Showing posts with label adjuster. Show all posts

Wednesday, April 8, 2015

Hail is upon us

Storm season is here and hail is upon us! Just a friendly reminder to renew/apply for your state licenses now, as IA firms will likely be sending out deployments soon! Now would also be a great time to update your availability with your IA firm or to apply to be on the roster for a new IA firm. If you need to see a large list of IA firms, who are always looking to add new adjusters to their rosters, then please visit the IA Firms page. http://insurance-adjuster-help.blogspot.com/p/ia-employers-now-hiring.html

The more IA rosters you are available on, the higher the chances for a deployment (especially if you are new to the industry)

Tuesday, October 1, 2013

Eating a deductible is breaking the law! Do you need help finding a reputable contractor?

While some of us have been busy filling our down time from a deployment by playing Grand Theft Auto V online, watching the Breaking Bad Finale or being irritated by all of the media surrounding the Government Shutdown... Lets focus on a ethical hot topic that will have many contractors screaming in protest! Ignoring deductibles! This is a serious issue that could land the homeowner and contractor in jail and with some hefty DOI fines! (Department of Insurance) As an adjuster, it is important to be aware of this moral dilemma; because roughly 85% of all contractors are going to do this! (that's almost 9 out of 10 contractors)

By law, insureds are required to fiscally participate in a loss with the insurance company. This is why there are deductibles; and this is why everyone is required to pay a deductible to the insurance company whenever a loss is suffered.

"Eating a deductible" means that a contractor will attempt to negotiate with your insurance company so you do not have to pay your deductible on your claim. Your contractor may make this sound like a good deal; but the problem with this is that "eating a deductible" is classified as insurance fraud. In order for a contractor to do this, they would need to either: screw you over when you try to claim your RCBs (recoverable depreciation) or double invoice your insurance company. Double invoicing means that they will give the insured (you) an invoice for "xxx" dollar amount, while submitting a different invoice to the insurance company for a higher dollar amount. This higher dollar amount will conveniently be in the amount of your specific deductible. In other terms, your contractor is purposely lying to the insurance company! Once you (the insured/homeowner) have been made aware that your contractor is doing this, then you can be held liable as well!

Lets take a look at how most state laws will define insurance fraud.

This is the current Indiana insurance law which will hold true and be consistent with most states. Visit your local government facility to obtain the exact insurance law in your area.

INDIANA CODE 35-43-5-4.5

A person who knowingly and with intent to defraud:

(1) makes, utters, presents or causes to be presented to an insurer or insurance claimant, a claim statement that contains, false, incomplete, or misleading information concerning the claim.

(2) presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, an oral, a written, or an electronic statement that the person knows to contain materially false information.

There ya' have it.... That is insurance fraud! Not a whole lot of room for grey area is there? If you and/or your contractor are found guilty of this, then you will have performed a Class C Felony! Once you commit a felony, you can no longer vote or purchase/carry a firearm. You will also face jail time and hefty penalties.

Now the question is... "Is my contractor doing this?" Unfortunately the answer is most likely, "Yes!" Most contractors are unaware that eating a deductible is insurance fraud; therefore most are going to openly advertise that they will do the job so you don't have to pay for your deductible... The competition is fierce out there! Especially after a new storm hits! Almost all contracting companies are going to feel inclined to offer "eating a deductible" to you because otherwise they don't feel like they can compete in the market. They can be a little sneaky with how they present this to you. They may also try to pressure you! You may have heard this before:

I'll just do the job for "xxx" amount less than what the insurance company pays you. That way you don't have to worry about paying for your deductible.

I'll give you "xxx" amount off of your total job cost as an advertisement discount; but only if you let me put my sign in your yard!

I don't need "xxx" amount that the insurance company paid you to do your job... I'm a lot cheaper than the competition. If you decide to use me today I can do your job for less and you can keep the extra money!

There are other problems that can also arise from "eating deductibles." Unless you live in a state that is RCV only (i.e. West Virginia) your insurance company is only going to give you a portion of your settlement up front. This is called Actual Cash Value or ACV. Without going into huge details, ACV payments are best described as "ransom money!" The insurance company doesn't want to overpay for your claim so they want to make sure you are going to actually do the work for the amount that has been settled/agreed upon. Your insurance company is going to ask for a contract or invoice from your contractor. They basically want to make sure you are legally contracted to complete the work before they release the rest of your settlement to you. If the insurance company receives an invoice from your contractor that is "xxx" less than the total claim settlement amount (assuming your contractor is not double invoicing and submits the invoice amount that he/she is actually charging you), then the insurance company is only going to pay you the costs you have incurred, less your deductible. In other words, you are getting a crappier roof than you deserve because you will still end up paying for your deductible!

I can guarantee you if your contractor is willing to cheat your insurance company, then they are going to cheat you too! It may come in the form of your deductible, but your contractor is going to "cut corners" elsewhere so they can still make some sort of profit on your job. You will get a lesser quality roof if you go with a contractor who is doing the job for your deductible!

"IF YOU ARE A CONTRACTOR WHO IS KNOWINGLY DOING THIS TO YOUR CUSTOMERS..... SHAME ON YOU!"

Saturday, September 14, 2013

What is Bad Faith Adjusting? Is my Insurance Company/Contractor Actingin Bad Faith?

Bad faith adjusting will end your career...

When you are adjusting in bad faith you are intentionally setting the claim up to be fixed (cleaned up) by another adjuster later on down the road. In other words, you are being lazy! Bad faith refers to breach of contract when dealing with all involved parties (including contractors) who will assume you are acting in good faith and fair dealing. Acting in bad faith will end your career and can also put you in jail!

Bad faith involves being dishonest or fraudulent in a claim. Examples of bad faith claim handling could be:

Entering into an agreement without any intent of living up to the terms that have been agreed upon. (not fulfilling the contractual obligations to the insured based on what is written in their insurance policy)

Knowingly misrepresenting the quality of an item you are attempting to settle with the insured.

Intent to deceive or mislead in order to gain some sort of advantage.

Failure to thoroughly investigate a claim.

Failure to promptly investigate the insured's property.
- Time periods that are deemed acceptable in reference to the above item will be defined in the insurance policy.

Unreasonably delaying or denying payment.

Refusing to settle the claim in its entirety. (intentionally providing a "less than fair/reasonable" settlement on an item)

Bad faith is also a two way street. Insureds (policy holders) and contractors may also be found guilty of acting in bad faith. It usually involves falsifying information in an attempt to mislead the insurance company. Yes, this includes eating deductibles!

Sunday, August 18, 2013

Garmin nüvi 40LM 4.3-Inch Portable GPS Navigator with Lifetime Maps (US)

Every adjuster will need a good navigation system! Insurance adjusters will be traveling to very rural and sometimes isolated areas. It is important to have a navigation system that is up to date and can give the adjuster the fastest route possible. This is a priceless tool if your job requires you to constantly travel! I've had my Garmin GPS for years now! I update the map system on it before every storm deployment and I rarely get lost. The user interface on the nüvi 40LM is easy to read and easy to use. My wife uses a Tom Tom GPS; personally I can't stand the Tom Tom's user interface. The Tom Tom feels cluttered, hard on the eyes and is difficult for me to use while on the road... Take a look at the product details below to see if a Garmin GPS is for you!

Product Description

Edition: 4.3-Inch with Lifetime Maps

nüvi 40LM delivers you safely wherever life takes you. Designed to make

navigation easy, simply enter an address and premium features including lane assist with junction view, help you make all the right turns!

Start out for your destination and leave the navigating to nüvi 40LM. This device features a 4.3” (10.92 cm) touchscreen and provides accurate, turn-by-turn directions that speak street names. It also includes FREE lifetime map updates.

Get Turn-by-Turn Directions

nüvi 40LM's intuitive interface greets you with two simple choices: "Where To?" and "View Map." Touch the screen to easily look up addresses and services and to be guided to your destination with voice-prompted, turn-by-turn directions that speak street names. It comes preloaded with maps for

the lower 49 States. nüvi 40LM’s speed limit indicator shows you how fast you can go on most major roads. With its "Where Am I?" emergency locator, you always know your location. It also comes preloaded with more than 8 million points of interest (POIs) and offers the ability to add your own.

Enjoy FREE Lifetime Map Updates

With FREE lifetime map¹ updates, you always have the most up-to-date maps, POIs and navigation information available at your fingertips. Map updates are available for download up to 4 times a year with no subscription or update fees and no expiration dates.

Know the Lane Before It’s Too Late

Now there’s no more guessing which lane you need to be in to make an upcoming turn. Available in select metropolitan areas, lane assist with junction view guides you to the correct lane for an approaching turn or exit, making unfamiliar intersections and exits easy to navigate. It realistically displays road signs and junctions on your route along with arrows that indicate the proper lane for navigation.

What's in the Box

nüvi 40LM

City Navigator® NT data with preloaded street maps for the U.S.

Lifetime maps¹ (indicated by "LM" after model number on the box)

Vehicle suction cup mount²

Vehicle power cable

USB cable

```
Quick start manual
```

Product Information

Edition: 4.3-Inch with Lifetime Maps

Technical Details

Item Weight	5.3 ounces
Product Dimensions	0.7 x 4.9 x 3.1 inches
Item model number	010-00990-21
Batteries:	1 Nonstandard Battery batteries required. (included)
Display Size	4.3 inches
Warranty	Limited 1-year parts and labor
Battery Life	2 hours

Additional Information

ASIN	B0057ODG6Y
Customer Reviews	4.3 out of 5 stars See all reviews 3,165 reviews 4.3 out of 5 stars
Best Sellers Rank	#25 in Electronics (See top 100)
Shipping Weight	1 pounds (View shipping rates and policies)
Shipping	Currently, item can be shipped only within the U.S.
Date First Available	August 24, 2011

View Customer Reviews for this product

Wednesday, August 14, 2013

How to earn quick and easy CE Credits online

So your adjuster state licensing is getting ready to expire and you haven't gotten nearly enough of the required continuing education credits... Fear not! There is no need to worry about the $50 per credit hour penalty! You can easily acquire them in one night if you have a few hours to spare! In this article I'm going to briefly go over how to quickly and easily earn CE credits by utilizing WebCE online!

All you have to do is go to www.webce.com. From here click the Course Catalog link. Then select your resident state from the diagram. A list of license types will pop-up, choose "Adjuster". If no adjuster option is available then choose "Property & Casualty" (Adjuster and P&C are essentially the same thing anyway). The following page will show you exactly how many credit hours you will need to fulfill your insurance license obligations. You can also view your state's specific requirements in the Compliance Requirements section.
WebCE offers discount pricing when you bundle and purchase your CE courses at once. You can expect to spend roughly $40 - $60 depending on how many credit hours your resident state requires. Once you are in compliance with your resident state, most of the other states that you hold an adjuster license in will also deem you in compliance. So the good news is "You don't have to repeat this process for every state you hold an adjuster license in!" WebCE will also report your earned credits to your state for you.

You will be required to pass an exam once you have reviewed the CE course material. If your resident state requires an exam proctor then you will need an adjuster buddy to login using their licensing credentials to verify that you did not cheat on the exam... Its a pain, but this is still the quickest, easiest and least expensive way to earn your CE credits!

Friday, April 5, 2013

Local Woman Interviewed about Intense Hail Storm - Kapooyah!

This has been floating around the interwebs for awhile, and it still cracks me up every single time I watch it! A local woman is interviewed about a significant hail event that hit her neighborhood. Watch to see her hilarious explanation of the events that occurred!

Thursday, March 14, 2013

To O&P or not to O&P...

That is the question...

O&P stands for overhead and profit and is usually included into an insurance claim when a job warrants extra work/coordination of sub crews from a general contractor. It is extra money allowance of 10% overhead and 10% profit added to the overall claim settlement amount (20% total). The definition of overhead and profit inclusion is "Complexity of repairs or coordination of multiple trades". There is a lot of controversy surrounding what warrants O&P into an insurance claim. Arguments can easily be made on both sides of the fence. But it all comes down to how well the insurance adjuster can justify O&P inclusion into his or her file notes.

Once upon a time, insurance companies used to automatically include O&P into a job when 3 or more different trades were present in the claim. For example, if the roof was being replaced along with: an elevation of siding and interior drywall/paint repairs, then this job would quality for O&P for multiple trades (because there would be a total of 4 different trades in this example). This type of job is also complex (as some of the trades are contingent upon each other), which is also another reason why O&P would be warranted. However, it only takes a few bad eggs to spoil the batch for everyone... What insurance companies were finding is that some general contractors would purposely hire additional sub crews to perform miniscule/unnecessary tasks (such as hiring an HVAC tech solely to unhook the furnace cap during a roof replacement) or hiring a window installer to replace an exterior window screen, just so they could bill the insurance company for O&P. It is for this reason, that most insurance companies will look for "complexity of repairs" as another area to consider O&P.

So how could an adjuster justify coordination of multiple trades properly in his or her file notes? You could take the approach of:

"Overhead and profit is warranted on this job due to coordination of multiple trades and complexity of repairs. This job has complexity due to the need to coordinate between the roofing, siding, drywall and painting subcontractors and the homeowner. The painter cannot begin his work until the drywall subcontractor has finished his work and the mud is dry. The drywall subcontractor cannot begin his work until the roofing subcontractor is finished with his work and the roof stops leaking. All of this has to be coordinated with the homeowner’s schedule, as interior access will be necessary to complete the repairs; thus adding complexity to the job."

Feel free to paraphrase, but if you want to sound like a smarty pants and get management off of your back about your settlement decisions, then this example would be a good place to start in how you should structure your logic within a file note. Of course your photographs should also support justification of overhead and profit as well.

What should I do if I am not sure if a claim warrants overhead and profit?

You should review any settlement/coverage questions with your manager. But if your manager is not available and you are out in the field ready to make an on-site settlement then INCLUDE IT! If you are on the fence and there is any question in your mind at all about including O&P into a claim; then just include it!

You are more likely to get in trouble for not paying O&P when it should have been warranted, than vice-versa. There is an old saying that one of my old managers loved to throw around at the office "The tie goes to the runner!" It is just good customer service to include O&P as much as you can justify it. This will make the contractor happy, and in turn will make the homeowner happy; because that is just one less step that the homeowner will have to deal with. Homeowners HATE having to ask the insurance company for supplemental payments! The same cannot be said for the contractor ;)

Also think of it this way. If overhead and profit is included in the claim that you are adjusting, then you have a greater chance for the claim to reach eligibility for percentage file billing. Which is more money in your pocket! Everyone loves more money! It's a win-win situation! Just be sure you are not going crazy with it and that you can reasonably justify your thought process within your file notes. Un-ethical billing on your files can lead to a quick release from the storm and a probable DNR or (do not rehire) black-listed to your employment.

Friday, February 8, 2013

State of Emergency: NY, MA, CT, RI

Winter Storm Nemo is a monster! And it is only getting worse! (2/8/2013 - 2/9/2013)

The brunt end of the storm is currently in New Jersey and is headed toward Boston fast! A state of emergency has been issued for many areas of the northeastern US. Areas of New York, Massachusetts, Connecticut and Rhode Island have all issued travel bans. If you are in these areas and attempt to travel then you could be issued a hefty ticket. DO NOT TRAVEL IF YOU ARE IN THESE AREAS! Remember, you are not only putting your life at risk, but you will also be putting first responders at risk.

Winter Storm Nemo is intensifying and is projected to become worse later on tonight. Gusts in upwards of 50 mph are being reported. By 5 or 6am tomorrow (Feb. 9th) the storm will be ending for the western-most areas that have been affected. Hunker down, Bahston! It looks like you are going to be taking the brunt of this storm!

Stay safe and God bless! Click here to FIND more information on Winter Storm NEMO

Wednesday, January 2, 2013

Product Review of the Bosch DLR130K Digital Distance Measurer Kit

As an insurance claims adjuster, I am often asked "How do you adjust 5 or more claims per day, while producing quality inspections?" Besides general work experience, I will attribute part of my speed to the Bosch DLR130K Digital Distance laser measuring device. This niftly little device will save me up to 30 minutes or more, per interior inspection! Time is money to an insurance claims adjuster; and the Bosch DLR130K allows me to focus on more important elements of the damage assessment process. This was the first piece of equipment I purchased as an adjuster; and it was the best investment I have ever made! It also doubles as a fancy laser pointer to torture my dog and cat when I am at home. ;)

The Bosch DLR130K is easy to use. All you have to do is point and click, and the unit will display the distance (or how far away) an object is. It is accurate to within a sixteenth of an inch! This is very useful to me when I am measuring eave heights, fence lengths, elevations, cabinets, interior rooms and ceiling heights. The Bosch DLR130K Digital Distance Measurer can be displayed in inches/feet, decimals and metrics. It will also measure areas and volumes. The Bosch DLR130K is very durable. I use mine every day and it has been abused! I've dropped it countless times onto the concrete and even off of roof tops and it still works perfectly!

The Bosch DLR130K laser measurer is also very reasonably priced! The Bosch DLR130K Digital Distance Measurer is currently listed on Amazon.com for only $89.99 new. I would strongly recommend this item if you are an insurance claims adjuster, general contractor, carpenter or if you are just a handy person who enjoys fixer-uppers! For more insurance claims adjuster related items, please visit the Insurance Adjusting Equipment page and the "What equipment will I need when adjusting insurance claims?" page.

Tuesday, January 1, 2013

Insurance Claims Adjuster Jobs

Here is a current listing of insurance claims adjuster jobs (auto, health, liability, subrogation, worker's compensation and property) throughout the United States: