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.

Calling for Reinforcements on Business Interruption Claims

March 22, 2020 by  
Filed under Uncategorized

Employing  Experts Adjusting and in an Insurance Appraisal.

Public Adjusters and Business Interruption Claims

Does your Insurance Policy Cover Coronavirus Closing

 

As a Public Adjuster hired by the policyholder to assist in preparing and substantiating an insurance claim, all Public Adjusters have had the following experience. The Insurance Company is sending in XYZ experts to evaluate the damaged property. Quite a few of you reading this just had several names pop into your head.

With all the talk of potential Caronavirus and Business Interruption insurance claims, it’s time to take stock of our skills as well as our limitations. How many of us have the experience to adjust or be the Named Appraiser on a business interruption claim?

Gather Your Experts Now for Business Interruption Claims

Most of us are highly competent with building damage, loss of use, and personal property. The documentation requirements are going to be a handful. The interpretation of those documents will require you to call in the cavalry. Line up your experts now. The insurance companies will be deploying an army of Forensic accountants, Certified Public Accountants, Tax Attorneys, and maybe a few former IRS agents. Public Adjusters and Appraisers better have them, too, along with your Industrial Hygienists and decontamination experts.

All of us in the world of policyholder advocacy should not be handling claims we are not qualified to handle. Have your bullpen stocked, have your battleships on standby. Insurance companies will be digging deep and asking questions that most Public Adjusters and Appraisers should

Can you file a claim for business interruption?

Do you have the resources available to guide your clients through a Business Interruption Claim?

not or could not answer.

Bring yourself up to date on all commercial insurance forms, exclusion, endorsements. Keep up to date on any changes in the law.

Business Interruption Claims and Insurance Appraisal

On the Appraisal front, you can assume that a Business Interruption claim that has come to you for Appraisal will have both sets of documentation that has caused the disagreement in the amount of loss, which has moved the claim into the insurance appraisal process.

In a contentious appraisal, it may be best to have the umpire bring in neutral experts to dissect the conflicting findings. As an Appraiser, you may be an expert in the Appraisal Process, and an expert in accounting, taxes, or business administration may need to help you put together your appraisal finding.

As the named Appraiser substantiating the amount of loss for a business interruption claim, you will be called upon to present the financial damage the Insured has sustained concisely and accurately. Many livelihoods could be riding on our skills and decision in the coming year, on both sides of the policy.