Missouri Insurance Claims and Politicians Don’t Mix Well

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The Great State of Missouri

 

There is a disconnect between legislative promises and regulatory reality in Missouri property insurance claims. Here, what THEY don’t know can hurt YOU.

In the world of property insurance, the language we use to set consumer expectations matters. Currently, Missouri’s proposed Senate Bill 1543 is attempting to change, among other things, how consumers interact with public adjusters. There are some good provisions in this bill, but a close look at the bill’s mandated language reveals a massive gap between what legislators are promising and what state regulators can actually deliver.

The Legislative Promise: “Free Help”

Missouri SB 1543 proposes that public adjusters must include a very specific, bold-text disclaimer in their contracts. It requires them to tell the consumer: “YOU DON’T HAVE TO HIRE A PUBLIC ADJUSTER TO FILE A CLAIM WITH YOUR INSURANCE COMPANY… IF YOU NEED HELP WITH YOUR CLAIM, THE MISSOURI DEPARTMENT OF COMMERCE AND INSURANCE WILL HELP YOU FOR FREE”.

It is true that a policyholder does not have to hire a public adjuster to assist with their insurance claim, just as a taxpayer does not need to hire a tax preparer or CPA to prepare their taxes.  Particularly, when the firetruck is still at your home spraying water on the fire and a public adjuster or solicitor is there trying to get you to sign a contract for representation before you have had a chance to consider your entire situation (yes, unfortunately, this happens), this warning is certainly valid and useful. I enthusiastically endorse it. However, when you have already filed a claim and are seeking help with it, is the Missouri Department of Commerce and Insurance able to represent you in the same way I can for free? 

In the context of the bill, which tightly regulates who is allowed to “negotiate” a claim—defined as discussing or exchanging offers with an insurance company to reach a settlement amount—this mandatory disclaimer strongly implies that the Department of Insurance will step in and act as a free alternative to a hired public adjuster.

The Regulatory Reality: “No Authority to Determine Loss”

However, if we look at the actual letters sent by the Missouri Department of Commerce and Insurance when consumers today request this “free help,” a completely different reality emerges.

When responding to consumer complaints regarding property claim disputes, the Department explicitly clarifies the strict limits of its power. A standard response from a Department complaint investigator plainly states: “I do not have the authority to determine the amount or extent of loss you have incurred”.

Instead of negotiating the dollar value of the damage or debating the scope of repairs with the insurance company, the Department outlines a strictly regulatory role:

  • Finding out the current status of the claim file.
  • Evaluating how the insurance company is handling the situation.
  • Assisting in claim resolution if possible, primarily by ensuring “the company is compliant with Missouri insurance laws”.
  • Cannot address property claim denials or partial denials.
  • Cannot establish the facts regarding any other disagreement between you and another party.

How much “help” can they really provide without determining or negotiating the amount of the loss, the scope of the damage, or the merits of the claim they are presumably helping with for free when the claim has been denied or underpaid?

The Danger of Overpromising

The difference between these two documents is staggering. The proposed contract language suggests to consumers that they can forgo professional representation because the state will step in and “help” them resolve their claim for free. Yet, when the state actually arrives, they legally cannot evaluate the damage, determine the cost of the loss, or negotiate the financial settlement.

If an insurance company relies on an engineer to deny structural damage or limit a roof replacement, the Department of Insurance does not have the authority to argue the engineering merits or negotiate a higher payout on the consumer’s behalf. They merely check to see if the insurer followed the statutory timelines and processes. When they have finished helping you for “free” and informed you that the insurer who has denied or underpaid your claim has violated none of the particular rules they govern, is not the insurer who denied or underpaid your claim even more solid in their partial or full denial of your claim? What can you do at that point other than sue?

Conclusion

For property owners facing devastating losses, clarity is essential. Suggesting that a regulatory body can replace the active negotiation and valuation services of a public adjuster is not just misleading; it leaves the consumer fundamentally unprotected during the most critical phase of their claim.

In short, while the state will offer its regulatory review for free, they will not—and legally cannot—act as a free public adjuster to negotiate the financial value or factual merits of either a residential or company’s commercial insurance claim.

Legislators must ensure that the statutory notices they force upon professionals accurately reflect the actual powers of the state agencies they promote. If those lobbying for this bill to become law are successful, Missouri policyholders will need to know that the promise of “free” help in this contract language may not be true.

James H. Bushart, Licensed Missouri Public Adjuster
MO License #8207067 | SCLA | NAPIA
314-803-2167 | missouripublicadjuster.org

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James H. Bushart
Jim Bushart is a licensed public adjuster helping Missouri home and business owners negotiate insurance claims for property loss and damage.

3 responses

  1. Pingback: Don’t Sign Anything: Protecting Yourself from Predators After a Disaster

    • Nor does the state government have the authority to do more than enforce their rules which, among those rules, preclude them from calculating or communicating what the client is owed.

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