Tag Archives: Claims adjuster

Protecting Yourself from Claims Predators After a Disaster

April 13, 2026 By in Property Insurance Tags: , , , , 1 Comment

Don’t sign ANYTHING.

A fire has just torn through your home. The flames are still being beaten back by firefighters. Hoses snake across your lawn. Smoke fills the air and your eyes sting from the heat. Your family is standing in the street in whatever you managed to grab on the way out. You don’t know yet what you’ve lost, what’s left, or where you’ll sleep tonight.

And then someone walks up and hands you a contract.

It sounds almost unbelievable. Unfortunately, for far too many Missouri homeowners, it’s a scene that plays out all too often.

Who Are These People — and Why Are They at Your Fire Scene?

Some public adjusters — mostly from out of state who work claims here, but a few licensed and working in Missouri — hire paid local solicitors specifically to drum up business at disaster scenes. These solicitors are often the first non-emergency personnel to arrive at a loss. They scan police scanners, monitor fire department radio frequencies, and show up while smoke is still rising from the rubble, clipboard and contract in hand.

Their job is simple: get your signature before you have a chance to think.

Public adjusters are professionals who represent policyholders in insurance claims — and legitimate ones can provide real value, especially in complex losses. But the tactics used by the predatory fringe of this industry are a different matter entirely. When someone approaches a grief-stricken, disoriented homeowner at the scene of a disaster and pressures them to sign a legal contract, that’s not advocacy. That’s exploitation.

The Problem with Signing Under Duress

In the immediate aftermath of a fire, flood, or other catastrophic loss, you are not in a position to make clear-headed legal and financial decisions. That’s not a character flaw — it’s simply human nature. Trauma, shock, and fear are powerful forces, and they impair judgment in ways that even intelligent, capable people don’t always recognize in the moment.

Public adjuster contracts are legally binding agreements. They typically grant the adjuster the authority to communicate with your insurer on your behalf and entitle them to a percentage of your settlement — often between 10% and 15%, sometimes higher. Signing such a contract at the scene of a loss, before you even know the full extent of your damages, means you are committing a significant portion of your recovery funds to someone you met minutes ago, under circumstances no reasonable person could call voluntary.

Many homeowners who signed these agreements later reported feeling they had no choice, that the solicitor implied it was necessary to get the claims process started quickly, or that they were simply too stunned to push back. Some didn’t even fully understand what they had signed until weeks later.

A Legislative Gap That Leaves Policyholders Vulnerable

You might expect that showing up at an active fire scene to solicit business from disaster victims would simply be illegal. In many states, it should be. But legislators have often been reluctant to outright prohibit this kind of solicitation, instead attempting to address it through disclosure requirements, waiting periods, and contract cancellation rights.

While those protections have some value, they rely on policyholders knowing their rights and having the presence of mind to exercise them at one of the most disorienting moments of their lives. That’s a fragile safety net at best.

Until stronger protections are in place, the burden of self-defense falls largely on you.

How to Protect Yourself

The single most important thing you can do in the aftermath of any disaster is this: do not sign any contract, agreement, or authorization with anyone until you are ready.

That means waiting until you are somewhere safe and calm. It means waiting until you have had time to assess the full scope of your loss. It means waiting until you have spoken with your insurance company, understood what your policy covers, and had the opportunity to consider every option available to you.

You have time. Despite what a pushy solicitor may imply, your insurance claim will not be lost or compromised because you took a few days — or even a few weeks — before hiring a representative. Your insurer is legally obligated to work with you. Your rights as a policyholder do not expire.

Here are a few practical steps to take immediately after a loss:

  • Call your insurance company directly to report the claim and begin the process. You don’t need a third party to initiate this.
  • Ask for identification from anyone who approaches you at the scene claiming to represent your interests. Get their name, company, and license number.
  • Never feel pressured to make decisions on the spot. Any legitimate professional will respect your need for time.
  • Consult someone you trust — a family member, attorney, or financial advisor — before signing anything.
  • Know your cancellation rights. Missouri law gives policyholders the right to cancel a public adjuster contract within a set period after signing. But it’s far better not to sign under pressure in the first place.

The Bottom Line

Disasters are devastating. The recovery process is long, complicated, and emotionally exhausting. There are honest, ethical professionals who can genuinely help you navigate an insurance claim — and if you decide you need one, you should have the time and clarity to choose one wisely.

Don’t let anyone take that choice away from you in the chaos of the worst day of your life. Put the contract down. Step back. Breathe. The decisions you make in the days and weeks ahead will shape your recovery for years to come — and you deserve to make them on your own terms.

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

Missouri Insurance Claims and Politicians Don’t Mix Well

April 13, 2026 By in Property Insurance Tags: , , , , , 3 Comments
map of missouri

The Great State of Missouri

 

There is a disconnect between Missouri 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 Over-promising

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

What Must I Prove When Filing an Insurance Claim?

July 2, 2021 By in Property Insurance Tags: , , , , 2 Comments

 

Burden of proof with insurance claim

Filing an insurance claim is often more complicated than it first appears. Someone who has never filed before may assume the process is simple: notify the carrier of the loss and wait to be paid. What many don’t realize is that the responsibility to show that covered property was damaged by a covered cause of loss falls on the policyholder. A common and costly misunderstanding is the belief that the carrier owes payment unless it can prove otherwise. That’s backwards, and it usually leads to frustration.

Before deciding to file, a policyholder should understand two points about how property claims generally work:

  1. The policyholder is responsible for showing that a covered cause of loss damaged covered property.
  2. The insurer is responsible for showing that an excluded cause of loss produced the damage, if the insurer intends to deny on that basis.

Too often, a policyholder notices a symptom — a ceiling leak, for example — and files a roof claim without knowing what actually caused the leak or whether that cause is covered. They ask the carrier to send an adjuster out to “pay the claim,” having done nothing to establish coverage.

The company’s adjuster works for the insurance company and protects its interests. That adjuster has no duty to prove a covered cause of loss caused your damage. The adjuster’s job is to gather information and evidence — and, where an exclusion may apply, to build the support the company would need to deny or limit the claim. When the adjuster is unsure about what he’s seeing or whether an exclusion applies, he may bring in a third party such as an engineer, architect, or consultant to assist.

By the time that investigation is done, the carrier is prepared to argue against coverage — while the typical policyholder, who never built a case that a covered cause of loss damaged covered property, is not.

So the prudent policyholder investigates the claim before inviting the carrier to investigate it. Here’s what I generally recommend:

  1. Know what is damaged and what caused it — as best you can. If you can’t determine this yourself, get the opinion of a trusted professional who is skilled with the damaged material. If your roof is leaking, have a roofer identify the source of the leak and what caused it.
  2. Collect the evidence. Preserve physical and photographic proof of the damage and its cause, and obtain a written repair estimate from a trusted contractor to restore the property to its pre-loss condition. (Avoid letting your contractor negotiate directly with the carrier. A contractor typically doesn’t know your coverage and has a financial interest in the work — a combination the adjuster can exploit.)
  3. Determine whether the damage is covered. Read your policy and talk with your agent. If a question turns on what your policy language legally means, that’s a question for an attorney. If you want help organizing your claim and presenting your damages, a licensed public adjuster can represent you in that process.
  4. Give your evidence to the carrier when you file — or when the adjuster inspects, if that’s more convenient. If you aren’t comfortable handling this yourself, a public adjuster can manage it for you.
  5. If the carrier won’t cooperate after you’ve documented your loss, get help. A public adjuster can represent you on the claim itself; an attorney can advise you on your legal rights and options.

The goal is simple: don’t hand your claim to the insurance company before you’ve done the work to support it. Prepared policyholders get better outcomes.

James H. Bushart is a licensed Missouri public adjuster. This article is general information about the claims process, not legal advice.

Do You Become the Enemy When You File an Insurance Claim?

June 19, 2021 By in Home Owner Insurance Issues Tags: , , , 1 Comment

Enemy for filing a claim

   “I have paid my premiums on time for twenty years and have never filed a claim.  Now, it is difficult for me to tell who has caused me more damage — the storm or my insurance carrier.”

     The above exclamation, or words like it, is something that I hear daily from Missourians who have had the misfortune of needing to file an insurance claim for damage to their homes and businesses.  Do you really become “the enemy” of your insurance carrier when you file a claim?  Do they really consider you more as an adversary than a customer?  

     I received an email today from an attorney representing an insurance carrier from out of state and who sells insurance policies in Missouri who provided a clear and convincing answer to those questions.

     My client, a commercial business, had incurred extensive and obvious hail damage to multiple buildings and filed an insurance claim.  Their insurance company hired an independent adjustment firm to inspect the damage who reported their observations to the carrier.  The carrier, after receiving their report and photographs, decided to hire an engineer who regularly assists insurance carriers in denying coverage for hail damage to properties in Missouri.

     With the hail damage being as obvious as it was, there was no legitimate reason to have an engineer look at the same dents, gouges, and tears that their independent adjuster had just seen and photographed.  I suspected that the independent adjuster had recommended that the claim be paid against the carrier’s wishes, and I requested a copy of his report.  Insurance companies will share their reports when their report supports a claim denial.  For some reason, the carrier did not want to share this one and I was suspicious of their intention.

     When I submitted a formal written request for a copy of the report from their independent adjuster that I believed supported my client’s claim for damages, I received a letter from the carrier’s attorney in response that confirmed my suspicions.  In part, it read as follows:

     “Under Missouri law, the relationship between an insured and the insurer with regard to first-party claims becomes adversarial when a claim is made on the policy.  Therefore, the insurer is entitled to assert work product privileges to prevent access to materials found in the claim or investigative file.”

     Because my client had filed a claim, he became an “adversary” to his insurance carrier and was not entitled to see documents in his file that might support his claim.  In return for his annual premiums exceeding $80,000.00 per year, this is what his money bought for him.  An adversarial relationship.

     Of course, we’re suing.  Soon, that report and all the other documents in the file will be in the hands of his attorney.  He will recover all the money owed to him by his insurance carrier along with (most likely) punitive damages and his attorney fees.  He is, indeed, an “adversary” to his insurance company – but not because he filed a claim.  Rather, it was the insurance carrier that decided to vexatiously withhold money that was due to him under his contract rather than to pay him what he was entitled to.  That action taken by them, and not their claim, is what made him an adversary … and a worthy one, at that.

Missouri Law and Your Insurance Company

May 16, 2021 By in Home Owner Insurance Issues, Property Insurance Tags: , , , , Leave a comment

Not everything that is unethical is illegal.  There are ways of stepping right up to the line without crossing it and no one can do it better than some insurance companies with their vast financial resources and lobby power at the state government level.

But how far is too far? 

This is how the statute reads …

Universal Citation: MO Rev Stat § 375.1007.

Improper claims practices.

375.1007. Any of the following acts by an insurer, if committed in violation of section 375.1005, constitutes an improper claims practice:

(1) Misrepresenting to claimants and insureds relevant facts or policy provisions relating to coverages at issue;

(2) Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;

(3) Failing to adopt and implement reasonable standards for the prompt investigation and settlement of claims arising under its policies;

(4) Not attempting in good faith to effectuate prompt, fair and equitable settlement of claims submitted in which liability has become reasonably clear;

(5) Compelling insureds or beneficiaries to institute suits to recover amounts due under its policies by offering substantially less than the amounts ultimately recovered in suits brought by them;

(6) Refusing to pay claims without conducting a reasonable investigation;

(7) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed and communicated to the insurer;

(8) Attempting to settle a claim for less than the amount to which a reasonable person would believe the insured or beneficiary was entitled by reference to written or printed advertising material accompanying or made part of an application;

(9) Attempting to settle claims on the basis of an application which was materially altered without notice to, or knowledge or consent of, the insured;

(10) Making a claims payment to an insured or beneficiary without indicating the coverage under which each payment is being made;

(11) Unreasonably delaying the investigation or payment of claims by requiring both a formal proof of loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form;

(12) Failing in the case of claims denial or offers of a compromise settlement to promptly provide a reasonable and accurate explanation of the basis for such actions;

(13) Failing to provide forms necessary to present claims within fifteen calendar days of a request with reasonable explanations regarding their use;

(14) Failing to adopt and implement reasonable standards to assure that the repairs of a repairer owned by or required to be used by the insurer are performed in a workmanlike manner;

(15) Failing to promptly settle claims where liability has become reasonably clear under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.

 

Fighting the Good Fight

May 5, 2021 By in Home Owner Insurance Issues, Property Insurance Tags: , , , , , , Leave a comment
Fighting the good fight

Photo by Pavel Danilyuk on Pexels.com

 

     I recently read a touching and inspiring tribute written by an attorney who advocates for policyholders and who had recently lost a valuable partner and fellow advocate to cancer.  Together, they would fight the good fight. There are not enough fighters like them in this arena, and in his tribute to his partner, he described her drive and enthusiasm for battling with insurance companies on behalf of their clients.

     Being one who shares in the same fight (though not at such grand of a scale), I felt a great sense of personal loss.  Even though I did not know her, personally, I know her heart and I have shared similar pain with the clients who had purchased insurance for peace of mind but found, when disaster came to their door, that this peace was only a temporary illusion.

     Though Missouri law tasks an insurance company to provide prompt and fair assistance to its policyholders in exchange for payment of premiums, minimizing risk, and filing a claim only upon sustaining damage – some insurance companies, to protect their own financial interest, inflict more stress and financial harm upon their policyholders than the destructive event that prompted their claim, and at a time when the policyholder is most vulnerable with the least financial reserve.  Instead of providing the warm professional care and assistance projected by their televised mascots, the policyholder is frequently met with fierce opposition and obstruction intended to exasperate, wear down, and break the resolve of the most committed policyholder defending his own rights under the very insurance policy he bought for “peace of mind”.

     Fighting through a barrage of tactics used by insurance companies to delay, deny, and defend against the policyholder is certainly not an enjoyable experience for either the policyholder or his advocate.  It is, however, something that must be done in order to receive a dollar-for-dollar payment for the incurred loss.  That is the reality that is not shown on friendly and warm television commercials.

     We lost a fighter.  Who will take her place?

 

 

 

 

 

Missouri Homeowners/Business Insurance and the Roof

April 29, 2021 By in General Home Issues, Home Owner Insurance Issues, Home Repairs Tags: , , , , , , Leave a comment

 

Insurance

     There are two kinds of roofs on Missouri homes and business structures.  There are those that have storm damage and those that will have storm damage.  Understandably, the various insurance companies from all over the country that sell policies in our state will offer a wide variety of coverage options that are not always fully understood by the property owners before disaster strikes.  

     Learning after the roof has been damaged that you have been saving pennies per year by NOT including coverage to match replacement shingles or siding, or learning that hail dents that destroy the appearance of your metal roof is not considered “damage” by your insurance company, can result in costly out of pocket expenses that you thought were covered by insurance.  

     The Missouri Department of Insurance has created an informational and interactive website that helps you to understand your roofing coverage for each insurance carrier.  While I recommend that you visit their site, I urge you to take the time to read and understand your insurance policy, as well.  Have your agent clearly explain to you, when necessary, what it does and does not provide and ask lots of questions.

     Considering that when an insurance company’s claims department is on its absolute best behavior, its job is the same as any corporation that is run by a board of directors.  That job is to put the monetary interests of their shareholders (not their policyholders) at the top of their priority list.  Their duty to you, as a policyholder, is not fiduciary (as it is with their shareholders) but contractual.  Thus, even when you are dealing with a fair and reasonable adjuster, you need to know what your contract with them says.  That contract is your insurance policy.

     Your insurance company is prepared and well-practiced to fight and defend their rights under that contract.  How prepared are you?  Don’t let the first large claim be the first time you read it.  Caveat emptor.

Why Missouri Contractors Cannot Negotiate Your Insurance Claim.

April 18, 2021 By in Home Owner Insurance Issues, Home Repairs, Property Insurance Tags: , , , , , , , , , 2 Comments

missouri contractors cannot represent your claim

Missouri contractors cannot negotiate your insurance claim on your behalf with your insurance company.  On August 28, 2011, the Governor of Missouri signed into law Senate Bill 101, which prohibits home exterior contractors from representing a policyholder or negotiating with their insurance company for exterior work on their home as a part of an insurance claim.

Here is a link to the law:   It is obvious.  

So why do insurance companies continue negotiating with residential contractors despite this law?  Perhaps it is because, when they do, they can get away with underpaying your claim.

An insurance adjuster can say things to your contractor that he cannot tell you, your Missouri attorney or your Missouri licensed public adjuster because, unlike you (and those who lawfully represent you), the contractor is not a party to the agreement (the policy) between you and the insurance company. 

Insurance adjusters will often withhold certain information from the contractor, misrepresent or not fully disclose your coverage to the contractor, and say things to your contractor such as, “We are not paying that much for that building material … Your estimate is too high for labor, and you need to revise that … We are not going to pay more than such and such dollars for this claim … We won’t pay your overhead and profit” … and so forth because they are not communicating with you or anyone lawfully representing you.

It would be an act of bad faith, and perhaps a vexatious act carrying severe penalties, for the adjuster to say such things to you or your lawful representative.  Why?  Because certain communications and actions between insurance companies, their policyholders, and their lawful representatives are regulated by the Missouri Department of Insurance. Such regulations, however, do not necessarily extend to their relationships with contractors and other vendors.  In their opinion, your contractor represents his interests and not yours. 

For example, when an insurance adjuster makes a statement of fact regarding your coverage to you or your lawful representative, he must respond with supporting language from your policy upon demand.  Not so, however, when your contractor makes the same demand.  Since the contractor is not a party to the agreement or lawfully representing anyone who is, he is not entitled to know all of the critical information the policy contains.  Withholding this information about your specific coverage from your contractor puts him in the dark and the insurance company’s adjuster in complete control. 

Some contractors mistakenly believe that since they have worked with certain insurance companies or adjusters in the past, all policyholders with that company have the same or similar coverage – which is not true.  The same insurance carrier can insure three or four neighbors living side by side on the same street and have different policies with different coverage. Some contractors quote what they believe to be “state law” regarding what an insurance company must pay for, which is also untrue.  In Missouri, state laws do not govern or control all of the information contained in an insurance policy, and policy interpretation disputes are settled in civil court and are generally not legislated.

I hold skilled and experienced exterior contractors in very high regard. They are essential advisors for you and your lawful representatives in settling a claim.  Their skillful and experienced input in determining the full scope of the damage and what they charge for restoration of that damage is often vital in settling your claim.  It is when they extend beyond their valuable construction skills and expertise and go beyond the “low hanging fruit” that the adjuster would pay anyway and (as some contractors advertise) “push” the adjuster toward a larger settlement, complete documentation, communicate with the carrier on your behalf and settle your claim, those and similar actions may not be in accord with the law and their results may not produce all of the money that you are entitled to.

On your own, reflect as to how an independent roofing contractor negotiating a claim for hail damage to shingles is likely to overlook and omit hail damage to windows, siding, screens, wood trim, decks, and HVAC equipment from his estimate as he argues with an insurance company’s adjuster for a complete roof replacement.  Then consider why an insurance adjuster would be willing to negotiate with him even though the law forbids it.  It could be a bargain for the insurance company at your expense.

Most damaging is the harm some do to your claim before you finally bring in qualified and lawful representatives, such as your attorney or licensed public adjuster, to assist you.  While their lack of ability to correctly interpret your coverage or communicate your rights under the policy may have limited their ability to help you fully resolve your claim, what they spoke to the insurance company (correctly or incorrectly) can interfere with a fair resolution and must be identified and resolved before progress can be made.

I work with many exterior contractors and help them operate within the boundaries outlined in Senate Bill 101, allowing them to focus on their areas of skill and expertise to serve their customers’ construction needs fully.  Their customers can recover from their insurers what they require to restore their home to its pre-damaged condition, and the contractor makes what he bids for the needed work.  When done correctly, all parties are served in a win-win position.  However, when done improperly, some or all come out on the losing end.

Not all claims require an attorney or a public adjuster to handle them.  Most can be taken directly by the policyholder with no representation if they understand their rights under their contract with the insurance company and have a skilled contractor they trust to inform them of their damage correctly and what must be done to restore their property to its pre-loss condition.

No one but you, your Missouri attorney, or your Missouri licensed public adjuster should be communicating with your insurance company on your behalf and remember that a “no” from the insurance adjuster to your exterior contractor is not the final word on your claim for damage.

 

 

 

This Blog/Website is made available by James H. Bushart, Public Adjuster LLC, for educational purposes only and to give you general information and a general understanding of the work of a public adjuster, not to provide specific legal advice. The authors and site manager make no representations as to the accuracy, completeness, currentness, suitability, or validity of any information on this site and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. Using this blog site lets you understand there is no public adjuster/client relationship between you and James H. Bushart, Public Adjuster.  The Blog/Website should not be used as a substitute for competent legal advice from a licensed professional attorney or for capable maintenance or repair advice from a qualified contractor licensed to perform work in your state.

The Need for a Personal Contents Inventory

April 18, 2021 By in Property Insurance Tags: , , , , ,
Need for a personal content inventory

Sifting through the ashes to write an inventory of personal contents to provide to your insurance company can be stressful.

 

The most cumbersome task required of a homeowner by their insurance company when filing a claim after a catastrophic fire or tornado loss is the preparation of a personal contents inventory. 

Test yourself right now.  Close your eyes and make a mental list of everything in the room you are in … then open your eyes and marvel at all you failed to include in your list. Think of doing this for every item in your home after a fire, tornado, or other tragic events then add to this overwhelming task your insurance carrier’s request that you also add to each item on your list the date you purchased it, its manufacturer, price, and more.

It’s hard.  It’s expensive to be wrong.  It seems unfair.  It will make you angry to be required to perform this task and it will upset you to be forced to revisit your loss and relive this tragedy each time you return to the task.  I’ve seen many of my clients experience this anguish repeatedly.

There is something you can do TODAY, however, that will help you to minimize this daunting effort should you ever be faced with such loss.  That something is to create and maintain your inventory right NOW.  Remembering all of your items can make the difference of thousands of dollars in your insurance claim.  Imagine being paid a thousand dollars per minute to file your claim.

The Missouri Department of Insurance provides a handy booklet you can download to get started, but I recommend that any written list of your belongings you create be supplemented with a gallery of photographs and videos.  When photographing your items for your inventory, including photographs of the data plates that record the serial numbers, manufacturer, and manufacturing date.  A digital recording of a slow span of a room, a drawer, a box of mementos, tools, and cupboards will assist you and your insurance company, as well.  There is also a phone app. 

It is important to keep your inventory and video/photographic record of your belongings in a safe place other than in your home where they could be destroyed along with the recorded belongings.  Keep it up to date when items are added or removed from the home … and may you never, ever have to use it.

For more information, contact James H. Bushart, Missouri Licensed Public Adjuster.

 

 

This Blog/Web Site is made available by James H. Bushart, Public Adjuster LLC for educational purposes only as well as to give you general information and a general understanding of the work of a public adjuster, not to provide specific legal advice. The authors and/or site manager make no representations as to accuracy, completeness, currentness, suitability, or validity of any information on this site and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. By using this blog site you understand that there is no public adjuster/client relationship between you and James H. Bushart, Public Adjuster.  The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state, nor should it be used as a substitute for competent maintenance or repair advice from a qualified contractor licensed to perform work in your state.

Who Can Represent You With Your Hail/Wind Damage Claim

July 2, 2019 By in Home Owner Insurance Issues, Property Insurance Tags: , , , , , 1 Comment

Your contractor will be valuable to you as you present your insurance claim to your adjuster.  Without his skill and expertise, you will have a tough time communicating all that has been damaged and the work necessary to restore your home to its original condition.  

You might have read the Missouri law that states that a roofing contractor cannot represent you with your insurance claim when communicating with your insurance company about the condition of your roof. Your insurance company’s adjuster certainly has.

Specifically, it reads in part, “A contractor shall not represent or negotiate, or offer or advertise to represent or negotiate, on behalf of an owner or possessor of 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.” [Missouri Revised Statute Title XXVI, Trade and Commerce, 407.25]

You can represent your hail damage claim by yourself, or you may decide to hire an attorney or Missouri-licensed public adjuster to represent you with your insurance claim. However, if you choose to have your roofing contractor do the talking for you, he represents only himself and his company’s financial interests in restoring your storm-damaged roof. Not you.

Accordingly, your insurance company’s adjuster will often disregard much of your contractor’s input as being self-serving … unless it serves the insurance company’s best interest to do otherwise. For instance, if your roofing contractor is willing to compromise and agree to the adjuster’s lower computer-generated estimate, the adjuster may strike a deal with you based upon his agreement to work for the lesser amount. However, a roofing contractor’s opinions or arguments calling for more money or materials that differ from what the adjuster has already decided to pay will likely be dismissed. As the governing regulations state, the contractor cannot negotiate your claim.

A policyholder called me for assistance recently and told me that he had three different roofing contractors speak to his insurance company’s adjuster on his behalf, and all three told the adjuster that his roof required replacement. According to him – and to his dismay – the adjuster disregarded the arguments from all three of them and refused to pay him to replace his roof.

Of course, the policyholder was convinced that the adjuster acted improperly and unfairly. He believed that his insurance company had a duty to accept these arguments, particularly since they came from three different contractors, as definitive proof of his loss, but he was wrong. What the policyholder’s three contractors presented to his adjuster were three other sales presentations for replacing his roof – none of which proved to the adjuster that the roof had been damaged by hail on the reported date of loss to the extent that it needed to be replaced.

Simply put, the insurance company’s adjuster was not convinced by the three different contractors, each of whom is in business to sell new roofing systems, that the home required a new roofing system as a direct result of the claimed hail event.

Sometimes, the roof’s overall condition may require the roof to be replaced. The roofing contractor is doing his job by correctly informing the homeowner of that need and can undoubtedly observe and communicate that to the insurance adjuster. The adjuster might even agree with him regarding the roof’s overall condition. However, one item usually required to recover money from the insurance carrier to pay for the roof replacement is physical proof that the reported damage is the only cause of that condition.  Another is to prove that the damage occurred under conditions covered by the insurance policy in effect on the date of the loss.  I have observed that this is where many roof claims presented by roofing contractors, prohibited by law from negotiating the claim on behalf of a homeowner, fall short of those limitations.

Consultation with a reputable roofing contractor or expert is crucial as you prepare to present your claim to your insurance company. Suppose you know what to request from your roofing contractor so that you can acquire and present proof of your loss to your insurance company; you can present that proof to your adjuster, who, under the state rules that govern insurance claims, must respond to you on the record to the evidence that you present. This is what your licensed public adjuster would do on your behalf, as well.

There are a select few high-end roofing companies in Missouri that are staffed with experienced professionals who have proven to be able to acquire and provide convincing evidence that I have used to turn claims that the insurance company initially denied into recoveries of $80,000.00 to $925,000.00 – but the collected evidence was presented to the insurance company by me.

In the absence of such proof of loss or if the adjuster is simply not accepting the sales presentation from the roofing contractor as being definitive, the policyholder will likely be unsuccessful in his attempt to obtain more than what the adjuster initially values the loss to be – whether the adjuster is correct or not.

Since the roofing contractor does not officially represent the policyholder with his claim, the adjuster can disregard anything that the contractor directly presents to him. Where the insurance company’s adjuster must respond to your written requests in writing, he can reject arguments presented by your roofing contractor without justification or explanation. In certain instances, the insurance adjuster will go as far as to ignore or refuse to communicate with the roofing contractor on site since he is not required to do so.

Keep this in mind when you decide to ask your roofing contractor to present your roofing claim to your insurance company. A “no” to your roofing contractor from your insurance adjuster is not always the final word.

 

 

 

This Blog/Web Site is made available by James H. Bushart, Public Adjuster LLC for educational purposes only as well as to give you general information and a general understanding of the work of a public adjuster, not to provide specific legal advice. The authors and/or site manager make no representations as to accuracy, completeness, currentness, suitability, or validity of any information on this site and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. By using this blog site you understand that there is no public adjuster/client relationship between you and James H. Bushart, Public Adjuster LLC.  The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state, nor should it be used as a substitute for competent maintenance or repair advice from a qualified contractor licensed to perform work in your state.