A proposed revision to Missouri law will further restrict Missouri contractors from being involved in residential and commercial insurance claims.
“A [residential] contractor shall not represent or negotiate, or offer or advertise to represent or negotiate, on behalf of an owner or possessor of [residential] real estate on any insurance claim in connection with the repair or replacement of roof systems, or the performance of any other exterior repair, replacement, construction, or reconstruction work.”
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.
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 firstname.lastname@example.org . There is no charge to call and see if I can help you.
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.
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?
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.
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.
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.
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.
Insurance is based on the law of large numbers. By combining a large number of common units, the insurers are able to make predictions of possible loss and are able to calculate their probable losses — and establish the rates for those losses and their operating expenses (which, depending upon the type of company, can include significant profits for the insurer’s stockholders).
Too often, the effects of losses on profits are managed at the claims level where insurers will routinely delay, deny or defend against the payment of claims. (This is when the insurer will hire people like me.)
In my opinion, the amount of the premium for any insurance should be among the last considerations used by a consumer when considering an insurance company to hire.
When the premiums are significantly lower than the average premium among remaining insurers, one can be reasonably assured that the insurance company will be using other (and possibly less desirable) means to make the same or more profit than the company with the average premium rates. Typically, one will find that such insurers are much more enthusiastic and prompt in their collection of premiums than their payment of claims at the time of loss.
Recently, I had some interesting results for a client whose home had been damaged by fire and needed extensive repair. The insurance company had underpaid him by claiming a depreciation of more than 63% on the interior plaster walls that were in excellent condition prior to the fire, but were old.
After I reopened the claim, the insurer agreed to pay him an additional $11,438.00 that he had been originally entitled to and almost walked away from.
If there is a moral to this story, I think that it is to seek a reputable insurer with a fair rate in comparison to other insurers and not the lowest rate which is likely to find you struggling to be paid for your loss at a time you can least afford the hassle.
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.