Filing a Claim Turns This Homeowner Into His Insurance Company’s Adversary

After we have wrapped up negotiations with their insurance company I will often ask my clients to provide me with a few words describing their experience.  Today I was gifted with more than just a testimonial and recommendation … but an education.  I thought I would pass it on.
After a few hours of being away from the house running errands we arrived home to find water POURING out of the ceiling of the main floor of our house, only to find out that a water pipe had burst on the 3rd floor of the house which resulted in flooding all 3 levels of our house! Since I had never filed an insurance claim before, I was under the impression that the insurance company was on my side, therefore would take care of the damage on the property I had been paying them to insure…after all, this was MY insurance company, right? I soon found out just how wrong I was!!  
 
The insurance company’s adjuster came out about a week after the pipe burst, and inspected the damage to the house, then we anxiously awaited his figures so we could begin the work and get our family moved back into our home.  We were shocked at that point to find out that the insurance company only wanted to pay us $11,000 to fix all 3 stories of our flooded home!!  I immediately called my agent for help, and despite his good intentions, I quickly discovered that no matter how well you know your agent, and how good you think they are, they have absolutely no pull with the large insurance company.  It was at this point that I knew the insurance company had no interest in helping me, and realized I would have to help myself, so I began searching the internet for options to help with insurance claims.
 
When I began doing research online for help with my insurance claim, I discovered the profession of a “Public Adjuster”, which I had never heard of before. I found a few different companies online, and began calling around, as I wanted to ensure I found someone that was reliable. I was not impressed with the large companies that covered the entire US, as they just treated you like another number…I did not feel that they would provide the personal level of service that I was looking for to address this major event that I had going on. I then called Mr. Bushart, who personally answered the phone, listened to all of the problems I had, then explained how he could possibly help me. By the time I got off of the first call with him I was very relieved…I finally had found help!! 
 
I have to admit though, at first I was leery of committing to pay the fee a public adjustor charged, so I thought about it for about a week before I committed to hiring Mr. Bushart, but in the end, I would have been more than happy to pay him twice as much as he charged. Not only due to the eventual insurance payout of nearly quadruple their initial estimate, but more importantly because of the personal level of service he provided. He actually made two 9 hour roundtrips to my house…first to view the damage, which I expected, but then he came back the second time when the insurance company sent their adjuster back out to address the discrepancies between their adjuster’s estimate, and Mr. Bushart’s estimate. I was very glad that he did make it back the second time…it was worth every penny I paid to be able sit there and watch Mr. Bushart use his vast knowledge to shoot down the insurance company’s arrogant adjuster!   
 
I hope to never have to go through another insurance claim again, but if I do, I will call Mr. Bushart in on Day #1!
Andrew Kestner, Dexter, MO
I am very grateful to Andrew for helping me to better understand what it is like to be in his shoes during such a tumultuous time in his life and how he came to hire me.
He added:
Sorry it took so long to get this to you, but here is my story, feel free to take any or all of it to put on your website…I had trouble condensing it into a couple of sentences.  Also, don’t ever hesitate to give any of your potential clients my phone number if they have any questions about how great your service is!
 

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 .

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.

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

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

Property Depreciation – Age Should NOT Be The Only Factor

By James H. Bushart

www.publicadjustermissouri.com

Most insurance policies will define the terms by which the insurer will calculate ACV (“actual cash value”) in determining how much to pay and, usually, the factor of “age” is not one of those conditions. Still, the age of the property is often used as the primary determining factor when depreciating or subtracting from the replacement costs of an item of property that is being adjusted for settlement.

While it is true that an object’s age can correspond closely to its extent of physical wear and tear – it is not true in every circumstance. Age alone should not cause an object to lose a large percentage of its value and if the object is functionally sound, it should retain most of its value.

I have helped clients recover higher settlements from insurers who had initially calculated depreciation as high as 75% for perfectly working and maintained fireplaces that happened to be original to older homes. Plaster on the wall that was lost to fire was depreciated by more than 65% even though it was fully intact and functional prior to the fire and the insured home owner was entitled to a higher adjusted settlement. Countless other items and systems in the home have been grossly over-depreciated – at a great expense to the insured – for no other reason than their age.

In some cases, the age of the item may be incorrectly calculated and higher rates of depreciation can be mistakenly applied.  One recent case highlighted certain items as being subject to excessive depreciation due to what the adjuster determined to be advanced age when, in fact, the same insurance company had actually paid for their replacement less than a year prior when vandals had damaged the home.

Property owners should know and understand that an object’s amount of depreciation is identical to the amount of how much better, or more valuable, a new object is compared to the older object. This is what is actually being determined. Age is not always an appropriate measure of this and arbitrary deductions from replacement values that are simply based on age should be challenged by the insured. The adjuster must carefully listen to the insured’s arguments and negotiate in good faith.

If you feel that your property was unfairly depreciated and that your insurance company’s offer of settlement is unreasonable and unfair, contact me (if you live in Missouri) or a public adjuster licensed to represent you in your state.

[Update – 3/12/13 –  My client had a home damaged by a fire that needed extensive repair, as mentioned above.  The insurance company underpaid him … claiming a depreciation of 67% on the interior walls based totally upon their age.  After reopening the claim and further discussion with me,  they issued him an additional check for $11,438.00.]

www.publicadjustermissouri.com

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

Superstorm Sandy and Property Damage Insurance

As is often the case following such damaging events as the recent storms in the Northeastern section of the United States from yesterday, hundreds of thousands of home and business owners will awaken and begin to discover the realities of their insurance contracts … those conditions and exclusions that are written into their insurance polices that, like landmines, often impede their steps toward restoring that part of their lives that has to do with their property damage and loss.

Believe it or not, thousands of home owners with their houses under water brought in by the sea or overflowing river banks will only — today — discover that flooding is not a covered peril under their insurance policies.  With all or most of their personal property missing or destroyed, providing proof of their losses will appear to be impossible.

Because the burden is on the insured to “prove” his loss and most are not totally aware of their rights or the process of proving their insurance claims, many will accept lower settlements or denials that will unnecessarily add to the burdens that they already are forced to endure.

Some “storm chasing” public adjusters from all over the country will soon be descending upon the area to help people with their insurance claims to help home and business owners contend with the wave of adjusters sent by the insurance companies to protect their financial interests … and while many of them will actually be helpful, the shock and the awe of the recent disaster still hangs over its victims like a dark cloud and not all of their choices during this period will be, upon later reflection, “good” choices.

Prudent home and business owners throughout the country can benefit from this lesson and take the opportunity — today — to meet with a public adjuster close to their home.  Get to know him and discuss your insurance contracts with him.  Let him show you what they do and do not cover, what your immediate steps should be following a loss and how to protect yourself from actions that could nullify or reduce the amount of your claim.

Public adjusters do not work for insurance companies and can help you through the process of proving your claim  … even before it happens … so that you can concentrate on more important things that you will certainly face during a personal property disaster.

It is also important to note that, if you try to handle your claim on your own and are unsatisfied with the results, a local public adjuster can review your claim and reopen it to address a wrongful denial or underpayment.

Take the time, today, to find a local public adjuster who will be there for you when you need him the most.

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