Public Adjusters Negotiate on Behalf of Policy Holders … Not Their Contractor

All of my business comes to me by way of my internet advertising and referrals.  I do not “chase fires and storms” or otherwise solicit policyholders who have suffered a loss to hire me.  A potential client (or the person referring them) must contact me, first.

Referrals come to me regularly from former clients, attorneys, and building contractors who recommend me to policyholders that they know, and that might benefit from my involvement with their insurance claim.

Some Missouri building contractors will attempt to negotiate with an insurance company on behalf of the owner of the property that they are repairing or rebuilding and will often find that the insurance company refuses to cooperate with them.  Instead of contracting to do work for less than what they need to make, or before using inferior products and labor and cut corners to afford to work for the insurance company’s lowball estimate, they advise the homeowner to hire a public adjuster for assistance.

I have received many referrals from building contractors and have assisted the policyholders that they referred to me with successfully reopening their claim and getting a fair settlement that covers the full cost of the project (as well as my fee) so that the contractor can receive his full pay to do quality work.  This is a win for the policyholder, a win for the contractor, and a win for an insurance company who operates in good faith.

Likewise, policyholders that I help will often ask me for advice or referrals when they have been paid and are ready to begin the work of restoring their home or business.  I will recommend many of the fine and reputable building contractors that I have come to know and admire, knowing that they will be satisfied with the results.

Sometimes I will get calls from contractors who are simply wanting me to aid them to increase their own level of profit, at the expense of the insurance company and the policyholder, by adding unnecessary work to the scope to increase the cost to the job and expect me to negotiate on THEIR behalf and convince the insurance company to pay it.  I don’t do that.

A recent case in point was a Missouri policyholder who was reluctant to hire a public adjuster but was pressured to contact me by his building contractor.  The contractor initially attempted to “represent” the policyholder in negotiating his contract with me and discussing the claim with me, but I refused and communicated directly with the policyholder.  This is the only way I do business.

As I investigated the claim, I found that the insurance company had inspected the hail-damaged roof and siding with the contractor’s estimator and had actually agreed to pay what the estimator had originally estimated the costs to be.  Then, for reasons not clearly explained, the owner of the construction company revised his estimator’s original estimate and added a large amount of money for something outside the normal scope of work, and the insurance company refused to pay for this additional cost.

My job, according to the building contractor who pressured the policyholder to hire me, was to get the homeowner this extra sum for this unnecessary work so that he could pay it to the contractor.  I refused to do this and advised the policyholder that the insurance company had offered a fair settlement that matched the original estimate provided by his contractor, and that I was withdrawing from his claim.

An insurance claim is a matter that is between the policyholder and his insurance company, and the only acceptable resolution to an insurance claim is a complete restoration of the insured property to the condition that it was immediately before the event that caused the loss.  The contractor is hired by the policyholder to perform the work to meet that level of restoration and the insurance company has a duty to pay the costs associated with that level of restoration.  Nothing more … nothing less.

I appreciate the many referrals that I receive from building contractors who are looking to help policyholders achieve fair settlements so that they can be paid in full for their valuable services; however, when the policyholder and I agree to work together on his claim, I represent the policyholder and his interests, only.

Home destroyed by fire.

Home destroyed by fire.

Insurance Adjuster and Engineer Make a $69,000 Mistake at Policy Holder’s Expense

An expensive slate roof with copper flashing was severely damaged by hail.  The insurance company’s adjuster and his contracted engineering company agreed that it was damaged by hail … but still refused to pay for the repair.

The insurance company’s adjuster referred to a paragraph written on the third page of a letter that had been sent to the policyholder six months before which totally excluded hail damage to soft metals that did not result in leaks.  He told the policyholder that the vast majority of the $69,000 (plus) damage to his roof would have to be paid at his own expense.

The policy holder’s roofing contractor referred him to me for assistance with his claim.

My close examination of the policy, the letter, and the engineer’s report (in addition to localized weather reports) revealed that the exclusion the adjuster used to deny coverage did not take effect until four weeks after the hail storm. Accordingly, his denial of the claim was improper and he owed the insured for the damages.

When I brought this to their attention,  the insurance company reluctantly acknowledged their duty to pay.  The policyholder will be made whole and the contractor will be able to serve another homeowner in need of his services.

“No” is not always the final answer.  Have a licensed public adjuster review your claim before walking away from your money.

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!
 

A Broken Water Pipe and the Insurance Claim

The recent cold blasts and “polar vortexes” that have made their way south into Missouri this winter have not been kind to some homeowners … particularly a recent client who had the misfortune of having a bathroom water pipe burst on the second floor of his home.

Broken water pipe on the level above.

Broken water pipe on the level above.

For an undetermined number of hours, water cascaded from the second-floor bathroom, then through the ceiling of the first-floor master bedroom, and then soon created a path into the finished basement and game room.  The damage was significant … not only to the structure of the home but also to the furnishings, clothing, pool table and electronic equipment that found itself underwater for hours before being discovered.

He called his insurance company who, in turn, hired a local “independent adjuster” who came to the home to assess the damage and determined that the insurance company would agree to pay approximately $11,000.00 to cover the loss of personal property and restore the home to its original condition.   Having recently spent much more than this to install the destroyed wooden floors and finish his basement the previous summer — my client was offended by his insurance company’s apparent disregard for his condition and was understandably upset.

In the search for a public adjuster to represent him, he found this blog on the internet and called me for assistance.

In a little more than four weeks, we were able to negotiate a settlement with his insurance company for over $38,000.00 with which he will be able to fully restore his home back to its original condition and replace his personal property exactly as promised by his insurance policy.

Most states now license public adjusters to assist homeowners and business owners with their property claims.  Help is available.  All you need to do is ask.

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

“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

Considerations for Insurance Premiums

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.


Copyright 2013 James H. Bushart

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

How Many Will Walk Away From Their Own Money?

My client’s legitimate claim with his insurance company for property damage had been denied and so he contacted me.
After my first contact with them, the insurance company offered a very small amount of money which they had calculated from their adjuster’s database (commonly used by adjusters throughout the United States) and that was less than his deductible — for which they would still pay nothing.
Following a few more contacts from me, I received this email from the insurance company:
  “Mr. Bushart, after doing some additional research on patio cover pricing, I feel that the pricing that you provided is more in line with what the insured had than what is on our data base. As such, we will use your figures for settling on the patio cover.
  How would you like the check issued and where would you like it delivered?”
How many other insured home and business owners will simply walk away from a denied or underpaid claim and leave money that is rightfully theirs laying on the table?
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