Some Tips to Make Insurance Claim




Call a Public Adjuster to evaluate your claim!
A public adjuster (PA) is an adjuster that assists an insured who has had a loss in the preparation and presentation of the insurance claim. PAs perform very valuable services to the insured by consulting with the insured on options available in their recovery, filling out forms, helping prepare inventory lists, preparing estimates on structural damages, helping to find you a temporary place to live if you're home is too damaged to live in, assisting in negotiations for settlement...and many more vital functions.
Public Adjusters work only on losses that involve property, such as homes, businesses and public buildings. Those are called "first party property claims."

If you have a loss to your property that was caused by someone else, that is called a "third party property claim." An example is when a vehicle runs into a dwelling, causing damage. In some situations, PAs will accept clients for third party losses. However, PAs cannot directly negotiate a third part claim. They can either advise the client as to the extent and value of the third party loss, or work with an attorney in presenting the claim.

Public Adjusters do not handle Bodily Injury (Casualty) losses, such as happen in an automobile accident. For assistance in those kinds of losses, consult a personal injury attorney.
There's an easy way to understand the function of a Public Adjuster. Compare them to an attorney in a lawsuit, or a Certified Public Accountant or tax preparer when filing your tax forms with the Internal Revenue Service.

PAs usually have to be licensed adjusters, and are usually regulated by the Insurance Department of your state. Some states have special licenses for Public Adjusters. Call your state's Insurance Department office to find out more information about what Public Adjusters can do in your state. You'll find contact information for the Insurance Commissioners for all US states in the Appendix of the book.

Many of the people on the insurance company side take it very personally when a policyholder hires a public adjuster. Many truly believe that the policyholder should just trust the insurance company and adjuster to do the right thing, and not ever question them.

Adjusters and insurance company personnel sometimes play games with their own policyholders when the insured hires a PA. I've heard claims examiners refuse to speak with the insured by phone, telling the insured that, now that they are represented, all conversations have to go through the PA.

However, there's nothing in your policy that states that. Public Adjusters are not attorneys, and the attorney/client relationship is not the same as the relationship between an insured and a Public Adjuster. If your adjuster or insurance company examiner tries to pull that stunt, he's just doing it to delay and cause you problems. Call his supervisor or call the Department of Insurance.

Isn't this amazing? The insurance company writes the policy, makes the rules hard to understand, and then gets mad at you when you hire someone to help you submit a claim. This would be like the Internal Revenue Service getting mad at you because you hired an accountant to help you prepare your tax return.
But it still happens, even though it makes no sense.

The environment is changing, though. Following the hurricane seasons of 2004 and 2005, a newfound respect has grown within the insurance community regarding the value and professionalism of an accredited, licensed Public Adjuster.

Why do you think that the insurance companies and adjusters are not happy when you hire Public Adjusters? There's one big reason. Usually, when a PA is involved, the dollar amount of the claim is higher than a claim without a PA.

When I first got into the claims adjusting field, the "old timers" told me horror stories about public adjuster. They told me how crooked they were, and how they grossly inflated the repair or replacement costs in claims. They told me stories of how PAs were liars and cheats and totally dishonest.

Yet, in my experience dealing with PAs in claims, from homeowner losses to large apartment building fires, to commercial and business losses, I have not met one public adjuster that I didn't like as a person. I have not met a public adjuster who acted in an unprofessional manner. I have not met a public adjuster who wasn't trying his best to make sure that his client...the policyholder who had a loss...got every dollar that was owed to them by the insurance company.

Public adjusters usually represent a client on a contingency basis. That simply means that they help present the claim documents to the insurance company and receive a percentage of the total amount of the insurance proceeds. The average percentage nationwide is 10%. The major incentive that makes the PA work hard is to help the insured get a larger settlement from the insurance company than the insured could have gotten by himself.

The PA is motivated to maximize your claim and expedite the claim adjustment process. It is a balance of making sure that the claim is packaged as completely as possible so you collect every dollar you are entitled to collect without creating unnecessary disputes with the insurance carrier. The PA does not charge for his services until after the claim is paid to you, so they are motivated to get it settled as quickly as possible. Their fee is usually all inclusive, with no additional out-of-pocket expenses. Most established Public adjusting firms can show you how their fee is absorbed in the adjustment process.

You should know that fees are negotiable with PAs. I've seen PA firms agree to substantial discounts from their standard 10% fee on huge commercial losses, and I regularly see 10% contracts on dwelling and small commercial losses. Caveat emptor...let the buyer beware. Just be aware that if the PA plunks down a contract in front of you with a blank space where the fee percentage is supposed to be, DON'T SIGN IT!! Negotiate the fee you're willing to pay BEFORE signing the contract. Then let your attorney review it before you sign.

Some state's Department of Insurance regulations cover Public Adjuster fees, and the maximum amounts they can charge for their services. I don't think that's any of the State's business. For the most part, states do not regulate the fees that independent adjusters charge the insurance companies. Why regulate PA fees? I believe that the policy holder and the PA should be able to set whatever fee they can agree upon.
Regardless of my opinion, you need to check with your state's Department of Insurance for this information if you're considering hiring a PA.

You've heard of personal injury attorneys being called "ambulance chasers?" Well, sometimes PAs have to be "fire truck chasers." It is quite normal for PAs to listen in to fire and police scanners and follow the fire trucks out to the location of the fire. It is quite normal for PAs to go door to door in a tornado or hurricane damaged area and solicit business. There is nothing wrong with this, since it may be the only way to contact victims after a fire or windstorm. That being said, the PA should always be professional, respecting your time and your personal situation.

A professional public adjuster can offer valuable assistance in the preparation of your claim, or even represent you in the presentation of the claim. Hiring a PA early in the claim process can help control the situation and quickly begin the recovery process. The PA can control over-zealous restoration contractors and pushy adjusters. The PA can accelerate and smooth the claim process by walking through the loss with the insurance company's adjuster so they agree on the scope of the loss. This one process can make a huge difference in how quickly your claim is settled, and many times, prevent disputes later on. You may decide that, in your situation, it makes sense to hire a PA in the first 24 hours after your loss.

If you wish to consider hiring a public adjuster, you should treat them just like you treat the adjuster and contractor. Call two or three public adjusters. Meet them, go over the details of your claim, and listen to their proposal of how they are going to represent you.

Get referrals of satisfied customers with phone numbers that you can call and verify. Then, spend the time checking them out. Call the Better Business Bureau about them. Find out if they have a good reputation.
Once you've checked them out, and if you want to retain a PA, hire the one who checks out best.
Remember what I told you in Chapter Six, "Should I Get a Lawyer?" Don't sign anything without having your attorney review the document FIRST. But, having said that, remember that there may be many things that need immediate attention, like contents removal, emergency board-up, and temporary family accommodations. This means that you should get your PA contract in front of your attorney immediately!
If you've hired a Public Adjuster, you should treat him just the same as the insurance company adjuster. See Chapter Four, Don't Be In A Hurry, with regard to writing down everything you discuss with him. Keep an accurate record of the date and time of all of your conversations, and what was discussed. Record the conversations if possible.

Insist that the PA give you copies of every document he generates on your behalf. Insist on copies of all letters and correspondences between the PA and the adjuster or insurance company.
Your PA will likely have you sign an assignment form, in which you agree to have the PA's name placed on the settlement checks along with yours.

There are only six states in the USA that require the PA to be included as a payee on an insurance company settlement check: Pennsylvania, New York, Virginia, Wyoming, Illinois and Kentucky. That means that if the insurance company doesn't want to be cooperative and place the PA's name on the check, they might not be cooperative unless the law requires them to do so.



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