I have long said that the best claim professionals resolve disputes without ever setting foot into a courtroom or appraisal hearing. That is not because necessary litigation lacks value, but because true mastery of property claims handling lies in understanding, communication, and persuasion long before positions harden. Bill Wilson, one of the finest educators the insurance industry has ever produced, reminds us of this truth in a thoughtful article, Two Ways to Deal With Claim Disputes, which discusses two primary paths for resolving claims disputes. His insights deserve careful attention from every property insurance claims professional.
Wilson’s central point is that many disputes arise not from bad faith, but from differing interpretations of policy language. That observation alone should shift how public adjusters approach their work. If a disagreement is rooted in interpretation, then the solution is not immediate escalation but a better explanation, clearer framing, and more effective communication of why a policyholder’s reading is reasonable and correct.
I suggest that Wilson is talking about “the art” of claims advocacy.
John Witt’s comment at the end of Wilson’s article takes this discussion to an even more fundamental level. He reminds us that insurance policies are contracts of adhesion. The insurer drafts the language. The policyholder has little to no ability to negotiate terms. With that imbalance comes responsibility. If an insurer fails to clearly define its intent and a reasonable person can interpret the policy differently, that is ambiguity. Under long-standing legal principles, ambiguity is not a drafting oversight to be exploited, it is construed against the drafter.
Yet Witt correctly points out a troubling reality. Too often, insurers advance narrow, self-serving interpretations of language they could have clearly defined but chose not to. The ongoing disputes over computer fraud coverage are a perfect example. Courts have rejected restrictive interpretations, yet similar arguments continue to surface in claims handling. That is not a failure of the legal system. Instead, it is a failure of communication and discipline within claims culture.
Public adjusters should take this as both a warning and an opportunity. The warning is that simply being “right” is not enough. The opportunity is that most of these disputes can be resolved without litigation if the public adjuster knows how to present the argument effectively. This is where I have consistently urged public adjusters to study Bill Wilson’s work, especially his excellent book, When Words Collide. Wilson teaches that coverage disputes are won by those who understand language, context, and intent better than the other side. I suggest that this knowledge, combined with significant and creative negotiation skills, is the key to mastery of these situations.
I have written before about Wilson’s teachings and encouraged public adjusters to learn from him in Bill Wilson Teaches How to Argue for Coverage at NAPIA—What is RTFP. His approach is not about confrontation, but clarity. It is about showing, not telling. It is about guiding the adjuster on the other side to the inevitable conclusion that your interpretation is not only reasonable, but the better reading of the policy.
That approach aligns closely with the principles of effective negotiation taught by Christopher Voss and others who emphasize listening over arguing, as I noted in Steve Patrick Endorses Chris Voss and Never Split the Difference. The best claims advocates do not begin by telling the insurer they are wrong. They begin by asking questions, understanding the insurer’s position, and then carefully reframing the discussion. They use calibrated questions, patience, and strategic empathy to move the conversation forward. They make it easy for the other side to say “yes.”
Too many disputes escalate because both sides stop listening.
Wilson’s article reminds us that there are ultimately two paths—resolution through dialogue or through formal dispute mechanisms such as litigation or appraisal. Public adjusters should always exhaust the first path with skill and intention. That does not mean compromising valid claims. It means presenting them so effectively that resistance becomes difficult to justify.
When public adjusters master policy language, study and understand insurance contract interpretation doctrines, and apply disciplined negotiation techniques, they elevate the profession. They move from being participants in disputes to being leaders who resolve them.
That is the standard worth striving for.
Thought For The Day
“The single biggest problem in communication is the illusion that it has taken place.”
— George Bernard Shaw