No Insurance? What? Me Worry?

No Insurance? What? Me Worry?

Mold remediation is no big deal… until it’s not. Let me tell you about the dangers.
#moldremediation #insurance #liability #sick

Insurance Power Questions

Insurance Power Questions

Take Your Power Back!

Ask your insurance company THESE QUESTIONS to get PAID IN FULL, before things get ugly. Request the answers via email so you have documentation for later (especially if this goes to trial!)

    1. Is my claim covered? This seems like a very simple question. If we lived in a perfect world, it would be. You would hope that the answer is “YES!” and you could get down to business. Unfortunately, the answer is usually “Maybe” and leads to an entirely different set of questions. Basically, you want to determine if the insurance company wants to make you whole, or just cover their butts and continue to make money.
    2. What if my loss exceeds my policy limits? Here’s where the picture starts to become more clear. Is the insurance company going to do right by me? Who knows? It could happen.
    3. Are there exclusions in my policy which apply to this claim? Welcome to the insurance game. Unfortunately, they wrote the play book. If there is a legal way for them to wriggle out of paying you, they will likely take it. Find the possible loop-holes now and save yourself a nasty surprise later.
    4. Will my insurance company pay all the necessary costs I incur to put my home back the way it was? Sometimes, a company will pay only the bare minimum. Your house might have had wall-to-wall, plush carpet. Will the restore include this?
    5. Can I choose the contractor to perform the needed repairs to my home? (If not, why?) Crooked insurance companies have led to the rise of “pet contractors.” These mercenaries will do exactly what the insurance company asks them. They will use substandard, cheap materials. They will cut costs by cutting corners. The only way to protect yourself is to hire your own contractor. This is the option we recommend. If you need a recommendation for a reputable contractor, we suggest a member of the Restoration Rebels group.
    6. Is there anything you can tell me that will help to settle this claim? Every insurance company has a quirk or two. We want to dot the i’s and cross the t’s. It is better to jump through the required hoops and get paid in full. You don’t want your claim hung up on a simple form.
    7. When can I expect the first check (how much will it be?) and when will the remaining checks be issued? Like lottery winnings, sometimes a claim is paid out a little at a time. This can be good to get a contractor to work faster. He or she needs to buy equipment and hire a crew. This is a whole lot easier with a little money to grease the wheels.
    8. What if the total of all of the checks is not enough to complete repairs? This is a trick the insurance company might pull on you. They might send a hefty advance and then not follow through with the remaining payments. Keep a running total of what you have received and what you have left to go.
    9. Are you authorized to settle my claim? (Obtain a name, title, phone number, and email of the person that is authorized). Do you know that old trick a used car salesman uses? “I have to go speak to my manager.” Don’t let this happen to you! Make sure you are getting answers from the manager. Full stop.

Insured

Take your power back! Download a copy of these questions as a PDF.

Put Me In, Coach!

Put Me In, Coach!

It’s a common dilemma. You had a flood in your house. The insurance company offers $10,000 to fix it. You can’t find a contractor to do the work for under $40,000. You may feel this is unfair. It certainly is. This is also by design. The insurance company makes more money when it pays you less than what you’re OWED.

Insurance companies use a very complicated program called Xactimate. This is also by design. If it were easy to use, the common property owner could master it. Xactimate software is very expensive. If it were affordable, the average property owner would have a copy.

We’re not talking about Microsoft Word, here.

Is it starting to feel like the deck is stacked against you? The insurance company is trying to get you on the ropes. They want you to feel powerless and hopeless. When you’re in that position, you will accept ANY low-ball offer they give you. Hint: You don’t have to accept the first offer.

Time to get US in your corner!

Like it or not, the insurance company uses Xactimate. That is their “language.” Speaking the same language as the insurance company generally leads to bigger and more successful claims. That’s why you need Xactimate.

Don’t let the insurance company tell YOU how much the damage is worth. Let an advocate fight for you. We’re on YOUR side!

We’re industry veterans. We’ve been doing restoration jobs for decades. We know the REAL cost of fixing a damaged property. Hint: The first offer from the insurance company will ALWAYS be less than what they think your claim is worth.

We need to be on the same page when we go to the mat with the insurance company. They have a “professional” quote that says the damage can be fixed for $X. We have a quote that says the damage can be fixed for $Y. Which quote is going to succeed? Hint: The property owner (YOU) have more power than you think you do!

Andy McCabe is a licensed Public Adjuster. He is insured and bonded. He’s been doing this a long time. Let him go after your carrier! Put me in, coach!

Why Pay For Insurance Claim Advice?

Why Pay For Insurance Claim Advice?

I went on a little rant tonight.  After re-reading what I wrote in an email to a prospective client, I decided this might have some value to ya’ll. So here goes.

We’ve had a major ice storm roll through and there are tens of thousands of homes with water damage.  I’ve been contacted by several homeowners who’ve recieved their insurance repair estimates and are getting worried.  Here’s one of them.

(Names have been redacted to protect the innocent)

Q

“Hi Andy,

Thanks for the info.  I recall per our conversation the $XXX fee but do not recall your hourly rate for negotiations or changes with the insurance.  I am sure you are great what you do but I need to know what the total will cost me (even if rough estimate) and what I can expect with your results.  I know you can’t realistically answer that without inspecting my house and also knowing stance with insurance company.  There is also no recourse in your fee if you do not make any headway with insurance.  I hope you can appreciate my questions and concerns….I am always a little reluctant to sign on the dotted line with hourly rates and unknown results and timelines.  Feel free to call if easier to explain over the phone.”

A

I can appreciate your reluctance.  Most folks don’t understand why they need to pay for help, when it’s their insurance company who should be taking care of them. I get it.
I’ve also been in this industry for 18 years.  I know that insurance companies are not in the business of paying claims in full if they don’t have to.  Right now you don’t have the right tools to make them pay in full.
Do you expect your roof to perform next winter with some patched-in shingles?  Will your roofer guarantee that it won’t leak?  In my experience, no roofer will stand behind a patch job.
Were your gutters bent and dinged before this storm?  Just because they still hold water doesn’t mean they won’t affect your resale value.  New gutters are likely justified and covered by your policy.

I’m a busy guy with plenty to do.

I can only estimate as far as I can see.  Right now, I can see how much time it will take me to inspect your property and write up a proper estimate of repairs.
What I can’t see is whether [INSURANCE COMPANY] is going to play nice.  So there is no guarantee.  I can only tell you that in my experience, this claim is woefully deficient. You can’t know how deficient without an apples-to-apples comparison written in the same estimating program.
You pay for good information.
A Public Adjuster will want 15-25% and total control of your claim (and they don’t take projects under $250k).  A restoration contractor will want 35% and total control of the claim.
There is an entire industry of contractors who know the game and how to play it. That’s where I come from.  If you want to wait a month, you can probably get one of the local restoration companies to come write an estimate for you.  They’ll want the entire project in return.
What I’m offering is a realistic estimate for you to use to go back to [INSURANCE COMPANY] and get what you’re owed.  That’s all.  It’s a starting point.  I give you the ammunition and you’re not tied to anything longer term with me.  I should charge more for this service, but unfortunately most folks don’t see the value until AFTER.
I’m too busy to come out and take a look in order to provide a more accurate estimate of my ultimate charges.
There are hundreds of contractors in Bend that need my help right now.  Everyone thinks they know how insurance claims work, until they actually have to deal with one.  I can only work with folks who feel the need and see the value of my advice.
At the risk of giving away even more free advice, consider this.  You are going to hire a General Contractor to perform these repairs.  The standard markup in the insurance industry is 20% (10% Overhead + 10% Profit). O&P on your project is $3,008.73.  And [INSURANCE COMPANY] left it off because they are hoping you don’t know any better.
There. I just made you 3 Grand.  That one is on the house.
If you want to move forward with me, just fill out the link I sent and pay the deposit. If not, I’ll see you on the slopes some time.
Best of luck either way,
8 Basic Insurance Policy and Claims Guidelines For Happy Customers

8 Basic Insurance Policy and Claims Guidelines For Happy Customers

The insurance claims world is a dangerous place for amateurs.

“Beginning in the 1990s…insurance companies reconsidered [their] understanding of the claims process. The insight was simple. An insurance company’s greatest expense is what it pays out in claims. If it pays out less in claims, it keeps more in profits. Therefore, the claims department became a profit center rather than the place that kept the company’s promise(s).” – Jay Feinman Delay Deny Defend 2010
I read this book about four years ago, when I was first thinking I could take the insurance industry and flip it on it’s head.  Ah, the arrogance of ignorance.  A few years on, and I’m a little closer to making a dent in the claims universe.  No revolution has happend yet, mind you, but I can see some changes coming.
I picked up a journal from 2013 tonight.  I like to re-read my thoughts from time to time, to help keep perspective.  I saw some notes I made in February regarding this book and thought it was time to put together a post for them.  What follows is my top eight takeaways from reading Jay Feinman’s wonderful book on insurance claims.
I’ll elaborate on each after I list them.
“You are an amateur in a field of professionals.” Jay Feinman Delay Deny Defend 2010

1) Evaluate your relationship with your carrier.

2) Pick a good company.

3) Buy the right policy.

4) Understand your coverage.

5) Understand the Claims Process.

6) Fully Document your claim.

7) Meet your adjuster.

8) Decide on your need for professional guidance.

  1. Evaluate your relationship with your carrier.

We’ve all been taught that we were in “good hands” or that our insurance company was like a “good neighbor”.  The commercials and jingles are burned into our heads with millions of dollars of advertising.  The reality is that our insurance companies are not our friends or neighbors.
Jay calls the situation a “special kind of business relationship.”  Insurance companies should not be viewed as friends.  Nor should they be viewed as enemies.  You’ve entered into a contract with a large corporation.  The takeaway advice is to look out for yourself first, while being cooperative.  No need to be abrasive or combative.
Afterall, you want this large corportation to write you some potentially large checks, right?
  1. Pick a Good Company.

I’m not going to share my opinion here regarding the good, bad & uglies out there.  You don’t have to wander around the Claims Delegates blog for long to get my thoughts on who the bad actors are.  There are a couple web sites that will help you figure things out though:
The Consumer Federation of America is a wonderful place to start.  This little piece sets the tone nicely, right on the front page.
” Consumers spend hundreds of billions of dollars a year on car, home, and life insurance products whose complexity and individual pricing permit insurer inefficiency and abuse. A large majority of the state insurance departments that regulate these insurers have neither the resources nor the will to do so adequately.”
I think they might have seen folks get taken advantage of once or twice, no?  I read in my notes that I found a quote saying, “avoid Allstate at all costs.”  I wasn’t able to locate that specific quote just now, but I did find quite a scathing report from ’07.  I don’t think things have gotten better over at Allstate over the last nine years.  I’ll just leave this link here.
Of course you can use the Google as well as I can, but here’s another “Hall of Shame” list I found.
What you should do is find a good, independent agent who has access to more than one carrier.  They have the best opportunity to shop your premium and get the best coverage.  Which leads us to…
  1. Buy The Right Policy.

The most important thing to consider when buying ANY insurance is coverage.  And when you’re talking about what IS covered in your policy, you also want to check out what things ARE NOT covered in your policy: the EXCLUSIONS.  I’ve seen policies which weren’t worth the paper they were written on because of the exclusions which were hidden inside.  I spoke with a client last week with a Builder’s Risk policy that excluded damage by fire if the fire was caused by “combustible materials.”  Really.  A job site with combustible materials? What are the odds?
They suffered a total structural loss and their claim was denied. Because they didn’t understand their policy. (oh, I’m a little ahead of myself)
  1. Understand Your Coverage.

Along with the previous section, I’ll add this advice: READ YOUR POLICY!  Just do it. That is all.
  1. Understand the Claims Process.

This is where things get tricky.  Mr. Feinman said you’re an “amateur in a field of professionals.”  Once you have a claim you’ve entered a “system designed to make the company money.” (refer to the paragraph that started this post).
The claims center has become a profit center for insurance carriers.  They take in over $1 Trillion in premiums every year, and they want to keep as much of it as possible.  They have a lot of paid professionals on their side.  You need to have someone on yours.
Choose your champion.  Is it your contractor? Fine, as long as they aren’t the contractor your adjuster brought with them.  Just tell them that you need their help.  And ask questions.  Don’t think that you have to come off as an expert.  I’ve seen plenty of highly educated doctors and lawyers screw up their own claims because they thought they were the smartest folks in the room.  They can afford to pay for arrogance and pride, most of us cannot.
I could right a book on this section, and probably should.  Just not right now.
Be polite, be prompt and above all BE PERSISTENT.
  1. Fully Document Your Claim

This is another section that could use it’s own book, but let’s get the basics down.
Once you have a loss, you need to get incredibly organized and start keeping EVERYTHING.  Pictures are king, and don’t throw away anything.  Don’t let your contractor throw anything out either.  Keep it until you’ve been paid for it.
Don’t overshare.  There is a section in the book which talks about how too much information can be harmful to your claim outcome.  Be polite and answer questions truthfully when asked. Just don’t volunteer your life story.
Your job is to Prove your Loss.  The adjuster is not going to give you the benefit of the doubt.  It is up to you to prove, within any reasonable means, your loss.
I’m adding to my list of to-dos, a list of all the things you’ll need to include in your own claim file.  DO NOT assume that documents, emails or pictures that you send to your adjuster will be available for later viewing.  Heck, don’t assume they’ll even exist.  One of the oldest tricks I see is the “I’m afraid I don’t see that in your file ma’am” trick.  Billions of dollars of premiums yet they still have a basement full of filing cabinets where everything is cataloged. Please.
You’re apt to have to send the same form to different departments multiple times before things are settled out.  You may as well keep everything yourself in an organized fashion.
  1. Meet your Adjuster

This section is a little vaugue for me right now.  It’s been a couple years since I read the book and I’ve since given it to someone.  So I’m ad-libbing some here.
If you don’t get a good feeling from your adjuster, make the call right away.  Find their manager, and their manager’s manager, and get a new adjuster assigned.  You’re going to be dealing with this person for a long time.  If you don’t get a good vibe or believe they are going to handle your loss adequately, move on and don’t look back.
These days the person that comes to inspect your loss likely won’t even be a company adjuster.  If an IA (independent adjuster) comes to inspect, find out who the Desk adjuster is and open direct dialogue with him/her.  The IA is just a contractor to the insurance company who’s job is to write as small of an estimate of damages as possible.
Ask for advance payment.  The idea is to get them used to writing checks.  It doesn’t have to be a huge settlement check either.  Tell the adjuster about the clothing you had to replace or the groceries you had to buy.  Get them to write you a $1,500 or $5,000 check right away.  You shouldn’t have to come out of pocket for anything claim related.
  1. Decide on Your Need for Professional Guidance.

I realize this last one is exactly why you’re reading this blog post right now.  You got stuck/confused/frustrated with the progression of your claim and went to the Google for answers.  I’m glad you found us, and I hope this is helping.

Professional help is not free.  Good help is not cheap.  Getting what you pay for certainly applies here.

No, you probably won’t have coverage in your policy to pay an expert to represent you.  That’s why a lot of PAs (Public Adjusters) work on a commission or contingency basis.  I don’t, but I’m not normal.

If you’re insurance company is being completely unreasonable, it may be time to hire an attorney and let them fight it out.  A PA will do the same, except they can only take things so far before having to hire an attorney anyway.  The going rate for public adjusting is 15% of the claim settlement.

That just about covers it for now.  It looks like I’ve obligated myself to more writing.  I’ll get right on it.  In the meantime, you can read the rest of the blog here.

Need Some Advice Quick?

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