Lowballing an Insurance Claim

Lowballing is a negotiating tactic used by some insurance claims adjusters by which the adjuster knowingly offers far less than the merits of the claim warrants.  Lowballing is effective.  It forces many insured home owners to accept settlements that may be lower than their claims deserve.

The insurance claims adjuster’s purpose is to perform the insurance company’s promises under the insurance policy.  He has an ethical obligation to pay covered claims.  Lowballing is unethical and wrong.  An insurance adjuster who engages in lowballing is ultimately refusing to settle covered claims.

Many insured home owners are unaware that they have the option to re-open closed claims which they feel were underpaid or wrongfully denied.  Public adjusters can be helpful toward that end.  Consult with a public adjuster when you feel that your claim was underpaid or wrongfully denied.

In Missouri, I provide free consultations to insured home owners who feel that they may be entitled to more than what they were paid for their claim.  Call me at 314-803-2167.

 

Five Good Reasons to Hire a Public Adjuster

1) Call a private adjuster before you file your claim.

Sometimes, if you wait and see what the insurance company is going to offer, it may be too late to present your claim in a way that meets your policy agreements. “My basement is flooded” could result in a denial for lack of “flood” insurance when the cause for flooding, presented correctly, could be covered under a standard home owners policy.  A public adjuster will know how to communicate your loss and will know the state rules governing the insurer’s response.  He works for you … not the insurance company.

2) A private adjuster will know your insurance policy and how it works.

Insurance policies are confusing and difficult to read and understand if you do not work with them, regularly. Public adjusters have detailed knowledge of most home and business policies and how they work. They will present their own estimates of damage to the insurance company, giving guidance from the very beginning of the process.

3) Concentrate on getting “back to normal”.

Having a public adjuster working for you allows you to focus on getting your family or business back to normal and take away the often tedious and anxious process of settling your claim to make needed repairs.  While you are attending to matters necessary to restore your home or your business, you public adjuster is focused on your claim without the same distractions that would be interfering with your efforts to do the same.

4) There are no up front or “out-of-pocket” costs.

You can afford a Public Adjuster. You do not pay a public adjuster until you have been paid by your insurer. Fees for public adjusters may vary and are higher (around 10%) for the smaller claims of up to $250,000 and will generally decrease for recovery of amounts greater than that.

5) Even after your claim has been closed, a public adjuster can help you recover a fair settlement.

After you have settled with your insurance company and find that the amount of your recovery was less than what you needed — or may have been entitled to — to properly address your loss, a public adjuster may be able to reopen your claim and obtain additional recovery.

In Missouri, contact me at 314-803-2167 or email me at jbushart@publicadjustermissouri.com .  There is no charge to call and see if I can help you.

Do You Have an Insurance Claim?

You know that there is damage to your home or personal property … but are you entitled to money to to address your damage from your insurance carrier?

The insurance company will send their adjuster (or one that they have contracted to represent them) to the home to investigate and prepare a report.

The following questions are what your insurance company’s adjuster will be attempting to answer in making the determination as to whether or not you should be paid and, if you should be paid, how much to pay you.

1.  Is the cause of loss covered?  His interpretation of the cause may or may not fall under a cause of loss covered by your policy.

2.  Is the property involved in the loss covered?  Coverage is limited to the property that is described on the declarations page but can also include grave markers and property off the premises, as well.

3.  Is the type of loss covered?  Not all types of losses are covered under a home owner’s or business insurance policy.  Items that should be replaced through normal maintenance, for example, would not be covered.

4.  Are the types and amounts of damages covered?  Does your policy contain certain limits for certain types of losses and damages?

5.  Is the person involved in the loss covered?

6.  Is the location of the loss covered?  Many home owners are unaware that certain losses their children experience in the college dorm can be covered under their policy.

7.  Is the time of the accident or occurrence within the policy period?

8.  Are the hazards involved in the loss covered?   Vandalism, for example, may not be covered when the property is vacant.

9.  Do any exclusions apply?

Use these questions to guide you in determining if you have a claim and should be paid.  When your insurance company’s adjuster does not agree with you, consult a public adjuster before accepting less than what you may be entitled to.

 

Consider Risk Management Strategies When Buying a Home

 

Real estate markets in many parts of the country are heating up, with prices rising at a good clip. In many areas, it is a true seller’s market. So buyers should take heed of the various risks inherent in buying a home and should use sound risk management strategies before taking the plunge on an asset of such size. Here are some risk management and insurance tips to consider for your clients who are shopping for a home.

  • Consider the financial risks by not overextending yourself when buying a home. A good rule of thumb is not to buy a home that costs over 2.5 times your annual salary. Many online calculators can assist you in determining the maximum price for a home you can afford.
  • Consider the property and casualty risks. What are the key loss exposures to the home? For example, is the home in a flood zone? How far is it from the nearest fire department? Is it in an earthquake seismic zone 3 or 4?
  • What is the condition of the home? If it is apparent the home has not been properly cared for by viewing surface level deficiencies, there is a good chance that deeper problems may eventually manifest themselves. Thus, the value of a good home inspector cannot be overemphasized. If it is an older home, when were the various systems upgraded?
  • What types of losses have appeared on the Comprehensive Loss Underwriting Exchange report during the past 5 years? For example, a pattern of water losses may be a warning sign.
  • What type of loss control features does the home have? For example, is there a central station burglar and fire alarm system or a sprinkler system? If the home is in a hurricane-prone area, what windstorm protection devices are in place?

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

Copyright 2013
International Risk Management Institute, Inc.

 

Hail Damage to Gutters – Repair or Replace?

I recently received an inquiry from a homeowner who, following a recent hail storm, had his gutters damaged.  He asked if he should seek to have his insurer pay to have them painted or replaced.

Although aluminum gutters can be repainted, this will become a process that will have to be repeated again and again over a period of time.  Even while the original surface will change color or become dull over time, the original surface is baked on and will not peel or crack, as will paint.  Painting gutters are, over time, the most expensive and least effective option.

This also applies to a metal siding.

A home owner’s insurance policy entitles that the home is restored as close as possible to the condition that it was prior to the loss event.  Painting a gutter or metal siding does not accomplish this.  Replacing it does.Damaged Gutter

Copyright 2013 James H. Bushart

www.publicadjustermissouri.com

 

Home Insurance Claim Highlights – 2013

As a very busy summer draws to a close, here are some of the highlights from the season’s most interesting claims.

1. The insurance company had delayed a response to a fire claim for six months. The home owner called me and soon after received an initial payment of $111,000.00 which, upon further review, was underpaid. We recovered an additional $14,000.00 a few weeks later.

2. The insurance company denied the church’s claim for storm damage to its steeple and interior. Their roofing contractor referred them to me and we soon recovered the full amount to repair the steeple, repair the damage to the interior of the church and to replace a section of the roof.

Damaged by 100 mph wind, this steeple was allowing water to flow into the church.

Damaged by 100 mph wind, this steeple was allowing water to flow into the church.

3. The insurance company denied a claim for damages to a home caused by a dishonest contractor. His financial advisor referred his client to me and we turned that “no” into a check for $10,000.00 and a waived $5,000 deductible (total value, $15,000.00).

4. The insurance company denied a claim for hail damage to his roof and my client’s roofing contractor referred him to me. We turned that “no” into a new roof.

5. The insurance company had refused to address the storm damage to her home and my client was referred to me by a friend. In a matter of weeks, we turned that “no” into a several thousands of dollars and a new roof.

6. The insurance company had said “no” and denied coverage to a storm damaged deck. My client was referred to me by a real estate agent. We turned that “no” into $16,400 for a rebuilt second story deck.

7. The insurance company had denied his roof claim stating that the storm with golf ball sized hail did not damage his roof. My client called me after finding me on the internet. We turned that “no” into over $21,000.00 for a new roof and gutter.

We did well on many other storm, theft and fire claims, as well. I’m looking forward to Autumn.

 

Copyright 2013 James H. Bushart

Dangers of Asbestos After a Fire or Natural Disaster

Special thanks to guest blogger – Kaitlin Wilson

 

Asbestos has been used for its heat and fire-resistance properties dating back to ancient Rome. However, the mineral that was once used for its resistance against fire is also a potential hazard should a fire or a natural disaster happen. The fire-proofing properties of asbestos are a double-edged sword. A building full of asbestos can collapse after a fire, sending dust laden with the dangerous fibers into the air. Should any other natural disaster occur, such as a flood or tornado, homes and buildings built prior to the 1980s’ may send out millions of asbestos fibers into the air.

 

Asbestos Use in Homes and Buildings

 

After the Environmental Protection Agency (EPA) warned people of the dangers of asbestos fibers in the 1970s’, homes and buildings were eventually built without using asbestos. However, prior to the early 1980s’, asbestos was used quite a lot in homes, buildings, at job sites, and in products. Today, should a natural disaster or fire break out and come into contact with any structure that contains asbestos, its fibers, which as aforementioned are fire and heat-resistant, can become airborne and travel for several miles.

 

According to the EPA, in the summer of 1993, the community of Lincoln County, Missouri experienced a devastating flood that left over 50,000 people without homes, and several others with broken appliances, household items, automobiles, and more. As a result, county staff were responsible for disposing of the debris. After investigations, it was found that a good majority of the debris, specifically car parts, shingles, wood, and home insulation, was riddled with asbestos fibers. This of course, posed risks to the entire community.

 

Preventative Actions

 

Although no one knows for sure when a natural disaster will strike, the Centers for Disease Control and Prevention (CDC) suggests that taking proactive measures beforehand will reduce the risk of asbestos ingestion when and if a disaster occurs. For example, if waste hazards need to be burned after a disaster, proper precautions should be used at all times:

 

  • Shower facilities should be available to all workers.
  • The general public should be warned about the work being performed.
  • Coolant vests, face masks, and other safety equipment should be utilized.
  • Burnup and cleaning sites should always meet federal and state guidelines.
  • Local authorities should always be on-board to help meet regulations and safety issues, such as the local fire department and emergency response team.
Asbestos Victims

 

Anyone who has been diagnosed with asbestos cancer or another asbestos related disease is advised to seek legal assistance due to the complex nature of these cases. The Mesothelioma Lawyer Center has in-depth information on asbestos-related diseases, such as mesothelioma, and legal information for each of the 50 states, including information on asbestos exposure in Missouri.

 

Public Adjusters and Independent Insurance Agents

Independent insurance agents often find themselves caught in the middle between their insured clients and the insurance company when a claims department fails to meet expectations.

Excerpt from Claims Journal Article

1.After a disaster, insureds have hundreds or even thousands of questions and worries. In a large-scale disaster, many of your local customers will be coming to you for answers. You may find yourself answering the phone every few minutes to address more questions and to resolve their fears. As an agent you will find it necessary to read the policy and then get back to the insured with their answers. You may find yourself at odds with the insurer if you add your own opinion or interpretation of the policy language and it differs from the insurer’s. This is an area where a public adjuster can add value since they will be the ones working directly with the insured and the insurer to address all coverage issues.

2. Customers who have suffered a loss are very emotional and upset. You will likely be the first person they call about their loss. Your customer will be in need of some immediate assistance and resources. Some of the things they will need are emergency services and temporary housing. Customers will also ask you to report their claim for them and will inquire as to the entire process. It is likely they will ask for a copy of their policy with a full explanation of their coverages. This is an important process that can be handled by a public insurance adjuster.

3. For the insured who experiences a disaster, working with numerous company adjusters, independent adjusters and contractors can be cumbersome, time-consuming and sometimes may even be infuriating. However, you as an independent agent want to stay neutral – you don’t want your customers yelling at you for decisions the insurer may be making and you certainly do not want your insurance company clients upset with you either. This can be a very challenging position to find yourself in. This is another reason why it makes sense to engage a public insurance adjuster – they are outside of the decision making process and will be an advocate for the insured.

Read this excellent article in its entirety that addresses several unique problems facing independent insurance agents … and offers a workable solution.

http://www.claimsjournal.com/news/national/2010/03/05/107917.htm#

 

Copyright 2013 James H. Bushart

 

“No” is Not Always the Final Answer With an Insurance Claim Denial

Steeple

A storm with 100 mph winds had damaged a steeple and allowed water to enter the church and cause significant damage. The church was insured and a claim was filed the following day.

The church’s insurance company denied their claim by improperly applying an exclusion in the policy that referred to “wind driven rain” and that precluded the church’s right to recover for the damage.

Their roofing contractor recommended that they contact me for assistance, which they did.

Although the insurance company’s adjuster and their engineer supported this exclusion and the denial of the claim, the facts that I brought to them after my investigation of the damage forced them to re-evaluate.

They eventually came to agree that the cause of the damage DID fall under the policy and  agreed to reverse their denial and issue a check to the church to cover their total loss.

“No” is not always the final answer with an insurance claim.

Copyright 2013 – James H. Bushart.

www.publicadjustermissouri.com

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