Additional reading material to help further familiarity when submitting a claim.
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November 2021
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Managing your insurance can be difficult, especially since insurance companies have become notorious for highly priced premiums, large deductibles, rises in cost each year, and being reluctant to pay out money.
When investing in an insurance agreement policy, we are investing our trust that whenever we suffer a loss, our insurance company will reciprocate and give us a “just claims settlement.” As we have entered a lawful agreement and dutifully pay our part, we expect them to pay a claim that deserves to be paid – especially since most residential owners or commercial property owners only file a claim VERY infrequently (maybe once or twice in a lifetime?) The question most are left with is “why has my claim been denied and where do I go from there?” The truth of the matter is that many people don’t know what to do if an insurance company denies your claim. Certainly, it is unexpected when you receive a denial letter with no easily understandable reason for the denial given. Some of the most common sources of denial are: TECHNICAL LANGUAGE Often the technical language used when the insurance company interviews the client after the damage, causes for confusion and misunderstanding. The use of confusing and legal jargon often results in the client reporting the claim incorrectly and thereby the claim is denied. EXCLUSIONS Often the insurance company will refer to an exclusion that is not necessarily applicable in the particular situation, which makes having a public adjuster, who knows the legalities, crucial to redeeming the compensation you deserve. REQUIRED DOCUMENTS Filing an insurance claim requires many forms and documents to provide proof and to abide by certain legalities for compensation. Sometimes the insurance company asks for documents that the homeowner can’t find or is late in sending, which can cause a denial. POLICY COVERAGE LAPSE There are times the policy has lapsed and there may not be coverage at the moment, but it is possible there was coverage during the time of damage. WE CAN HELP! Depending on the property damage, each claim is different, and this consequently results in a multitude of potential reasons for denial. Due to the complexities of each claim, it’s crucial to have someone who can clarify the situation by going through the sequence of events to determine the reasons for the insurance company rejecting the claim. Our team of experts can oftentimes turn around a denied claim by clarifying the facts with the insurance company and sending the correct forms in. We know the tricks of the trade and have developed expertise in the requirements and determining what is incorrect or missing in each claim. We have handled many denials and have been able to secure the funds our client was looking forward to. Nine out of ten times a denial will get paid – Most times with more money than the property owner ever expected to receive. DB Solomon Public Adjusters is happy to review your case and read your letter of denial to see what would be the best course to take.
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6 Signs You Should Hire A Public Adjuster10/18/2021 1. You’re Being Asked to Provide Documentation to File Your Claim
When you have a significant claim as a result of catastrophic damage to your home, your insurance company will ask you to document your claim with reports, receipts, and pictures. Make no mistake. This is a crucial step in the claims process, and the insurance company won’t be helping you to prepare your claim. The entire process will be up to you unless you hire a public adjuster. Documenting your catastrophic losses is an enormous task that really only seasoned experts can do correctly. Otherwise, you risk missing out on a portion of the amount you are due; either through omission or undervaluing your losses. 2. The Insurance Policy Language or Claims Process is Confusing to You Insurance policies are often written in legalese that is challenging for the average person to fully understand. Even the supposed “user-friendly” versions may contain confusing language like Period of Restoration, Business Interruption Coverage, Actual Cash Value, and Replacement Costs. These industry terms can be hard to fully grasp. Not only that, but you may have received a significant amount of information about the actual claims process over the phone, where it’s impossible to accurately write everything down that the insurance representative told you. If you are feeling overwhelmed with the complexity of the policy or the claims process, this is a clear sign you should hire a public adjuster to handle the claim on your behalf. 3. You Lack The Time To Handle The Insurance Claims Process Yourself When you suffer a major loss to your business or home, there’s a big challenge ahead. Not only are you expected to carry on your family life and work responsibilities; now you are tasked with the full-time job of handling the monumental claims process. Frankly, this can feel like a second full-time job, and there are only so many hours in a day. The stress of dealing with the emotional crisis following a major loss combined with the stress of trying to submit an accurate claim can feel like its own catastrophe. If you’re in this position, you can immediately alleviate the burden simply by picking up the phone and hiring a public adjuster. 4. You Feel Like You’re Getting the Runaround From Your Insurance Company Many home insurance companies strive to give the best customer service they can. Unfortunately, things don’t always happen as they should. What sometimes happens is that the homeowner’s phone calls aren’t returned in a timely manner, or there’s a “disconnect” in communications. If you suspect that you aren’t getting the right attention from your insurance company, it’s definitely time to call in the services of a public adjuster. 5. The Insurance Company is undervaluing you claim If your insurance company has underpaid your claim or they are taking far too long to assess your claim, then this could be a sign that it is time to call in a public adjuster. An insurance claim can be a lengthy process. If you feel you are being neglected by your insurance company, or they are not responding to your calls in a timely manner, it would be wise to expand your team to include a public adjuster. 6. Knowledge and Professional Standards Claim adjusting is art, not science. If you rely completely on your insurance company to calculate the amount of damage and what you’re owed, you’re unlikely to recover a full or fair settlement. The insurance company sends out their own staff adjuster or “independent” adjuster, and their handpicked contractor, whose job it is to define a scope of the damage and estimate the costs to repair or rebuild your home. They measure the loss for the insurance company, not for you. This matters because big dollars are at stake and your financial goals and the insurers’ financial goals are not the same. You want your loss to be accurately measured, you want to maximize your insurance coverage and recover every dime you’re owed. Many people hire their own experts/contractors to measure and value damage independently from the insurance company. In Closing Documenting and navigating a catastrophic property loss is time-consuming and burdensome to even the most sophisticated insured. It is hard for you, the insured, to know whether you are getting all that is owed under your insurance policy. Your policy may actually give you extended coverages beyond the stated dollar limits on the policy and way more than the insurer offers you. An experienced claim advocate on your side can be a strong voice for you in the process and give you much more input and negotiating leverage on your final insurance settlement than you’d have on your own. Instead of relying on the insurance company to decide how much you get to rebuild your home, hiring a good public adjuster can help you receive the best possible settlement.
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Since home insurance can be a complicated thing, it’s no surprise that filing a claim on your homeowners insurance can be, too—especially if you have extensive damage or a complex claim. But you can avoid some of the worst home insurance claim mistakes.
Your odds of filing a claim in 2020 might seem higher than ever. The eastern United States is heading into the peak of hurricane season, and the western U.S. has already started its annual fight against wildfires and whatever else Mother Nature throws in its path. Nearly 6% of insured homeowners filed a claim in 2018, according to the most recent data from the Insurance Information Institute. Home Insurance Claim Mistake No. 1: Failing to Read Your Policy You could be forgiven for not reading your home insurance policy. After all, insurance policies can be impossible to read. But that doesn’t let you off the hook. At the very least, understand what the coverages in your policy mean. Home Insurance Claim Mistake No. 2: Not Having the Right Coverage If you don’t have the right insurance, you could find yourself in a significant financial hole. A thoughtful conversation with an insurance agent can help you avoid these errors. For example, if your policy has only actual cash value coverage for your possessions, and you’re expecting to be paid replacement cost, you’ll be very disappointed. Some homeowners assume that damage from hurricane wind and flood water is covered by their home insurance policies. But that assumption could be a costly mistake. Insurance companies in hurricane-prone regions might exclude wind damage, and flood damage is generally excluded from a standard home insurance policy. A good hurricane insurance plan might actually be made up of three separate policies to ensure you have the right coverage in place. The bottom line is that a policy’s exclusions can come back to bite you, especially if you live in an area that’s affected by natural disasters. Home Insurance Claim Mistake No. 3: Not Having a Home Inventory Another claim mistake that starts long before you have any damage: Not having a home inventory. This complete list of your possessions will be especially crucial if you have extensive damage. If you have to work from memory, you’re likely to forget some items and fail to include them in your claim. Sure, you’ll remember your living room furniture. But will you remember all your kitchenware and items stored in drawers and closets? A home inventory will make your claim easier and faster. Home Insurance Claim Mistake No. 4: Failing to Maintain Your Property Home insurance is for unexpected damage, not problems that could have been dealt with. Neglecting to maintain your home can lead to problems that won’t be covered by home insurance. For example, damage from a water pipe that suddenly bursts is covered. But a roof leak that you don’t fix could be denied because you didn’t take action to stop damage. Home Insurance Claim Mistake No. 5: Poor Communication Poorly communicated claims by the homeowner typically result in delays, which can bog down the entire claims process. It is recommended homeowners be as clear as possible about the damage when reporting the claim. Your public adjuster should be your first form of contact regarding questions and how to present them to the carrier. Home Insurance Claim Mistake No. 6: Waiting Damage doesn’t get better with time. Reporting a claim as soon as possible can help get repairs going sooner, lessening the time the insured is dealing with the repair process. You may have up to one year to file a claim (it depends on the state). But, there is no benefit to waiting. If your house gets hit by a tornado or singed by a wildfire, do not wait. Home Insurance Claim Mistake No. 7: Trying to Tackle a Big Claim Alone Large and expensive claims can be very complex and take months to resolve. In the meantime, you can be dealing with multiple insurance adjusters and stacks of paperwork. If you have extensive house damage, you may want to hire a public claims adjuster early in the process. This is someone who works on your behalf to deal with the insurance company’s adjusters, make sure you have the right documents and to meet deadlines. Home Insurance Claim Mistake No. 8: Not Documenting the Damage Photos are your friend when you’re filing a claim. Ideally, you’ll have “before” and “after” photos that show the extent of the damage to your home. This is not entirely contained to damage and loss. It is the best value data to have overview photos of as many rooms in the home before loss occurs. Home Insurance Claim Mistake No. 9: Cleaning Up Too Fast After an accident, you might be in a rush to clean up the mess. But cleaning up too fast can be a big financial mistake. Homeowners sometimes throw away items that were damaged in a fire or flood before the total damage is documented. And they discard receipts that they need to support a claim. If you’re filing a claim for a damaged item, keep it until you have sufficient documentation that it’s been damaged, such as photos or repair estimates. It’s important to keep a thorough paper trail during a claim. Not doing so could be a serious home insurance claim mistake. Home Insurance Claim Mistake No. 10: Filing Too Many Claims Insurers will take a look at your claims history when setting your rates. Homeowners and auto insurance claims submitted in the past seven years can be found by insurers in what’s called the Comprehensive Loss Underwriting Exchange (CLUE) database. The more home insurance claims in your history, the more expensive your home insurance premiums will likely be. That’s because insurers correlate claims to a higher risk of filing more claims in the future. Risky customers get higher premiums. So, if you can, it may be better in the long run pay for small repairs yourself rather than filing an insurance claim.
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The information presented in this publication is for general informational purposes, and is not a substitute for legal advice.
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Insurance policies are usually divided into four or five main sections or categories by what is covered and the maximum amounts the insurer will pay in the event of a loss. Typically there’s Coverage A, (Structure), B (Other structures; garages, outbuildings), C (Contents) and D (Loss of Use/Additional Living Expenses). Here’s a basic summary of the main types of coverage in a typical homeowner’s policy.
Your declaration page (often called a “dec” page) states your name and address, policy number, dollar amounts of coverages and “endorsement” codes. You can think of your dec page as the body of a car. The wording inside is the engine, the parts, the wheels, etc. Your dec page states the dollar amounts/limits for your main coverage categories, but what you see is not always what you’ve got. There are extensions, limits and exclusions for certain items. For example, many policies contain a “sub-limit” for valuable papers, computer equipment and jewelry. You’ll need to do some math and piecing together to figure out what your policy limits actually are. Don’t rely solely on your insurer’s calculations. Use our tips and the sample declaration page in this PDF to figure out what’s in your policy and how to collect what you’re owed. --- Special note for California: There is a Residential Property Insurance Disclosure law that requires insurers to provide every customer with a form that alerts you to the specific types of coverage you have bought, plus the ones you could have bought.
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Top 10 Insurance Claim Tips8/23/2021
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First Steps After a Wildfire8/23/2021
Appended from United Policy Holders: First Steps After a Wildfire - United Policyholders (uphelp.org)
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