Dealing with a Property Insurance Claim…One step at a time.

PUBLIC AWARENESS: PART 1

 

 

HELP: My Home has been damaged or destroyed…what should I do? What should my first steps be?

SOME FREQUENTLY ASKED QUESTIONS REGARDING A HOMEOWNERS INSURANCE CLAIM

First, …we hope that all in your home are physically ok. Second, …take a deep breath and know that you have help.

It may seem overwhelming;  Dealing with a loss like what you have experienced is a traumatic event. So, take a deep breath; now take some more.

Now let’s walk through the process;

 

If your property was insured, your first step starts with your insurance policy. It will outline the process, your coverage, and your rights.  This doesn’t mean that it will be easy to understand or a straightforward process. Insurance is a business and an insurance claim is, in essence, a business negotiation.

Fire Damage

 

The issue for most homeowners is that they are not experts in insurance. Unless you are in the insurance, legal or construction business, you might be – you probably are – at a disadvantage. And insurance companies will try to make the most of the gap in your knowledge versus theirs.

Some good news: you have rights and there are laws and rules that protect you. Insurance is a business that is highly regulated, and you can get help in negotiating with your insurance company.  It is your right.

We can help you understand the process and your rights and help ensure that you recover everything you are entitled to under the terms of the insurance policy that you have paid for.

Step One: The Policy Declarations

The starting point is your policy’s declaration page (GET PICTURE OF ONE.) Grab a copy of your policy.  Don’t have one?  Request one from your insurance agent or the insurance company directly.

The “Dec” page will break your policy into the categories of coverage:  for your “dwelling;” for “other structures (a shed, detached garage, etc.); personal property; living expenses, etc. There may be more. The “Dec” pages outline what the coverage is that you have paid to insure.

[UP’s “Simplified Guide to Your Homeowners Policy” will help you understand what’s inside your policy.

Step Two: Understanding Your Policy

When you have the policy in your hands, read it over.  Ask yourself these questions:

  • Do I fully understand my policy?
  • Do I know what I am entitled to receive or to ask for?
  • Do I feel comfortable working directly with the insurance company representative (the “adjuster”) to
  • Do I want someone representing me?

 

The reimbursements that your policy covers may be spelled out in the document, but they are not always straightforward. There are calculations that need to be made for various provisions: replacement value, landscaping, inspections, hauling, and debris removal, and many other items.

 

The most common issues that homeowners face include:

  • Being underinsured (Not having enough coverage)
  • Confusion over what the policy covers and what it doesn’T
  • There are A TON of items that may be covered that may not be obvious to you, and complicated formulas to determine what you are rightly entitled to.
  • Differences of opinion over the value of loss and the scope of the work needed to repair the damage
  • Unfair or “lowball” estimates and offers by the insurance company
  • Delays in processing your claim
  • An insurance company adjuster who is difficult to work with

    Property Damage

    Mold Damage in White Plains

 

Step Three:  Getting Help

 

If you feel you need assistance – and you are not alone in feeling that way – you have two options:

  1. Contacting the State Insurance Department to request assistance, or
  2. Hiring a reputable and experienced Public Adjuster.

 

Repairing/replacing your home can be a long and complicated process.  It can wear you out – at a time when most people are still recovering from the trauma of the event. It is not uncommon to take 18-24 months to repair or rebuild/replace your home and possessions after a large loss.

Remember, for most of us, our home is your biggest asset. An insurance company is going to act in its own best interest, and that may mean interpreting the policy provisions in their favor – not yours. And remember an insurance company adjuster works for the insurance company, not you.

 

This is not meant to scare you or make you distrustful.  Most insurance companies and their teams are wonderful to work with and go the extra mile for their policyholders.  But not all do, and not all the time. As the saying goes: “Trust but verify.”

You paid good money for insurance benefits and good claim service. Do your best to settle your claim directly with your adjuster/insurer by following United Policyholder‘s tips. Try getting help from elected officials, Case Managers, and government agencies. You may be unsure of what to do next.   Or are not certain you can trust what you are being told by your insurance company.  Maybe you are just running out of steam because it has taken so long to put the pieces back together.  All three are common feelings folks have. If that sounds like you, hire professional help.

 

A reputable builder/construction pro, a policyholder attorney or a reputable public adjuster are all good options. But do your research and be knowledgeable in this area, too.

Here are examples from our recent experience:

 

  • An insurer offered reimbursements based on its “computer model” that did not come close to matching what qualified local contractors estimated the work would cost.
  • An insurance company refused to factor in a contractor’s overhead and profit in its reimbursement, despite a provision in the policy that allowed it.
  • Insurance companies often send inexperienced adjusters to claims which leads to incomplete estimates or low valuations.

 

In each of these situations, the policyholder turned to an outside professional to get the insurance company to play by the rules and pay all that the homeowner was entitled to. You can push back…you do have the ability to challenge what you are told and what you are offered.

 

Step Four: Hiring Help

 

Many folks need someone to help them through the process of understanding what they are entitled to and recovering that full amount. They turn to a public adjuster – an independent professional without ties to the insurance company. Public adjusters charge for their services, with most reputable public adjusters charging between 7% and 10% of what they recover after they are retained.

 

If you need someone to help you exercise your legal rights, consider hiring a plaintiff-side insurance attorney on a contingent fee basis who will advance litigation costs if a settlement cannot be reached and a lawsuit becomes necessary.

 

In all instances, please protect yourself: make sure you check references carefully and hire only an experienced and reputable professional who represents policyholders, not insurance companies.

We’d be happy to help you through the process.  It only takes a call or a click to reach us for a free, confidential consultation.

Coronavirus Update: Are You Covered for Business Interruption? Is Your Boss?

March 23, 2020 by  
Filed under Blog, Uncategorized, Website

Progress Is Being Made to Clarify Coverage for Business Interruption for Coronavirus.

 

We started getting calls today from business owners asking if they were covered due to the shut down due to the Coronavirus. We, as usual, asked for the policy in order to check the language.

Additionally, we received a letter from our own insurance company that was mandated out of the New York Department of Financial Services requiring all companies writing commercial insurance to explain the coverage or lack thereof.

The New Jersey State Assembly is working on Bill A3844 which will require insurance companies to construe coverage to include Covid-19, or Coronavirus related closures. They will be considering contamination to be direct physical damage.

Our own coverage as mentioned earlier affords coverage for Civil Authority if due to action by said authority prevents access to our Main or Dependent Properties. Of course, there will be additional language to sort through and we need a topic for tomorrow.

Until then we transposed a copy of the New Jersey Assembly bill for you. Do not hesitate to contact us with any questions.

Will Your Business be covered for lost revenue because of virus shut down

Will New Jersey Require Insurance Companies to Cover Business Interruption Due to Coronavirus ( Covid-19)

 

Text of New Jersey Assembly Bill A3844:

ASSEMBLY, No. 3844

STATE OF NEW JERSEY

219th LEGISLATURE

 

INTRODUCED MARCH 16, 2020

 

 

Sponsored by:

Assemblyman  ROY FREIMAN

District 16 (Hunterdon, Mercer, Middlesex and Somerset)

Assemblyman  LOUIS D. GREENWALD

District 6 (Burlington and Camden)

Assemblywoman  ANNETTE CHAPARRO

District 33 (Hudson)

 

Co-Sponsored by:

Assemblywomen Reynolds-Jackson, McKnight, Lopez, Assemblymen Wimberly, Mazzeo, Chiaravalloti, Assemblywoman Jasey, Assemblyman Mejia, Assemblywomen Jimenez, Swain and Assemblyman Zwicker

 

 

 

 

SYNOPSIS

Concerns business interruption insurance during coronavirus disease 2019 state of emergency.

 

CURRENT VERSION OF TEXT

As introduced.

 

An Act concerning certain covered perils under business interruption insurance and supplementing Title 17 of the Revised Statutes.

 

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

  1. a.  Notwithstanding the provisions of any other law, rule or regulation to the contrary, every policy of insurance insuring against loss or damage to property, which includes the loss of use and occupancy and business interruption in force in this State on the effective date of this act, shall be construed to include among the covered perils under that policy, coverage for business interruption due to global virus transmission or pandemic, as provided in the  Public Health Emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020 concerning the coronavirus disease 2019 pandemic.
  2. The coverage required by this section shall indemnify the insured, subject to the limits under the policy, for any loss of business or business interruption for the duration of that declared State of Emergency.
  3. This section shall apply to policies issued to insureds with less than 100 eligible employees, in the State of New Jersey, and in force on the effective date of this act. “Eligible employee” means a full-time employee who works a normal work week of 25 or more hours.

 

  1. a.  An insurer which indemnifies an insured who has filed a claim pursuant to section 1 of this act may apply to the Commissioner of Banking and Insurance for relief and reimbursement by the commissioner from funds collected and made available for this purpose as provided in section 3 of this act.
  2. The commissioner shall establish procedures for the submission and qualification of claims by insurers which are eligible for reimbursement pursuant to this section.  The commissioner shall incorporate in these procedures such standards as are necessary to protect against the submission of fraudulent claims by insureds, and appropriate safeguards for insurers to employ in the review and payment of such claims.

 

  1. a.  In addition to the special purpose apportionment made pursuant to section 2 of P.L. 1995, c.156 (C.17:1C-20), the Commissioner of Banking and Insurance is authorized to impose upon, distribute among, and collect from the companies engaged in business pursuant to subtitle 3 of Title 17 of the Revised Statutes, such additional amounts as may be necessary to recover the  amounts paid to insurers pursuant to section 2 of this act.
  2. The additional special purpose apportionment authorized pursuant to subsection a. of this section shall be distributed in the proportion that the net written premiums received by each company subject to the apportionment authorized by this section for insurance written or renewed on risks in this State during the calendar year immediately preceding, bears to the sum total of all such net written premiums received by all companies writing that insurance or coverage within the State during that calendar year, as reported.  The commissioner shall adopt the same procedures and calculations as are provided in section 2 of P.L.1995, c.156 (C.17:1C-20) as appropriate to calculate the additional special purpose apportionment authorized by this section.
  3. For the purposes of this section, “net written premiums received” means gross direct premiums written, less return premiums thereon and dividends credited or paid to policyholders, as reported on the company’s annual financial statement.

 

  1. This act shall take effect immediately, shall be retroactive to March 9, 2020 and shall apply to insurance policies described in section 1 of this act and in force on that date.

 

 

STATEMENT

 

This bill provides a mechanism by which certain businesses that suffer losses due to interruption as a result of the coronavirus disease 2019 pandemic may recover those losses from their insurer if they had a policy of business interruption insurance in force on March 9, 2020, the date on which the Governor declared a Public Health Emergency and State of Emergency in Executive Order 103.  The bill would apply to businesses covered by such a policy with less than 100 eligible employees in the State of New Jersey.  “Eligible employee” is defined as a full-time employee who works a normal work week of 25 or more hours

The bill provides that every policy of insurance insuring against loss or damage to property, which includes the loss of use and occupancy and business interruption, in force on the date of the Executive Order, shall be construed to include among the covered perils under that policy coverage for business interruption due to global virus transmission or pandemic, as provided in the Governor’s  Executive Order.  The coverage provided would be subject to the limits under the policy and would indemnify the insured for losses incurred during the State of Emergency.

The bill then provides that an insurer which indemnifies an insured who has filed a claim pursuant to its provisions may apply to the Commissioner of Banking and Insurance for relief and reimbursement from funds collected and made available for this purpose as provided in the bill, pursuant to an additional special purpose assessment under the general scheme already established by law to recover the general expenses of the Department of Banking and Insurance as the regulator of the insurance industry in this State.  The commissioner shall establish procedures for the submission and qualification of claims by insurers which are eligible for reimbursement, incorporating such standards as are necessary to protect against the submission of fraudulent claims by insureds, and appropriate safeguards for insurers to employ in the review and payment of such claims.

Finally, the bill authorizes the commissioner to impose upon, distribute among, and collect from insurance companies, other than life and health insurance companies, the additional amounts as may be necessary to recover the amounts paid pursuant to the bill.  The additional special purpose apportionment authorized by the bill shall be distributed according to essentially the same procedures and calculations as are provided currently for the existing special purpose apportionment.

Industry sources have indicated that global virus transmission and pandemic are generally excluded from the list of covered perils under the existing standard business interruption insurance policy. The Insurance Services Office, ISO, has developed a rider to provide an insured with the option of purchasing such coverage, but to date, no states have yet approved the form.  This bill, then, is intended to hold harmless a certain portion of the business sector, which had the foresight to purchase business interruption insurance, for losses sustained as a result of the current health emergency, but for which no such coverage is currently offered.

Storm Damage, What Now?

March 7, 2020 by  
Filed under Website

It all starts when you have an insurance loss. The first thing you should do is contact your insurance company and get a claim started. This is usually done through your agent, but most companies have a claim page on their website as well.

Depending on the type of loss, you may have some work to do at the house. One of your main responsibilities, written into your policy, is to reduce or eliminate the possibility of further damage, to the best of your ability. For example, if you have water damage, you should call a water damage mitigation company. They will take steps to clean up any standing water and prevent mold growth. Click here for more about the mitigation process. Or if you have structural damage, you should call a contractor to stabilize the area and cover any exposed areas with a tarp.

Click here for more information on the claim process.

NY Standard Fire Policy (165 lines)

June 5, 2012 by  
Filed under Website

Comments Off on NY Standard Fire Policy (165 lines)

Although no company issues a NY Standard Fire Policy alone, NY law requires that all policies covering property for the peril of fire damage meet the minimum standards of the 165 Line Standard Policy.  If your company is licensed to write business in NY, they are required to follow this rule.  However, unlicensed companies (such as Lloyds of London) are not required to meet this standard.

You can view the Standard Policy here: NY Standard Fire Policy