Should Insurance Companies Adjust Their Own Claims?

Should Insurance Companies Adjust Their Own Claims?

The State of Hawaii’s legislature is presently reviewing a bill that would dramatically change the way insurance claims are handled.

The proposed law dares to ask the questions “Can the insurance company be trusted to be fair when determining how much they should pay?”

Some people say “No”.

Read more by clicking on the link, below:

http://www.propertyinsurancecoveragelaw.com/2016/04/articles/state-legislation/hawaii-considering-new-law-relating-to-claims-handling/#.VwuHDVRhl1s.linkedin

2015 – Our Most Interesting Claims

As more people in Missouri have become aware of the success and benefits they can derive from hiring their own claims adjuster to present their loss to their insurance company, this past year was our busiest yet.  Of our many claim settlements in 2015, here are a few that stand out from the ordinary:

  1.  After an expensive slate and copper roof was damaged by hail, the insurance company denied the policy holder’s claim for his loss.  They cited a provision in the policy that excluded the damage.  The policy holder was referred to me by his roofing contractor.  My investigation of the facts showed that the date that the exclusion was added to the policy was AFTER the date of the hail storm – and should not have been applied.  My client, who had originally been told by his insurance carrier that his damage was not covered under his policy, received a payment exceeding $80,000.00 to affect the repairs to his roof.
  2. A fire destroyed a private residence and the policy holder and family were forced to sleep and eat in a camping trailer parked in the driveway while searching for a contractor willing to perform the repair work for the lesser amount that the insurance carrier had estimated the costs to be, which was considerably lower than any contractor was willing to bid.  They hired me to assist them and, after my negotiations with the insurance carrier, they received an additional $60,000.00 for the repair of their home and the full value of their policy (over $200,000.00) for their lost contents.
  3. The policy holder was told that, in spite of the fact that water was entering his home through the storm damage to his roof, the adjuster could not identify any storm damage and that no money would be allowed for roof repair.  The policy holder hired me to assist him and, after further negotiations, the insurance company paid to replace his entire roof.
  4. A frozen water pipe broke in the ceiling of a private home which resulted in a collapse of a major part of the ceiling and water damage to walls, carpeting, and personal contents.  The policy holder decided to hire me immediately after filing his claim and his insurance adjuster called him on the telephone and attempted to talk him out of using a public adjuster — and offered him $16,227.12 to settle his claim.  The policy holder refused to accept the settlement offer, allowed me to act as his public adjuster, and we settled the claim for over $62,000.00

Since starting this business in 2012, I have recovered millions of dollars for Missouri personal and commercial insurance policy holders. 2015 was another great year.

 

Insurance Adjuster and Engineer Make a $69,000 Mistake at Policy Holder’s Expense

An expensive slate roof with copper flashing was severely damaged by hail.  The insurance company’s adjuster and his contracted engineering company agreed that it was damaged by hail … but still refused to pay for the repair.

The insurance company’s adjuster referred to a paragraph written on the third page of a letter that had been sent to the policy holder six months before which totally excluded hail damage to soft metals that did not result in leaks.  He told the policy holder that the vast majority of the $69,000 (plus) damage to his roof would have to be paid at his own expense.

The policy holder’s roofing contractor referred him to me for assistance with his claim.

My close examination of the policy, the letter and the engineer’s report (in addition to localized weather reports) revealed that the exclusion the adjuster used to deny coverage did not take effect until four weeks after the hail storm. Accordingly, his denial of the claim was improper and he owed the insured for the damages.

When I brought this to their attention,  the insurance company reluctantly acknowledged their duty to pay.  The policy holder will be made whole and the contractor will be able to serve another home owner in need of his services.

“No” is not always the final answer.  Have a licensed public adjuster review your claim before walking away from your money.

What A Public Adjuster Does for You (Video)

A public adjuster is one of three classifications of insurance adjuster categories.

(1) There is the insurance company claim adjuster who is directly and exclusively employed by the insurance company to protect the insurance company’s financial interests in the handling of an insurance claim.

(2) There is the independent claims adjuster who is contracted to work for various insurance companies to protect the insurance company’s financial interests in the handling of an insurance claim.

(3) There is the public adjuster who is licensed by the state to work exclusively for the policy holder and represents the policy holder’s interests in the negotiations with the insurance company for a settlement to the claim.

Take Heed with Your Financial Records

 

Think of a family as a mini-business. Families plan, save, buy, and invest just like most businesses. For this reason, maintaining the proper family records is just as important as keeping business records is. Saving these records for the proper amount of time is an integral part of this whole process. The following tips are good rules of thumb to follow concerning your family and financial records.

  • Essential personal and family records such as birth, marriage, and death certificates should be permanently stored, preferably in a safe deposit box. The same rule applies to passports and original Social Security cards. Backup electronic copies via scanning should also be maintained.
  • Vital property records, such as real property deeds, burial lot deeds, and motor vehicle titles, should also be permanently stored in a safe deposit box.
  • An inventory of household goods and appraisals should be stored in a safe deposit box or electronically with backups. Photographs or videos of valuable personal property should also be maintained and safeguarded.
  • Insurance policies should be kept a minimum of 7 years in a home file. A list of all current insurance policies and policy numbers should be maintained in the safe deposit box or electronically with backups in the event of a house fire.
  • Auto service records should be retained in a home file for the duration of the ownership of the vehicle. These records may be helpful when selling the vehicle later.
  • Copies of canceled checks for non-tax-deductible expenditures should be stored in a home file or electronically for 3 years. Receipts and records of deductible expenses should be stored in a fireproof home file or electronically for 6 years.
  • Copies of past tax returns should be kept a minimum of 6 years (15 years is best).

Get more personal lines insurance and risk management tips and ideas from IRMI.

Copyright 2014
International Risk Management Institute, Inc.

A Broken Water Pipe and the Insurance Claim

The recent cold blasts and “polar vortexes” that have made their way south into Missouri this winter have not been kind to some home owners … particularly  a recent client who had the misfortune of having a bathroom water pipe burst on the second floor of his home.

Broken water pipe on the level above.

Broken water pipe on the level above.

For an undetermined number of hours, water cascaded from the second floor bathroom, then through the ceiling of the first floor master bedroom, and then soon created a path into the finished basement and game room.  The damage was significant … not only to the structure of the home but also to the furnishings, clothing, pool table and electronic equipment that found itself underwater for hours before being discovered.

He called his insurance company who, in turn, hired a local “independent adjuster” who came to the home to assess the damage and determined that the insurance company would agree to pay approximately $11,000.00 to cover the loss of personal property and restore the home to its original condition.   Having recently spent much more than this to install the destroyed wooden floors and finish his basement the previous summer — my client was offended by his insurance company’s apparent disregard for his condition and  was understandably upset.

In search for a public adjuster to represent him, he found this blog on the internet and called me for assistance.

In a little more than four weeks, we were able to negotiate a settlement with his insurance company for over $38,000.00 with which he will be able to fully restore his home back to its original condition and replace his personal property exactly as promised by his insurance policy.

Most states now license public adjusters to assist home owners and business owners with their property claims.  Help is available.  All you need to do is ask.

New York Joins Missouri in Forbidding Contractors from Representing Home Owners with Insurance Claims

There is a new law in New York to protect home owners.

“There’s a firewall that will help homeowners after their house is consumed by flames.

“A new state law mandates a legal separation between public insurance adjusters and the contractors they recommend to victims of house fires.

“The measure, intended to protect fire victims from two-timing insurance scammers, was borne of a series of complaints filed against a City Island business that was operating as both public adjuster and contractor.”

Read more: http://www.nydailynews.com/new-york/bronx/new-firewall-protects-homeowners-insurance-scams-article-1.1564929#ixzz2pJ34d8e3

Missouri House Bill 1086 — New Restrictions Concerning Contractors and Insurance Claims

A proposed revision to Missouri law will further restrict Missouri contractors from being involved in residential and commercial insurance claims.

“A [residential] contractor shall not represent or negotiate, or offer or advertise to represent or negotiate, on behalf of an owner or possessor of [residential] real estate on any insurance claim in connection with the repair or replacement of roof systems, or the performance of any other exterior repair, replacement, construction, or reconstruction work.”

http://www.house.mo.gov/billtracking/bills141/biltxt/intro/HB1086I.htm

Read more:  Should your contractor represent your interests regarding your insurance claim?

 

The Puppy Under the Christmas Tree: Homeowners Beware

Many puppies are welcomed into households every Christmas. Puppies are high on the wish-list of many young ones year in and year out. If you are a parent and homeowner, before bringing Fido home this Christmas, you may want to check your homeowner policy.

Wallace, the Wonderdog

The Puppy Under the Christmas Tree: Homeowners Beware.

You Will Know When You Need a Public Adjuster

Being a state licensed public adjuster provides me with an opportunity to read lots of articles and advertisements written by other public adjusters for public consumption.  With only a very few exceptions, I have found what I have read to be informative and valuable and  I am grateful to all who have taken the time to share their knowledge and expertise.

Many of these articles are written by financial and insurance experts and are directed toward insured home owners, intended to assist them in identifying when they need to call upon a public adjuster for assistance with their insurance claim.  Since many insured home and business owners are learning that such a person as a public adjuster even exists at the time they are reading the article it is natural for them to inquire more about what a public adjuster does in the first place.

Simply stated, a public adjuster is a licensed professional who will represent you to your insurance company in settling a first-party insurance claim for damage to your home or business.  Your choices in settling your insurance claim are (1) to do everything yourself, (2) hire an attorney to handle your insurance claim, or (3) hire a licensed public adjuster to handle your insurance claim.

The potential for a large insurance settlement can attract the attention of lawyers and public adjusters who may come directly to you when they learn of your financial loss.  Personal injury lawyers may call or leave phone messages when learning of an accident or injury and, likewise, some public adjusters may approach the home or business owner in person or by phone at the time of the fire, storm or other peril causing damage to the home or business.

Do you always need to hire a public adjuster to assist you?  No.  Not always.

Sometimes, the claim for damage may meet or exceed the total coverage of the policy.  The structure that is destroyed may have been insured for $100,000 and, being totally destroyed, the insurer has agreed to pay the maximum covered amount of $100,000. Hiring and paying an attorney or public adjuster to assist in this matter would be more of an expense than a benefit.

But insurance companies make money from collecting premiums … not by paying claims … and the process of recovering all of the money that an insured home or business owner is entitled to is not designed to be easy or prompt.  “Lowball” offers, delays and denials, and challenges that need to be defended are often introduced into the mix at the worst possible time for the damaged home or business owner.  Having an advocate to assist you through the process and who works for younot the insurance company … can be of great benefit.

When you find that you are faced with a difficult and cumbersome process or feel overwhelmed by the task of proving your loss to a skeptical insurance adjuster … you don’t have to face it alone.

When you find, as many do, that the insurance policy that you have faithfully maintained has failed to live up to your needs or expectations at the time you actually need it the most … you don’t have to face it alone.

When you find that you are being provided unacceptable “lowball” offers to cover your loss but are not confident in your own abilities to adequately negotiate a higher settlement … help is available.

I am not one of the public adjusters who will be contacting you at the time of the theft, vandalism, fire, storm or other peril. Instead, I wait until I am contacted by insured home and business owners who know, on their own, that they can use my help with their claim.

I am not paid anything until my client is paid and there is no cost to anyone who wishes to consult with me about their claim to see if I can help them.  Before you consider hiring me, you may contact others who have been assisted by me with their insurance claims and ask them about their experiences.

You will know when you need a public adjuster to assist you with your Missouri home or business insurance claim, and when you decide that you do, please call me at 314-803-2167 or email me at jbushart@publicadjustermissouri.com .

%d bloggers like this: