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 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.

Your Denied or Underpaid Missouri Insurance Claim Can Be Reopened

By James H. Bushart

www.publicadjustermissouri.com

Insurance adjusters hired by insurance companies will often deny legitimate home or business owner claims for property loss … or underpay them.  The chances are great that you are, or know, someone that this has happened to.

Until they have experienced the process, most folks believe that when they suffer an insurable loss to their home or business, all they need to do is contact their insurance company and someone runs out right away with a check to cover all that they need.  They are shocked to learn that, in the middle of their crisis, they are called upon to focus their attention on “proving” their loss while navigating a mine field of conditions and exclusions that often (and mistakenly) result in disappointment.

Public Adjusters do not work for insurance companies.  Instead, they work for insured home and business owners who benefit from assistance in negotiating their claim.It is important to know that … when the dust has settled and you are ready to address the disappointing shortfall … a review of your claim by a licensed Public Adjuster can be your best choice.

I am a Public Adjuster and I offer free consultations to Missouri home and business owners who want to inquire about their past claims and the possibility of recovering money that is owed to them under their insurance policy.  Many other Public Adjusters in other states offer the same service.

Remember that, when it comes to your insurance company, the first offer is usually the lowest and that “No” does not mean “forever”.

For more information, visit www.publicadjustermissouri.com or call me at 314-803-2167.

It’s your money.

How I Can Help When the Insurance Company “Lowballs” Your Settlement

Perhaps you’ve already filed your claim and received a lowball settlement that cannot possibly repair all of the damage to your Missouri property.

If there is money still owed to you by your insurer, I can help you by re-opening your insurance claim and negotiating a fair settlement.

My objective with the adjustment negotiations for your insurance company is a final agreement upon the maximum amount of money that you are entitled to receive under the terms and conditions of the insurance covering the loss.  This amount should coincide with the liability of the insurance company … meaning that, while an insured loss should not result in more than what it would take to restore you to your pre-loss condition, neither should it result in a payment of less.

The claim reopening process will begin with a review all the background documentation and your policy to determine if you were underpaid.  If you were underpaid and wish to hire me, I will contact your insurer and attempt to negotiate a fair settlement with them.  Sometimes, their “No” is simply a request for more information.

It costs you nothing to see if I can help you and if you do not recover additional money, you owe me nothing.

If your insured property is not located in Missouri, seek a public adjuster licensed in your state.

www.publicadjustermissouri.com

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