“The American people are being grossly deceived by their insurance companies,” said Scott Friedson, CEO of Insurance Claim Recovery Support.

Friedson is a public insurance adjuster who advocates for policy holders. He is fighting the insurance companies on this issue and trying hold them accountable.

“They need to be holding the interest of policyholders equal to their own. And wherever there’s some ambiguity, they need to do the right thing and indemnify their policyholders,” said Friedson.

He said this issue could go all the way to the Supreme Court because the result would likely affect all insurance companies and claims.

Read Full Story>> https://sanfrancisco.cbslocal.com/2020/07/09/chez-panisse-founder-alice-waters-lawsuit-insurance-company-covid19/

 

Avoiding Unnecessary Litigation With a Public Adjuster

Commercial contractors and their clients carry a lot of risk managing the time and expenses of dealing with insurance claims. Overhead and profit, general conditions, policy language, interpretation of policy, code upgrades, negotiations, statutes, estimates, engineer reports, adjusters, attorneys, and appraisers are just a few of the factors to consider when settling an insurance claim. What is the best way to settle a large-loss property damage insurance claim?

Pro-Policyholder Negotiating

Savvy contractors turn to a trustworthy public adjuster who legally negotiates and interprets policies on behalf of a policyholder to settle property damage insurance claims fairly and promptly.

Public adjusters are licensed and bonded in nearly every state. Their process includes reviewing the insurance policy for benefits and exclusions, inspecting buildings for damages, negotiating with the insurance company for maximum settlement in minimum time, and meeting with the insurer’s adjusters or representatives on site. A good first step is a line-item estimate to support the damage model and a request for an advance on a covered loss so the policyholder can get reimbursed for incurred mitigation expenses and start immediate repairs. Negotiating the full and final claim for the remaining policy benefits owed on a large loss often requires the expertise and authority of a public adjuster to get a claim settled fairly and promptly. The best public adjusters and contractors work together as a team.

Deadlines and Timing

The first deadline to be aware of is when a claim can be filed. Some policies allow filings to happen only within a year from the date of the loss.

Another important deadline deals with business interruption claims. Typical business interruption policies only provide loss of income benefits for a year from the date of loss. If a property damage claim isn’t settled within the same time frame as a business interruption claim, the policyholder could run out of time on his/her business interruption claim before the property is completely fixed and back in business.

How Can Public Adjusters Help Insurance Claims?

It is important to bring a reputable public adjuster into the process immediately when dealing with a large commercial loss. Though a public adjuster is able to come on board at any time or can even reopen closed claims, the time savings and ultimately getting a fair settlement amount are invaluable to both policyholders and contractors.

The whole process can be far more balanced when a good public adjuster is retained immediately. Public adjusters can hold insurers accountable. Insurance companies are required by law to give equal consideration to anything presented by a public adjuster that supports the insured’s claim in meeting the burden of proof. If policyholders wait to hire a public adjuster until after the insurance company partially paid some, but not all, of the money a claimant believes is owed, a supplemental claim can be opened by a public adjuster.

Policyholders carry the burden of proving their claim to an insurance company. Without considerable training and experience, navigating the process is a considerable challenge. Waiting for the insurer to make a coverage determination before engaging a knowledgeable public adjuster can cost a lot of time and money. All too often, after a property suffers damage, the policyholder files a claim, and then waits. Waiting and hoping that the insurance company will do the right thing can be very expensive.

Quite commonly, an insurance company sends out its representatives to document the company’s interests, not those of the policyholder. When no one is representing the policyholder’s best interest with any legal authority and the insurer knows it, settlement results tend to be disappointing.

Overturning coverage determinations takes some time. Insurance companies take their time in responding and defend themselves ferociously. Business owners who know time is money retain a public adjuster the moment they have a claim.

Is a Public Adjuster Right for Me?

Every situation is different, and not every claim warrants the use of a public adjuster. Big claims can lead to big disputes.

A property owner’s insurance claim on a 700,000-square-foot (65,032.1 m2) facility was initially denied. Preparing to sue the insurance company, the property owner’s insurance broker suggested they consider a public adjuster. With the public adjuster’s help, the denial was completely reversed, and the claim was settled for seven figures.

Insurance appraisals cost policyholders money and cannot be performed on contingency of outcome. Plus, there are very few rules and usually no time frame to compel insurance companies to perform. As a result, large appraisals can take one to two years. In addition, most policies contain less-than-amicable terms for policyholders, whereby the insurer typically retains the right to deny any appraisal award even after it has been made.

Subpoenas, depositions, mediation, and courtroom trials can be expected in lawsuits. Many cases do not make it to court because insurance companies often settle claims in mediation. That may sound good on the surface, but this could backfire.

Let’s say a policyholder believes he/she is owed $2.1 million in damages because he/she has $1.5 million in property damages plus $600,000 in legal fees. During a required mediation, an insurance company may say, “We’ll pay no more than $1.9 million.” Figuring out repair costs and fees or letting a jury decide can be a difficult decision. An attorney may turn to a policyholder in mediation and say, “This is a business decision you’re going to have to make. We can take this bird in the hand, or we can roll the dice and go before a jury.” A lot of times, people will just settle, which you rarely hear about because they also have to sign a confidentiality agreement.

Conclusion

There are several reasons first-time clients of public adjusters often become long-time clients: less time, less stress, protection of rights, fewer disputes, professional documentation to support the maximum settlement, lower costs, most work on contingency, and peace of mind knowing that a licensed advocate is fighting for full policy benefits so you can take care of business. These are all invaluable benefits.

Insurance companies have experts working for them. You should, too!™

 

Check out this article at Coatings Pro HERE

AUSTIN, Texas – May 21, 2015 – PRLog — Insurance Claim Recovery Support LLC, a leading licensed public insurance adjusting firm in Austin, Texas urges policyholders dealing with storm damage property in the Counties of Harris, Travis, Brazoria, Montgomery, Fort Bend, Tarrant, Dallas, and Johnson from weather-related events occurring April 16, 2015, through April 19, 2015, to be aware of the following insurance claim essentials:

Texas Department of Insurance (TDI) has declared these events catastrophe for the purpose of claims processing.  Per Texas insurance code 542.059, claim-handling deadlines under this subchapter are extended for an additional 15 days.

TDI Bulletin #B-0014-14 reminds insurers, insurance adjusters, and public insurance adjusters that House Bill 1183, effective September 1, 2013, establishes prohibited conduct of insurance adjusters, public insurance adjusters, and roofing contractors.

Roofers and contractors are prohibited from acting or advertising to adjust claims for any property for which the contractor is providing or may provide roofing services, regardless of whether the contractor holds a license to adjust insurance claims.  A roofer or contractor may not advocate on behalf of a consumer or discuss insurance policy coverages and exclusions. See FAQ regarding unlicensed individuals and entities adjusting claims and TX statute 4102.163.

Consumers are urged to keep the following in mind:
· Texas does not require roofers to be licensed. Be careful of any roofer or association that states they have a roofer license or claims to be a licensing entity.

·       Be wary if a contractor tells you of their experience in settling insurance claims or in dealing with insurance carriers and adjusters. Contractors are expressly prohibited from negotiating your claim with the insurance company and, other than providing and/or explaining an estimate to repair the damages that occurred, they should not be involved in the claim process.

·       Read contracts carefully before signing them. If the fine print says that you are authorizing the contractor to deal with the insurance company on your behalf, you can assume that the contractor is ignoring the requirements of the law above.

·       Do not sign contracts that assign all or a portion of an unsettled claim to the contractor and do not sign contracts that do not have a stated price for doing the work. Often we see contracts where the work will be done for “insurance proceeds recovered.” Many jurisdictions have found these contracts to be invalid because they do not state the exact price that is to be paid.

·       Do not sign contracts that require you to pay a contractor a percentage of the amount recovered in the claim if either party decides to cancel the contract. This is often a sign that the contractor plans to get involved in the negotiation of the claim in violation of Texas law.

·       Don’t become a victim of fraud schemes such as “Roofing deductible assistance programs.” See BBB investigation of Roofing Deductible Schemes.

Contractors are Vendors for the insured.  Public Adjusters are Agents for the insured who act solely on behalf of a homeowner or commercial building owner to negotiate the settlement of an insurance claim in a non-litigious manner.

Only Public Adjusters are licensed by the state department of insurance to advocate for the policyholder in negotiating first-party insurance claims.  A Public Adjuster settles claims for loss or damage under any policy of insurance covering real or personal property, usually for a fraction of the time and expense of an attorney. If you find yourself in a dispute with your insurance company, we encourage consumers to contact a Public Adjuster.

TDI investigates written complaints of persons (including but not limited to an individual, corporation, association, or other legal entity engaged in the business of insurance, including an agent, broker, adjuster per 541.002) violating the Insurance Code. Violating Insurance Code Chapters 4101 and 4102 may result in criminal penalties and license denial, suspension, revocation or fines.

While there are a number of good and ethical contractors, we encourage you to know your rights. Download Texas Consumer Bill of Rights for Homeowners.

The opinions expressed are those of the author(s) and do not necessarily reflect the views of the firm, its clients, or any of its or their respective affiliates. This article is for general information purposes and is not intended to be and should not be taken as legal advice.

AUSTIN, Texas – July 29, 2014 – PRLog — Hail damage insurance claims have become such a big deal in Texas that the department of insurance held a symposium titled “War on Hail“  Over 2 million hail damage claims were processed from Jan. 1, 2010 to Dec. 31, 2012. During this period, the top five states generating hail damage claims were Texas (320,823); Missouri (138,857); Kansas (126,490); Colorado (118,118) and Oklahoma (114,168).

In 2010, 2011 and 2012, Texas was the state with the most hailstorm events with 557, 741 and 795, respectively according to the National Insurance Crime Bureau.

So far, 2014 Texas Hail Storms have taken its toll on property owners…

– Abilene projected losses of $400 Million
– Insured loss estimates for the Denton area started at $300M then rose to $500M within a month after the occurrence.
– More than 50,000 homes were damaged throughout Kileen, Temple, and Belton

Policyholders deserve and expect a fair and prompt settlement but many dealing with the insurance claim process feel like a “Wolfpack of One”.  Ok, maybe you’re a “Wolfpack of Two” if you have a really good contractor. That’s not a bad start, but you still have to document your claim, the occurrence, meet with the insurance company’s “Claim Gang“, interpret your policy, correspond and negotiate a settlement with your insurance company.  Plus, there is a pretty good chance that your insurance company may presently be at war on hail claims unbeknownst to you.

Have you experienced the effectiveness of an insurance company’s “Claim Gang” comprised of Agents, Adjusters, Examiners, Engineers, Building Consultants, Labs, Actuaries, Appraisers, and Attorneys?  If so, you know that these insurance claim experts work very hard on a daily basis for the interests of their gigantic insurance company employers and take great measures to protect their bottom line.

Don’t forget that your policy is a contract and its language, endorsements, exclusions and provisions were written by a gigantic insurance company loaded with adjusters, actuaries, and attorneys in compliance with the Texas state insurance code. So, if you think you’re really going to have a “like it never even happened” experience, you may need to suit up like the Seattle Seahawks on Super Bowl Sunday.

Truth: Unfortunately, not all insurance claims have happy endings like the commercials you see on TV.  If your building has verifiable hail and/or wind damage, it’s possible you have a valid insurance claim that you should consider filing with your insurance company.  Hail and wind damage might not cause your roof to leak for years. If you’re not sure, have your roof inspected for damage by a reputable roofer or public insurance adjuster.

Are You Damaged And Don’t Even Know It? After a building has been impacted by hail, damage may not immediately be noticeable.  Many property owners are simply unaware that they have damage, but over the course of time, heat and cold expand and contract roof membranes that can cause fractures after a hail storm.   Ice and heavy rain on a roof with undetected hail fractured membranes can lead to interior leaks. If you are experiencing this scenario, don’t wait to get professional insurance claim assistance.

Fiction:  My contractor can negotiate my insurance claim on my behalf.

Fact:  While there are many expert roofers and contractors who are very good at repairing or replacing roofs, handling insurance claims is a completely different animal.  The issue of roofers handling insurance claims for policyholders has driven changes in the Texas Insurance Code Section 4101.251 with the passage of House Bill 1183, that went into effect September 2013 whereby the statute specifically states, “A roofing contractor may not act as an adjuster or advertise to adjust claims for any property for which the contractor is providing or may provide roofing services, regardless of whether the contractor holds a license under this chapter.”  Further, insurance companies know that they are prohibited from negotiating insurance claims with contractors.

Fiction: My insurance company will cancel my policy if I file a claim.

Fact: Most states prohibit insurance companies from canceling policies for filing claims arising from weather events. Check your state and your policy language.

Fiction: If I don’t file my claim, my insurance company won’t raise my rates.

Fact: After a disaster, insurance companies may raise everyone’s rates in a specific geographic area or “tier.”  By not filing your legitimate claim, your personal rate increase pays for everyone else’s damage except yours.  Read More>> Investigation – Homeowner’s insurance rates on rise

Fiction:  It’s too late to file a claim.

Fact: There is no time limit to notify your insurer of a loss unless the policy specifies a time limit.  However, a policyholder should certainly notify the carrier as soon as the damage from the loss is discovered.  Prompt notice of loss is required by most policies, though what is “prompt” is usually a fact issue—meaning it is arguable on a case-by-case basis.  Some policies now require that notice of a loss must be given within one year of the date of loss.    However, in order to avoid its obligations to pay policy benefits based on a failure to give prompt notice, an insurer must prove it was somehow prejudiced by the “late” notice.[1]   An example of prejudice would be a policyholder’s late notice of roof damage which subsequently (not simultaneously) caused water damage inside the property.  Arguably, the insurer would still be responsible for the roof, but may not be responsible for the interior damages because but for the policyholder’s late notice, the interior damage would have been prevented.

Insurance companies have experts working for them, you should too.
If you are dealing with an insurance claim that has stalled out, been delayed, denied or underpaid, time is of the essence for you to get help.  A public adjuster is a state-licensed insurance adjuster who solely represents the interest of the policyholder who can level the playing field in the insurance claim process.

– By Scott Friedson, Insurance Claim Recovery Support LLC and Shannon Loyd, The Loyd Law Firm PLLC

Scott Friedson, the owner of Insurance Claim Recovery Support LLC, is a Texas Licensed Public Insurance Adjuster.  Shannon Loyd, the owner of The Loyd Law Firm PLLC, is Board Certified in Consumer and Commercial Law.   The opinions expressed are those of the author(s) and do not necessarily reflect the views of the firms, its clients, or any of its or their respective affiliates. This article is for general information purposes and is not intended to be and should not be taken as legal advice.

[1] PAJ, Inc. v. Hanover Ins. Co., 243 S.W.3d 630 (Tex. 2008); Hernandez v. Gulf Group Lloyds, 875 S.W.2d 691, 692-94 (Tex.1994).

“What You Need to Know About Insurance Claims” presentation at New Jersey Apartment Association HQ in Monroe Township, NJ on Tuesday, March 26, 2013
Estimated $87 Billion in Property Damage from Superstorm Sandy

Feb. 27, 2013 – PRLog — AUSTIN, Texas — You don’t have to deal with insurance claims alone.  Find out by attending “What You Need to Know About Insurance Claims” at New Jersey Apartment Association HQ in Monroe Township, NJ on Tuesday, March 26, 2013.  This informative session will be presented by Licensed Public Insurance Adjuster Scott Friedson of Insurance Claim Recovery Support LLC.

You will learn…
– An overview of the commercial insurance claim process
– The difference between flood and wind claims
– Documenting wind damage claims
– What is a public insurance adjuster?
– Your options if you disagree with your insurance company’s claim assessment
– Your rights as a policyholder
– When to seek legal counsel
– What is an “appraisal of claim damage”?
– Business interruption claim tips
– How to receive your claim settlement in a timely manner
– Plus, other valuable tips and insights for commercial property damage insurance claim to get your maximum settlement in minimum time.

Free for NJAA Members, $75 for non-members
To register, download form or contact Jaclyn at 732-992-0607 for more information.
Or visit https://www.insuranceclaimrecoverysupport.com/register