Have you ever heard of a “Loss Consultant”? This is a new term that originated only a few years ago by unlicensed individuals asserting they can represent policyholders with property damage insurance claims. I bring this up after receiving a call yesterday from a woman seemingly desperate for help. I cannot stress enough and may sound like a broken record, but I wouldn’t be doing you any justice if I didn’t keep reiterating that unlicensed activity is harming Florida consumers and is rampant throughout our state and can be a costly mistake.
She explained that the person representing her with her claim told her he was a loss consultant and she didn’t need a public adjuster. “Loss consultants” don’t exist and only a licensed public adjuster or attorney can legally represent a policyholder with an insurance claim. To make matters worse, he met with her insurance company and told them what he “thought” was causing the damage. Without fully investigating and determining what really caused the damage, he said it looked like her roof leaked and walked the adjuster through the rooms of damage and said the roof needed to be replaced. Because of his lack of knowledge and understanding, he never read her insurance policy and had no idea what was covered or excluded. Why would someone act as an adjuster when they are not? I’m of the opinion that many do so to avoid the legal requirements and costs of having to be licensed, bonded and properly educated to represent policyholders. After all, the insurance companies are dealing with them so they are getting away with it and have no incentive to do things right. She continued to say that after the initial inspection with her insurance company, her consultant then professed that he was a contractor and could repair her home and save her money. Not checking his credentials, and trusting what he told her, she allowed him to repair her roof and the damage inside of her home. According to the insurance company, the roof was not covered because there was no damage to her roof caused by a covered loss in her policy. Unfortunately for her, the policy also did not cover the ensuing interior water damage from the roof leak and her claim was denied. While the insurance company dealt with this unlicensed individual, they then sent her a letter asking for a roof inspection report that her roof was in good condition and not in need of replacement or they would cancel her insurance. When she called her “loss consultant”, it turns out that he is an unlicensed plumber and not even a qualified roofer and he was unable to provide her with the letter she needed and avoided her calls. As a consumer myself, it is my obligation to help others and I will continue to bring awareness about unlicensed activity and how harmful it is. Additionally, Loss Consultants legally do not exist and unsuspecting consumers think they are hiring a public insurance adjuster when they are not. You must, must, must always make sure that anyone doing work for you is properly licensed and insured whether they are a contractor, roofer, plumber or electrician and yes, even a public adjuster or attorney!
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I have always been organized and know exactly where something is when asked at any given moment. For me, having everything organized and in place, creates a calm and peaceful environment. When Scott and I became business partners, we immediately realized we were very similar and understood that being organized was an essential part of our business running smoothly.
In today’s electronic and cloud world, having everything at your fingertips, literally, makes for an easy find. We are required to submit documents for our clients on a regular basis and we do this electronically through email. I cannot tell you how many times we have requested documents from a new client, and they have to go on a search in hopes of finding them. The all too familiar “I know I have them but have no idea where they are” only creates unnecessary stress for you. Having information and important documents stored in a file in your computer will provide easy access and everything in one place. It frees up space, declutters your home and also rids you of the paper collection you once thought you needed. You can create a personal file on your computer and then add sub files within that file for all your important documents such as insurance policies, closing documents, homeowner association documents, life and healthcare documents, photos, wills and important legal documents. You get the idea. Having your files backed-up to a cloud storage is also important in case of a disaster. You should also keep important names and numbers for your doctor, family members, police department and medication list on hand, so you can easily access them in an emergency. If you missed our hurricane supply checklist which includes documents and supplies, you can access our previous blog here and download it for free. You may feel uncomfortable with storing documents on your computer and I would suggest storing them on a zip drive and keeping the zip drive in a safe place as well as a back-up copy stored off premises of your home in case of a disaster. And, you can always store your documents in separate files in a plastic waterproof bin. The Florida insurance market is being disrupted and insurance companies want everyone to believe they are losing money and have to raise insurance premiums. The true culprit of rising insurance premiums and the losses reported by insurance companies, is the unlicensed and fraudulent activity that is rampant throughout our state.
So why should you be concerned? Insurance premiums are continuing to rise with no end in sight. Insurance companies are no longer insuring property owners in certain zip codes, they are placing $10,000 water damage limits into policies or eliminating water damage coverage all together and there are more “managed repair” or “right to repair companies” popping up daily. As a result, you now have limited options of admitted insurance companies to insure your property thereby leaving you to be insured with a surplus lines insurance company. I wrote about the difference between an admitted carrier and surplus lines carrier in last week’s blog which you can read here. There are so many times when I hear that the insurance company is dealing with these unlicensed individuals who are telling unsuspecting policyholders they can handle their insurance claim when they are not licensed to do so. Often times, these individuals think they are hiring a public adjuster, and in fact, they are not. This not only proliferates the problem, but the insurance carriers are aiding and abetting in this unlicensed activity. Did you know that unlicensed activity is a 3rd degree felony in Florida? It is and only a licensed public insurance adjuster or attorney can legally assist a policyholder with a property damage insurance claim. Make sure you do your due diligence and understand who is insuring your property, what coverages you have and what restrictions are being placed in your policy. You definitely do not want to be surprised with limited or no coverage should you have an insurance claim. We offer free insurance policy reviews and you can contact us here or call 561-288-6434. We have received many calls these past few months from prior clients inquiring about insurance companies that their agents are trying to place them with. They want to know our thoughts and if we have dealt with them.
Let me begin by explaining the difference between an admitted insurance company and a surplus lines insurance company. An admitted company sells insurance products that are regulated by the state. In Florida, that is the Department of Financial Services (DFS) and if you have an issue with your insurance company, you can turn to DFS for assistance. However, a surplus lines company can sell insurance products that are not regulated by the state and essentially, they play by their own rules with the state having no authority over them. So to add insult to injury, we recently learned that some surplus lines companies are placing restrictions on unsuspecting policyholders by not allowing them to utilize the services of a public adjuster should they need help with their insurance claim. Why would an insurance company want to restrict you from seeking help should you need it? Why is it okay for the insurance company to have a field adjuster “help” them, but you can’t have your own adjuster help you? This is terrible public policy and you, the consumer, have no protection and it's not okay. Surplus gents are currently required to show their efforts to place a policyholder with an admitted company before placing a policyholder elsewhere. This does not seem to be happening as I experienced this myself while looking for a new policy for my parent’s home. Although I specifically requested not to be placed with a surplus lines company, that was the only quote I was provided. I insisted that they continue looking and of course, was provided a quote with an admitted well known company. It turned out that the admitted company was a more affordable policy then the surplus lines company. It really doesn’t take a rocket scientist to figure out what was going on in this instance. I cannot stress enough the importance that you understand what insurance you are purchasing! It seems apparent that some insurance agents are placing policyholders with surplus lines carriers right off the bat, without fully explaining the difference and type of company, the restrictions and limits within the policy, nor are they searching for coverage with an admitted company. If you have any questions or concerns about your insurance policy, we are happy to assist and we offer free insurance policy reviews. Please contact us here or call (561) 288-6434. There is no secret that insurance companies try to increase their profits and limit their losses. I understand that they are running a business, however, minimizing their losses should not be to the detriment of you the consumer, the policyholder. You pay your insurance premiums when they are due and you expect to be paid when you have damage to your property. That’s not unreasonable. You should be paid what you are owed if you have an insurance claim. Yet when you file a claim, they try to limit your payout.
Insurance companies want everyone to believe they are losing money so they can justify their rate increases, when in fact they are making money, and have the large salaries to prove it. This leads me to share a story. A client of mine who had three young children was brought to tears one day. She had a broken waste line pipe in the kitchen wall that not only damaged her kitchen cabinets, it resulted in additional water damage to the home and caused mold. The insurance company grossly underpaid their claim. I don’t know how they expected her replace her kitchen and do all the repairs for $2500.00! I know. Believe me, they were just as shocked, just like you are reading this. We submitted all the requested documentation to the insurance company together with a very detailed estimate, photos, reports and a valuable explanation supporting our client’s request for payment. After discussing the claim in further detail with the adjuster and providing clarification for him on a few items, we were hopeful that someone was finally going to listen and be reasonable. Then the adjuster called me and said “I have no authority to settle the claim. It’s going to be up to management what they do next.” So, the “powers that be” get to decide, based solely on numbers and not facts, whether she would get paid for the claim or not. This person had not seen any of the documentation we provided and had not discussed the claim with me at all. All they saw were dollar signs, not circumstances or facts. Although they should, the powers that be do not put your best interests before that of the their own. So, when insurance companies claim they are losing money and request rate increases, I say that the people who regulate these insurance companies should dig deeper into the facts and do more to protect Florida consumers. When you live in a villa or a townhome and your building is under one roof system, who is responsible to replace the roof when the roof needs replacement? That can sometimes be tricky. If your HOA documents state the roof is owned by you, then technically, the roof is your responsibility and it falls on you. But how are you supposed to replace only your roof when your roof is shared with your neighbors under one roof system?
Generally, in situations like this, the HOA will set funds aside for the roof replacement in their “reserves”. This is an important factor that you should know and understand. You should contact your association to find out what their role will be in this situation. Back after Hurricane Wilma in 2005, I represented a client who owned a townhome. Although the roofs were the responsibility of the individual homeowners, they were also attached to their neighbor’s roofs. At that time, the association had been poorly run and many homeowners were defaulting on their monthly payments. The association was out of funds and could not assist the community with their roof replacements. Each homeowner filed their own insurance claim and some began replacing their roofs. Once this happened, the roofs in the community no longer matched and they lost consistency in the appearance. In addition to this, because one homeowner replaced their roof and another didn’t, the tie into the other roof was difficult and the “old” roof system leaked causing damage to the unit with the new roof. I know this for a fact because it happened to my client, and although she replaced her roof and completed all her interior repairs, her neighbors did not replace their roof and it leaked into her home causing interior damage again. It is important to read and understand your homeowner association documents to know what portion of repairs is your responsibility and what are the association’s responsibility. I also recommend that you know the financials of your association and attend all meetings when they are scheduled. You can always rely on Reliant for any questions relating to your insurance policy and homeowner’s documents. Call 561-288-6343 or contact us HERE for a free policy and document review. Often times when you file a property damage insurance claim, your insurance company requires you to provide certain documentation in support of your claim. This is a requirement in your insurance policy under your Duties After Loss. One of those duties, when requested by the insurance company, is to provide a Sworn Statement in Proof of Loss within sixty days of their request. However, there are a few insurance companies that require this document be submitted, without being requested and have made it an actual requirement in their policies. Most property owners would not even know this language exists in their policies, much less know how to complete this document or where to obtain the information needed.
A Sworn Statement in Proof of Loss, also referred to as a Proof of Loss or POL, is a document which sets forth information that is contained in your insurance policy, the date and time of loss, the type of loss, your information as the owner of the property and information on anyone who also owns an interest in your property. It also requires you to provide the amounts of your loss which is also accompanied by supporting documentation. There has never been a time when this request was made of our clients, that they knew what to do. We always prepare them on behalf of our clients and submit the Proof of Loss to the carrier together with the supporting documentation. We can 100% back up what is being claimed with our detailed itemized estimates and photos and any additional support documentation which is included in the valuation of your property damage. This is why we are referred to as insurance professionals. With our knowledge and expertise in the industry, along with being in business for over 15 years, we know exactly what is required. We make it our business practice to prepare and submit this document before it is requested by the insurance company. Also, by submitting the Proof of Loss, we place the insurance company on notice and they are required to respond within the time period specified in the policy. Always let a licensed, knowledgeable public insurance adjuster assist you to complete the required document submission for your insurance claim. You can always rely on Reliant! Call us 561-288-6434 or contact us here. During the past 15 years, insurance companies have removed coverage from your insurance policy little by little, thereby eroding important coverage needed to repair your property if you have an insurance claim. Some of them have “offered” for you to buy back the coverage they removed at an additional cost in your premium. Such a nice gesture, right? Wrong! What’s happening here is that your premium continues to increase year after year for less and less coverage.
Also, if you have an insurance claim, some insurance companies make you feel that they are doing you a favor by paying anything at all on your claim! I have had clients tell me that their insurance adjuster treated them as if the money being paid on the claim was coming from their pocket instead of the insurance company. Yes, you read right and it is mind boggling to me. You pay your insurance premiums all these years and expect to be covered when you have an insurance claim and need it the most. Unfortunately, they see it very differently. You have become a “number” in their system, and they need to keep the payout on that number as low as possible. We have also noticed that some insurance companies conveniently have blinders on when there is visible damage to property, such as mold, and leave that coverage completely undiscussed. Unfortunately, this doesn’t just affect one policyholder, it affects every homeowner, condominium owner and building owner with not only less coverage, but rising insurance premiums and fewer insurance companies to choose from to insure your property. With our knowledge and expertise in the industry, and being in business for over 15 years, we know exactly what is required to make sure all coverages are addressed in your insurance claim. You can rely on Reliant! Call us 561-288-6434 or contact us here for a FREE insurance policy and claim review. Months ago, life as we all knew it changed overnight. As I am always optimistic, I am certain that we will overcome this and come out of this stronger than before as we always do when faced with adversity. I will never forget 9/11 which is proof positive that we are strong, we stand together and we can overcome anything.
There is certainly a new normal as states and counties reopen. From day one during all of this, I have said and will continue to say, that you must take care of yourself. Taking care of yourself is not selfish, it is wise, and you cannot poor from an "empty cup" if you don't take care of yourself first. Keep your body moving and find the positive in every single day! There is amazing beauty that surrounds us, and I choose to take it in every day. Are there some days when I stop and say “What the heck! When will things be normal again?” Yes, but those days are few and far between. Truth be told, I do feel normal because I do everything I can to stay healthy both physically and mentally. Daily workouts, walks at dusk, breathing fresh air and enjoying the wildlife that surrounds me, eating healthy, drinking a lot of water and taking my vitamins. Read a good book, listen to music and dance like nobody is watching! I cannot stress this enough and if you do these simple things you have right at your fingertips, you too will feel good and realize how important it is for your overall mental and physical health. Some of you are feeling the added stress from assisting your children or family members with virtual schooling. Who knew you’d be going back to school at this stage of your life. But here you are, and you are killing it and doing great! Make sure to pat yourself on the back because you certainly deserve it. Also keep in mind that your children are not used to sitting in front of a computer all day to learn, and there is something very important in my advice above for them as well. It is extremely important for them to adopt these same habits. If they see you doing it, they will want to follow along and do it with you! Thought for the day ... Practice self care so you can be healthy and happy for everyone, including you so your cup remains full. Have a great day! During recent weeks, we heard industry rumors that some insurance carriers will no longer be insuring roofs at replacement cost value (RCV) and will only be insuring it at actual cash value (ACV). I know you are saying. “What does this mean and how will this affect me?”
Being that we are in hurricane season and most roof damage is caused by hail and hurricanes, I will use this example …“Hurricane We’re Screwed” strikes Florida and damages your roof causing water to enter your property, which then causes water damage to the interior. You report your claim to your insurance company and Mr. Adjuster conducts an inspection of your property. He agrees that the damage to your roof warrants replacement of the roof. You finally receive a check and think to yourself, “this can’t possibly cover all my damage!” Well, you are correct. Although your insurance company agrees to pay your roof replacement, they have depreciated the replacement of your roof by the age of your roof and, in addition to that, the depreciation may no longer recoverable. Roofs are normally paid based on replacement cost value, minus a deduction for recoverable depreciation and minus your deductible. Once the repairs are completed, the depreciation is reimbursed to you. Now, for those insurance companies only insuring a roof at actual cash value, there is no recoverable depreciation. Once one carrier adopts this into their policy, other carriers will follow. If you are insured with a carrier that has this in their policies, your roof will now be depreciated and paid based on it’s age. If you are a homeowner, a homeowner association or a condominium association, this is important information you should not miss as your policy could change upon renewal. This type of policy change is not favorable to consumers! We offer free insurance policy reviews. If you have any questions call 561-288-6434. |
AuthorKaren Schiffmiller Archives
January 2021
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