Insurance Claims: No Insured Is An Island

I was speaking with a friend of mine today regarding a potential referral for business. A friend of his has an insurance claim and was apparently having difficulty with their insurer. In short they were out matched and out gunned at every angle. It didn’t help that the insurance company was one of those who hate paying out claims. Now you might say that all insurance companies hate to pay claims, but I am not sure that is correct. I think the vast majority of companies, while not liking to pay claims, see claims as a way to fulfill the promise made when they took the premium. Getting back to my potential referral story: this insurance company hates to pay claims. They are at war with their policyholder and the only one who doesn’t know it is the policyholder. 

This got me to thinking about Benefit Bill™. One of the points that I advocate on that site is team building. You would never consider playing football team without 10 other people on your side (we’re not talking about pickup games here), why do you consider going up against the insurance company without your team in place? Think about it a minute. Your insurance company has a readymade team at their disposal: claims managers, supervisors, adjusters, contractors, engineers, accountants, contents experts, attorneys and the list goes on and on. You do you have?

If you said me, myself and I, and you are going up against the insurance team, my monies on the insurance team. Maybe that’s why so many insured’s wind up settling for pennies on the dollar. If you’re not sure how to build your team, keep checking back with Benefit Bill™ from time to time. We are putting together lessons on team building, one team member at a time. When you begin putting your team together, the odds swing dramatically in your favor. Happy team building… and

Have a Great Day!

Bill

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Roof Damage To Be or Not To Be

I’ve been in the chat rooms today where the conversation remains active regarding State Farm Insurance being investigated in Texas. What has amazed me is the number of adjuster who adamantly state that roof shingles that have been lifted by wind but are otherwise physically fit are not considered to be wind damaged … in their humble opinion. As you might imagine, I adamantly disagree. The crux of their argument, if I understand it correctly is that because the shingles have no other blemishes or observable defects aside from being lifted by wind, that they are not considered as damaged.  

Of course if you are a homeowner, this means you’re not going to get paid.

I believe this type of analysis is flawed and here’s the reason why.  As I’ve stated on many occasions property insurance policies do not insure property: they insure people. They insure people against risk of direct physical loss, but nowhere in the policy does it define what is meant by direct physical loss. So in my not so humble opinion you (the insured) are entitled to the broadest possible interpretation of what constitutes direct physical loss. To restrict the investigation and subsequent observation to the shingles in these situations is myopic at best and wholly disingenuous. Roofs are a system. They are put together in a systematic fashion and each part of that system is dependent upon the other parts to ensure it fully functions as it is supposed to.  When one part of the system fails, as is the case of wind lifted shingles the entire system is impaired. That impairment is direct physical damage.

I used the analogy of a piece of tape being pulled up. When put back into place it never seems to have the strength of bond equivalent to the original bond. Shingles are no different.  The system is broken when the shingle are lifted and no amount of pressing them back into place will restore the system to its’ pre-loss condition. In my not so humble opinion.

Bill

So Good

The other day I met with an adjuster out at a loss. I had heard of this adjusters reputation through the grapevine and the grapevine did not have much good to say about him. Anyway this adjuster shows up with the usual insurance adjuster repertoire of tools: tape measure and camera. This guy was so good that it only took one “o” to spell it and you started with a capital G.

My point in telling this story is not to rant and rail at every adjuster with whom hubris is a personality trait, but rather to point out as I’ve done before that some times losses are not open and obvious. Yet adjusters routinely show up without the tools necessary to do their job beyond what is obvious. The village idiot can see damage that is open and obvious; it takes a professional to see damage that is not.

Here’s the rub: the policyholder depends upon the insurance company to send out a professional adjuster. Those sent out however by and large are not professionals. I know it, you know and the insurance company knows it.

I say the insurance company knows it because they don’t trust these people with authority to agree on scope or price. They don’t trust them! Now here’s my question: if the insurance company doesn’t trust the adjuster they send out to adjuster your loss, why should you?