to us after he had to do a little more investigation. Funny thing was we never heard back from him or the claimant. The apartment complex did not either from what our insured told us and was still able to keep the customer.
The bottom line is do not make a decision until you have all the facts!
I realize that many reading this article do not always know what or how to respond to claims like these. What question to ask and not ask? As stated above, contact someone that knows these types of situations. A fellow pest control professional and, again, your association contact might help or know where to go. A legal person might be helpful but if they don’t know pest control exposures it could backfire. We have seen it happen. Finally, persons that handle these types of claims are a great source as well. Agents are ok, but it’s the claims person that you should really have access to help remedy these situations before they become claims or suits. Good luck.
Let’s take a general pest situation dealing with an exposure/inhalation or insect bite claim.
Don't Play Ostrich
DON’T - Please do not stick you head in the ground hoping it will go away. Most of us who handle these types of claims know the vast majority of inhalation/insect bite claims or suits are questionable at best. With that stated, telling the claimant they are not sick and hanging up won’t work. Yes, I stated this because we have handled some suits where the insured did not say some very nice things and the next notice was a lawsuit being delivered to their front door.
DO - Talk to the claimant assuming their complaint is legitimate. The main reason for many of these types of claims is the claimant’s lack of education or knowledge about the product used or the service that was rendered. LISTEN. The most important thing the PMP should do especially at the start of the claim is listening to what the claimant has to say. Let them talk. Let them tell their whole story. If you know there are issues that were not mentioned by the claimant, ask a question or two afterwards to get their responses.
Example: One time our PCO was dealing with a situation surrounding a brown recluse spider bite. Spoke with the claimant and discussed the basics. Nothing really got resolved and the claimant got an attorney. When I spoke with our insured, we went over the facts and the discussion he had with the claimant. How he handled this situation and what steps did he make to control the claim. Again only the basics were discussed so I asked our insured if he considered asking a few of the following questions to obtain more information:
- “Do you live alone in the apartment?”
- “Oh you are married. Do you mind if I ask what your husband does for a living?”
- “If you don’t mind what do you do for a living?”
- “How long have you lived in the apartment?”
- “Have you brought any new furniture or beds in the apartment in the last 30 days?”
- “How do you know it was a spider bite?”
- “Do you know of anyone that ever had a spider bite before?”
Go to the "Scene"
It is important to visualize what the claimant is telling you about the claim. Get the layout of how the alleged bite took place, where and under what circumstances. What time was the bite? What were you doing? Where you alone at the time? All of these questions should be asked (possibly again) but at the same time you get an idea of how the claimant was living and in what conditions. BRING A CAMERA! I would have to say the vast majority of the inhalation or insect bite claims, the conditions of the apartments or condos were not very good. As they say, a picture is worth a thousand words. For this spider bite exposure, our insured put some traps or boards around to see if any are found over the next few days to a week or so. This claimant allowed our insured to do this service (defense strategy really).
Educate the Claimant
This is only after you have received enough information of what allegedly occurred per the claimants allegations. You should have a copy of the agreement you have with the customer or the apartment complex. Discuss the target insects that you were contracted to service. Have the label and MSDS sheets also ready to verify how the application is to take place for that specific product used. Finally, your documentation is the main key to defending your service. Your treatment notices should reflect the product used, percentage, amount and type of treatment (crack and crevice, etc.). Now I realize that many states do not mandate PMPs keeping this type of information for general pest treatments. I understand but there is a difference between regulatory requirements and what is needed to defend a potential lawsuit.
Your documentation should reflect what is in the contract and how the property was serviced. Any ambiguity will kill a defense. To help with this type of documentation, the PMP should discuss ways to improve their paperwork by contacting their association, legal counsel or insurance representative that knows pest control exposures.
Make A Decision
If you noticed, at no time have I mentioned that you should state your company’s position on the claim. That is where most of the mistakes we have seen our insureds make causing the claim to fall to us. The claimant calls and says they are sick due to their application or they got bit by an insect you were supposed to control. Too many companies try to state right off the bat, “I am sorry this happened but we are not responsible.” Immediately the claimant if forced into a defensive position. They have no other choice but to go to an attorney and/or file suit.
Back to the spider bite example. After our insured told the claimant they were not liable, the claimant got an attorney and put them on notice by letter. No suit yet. The insured turned the claim over to us. We made contact with the attorney and went over the facts. Now one good thing about claims like these is plaintiff attorneys are usually very inexperienced on how to try these matters. That is good and bad. Some are too clueless to realize the claim they have is weak at best but the good side is other attorneys start to realize that they are in over their head and not worth the cost to go forward. On this spider bite claim we were lucky. With this attorney I did exactly what was discussed above. My position was tell me your story and afterwards I will ask the necessary questions to hopefully to really find out what happened.
Well we got the basic info and asked the same questions that I mentioned earlier the insured might have asked. After I got the answers I then educated the attorney about the habits of a brown recluse spider. They are nocturnal and do not like activity, etc. Attorney verified the husband’s job with the sofas. I asked how they knew it was a spider bite and that is when the husband's previous bite claim came up. The attorney mentioned the emergency room physician verifying the spider bite and I mentioned a document we had stating the misdiagnosis of a spider bite with a staff infection. Finally scanned and emailed a copy of the contract where the insured luckily had the target insects listed. No spiders. Then I mentioned that our insured put out traps and boards and after two weeks there was not one sign of a spider in the apartment. I told the attorney that after listening to him and with all the facts known to date, I do not see how our insured was liable or contractually obligated to pay this claim.
Bottom line after the discussion took place was the attorney stated he would get back to us after he had to do a little more investigation. Funny thing was we never heard back from him or the claimant. The apartment complex did not either from what our insured told us and was still able to keep the customer.
The bottom line is do not make a decision until you have all the facts!
I realize that many reading this article do not always know what or how to respond to claims like these. What question to ask and not ask? As stated above, contact someone that knows these types of situations. A fellow pest control professional and, again, your association contact might help or know where to go. A legal person might be helpful but if they don’t know pest control exposures it could backfire. We have seen it happen. Finally, persons that handle these types of claims are a great source as well. Agents are ok, but it’s the claims person that you should really have access to help remedy these situations before they become claims or suits. Good luck.
