 If you love the peace and tranquility of your home as much as I do, then you certainly wouldn’t want it disrupted in any way. There are times, and it has happened to me, when you have property damage from a either a leak, a fire, a hurricane and so on and your home life is completely disrupted. All you want to do is get back to normal and repair your home.
Wait! Before you rush to repair your property, you need to know what your “Duties After Loss” are within your insurance policy so you do not jeopardize your insurance claim. It is important to prove your damage and show your damage. Each policy is a little different and below is just a small example of the language (not all the language) so please make sure you read and understand your “Duties After Loss” in your policy. Duties After Loss … In case of a loss to covered property, we have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either: 1.Give us prompt notice to us or our agent; Except for Reasonable Emergency Measures taken under Additional Coverage 2. There is no coverage for repairs that begin before the earlier of: a.72 hours after we are notified of the loss; b.The time of loss inspection by us; or c.The time of other approval by us. 2.a. To the degree reasonably possible, retain the damaged property; and b. Allow us to inspect, subject to 2.a. above, all damaged property prior to its removal from the “premises”. 3.a. Notify the police in case of loss by theft .. b. Notify the credit card or electronic fund transfer card or access device company in case of loss as provided for in D.6. Credit 4.Protect the covered property from further damage … 5.Cooperate with us in the investigation of a claim; 6.Prepare an inventory of the damaged personal property … 7.As often as we reasonably require: a.Show us the damaged property and the cause of loss … b.Provide us with records and documents we request and permit us to make copies; c.Any and all “insureds” must submit to recorded statements when requested by us; d.In the County where the premises is located you, your agents, your representatives and any and all “insureds” must submit to an examination under oath while not in the presence of the other … e.Permit us to take samples of damaged and undamaged property for inspection, testing and analysis; and f.Any and all “insureds” must execute all authorizations for the release of information when requested by us. 8. You must give notice of a claim, a supplement claim, or a reopened claim for loss or damage caused by the peril of windstorm or hurricane within three years after the hurricane first made landfall or the windstorm caused the covered damage … 9.Send to us, within 60 days after our request, your signed sworn proof of loss which sets forth, to the best of your knowledge and belief: a.The time and cause of loss; b.The interests of all “insureds” and all others in the property involved and all liens on the property; c.Other insurance which may cover the loss; d.Changes in title or occupancy of the property during term of policy; e.Specifications of damaged buildings and detailed repair estimates; f.The inventory of damaged personal property described in C.6 above; g.Receipts of additional living expenses incurred and records that support the fair rental value loss; and h.Evidence or affidavit that supports a claim under D.6 … If you do not comply with your duties after a loss and repair the damaged property before the insurance company has an opportunity to investigate and inspect the damages, you risk having your claim denied. There are also documents that you may be required to complete and will need the assistance of a public insurance adjuster to prepare and submit them to the insurance company.
0 Comments
 When you have damage to your property, you expect that your insurance company will pay your insurance claim and cover the damage. There are times when a dispute arises because your insurance company feels they only owe a certain amount to repair your damaged property and you feel they owe a different amount. This happens more than you realize and there are dispute resolutions options available to you in your insurance policy.
Most policies provide the option for either Mediation or Appraisal. When the appraisal provision is included in the policy, it will read something like the following (they differ from policy to policy, but you will get the gist): Mediation Or Appraisal. If you and we : “Fail to agree on the amount of loss, either party may demand an appraisal of the loss. If you or we demand appraisal of the loss, the demand for appraisal must be in writing and shall include an estimate of the amount of any dispute that results from the covered cause of loss. The estimate shall include a description of each item of damaged property in dispute as a result of the covered loss, along with the extent of damage and the estimated amount to repair or replace each item. In this event, each party will choose a competent and impartial appraiser within 20 days after receiving a written request from the other. The two appraisers will choose an umpire … The only additional cost to you and the insurance company through this process is bearing the cost of the umpire equally if one should need to be retained. Although the two appraisers will agree to the selection of the umpire, the umpire is not needed unless the two appraisers are unable to resolve the dispute. At that time, the umpire will be called in to assist. The appraisal process is sometimes the path of least resistance when trying to resolve an insurance claim. In addition to being licensed public insurance adjusters, we are also Certified Property Insurance Appraisers and Umpires (CPAU) and are members of the Insurance Appraisal & Umpire Association and the Windstorm Insurance Network. We have resolved many insurance claim disputes over the years, both as appraisers and umpires throughout the state of Florida. If you have any questions, you can reach us here or call 561-288-6434. Insurance Policy Misconceptions Part 3 – My claim is at policy limit – Is the mold still covered?7/21/2020  In a prior blog, Don’t Shop Price, Shop Coverage, I discussed the importance of insurance coverage for your property. It is really important to make sure you have enough coverage for the limits in your policy. Here's why ...
A potential client had water damage to his condominium that came from the unit above. Everything from the ceiling to the floors had to be replaced and there were obvious signs of mold. Upon reviewing his insurance policy, I found he only had a policy limit for Coverage A – Dwelling of $10,000.00. This amount also includes the dry out the mitigation company performed to dry his property. He was concerned about the presence of mold which the declarations page of his insurance policy stated he had $10,000.00 mold coverage. In this example, the mold coverage is inclusive when you have reached your Coverage A – Dwelling policy limit, it is not an additional coverage under the policy. After explaining the policy to him, he was understandably concerned with the lack of coverage and said he will make sure he changes his policy. His exact words were, “I never realized I needed more!” Most individuals do not look at their coverage limits, and if they do, they think they have enough. My explanation on how to view your coverage and determine if you are adequately covered is simple. Imagine a catastrophic loss occurring, such as a fire, and it destroyed your property. Would the coverage limit you currently have be enough to cover the rebuild of your property? I know that many of you think this will never happen to you, but it certainly can, and you need to be properly insured so you do not have to come out of pocket for repairs. For additional information or answers to any questions you have, please contact us here or call 561-288-6434.  The Wedontsee Insurance Company has inspected the damage to your property and you are told that they will review the claim and get back to you. You receive a letter informing you “our adjuster’s estimate to repair your damaged property is below the amount of your deductible so therefore, we are unable to issue a payment at this time”. You think to yourself, “great, my claim has been denied and I don’t have enough money to repair the damage. What am I going to do?” Not so fast! First of all, your claim has not been denied and I will explain.
The letter you received reads something like this: Damage to Coverage A: $1,567.24 Deductible Applied: $2,500.00 Net Claim Amount: $ - 932.76 In the sometimes confusing and head scratching language of insurance speak, the insurance company has actually made a payment on the claim. They feel that they owe $1,567.24 to repair the property and have afforded coverage for your claim. But because the deductible amount is greater than the payment amount, they cannot issue a payment. This is a far cry from getting your claim denied. Here is where a public insurance adjuster can come to the rescue (enter stage left). Often times when asked to review these types of claims, we find that the insurance company has under paid for a variety of reasons. The Wedontsee Insurance Company and either overlooked damages, missed damages that could be hidden from view or they misapplied coverage. We have been very successful in re-opening these claims and getting our clients the proper claim settlements they need to repair their property. Yankees all-star catcher Yogi Berra is famous for saying “it ain’t over till it’s over”. At Reliant Insurance Adjusters we say “it ain’t over till we say so!” For additional information, a FREE claim review or answers to any of your questions please contact us here or call 561-288-6434.  The other day I was on the phone with a potential client discussing a water damage claim when the subject of her deductible came up. She explained that the reason she was hesitant to file a claim with her insurance company was that she could not afford to pay the deductible. You know the old saying, “if I had a dollar for every time….” It seems that at least once a week I have this conversation with a policy holder. In actuality, no one really “pays” the deductible. The reason it’s called a deductible is that it is deducted from any payout that an insurance company makes on your insurance claim.
For example, let’s say that Swamp Grass Property & Casualty is going to pay $10,000 you for water damage to your property and the deductible in your policy is $2,500. That amount will be deducted from the $10,000 and you will receive a check for $7,500. Let’s look at another scenario involving a hurricane deductible which is much higher than the regular or “all other perils” deductible example above. These deductibles are usually 2% to 5% of Coverage A. Coverage A is the amount that your building is insured for and this information can be found on the Declarations page of your homeowners insurance policy. Let’s say that Coverage A is $350,000 and your hurricane deductible is 2%. That means your friends at Swamp Grass Property & Casualty will deduct $7,000 from any payment issued if you have hurricane damage to your property (ouch!). I hope this clears up any confusion regarding deductibles. Don’t miss next week’s blog “Insurance Policy Misconceptions Part 2” where we will discuss under deductible insurance claim payments. If you have any questions, please contact us here or call 561-288-6434 and we will be happy to assist you.  With July 4th quickly approaching we all want to celebrate, have fun, enjoy the day and forget about Covid-19. As the numbers are once again on the rise, we must be mindful and celebrate carefully. I am never opposed to seeing a magnificent fireworks display and have always enjoyed attending them. I remember like it was yesterday, how I felt as a child being blown away by the beautiful bursts of color through the night sky. I am of the belief that we all still want that same feeling year after year. Unfortunately, this year is different.
For me, the thought of being among so many people in close proximity leaves me a bit apprehensive and I question to myself, “Did they adhere to the guidelines? What precautions have they taken over these past few months? Do they wash their hands regularly? Do they have the virus and not know?” No matter what, we need to keep doing our part to help stop the spread by wearing our masks and washing our hands. Although some public fireworks celebrations that draw large crowds are being canceled and others will still be televised. You can also purchase your own fireworks and enjoy them just as much and you can certainly enjoy professional like fireworks displays from surrounding communities just by sitting outside. Maybe attending a small family gathering with your own fireworks is the key knowing that you all have been careful during Covid-19. Whatever you decide to do, just keep it safe and protect your loved ones. Enjoy the delicious food offerings, cool beverages and amazing desserts. Be active outdoors and watching the expressions on the faces of the innocent children spinning sparklers will make for a perfect day. Social distance as best you can and wear a mask if needed. From our homes to yours, we wish you all a happy and safe July 4th.  Throughout the years, we have represented both homeowners and condo and homeowner associations with property damage insurance claims. There are specific items that each party is responsible to repair such as roof, exterior of building, drywall, interior finishes, plumbing and electrical. It is important to keep your Condo or HOA documents together with your insurance policy because these documents clearly state what repairs are the responsibility of each party i.e. the homeowner or the association. A copy of these documents are provided to you when you purchase your home or condo.
Let’s say you live in a condo and the roof leaks and causes water damage to the interior of your condo. You promptly report the leak to the association and they state “we are not responsible for the damage you need to file a claim with your insurance company” You do so immediately. After all, you trust your association and believe they are giving you the correct information because they have your back right? Your insurance company visits the property and inspects the damage only to tell you there is NO coverage in your policy and you receive a claim denial letter that reads in part: “Your policy does not provide coverage for rain, snow, sleet, sand or dust to the interior of the building unless a covered peril first damages the building causing an opening in a roof or wall and the rain, snow, sand or dust enters through this opening” Why is the association responsible for these damages? First and foremost, in a case like this, you do not own the roof, the association does. They are responsible for the maintenance of the roof and any and all repairs to the roof. Secondly, and unless otherwise stated in the condominium documents, the association also owns the drywall, insulation and exterior of the building. Therefore, the association should be filing an insurance claim for the damage to your home, NOT you! I have also reviewed condominium documents that state the homeowners are responsible for all repairs to the interior of their home which also include drywall, insulation, windows, doors, plumbing, electrical. This is why it is important to always keep both sets of documents together. In a scenario like this, when our client’s insurance company says they do not owe for these items, we prove they do and have always been able to get them covered for our clients. Let us help you understand your insurance policy and schedule your FREE insurance policy review today. Contact us here or call 561-288-6434.
As a homeowner, I cannot stress enough the importance of keeping the waste line pipes in your home clean. As Public Insurance Adjusters, what we often see while inspecting damage to a home caused from a broken pipe or back-up can take your breath away, literally. You are first hit with an odor that makes your eyes water and then comes the vision!
No one wants this to happen so you must do your due diligence in preventing damage from occurring. Here are some important tips to help keep your pipes clean and avoid blockages and back-ups in your home:
We are always careful in our own homes and probably more so from what we see as Public Adjusters. Call us at 561-288-6434 or contact us here if you have any questions. Make sure you do your part and protect your property to prevent the peace and tranquility of your home from being disrupted.  We are all consumers and pay our insurance premiums and we certainly expect to be covered when we have an insurance claim. Have you filed an insurance claim and the insurance company denied coverage? Has the insurance company underpaid your claim or failed to pay for some of the damage?
I received a call from an individual who never heard of a public insurance adjuster and was asked … Why do I need a Public Adjuster? Simply put, does the IRS prepare your taxes for you? If you are in a legal dispute, do you let the opposing side decide if you are correct and how much you should pay? The same is true of the insurance claim process. A qualified public insurance adjuster is licensed and bonded through the state and provides insurance adjusting services exclusively to the public, not insurance companies. There are so many moving parts to an insurance claim. Reliant Insurance Adjusters not only reviews your insurance policy, we determine the extent of your damage and advise you if your loss is covered or if you were adequately paid. In addition, we have the right equipment necessary to make a proper assessment and prepare very detailed reports with photographs of how much it will realistically cost to repair and recover financially from your loss. Policyholders should always get the professional assistance of a qualified, licensed public insurance adjuster to ensure that their interests are being protected. Does every claim need the assistance of a public adjuster? Not necessarily. We conduct a free onsite, comprehensive inspection of any potential client’s property damage to determine if a claim should be filed, and if it should, is the property owner better off handling the claim on their own, or will they need our professional expertise and help to recover all the funds needed to restore the property to pre-loss conditions. We always put an insured’s best interests before our own. Call us today for a free claim assessment 561-288-6434 or contact us here if you have any questions.  As a follow up to last week's blog on Unlicensed Activity & Insurance Fraud, contractors and roofers have jumped on this bandwagon of handling insurance claims when they are not licensed to do so. How are they getting away with this you ask? They require you to sign the oh so tricky “Assignment of Benefits” also known as an “AOB”.
What is an AOB? It is a contract and by signing this document, you “assign” your insurance claim “benefits” over to another party such as a contractor, roofer or mitigation company. By doing this, you lose any rights and control over your own claim! Also, there is tricky cancellation wording that you will still owe some money if you attempt to cancel the contract. Reputable restoration companies and contractors will limit their contracts to only the work you authorize them to perform. I was recently referred to a lovely family who needed help with their insurance claim. They continued to tell me they wanted to hire their own contractors to do repairs and I was unsure why they kept saying this. I asked if they signed any documentation prohibiting them from doing so and they showed me the AOB. I can understand that they needed to signed a contract for the emergency services to dry their property. However, the company also checked off to do mold remediation and the rebuild but never provided estimates for these additional services. I am always a bit stunned why anyone would sign a document like this without receiving any estimates for the work to be performed, much less signing their rights away on their insurance claim away. Being a former paralegal, I cannot stress enough the importance of knowing what you are signing. Do not sign any contract without a thorough review, and if you are unsure what something means or why it is there, ask questions! We will always provide you with a free damage assessment and policy review and help you to understand your coverage and obligations. Call us 561-288-6434 or visit us here. |
AuthorKaren Schiffmiller Archives
July 2020
Categories |
RSS Feed
