To ensure Account Managers (AMs) and Junior Relationship Managers (JrRMs) are fully prepared for negotiations by tracking, prioritizing, and organizing the highest-value items in CRM.
This process helps:
Identify where the gap between our estimate and the insurance’s approved RCV is coming from.
Break down that total gap into the individual line items driving it.
Understand insurance denial reasons.
Prepare targeted rebuttals.
Keep statuses updated for quick reference.
Avoid forgetting critical details during adjuster callbacks.
How to Populate This Field
Two ways to populate this field:
Click the "Add Row" button located below the "Top Items to Pursue" section.
If the button is unclickable, click "Edit" in the upper-right corner of the deal. This will take you to the Edit Deal page. Scroll to the Description Information section, locate the Top Items to Pursue field, and add the necessary details.
Table Fields:
Item Number – Reference number from our estimate (not the insurance’s).
Use these when speaking with the adjuster so you can quickly locate the item in our file.
Combine related items into a single negotiation topic.
- Example: “Siding” could include Items 7, 13, and 15.
Item Name – Name or description of the item you’re pursuing.
Keep it concise but clear (e.g., “IWS”).
Copy and paste what is in our estimate
Gap $ -Difference between the price of the unwarranted item from our estimate and the revised estimate (RE), minus overhead & profit (O&P).
O&P (Overhead & Profit) is excluded here since it will be entered as a separate item in the field.
Shows the dollar difference to focus on during negotiation.
Large gaps help you prioritize high-value items.
Important: The sum of all item gaps in this field should match or be very close to the total gap between our total estimate and the approved RCV.
Reason for Insurance denial – Explanation given by the adjuster for denying the item.
Always write it exactly as provided.
This would help you on how to negotiate (“pull” approach) instead of pushing in the wrong direction.
Example: Denied due to “No code coverage” vs. “Not visible in photos.”
Reason to approve – Justification for why insurance should approve it. Include supporting reasons like: Code requirement, Manufacturer specifications, Pre-existing condition. Also note how you would present or negotiate the point..
Example: “No code coverage → Argue pre-existing, attach photos showing pre-existing before loss.”
Status/notes – Current stage for this item, with date stamps for each update.
Always add a new note instead of overwriting old status.
Examples:
In negotiations: 9/01 –adjuster is reviewing the photos
9/03 – In negotiations: Spoke to adjuster, confirmed denial reason
9/05 – Requested photos from RF
Step 1 – Identify Items
The items should be listed in chronological order
Copy and paste these into CRM from the highlighted estimate.
Step 2 – Record Details
Input Item Number, Item Name, and Gap (using the correct formula).
Ensure the sum of all items entered matches or close from the total gap between our estimate and the approved RCV.
Step 3 – Document Denial Reason
Record exactly why insurance denied the item.
This prevents wasted effort negotiating the wrong point.
Step 4 – Create Rebuttal Plan
Match the rebuttal to the denial reason.
Example:
Denial Reason: “Not visible in photos” → Rebuttal: “Request production photos from RF.”
Denial Reason: “No code coverage” → Rebuttal: “Pre-existing condition with proof.”
Step 5 – Update Status Log
Always date your entries and keep prior notes.
Include:
Who you spoke with
What was discussed
Next step
Never delete previous updates.
Step 6 – Prioritize
Fight hardest for:
Largest gaps
Items RF requested to get approved
Consider effort vs. potential payout.
Step 7 – Maintain Readiness
Have this table open during negotiations calls. If an adjuster calls back unexpectedly, you’ll be ready with:
Item numbers
Denial reasons
Rebuttals
Be specific – Avoid vague status updates like “Called adjuster.” Instead, say “08/13 Called adjuster, left voicemail re unapproved items”
Stay current – Update immediately after calls or emails.
Think like a strategist – Know why you’re negotiating an item and how you’ll win it.
Mandatory to fill out this field
Pinpoints exactly where the total dollar gap is coming from.
Keep your negotiation focused on high-value targets.
Ensures no major item is forgotten or misrepresented.
Allow any AM/RM to jump in and see clear next steps.
In QIPs, this approach has shown significant increases in negotiation success rates.