Property Adjusters Associates

     
Home ]
 
The Claims Process
 
Home
About us
A Claims Story
Adjusters
The Claims Process
Commercial Losses
Construction Process
Contact
Contents Inventory
The Right Contractor
Major House Parts
Recent Losses
Whitten Street
Your Policy

 

 

 
 
 
 

 
  THE CLAIMS PROCESs

The claims process involves coverage and how that coverage applies. Endorsements often add coverage. If you can't locate copies of your endorsements ask your agent for copies or call our office we'll be glad to let you know how they apply.

While the adjuster is out at your home you'll notice he will take dimensions of your home or foundation. This is to insure that you are Insured to Value. You must carry an amount of insurance (limit) to 80% of replacement cost to be eligible for Replacement Cost Coverage. Typically you can figure replacement cost by taking the (living space) square footage (length X width) and multiplying that figure times $125.00 per square foot. Your adjuster will determine his rate per square foot. If you are not insured to value you would suffer a co-insurance penalty at which point you would call us. Don't worry this doesn't happen very often. This is a good way to figure what you should have for coverage. Your policy should have inflation guard coverage which keeps your limits on the home updated or increased.

The biggest misconception is that since you have Replacement Cost Coverage and your home or business is a Total Loss (Limit Loss) you don't need a Public Adjuster. If you've checked the Construction process link you found a minimum of $10,000 additional coverage you either didn't know about or were not told about.  If you did know it was there, then perhaps you don't need a Public Adjuster. Your Company Adjuster won't tell you!

Replacement Cost Coverage applies to both your Building and Contents (Cov C). Replacement cost is payable only when the building is actually repaired or rebuilt or you actually replace the items. All losses are figured at (ACV) or Actual Cash Value. This is replacement cost less depreciation. Your building and the repairs will be depreciated along with any contents loss. Once the repairs or replacement takes place you must furnish proof or receipts that these items have been repaired/replaced and then you get the holdback or monies withheld.

If you still owe a mortgage, your mortgagee will be listed on any checks issued on the building (Cov A). Make certain your contractor is aware of this arrangement and discuss with your adjuster, how this money withheld will be issued. Your contents must be replaced within 180 days from the date of loss to apply for these benefits. (See the contents inventory link) All of this creates problems with your contractor, your bank, and your pocket book.

Most towns/cities have ordinances towards dangerous structures. Some require that buildings damaged to 50% of their assessed value must be raised or demolished. Check with your building department as soon as possible after the fire to see what they will be requiring. They also have code issues and variance issues. Do you know what is or isn't covered? You may also ask about an abatement since you are no longer in your building.

Coverage B. Other Structures: Are structures separated by clear space; detached garages, sheds, swimming pools just to name a few. Does an electrical service line to a pool from your service panel make the pool attached or detached? Often times there are problems determining this coverage.

Coverage C. Contents:                                                                                                                          Your furniture, jewelry, household goods are all part of Coverage C. Like your building, your contents will be paid at ACV. Household goods depreciation is figured on a lifetime scale. Electronics usually 10 years etc. You have 180 days to replace these items to apply for replacement cost benefits. (See contents inventory)

Coverage D. Additional Living Expenses:                                                                                       This is coverage for the additional costs you incur because you are not able to live in your home. Be leery of the adjuster who offers you a trailer so that you can be close to your possessions and watch your home. This is a common occurrence where adjusters will be looking for the best interest of the company. Did your adjuster offer this?  By putting a trailer on site the cost would be roughly $700.00 per month. That's what you would be paid per month for Additional Living Expenses. To stay in a hotel would cost about $1,000.00 per week plus meals, laundry and any other expense. To some people the trailer is a good idea, just question the motive of the adjuster. Living in a trailer especially with children gets smaller and smaller. Nothing makes an insurance company move quicker to settlement then paying hotel bills.

In some cases the adjuster may come out with a contractor to write an estimate.  You have the absolute right to hire the contractor of your choice. The insurance carrier must come to an agreement with that contractor.  In the event that doesn't happen you may invoke the "appraisal" (conditions section) provision of your policy. "Your contractor and the insurance company's contractor, (The contractor brought to your home by the adjuster) agree on a third party contractor. Any agreement between two contractors is binding. The contractor will accompany the adjuster to help in two ways; control the cost, (He'll be paid for his time by the company) and keep costs down. As long as he keeps his costs down, the insurance company will call him in on other claims. This is a good relationship for the contractor, not you.

Once this estimate is received by the adjuster, he will prepare a reserve report. A reserve report is used by the company to take whatever money they think it will cost to settle your claim and invest that money until your claim settles. That way they gain interest on your money or pay less on the claim. That's how big business works. Once this report is filed, should the reserve exceed what was originally reported the company is losing money. The adjuster also looks like he didn't do his job (saving money) and the claim begins to get difficult. Bring in your own contractor or a Public Adjuster as soon as possible.

Another misconception is that an insurance company can cancel your policy for hiring a Public Adjuster. That's just not so. We are bonded and licensed by The State of New Hampshire Insurance Department to protect your best interest. You can be cancelled for having 2 losses in the same calendar year, misrepresentation, concealment, increase in hazard or non payment of premiums.

Most people also do not understand the relationship between your agent and your insurance company. Your agent is a broker for your insurance company. He/she sells you the insurance companies policy and makes commission on that policy based upon          loss ratio. Loss ratio is how many losses they have with that insurance company. The more losses the less commission. When shopping for insurance, your agent is the key. Will he represent your best interest or just collect your premium dollar. Service is key.

Insurance should be like grocery shopping, you feel you're paying too much and you probably are. Shop around. Now is the time after your many years of loyalty for your insurance company for them to step up and come through for you. You're in Good Hands, Like A Good Neighbor are all good mottos but you need more than that. If they don't come through for you, we certainly will. Call us at anytime with any questions you may have during the claims process. We're here to help and we will.  

 

 

 
 

Back ] Next ]
 
Copyright 2005 Property Adjusters Associates All rights reserved