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!
 

Missouri House Bill 1086 — New Restrictions Concerning Contractors and Insurance Claims

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.”

http://www.house.mo.gov/billtracking/bills141/biltxt/intro/HB1086I.htm

Read more:  Should your contractor represent your interests regarding your insurance claim?

 

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.

Do You Have an Insurance Claim?

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.

 

Consider Risk Management Strategies When Buying a Home

 

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?

Get more personal lines insurance and risk management tips and ideas from IRMI.

Copyright 2013
International Risk Management Institute, Inc.

 

Hail Damage to Gutters – Repair or Replace?

I recently received an inquiry from a home owner who, following a recent hail storm, had his gutters damaged.  He asked if he should seek having his insurer pay to have them painted or replaced.

Although aluminum gutters can be repainted, this will become a process that will have to be repeated again and again over a period of time.  Even while the original surface will change color or become dull over time, the original surface is baked on and will not peel or crack, as will paint.  Painting gutters is, over time, the most expensive and least effective option.

This also applies to metal siding.

A home owner’s insurance policy entitles that the home be restored as close as possible to the condition that it was prior to the loss event.  Painting a gutter or metal siding does not accomplish this.  Replacing it, does.Damaged Gutter

Copyright 2013 James H. Bushart

http://www.publicadjustermissouri.com

 

Home Insurance Claim Highlights – 2013

As a very busy summer draws to a close, here are some of the highlights from the season’s most interesting claims.

1. The insurance company had delayed a response to a fire claim for six months. The home owner called me and soon after received an initial payment of $111,000.00 which, upon further review, was underpaid. We recovered an additional $14,000.00 a few weeks later.

2. The insurance company denied the church’s claim for storm damage to its steeple and interior. Their roofing contractor referred them to me and we soon recovered the full amount to repair the steeple, repair the damage to the interior of the church and to replace a section of the roof.

Damaged by 100 mph wind, this steeple was allowing water to flow into the church.

Damaged by 100 mph wind, this steeple was allowing water to flow into the church.

3. The insurance company denied a claim for damages to a home caused by a dishonest contractor. His financial advisor referred his client to me and we turned that “no” into a check for $10,000.00 and a waived $5,000 deductible (total value, $15,000.00).

4. The insurance company denied a claim for hail damage to his roof and my client’s roofing contractor referred him to me. We turned that “no” into a new roof.

5. The insurance company had refused to address the storm damage to her home and my client was referred to me by a friend. In a matter of weeks, we turned that “no” into a several thousands of dollars and a new roof.

6. The insurance company had said “no” and denied coverage to a storm damaged deck. My client was referred to me by a real estate agent. We turned that “no” into $16,400 for a rebuilt second story deck.

7. The insurance company had denied his roof claim stating that the storm with golf ball sized hail did not damage his roof. My client called me after finding me on the internet. We turned that “no” into over $21,000.00 for a new roof and gutter.

We did well on many other storm, theft and fire claims, as well. I’m looking forward to Autumn.

 

Copyright 2013 James H. Bushart

Public Adjusters and Independent Insurance Agents

Independent insurance agents often find themselves caught in the middle between their insured clients and the insurance company when a claims department fails to meet expectations.

Excerpt from Claims Journal Article

1.After a disaster, insureds have hundreds or even thousands of questions and worries. In a large-scale disaster, many of your local customers will be coming to you for answers. You may find yourself answering the phone every few minutes to address more questions and to resolve their fears. As an agent you will find it necessary to read the policy and then get back to the insured with their answers. You may find yourself at odds with the insurer if you add your own opinion or interpretation of the policy language and it differs from the insurer’s. This is an area where a public adjuster can add value since they will be the ones working directly with the insured and the insurer to address all coverage issues.

2. Customers who have suffered a loss are very emotional and upset. You will likely be the first person they call about their loss. Your customer will be in need of some immediate assistance and resources. Some of the things they will need are emergency services and temporary housing. Customers will also ask you to report their claim for them and will inquire as to the entire process. It is likely they will ask for a copy of their policy with a full explanation of their coverages. This is an important process that can be handled by a public insurance adjuster.

3. For the insured who experiences a disaster, working with numerous company adjusters, independent adjusters and contractors can be cumbersome, time-consuming and sometimes may even be infuriating. However, you as an independent agent want to stay neutral – you don’t want your customers yelling at you for decisions the insurer may be making and you certainly do not want your insurance company clients upset with you either. This can be a very challenging position to find yourself in. This is another reason why it makes sense to engage a public insurance adjuster – they are outside of the decision making process and will be an advocate for the insured.

Read this excellent article in its entirety that addresses several unique problems facing independent insurance agents … and offers a workable solution.

http://www.claimsjournal.com/news/national/2010/03/05/107917.htm#

 

Copyright 2013 James H. Bushart

 

%d bloggers like this: