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 .

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

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.

http://www.publicadjustermissouri.com

Missouri Home Owner’s Policy – Changes to Your Deductible

Many insured Missouri home owners are caught off-guard, at the time they file a claim and can afford it the least, when they discover that their “deductible” has increased to several thousands of dollars.  (The policy’s “deductible” is a dollar amount that is automatically subtracted by the insurance company from any amount that is owed, per occurrence, to the insured as a result of damage or loss to the home.)

When many home owners first insured their homes, their policies originally had a $500.00 deductible that eventually changed to $1,000.  Now, with recent renewals, insurance companies have begun to assign a deductible amount that represents a percentage of the total value of the policy.  By this, if a home is insured for $300,000, a 1% deductible allows for each claim to carry a deductible amount of $3,000.  This means that a claim against the policy for a $7,000 to repair will result in a payment of $4,000.

A recent Missouri client was surprised and upset to learn that his deductible had increased from its original $1000 to over $5,000 when he filed what was his very first claim after decades of coverage.  While we were able to successfully negotiate an agreement with his insurer to waive this deductible amount for his claim, this was an exception to the rule that is not always available – as was the case of another client who discovered too late that she had a significant $2,300 amount to be deducted from her settlement of $6,400.

These increases in the deductible amounts are reported to the home owner at policy renewal on the “Declarations” page that is sent at the time of each renewal.  Unfortunately, many home owners will simply file this important page with their policies without reading and noting the change.

Take the time, today, to read your most recent declarations page to see if your deductible has changed.  It is possible to negotiate a lower deductible with your insurance company, in some cases, with a slight increase in your premium … but this must be done and in effect PRIOR to the date of any loss or damage.

Copyright 2013 James H. Bushart

What is a Missouri Public Adjuster?

Mississippi River Scenic Byway in Missouri

Mississippi River Scenic Byway in Missouri (Photo credit: Doug Wallick)

By James H. Bushartwww.publicadjustermissouri.comAside from attorneys, public adjusters licensed by the Missouri Department of Insurance are the only type of claims adjuster that can legally represent the rights of an insured during a first party insurance claim process in the State of Missouri.

Upon notification of a claim for property loss or damage, the insurance company will send an adjuster employed by them or an “independent adjuster” contracted by them to investigate the claim.  These adjusters work for the insurance company and only represent the financial interests of the insurance company.  The Missouri Public Adjuster, on the other hand, levels the playing field by representing only the interests of the insured policy holder who has suffered the loss or damage to a business or home located in Missouri.

The Missouri Public Adjuster’s main responsibilities are to:

  • Evaluate existing insurance policies in order to determine what coverage may be applicable to a claim
  • Research, detail, and substantiate damage to buildings and contents and any additional expenses
  • Evaluate business interruption losses and extra expense claims for businesses
  • Determine values for settling covered damages
  • Prepare, document and support the claim on behalf of the insured
  • Negotiate a settlement with the insurance company on behalf of an insured
  • Re-open a claim and negotiate for more money if a discrepancy is found after the claim has been settled

For more information about the Missouri Public Adjuster or to request a free, no obligation consultation regarding a particular claim, contact me by writing jbushart@publicadjustermissouri.com or call me at 314-803-2167.

Copyright 2013 James H. Bushart

Insurance Claims for Hail Damage

By James H. Bushart

 

Hail damage to a roof is a common occurrence and damage is often and routinely repaired at the expense of insurance companies.

For some insurance adjusters delaying, denying and defending a claim is also routine and are the three main strategies used to promote the financial interests of the insurance carrier at the expense of the insured.

As a part of this strategy when delaying, denying or defending a claim filed for hail damage to a roof, many claims adjusters (after making their own inspection and declaring that there is no damage to the roof) will arrange to provide an insured homeowner with a “special service” by having an engineer evaluate the roof for damage, as well.

Evaluating the condition of a roof covering does not require an engineering background, but it does impress many people to see an engineer’s seal and signature under an observation. While making an effort to appear to be objective, and while still fully aware that future referrals and fees are at stake, the hired engineer will sometimes seek ways to confirm the initial finding made by the adjuster.

Here is one of the methods used to minimize observed hail damage to a roof while appearing to be objective and “scientific”.

In spite of the damage that is visible to the naked eye many engineer reports that have been used by insurance companies to deny claims that I have personally read will refer to an opinion that a “rate of acceleration” and “velocity” of the hail strikes were insufficient to cause “significant” damage to the roof coverings.

Sounds like some real indisputable engineering stuff, doesn’t it?  At least, it does until one considers the following:

1.  The storm has passed by the time the adjuster and engineer have examined the roof.

2.  “Terminal velocity”, or the maximum speed reached by a falling object, is measured by a mathematical formula that takes into account the size of the hailstone and the high winds and gusts that can accelerate the speed of the hailstone.

3.  The actual size of each hailstone that struck the roof … and the speed of the wind and gusts that drove the hailstone into the roof … cannot be determined by simply looking at the roof days, weeks, months or years after a storm.

4.  Remarks that appear in the engineer’s report that address the sufficiency of the “velocity” or “rate of acceleration” to cause damage is pure speculation.  The fact that it is being “speculated” by an engineer does not make it more than speculation.  It is not factual.

The physical evidence of hail damage will speak for itself.  Speculations as to velocity and acceleration that are provided from observations made days, weeks or months after the event are not factual and should not be allowed to be used to deny a claim in the presence of actual damage.

If you find references to “velocity” and/or “rate of acceleration” in any engineer’s report that supports your insurance company’s denial of your claim for roof damage caused by hail, request in writing that you be provided with the factors and formula(s) used to calculate these rates.  Also, ask for the source of the data used to determine the size of the hailstones and the speed of the wind and gusts that drove the hailstones into your roof.

For more information about how some insurance companies use engineer reports to routinely deny valid claims, click on the following link and read:  https://missouripublicadjuster.org/2017/03/09/fraudulent-engineer-reports-and-your-homeowners-insurance-claim/

 

 

Copyright 2012 James H. Bushart

How I Can Help When the Insurance Company “Lowballs” Your Settlement

Perhaps you’ve already filed your claim and received a lowball settlement that cannot possibly repair all of the damage to your Missouri property.

If there is money still owed to you by your insurer, I can help you by re-opening your insurance claim and negotiating a fair settlement.

My objective with the adjustment negotiations for your insurance company is a final agreement upon the maximum amount of money that you are entitled to receive under the terms and conditions of the insurance covering the loss.  This amount should coincide with the liability of the insurance company … meaning that, while an insured loss should not result in more than what it would take to restore you to your pre-loss condition, neither should it result in a payment of less.

The claim reopening process will begin with a review all the background documentation and your policy to determine if you were underpaid.  If you were underpaid and wish to hire me, I will contact your insurer and attempt to negotiate a fair settlement with them.  Sometimes, their “No” is simply a request for more information.

It costs you nothing to see if I can help you and if you do not recover additional money, you owe me nothing.

If your insured property is not located in Missouri, seek a public adjuster licensed in your state.

www.publicadjustermissouri.com

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