Here is an insurance claim question that we recently were asked to weigh in on as a contributing member of insurance claim experts for United Policyholders who advocates for property owners. 

Q. We received a question from a North Carolina consumer regarding a roof replacement due to windstorm damage. The carrier is claiming that only a "spot-repair" is required under the policy but the homeowner has requested a full replacement. This position is supported by the North Carolina Department of Insurance, yet I find scant case law to support it. Further, when I browse through the North Carolina Insurance Code, I find a reference to "like, kind, and quality" v. "functional" repairs but I'm not clear on what this means in practice. If you have had any recent experience with this type of scenario, I would be interested in your insight.

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As public adjusters, we tend to see property damage resulting in an insurance claim sometimes well after the damage has been done and errors in filing and estimating the claim or just simple lack of documentation has occurred. Fortunately, policyholders can take a number of steps to protect their property claim. A recent article by Consumer Reports: Hurricane warning: Don’t let your house insurer blow you over states that “ the policyholder needs to stand tough and stand up to make sure you get everything you’re entitled to under your policy. They point out 10 ways to do that.

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A recent article from CNN Money Damaged home? How to get an insurer to pay up states that utilizing a public adjuster can help policyholders obtain a fair recovery. As the article states, “Often, policyholders accept low-ball offers from insurers because they don't know what they're entitled to, don't realize how much repairs cost or they're just worn down.” Public adjusters are typically insurance industry veterans who understand the claims process and know how to talk the industry language. Especially with large or complicated losses or during a disaster, involving a public adjuster early in the process can help the homeowner avoid costly mistakes and subsequent denials that require legal action. 

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A recent visit with a homeowner who had the misfortune of dealing with a very bad fire in his home prompts me to write about folks who are out there selling what they may not be licensed or trained to do.
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From Brad Barrett

We want to thank Orlando Public Adjuster Brad Barrett for authoring this insurance claim blog. Is there any future for Independent Adjusters? Some insurance companies would want you to believe that you should only see them from behind a glass window in a museum display.  Although we Public Adjusters sometimes have a contentious relationship with them because we represent the policyholder while they are paid by the insurance company, Independent Adjusters still provide a very important service in the claims handling process.

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Q. The restoration company who repaired our home after an attic fire caused a contamination of fiberglass insulation by improperly clearing and cleaning the attic from smoke damaged insulation.  We know that the restoration company should be the one to take responsibility and maybe even use their General Liability Insurance, however instead they went out of business. We have talked to several lawyers and they say we have no recourse with our property insurance carrier.  We feel that our insurance company should take responsibility and make the restoration company who messed our home up pay to have it cleaned up properly.   Does an insurance company have to use bonded and general liability covered contractors?
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Here is an insurance claim question that we recently answered as a contributing member of insurance claim experts for United Policyholders who advocates for property owners. 

Q. I have been offered a job in Wilmington, NC and would like to live in a nearby beach community such as Surf City, NC.  Other than USAA, What is the best insurance carrier for flood insurance? 

A. Before I answer your question, please allow me to give you some background on flood insurance as our public adjusting firm has seen significant changes over the years. Because of the high risk of flooding and the widespread damages that often result, the insurance actuarial folks could not manage or price this peril so as to set an affordable premium. Thus the private insurance industry was simply not agreeable to assuming the flood risk. Thus, flood losses were excluded in most all standard property insurance policies. In 1968, the National Flood Insurance Program (NFIP) was created by an act of Congress as the lack of this coverage was affecting the economy and commerce. In the beginning years, this program while providing flood coverage, was very poorly run and claim service was terrible. Probably not surprising given that the NFIP was headquartered in Washington, D. C. as it quickly became a typical Washington bureaucracy, unresponsive and extremely difficult to work with.

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An Orlando area client who filed what they thought was a simple property insurance claim for water damage to their home found them forced out of their home since September of last year due to mistakes made by the “preferred vendors” of their insurance company and the insurance company’s refusal to take responsibility for the situation.  Tutwiler Public Insurance Adjuster Brad Barrett  was eventually brought into the situation late and has been trying to bring the situation to what is called Appraisal, where an Umpire can hopefully rule in the client’s favor.

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This 42 page decision Biscayne Cove Condominium Association, Inc. v. QBE Ins. Corp., 2013 U.S. Dist. LEXIS 5194 (S.D. Fla. Jan. 14, 2013) makes for some very interesting reading. The case was one of those late blooming Hurricane Wilma condo claims that I suspect contributed to the thinking that a change in law regarding the time a policyholder has to file a claim might be a good idea. You can draw your own conclusions about what went on in this case (I know I have) but one of the clear take-aways is that in this case the Judge was not buying what was being sold.

As an aside, the 30% rule this public adjuster was relying on and thought existed drew some chuckles in a meeting our firm recently attended with a group of condo lawyers. Seriously, there are some very interesting points made in the Findings of Fact and Conclusions of Law. As the old saying goes; “it’s not my monkey and it’s not my circus” thankfully! 

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We want to thank Orlando public adjuster Brad Barrett for contributing this insurance claim blog.
When a policyholder experiences a loss, one of the first things they are supposed to do is contact the insurance company to report a claim. What we are being told by some policyholders, is that one of the first things some claims departments are doing is to instruct them not to speak with anyone (especially a Public Adjuster) and that they will be sending out their adjuster and their “approved” contractor to review the claim. This is a blatant effort to cut out public adjusters and independent restoration firms.
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