Insurance Claim

Summer Parties, Graduation Parties, Pool Parties, Cookouts, July 4th bashes, and Labor Day Parties are all good reasons to gather friends and families at your home and have fun. But behind the fun lurks the possibility of guest injuries that could ruin the party and ruin your finances.

So, here are some tips for making sure you are ready for the arrival of the guests.

• Read your homeowners, renters or condominium owners policy many days before the party. Discuss your liability coverage with your agent.

• Few people have liability limits that are high enough, and liability coverage is very inexpensive. Increase your limits to at least $500,000...$1 million is better. Consider buying a Liability Umbrella policy.

• Will you be serving alcoholic beverages at your party? Or, if not, will you allow guest to bring their own booze? Then, I suggest that you make guests hand over their car keys when they arrive.

• Never serve alcohol to a person under the legal drinking age. If you do, and you are sued, your insurance company will probably deny your claim or refuse to defend you.

• Serve lots of food, but not salty snacks. Bars serve free salty snacks because it makes people thirsty.

• Serve non-alcoholic beverages, like exotic punches. You can find no-booze cocktail recipes on line that taste just like the originals.

• Buy a breath alcohol analyzer. You can buy one for about $50 on the Internet. Then, when each person prepares to leave, make them blow in the analyzer. No blow, no keys. Alcohol level too high, no keys. No exceptions.

• Is your guest too drunk to drive home? Either drive them home, make up a cot for them, or call a cab.

• Be sure your home is safe. Fix broken walkways, handrails, etc. Clear away debris, such as leaves and grass clippings. If you have a deck, be sure that the surfaces are smooth and free of slivers. Walk around your home and look for tripping hazards.

• If you have ANY KIND of a backyard pool, be extra careful with who has access to the pool. Drowning is easier than you think. Having a lifeguard for the party is a pretty good idea.

Now that you’ve taken care of all of these tips, have a GREAT party!!

State Departments of Insurance report that dissatisfaction with claim settlements is the top reason consumers file complaints with them. Sometimes it is the fault of the insurer, and sometimes it is the policyholders’ fault for not having the right coverage.

Today, I’m going to walk you through the process of filing an insurance claim complaint. I’m going to use the process here in the state of Georgia, where I live. The process in your home state will be very similar, and can be found at the website of any state’s Department of Insurance. Or, you can phone your Department of Insurance and they will likely either tell you how, or send you printed information on the complaint process.

You may file a complaint with the Department of Insurance if you cannot resolve your dispute directly with your company. You can even file your complaint if you haven't been through the appraisal process (found in your policy).

The Consumer Services Division of the Department of Insurance provides consumer information and investigates complaints about companies and producers. They handle most insurance problems involving home, business, auto, health, HMO, life, credit, dental, etc. Those problems may include coverage issues, claim disputes, premium problems, sales misrepresentations, policy cancellations, and refunds, just to name a few. They will also investigate a complaint against a Public Adjuster.

The Consumer Services Division will not:

• Give you legal advice or act as your attorney;
• Recommend an insurance company, agent or policy;
• Resolve a dispute when the only evidence is your word against the word of the adjuster, producer or company;
• Make determinations related to the facts of a case. For example, they will not conclude who is at fault in an accident or determine the disputed value of damaged or stolen property;
• Resolve complaints against service providers, like body shops and restoration contractors unless the complaints involve the action of the insurance company. For example, they could resolve complaints against a restoration contractor that the insurance company required you to use;
• Make medical judgments.

The Department of Insurance recommends:

• Read your policy carefully. It is important to know what your policy covers prior to having a loss. If you have questions on the coverages you have purchased have your Agent provide you an explanation.

• Keep copies of all correspondence between you and the insurance company. When communicating with your insurance carrier keep track of the phone numbers you called, the date and time of the call and the name and title of the individual you spoke with. After the call keep notes on what was discussed.

• Ask the company for the specific language in the policy related to your claim. Determine whether the disagreement is because you and the insurance company interpret your policy differently. If there is a disagreement on the language in the policy you can seek assistance through the Consumer Services Division by filing a complaint and providing the documentation which will include the policy language in dispute.

• If at all possible take pictures or videos of your contents in your home and do this periodically which will help in the event of a loss. Keep the pictures or video in a safe deposit box or somewhere other than the home.

AVOIDING AUTO AND HOMEOWNER CLAIMS

• Keep all receipts for repairs you make to your property after damage. Auto and homeowners policies may require you to make reasonable and necessary repairs to protect your property from further damage. Your policy covers the cost of these repairs. Keep the damaged property for the claims adjuster to inspect. If possible, take photos or videos of the damage before making temporary repairs.
• Don't make permanent repairs until the adjuster has inspected the damage.
• Ask the adjuster for an itemized explanation of the claim settlement offer. For homeowners claims, this should include sales tax, depreciation, and holdback depreciation for policies with replacement cost coverage. Holdback depreciation is an amount of money withheld from your claim settlement until repairs are finished or the items are replaced. Ask how the adjuster determined the estimate amount.
• Be prepared to discuss your claim if there is a disagreement on the settlement offer. The more documentation you have on items owned will make the process easier.

If you do have a claim dispute, contact your insurance company first.

When contacting your insurance company have your policy number ready. Ask where your written dispute needs to be sent. State your complaint and how you expect the company to resolve it. Sending the dispute in writing encourages a written response.

Document your phone calls by noting the phone number you called, the name of the person with whom you spoke, the date of the call and a brief summary of the conversation. Keep copies of all written communications.

In addition to the written complaint, send copies (not originals) of letters, notes, invoices, canceled checks, advertising materials, or other documents that support your complaint.

The DOI Complaint Form

The DOI Complaint Form is a document that can be completed, printed and submitted with copies of documents that support your complaint. Obtain this form at the DOI website or phone them and request a copy be sent to you by mail. This will enable them to set up a case and eliminate the need for them to request documents, and reduce the delay in providing a response. Always keep your original documents for your records.

To help ensure that the Department of Insurance receives all necessary information to investigate your complaint, include the following information with your complaint:

* your name, address, daytime telephone number and email address
* the exact name of the insurance company
* the full name of any agent or adjuster who may be involved
* your policy number
* your claim number and the date of your loss, if applicable
* a copy of both sides of your insurance card
* a concise description of your problem
* copies of all supporting documentation, including invoices, canceled checks, advertising materials, and any letters between you and the company or agent.

What will the Department of Insurance do to resolve your complaint?

* Send a copy of your complaint to the entity you complained against and request a detailed written response.
* Determine if your issue was handled appropriately under the terms of the policy or certificate of coverage.
* Review your file to determine if the insurance company, insurance agent, or adjuster violated state insurance laws.
* Take enforcement action when laws are violated.

Even though they may not always be able to help you resolve your complaint, your complaints and inquiries help the DOI to assist other policyholders by identifying issues of concern and may help identify potential problems with insurance companies, agents, or adjusters. Their involvement can also cause insurance entities to look more closely at your concerns.

What happens after you file a complaint with the Department of Insurance?

* You will receive an acknowledgment letter, advising who the investigator is and their contact information. Your Case Number shown on the letter is for the issue submitted to the Department. The case number should be used to send additional information to the Department on your case.
* If you have future complaints you will get a new case number, acknowledgement letter and the new investigators name and contact information.
* The DOI will notify the company of your complaint and ask for a detailed response. They will send you a copy of the company's response, with their formal letter regarding the completion of our investigation. The review will result in one of the following actions:

o If the complaint has been resolved, they will send you a letter explaining the resolution.
o If an insurance law has been violated, they will request corrective action by the company.
o If the company is not abiding by the policy, they will request corrective action.
o If the insurer or producer has not responded to all questions or has not investigated the complaint thoroughly, they will require them to do so.

What happens if you are not satisfied with Department of Insurance results?

If you disagree with the Department’s response to your complaint, contact the Consumer Services Division and ask to speak with a Supervisor.

You may wish to consult an attorney to discuss your concerns. You may also request alternative dispute resolution (ADR) to settle disputes with your insurance company on property claims. ADR uses techniques such as mediation with a neutral third party to help settle a dispute outside a formal court of law. Please consult your telephone book for listings for attorneys and mediation services.

Now you have a basic knowledge of the complaint process. Remember, the Departments of Insurance exist to regulate insurance companies and protect consumers. Don’t be shy about enlisting their help. That’s why they exist.

Forensic Accountants are accounting professionals that specialize in calculating insurance claims. Customarily, they work on the side of insurance companies. When the insurance company retains them, their task is to calculate the claim with an eye toward minimizing the claim amount. After all, who is paying their fees?

You may be a business that has suffered a disaster or significant insured loss. In these types of losses, business owners typically have Business Interruption and Extra Expense coverage in their Business Owners Policy. This covers the loss of income and extra expense incurred by the business when their business operations are interrupted by a covered loss.

The biggest challenge for a business owner after a loss is keeping the business operation alive and moving forward. The disruption of operations makes that job very difficult. Then, when you add on the responsibility of preparing, documenting and submitting an insurance claim, it can be overwhelming for the business owner. Remember that your job as claimant is to submit a very accurate claim that maximizes your recovery.

So, my recommendation is to make your life easier by surrounding yourself with claims experts that are working for YOU, not working for the insurance company. And that team of experts should include a forensic accountant.

I do not recommend using your in-house accountants or your everyday business accountant to calculate your claim. Although they will likely assist a forensic accountant with your financial data, they do not know the methods of calculating an insurance loss. That could cost you hundreds of thousands of dollars.

To find a competent forensic accountant in your area;

1. Use your computer and search for “Forensic Accountant” and your city or zip code.
2. Contact some of the larger accounting firms in your area and ask them if they do forensic accounting. If they do not, ask for a referral to firms that do.
3. Contact the Certified Public Accountant Society in your area for a referral.

Once you’ve found forensic accountants in your area, call them and interview them with the following questions:

1. How many years have they done forensic accounting?
2. Ask for a list of satisfied customer with phone numbers for verification.
3. Ask about their fee schedule.
4. Ask to meet them to see if your personalities are a good fit.
5. Do you have any conflict of interest with my insurance company?

The fees incurred for a forensic accountant are usually considered covered expenses for claim preparation.

With this information, you should be able to retain the best accountant possible to calculate your business loss.

Public Adjusters (PAs) are licensed claims adjusting professionals that represent the policyholder in the calculation, preparation and submission of a claim. They do not work for the insurance company. They work for YOU, the person or business who suffered the loss.

Public Adjusters only work on property claims, such as homeowners, apartment complexes, and businesses. They do not represent clients in auto or liability claims.

The biggest challenge for a policyholder who has had an insured loss is the calculation, preparation and submission of his claim. Most people do not have the expertise to submit an insurance claim, and they end up leaving hundreds or even thousands of dollars “on the table” that they are entitled to collect...but don’t collect. A PA will maximize your claim settlement.

I strongly recommend that you contact a PA any time you have a property claim. A consultation will customarily cost you nothing, but their representation could collect thousands more for you.

When it’s time to find a Public Adjuster, do the following:

1. Use your computer search engine and search for “Public Adjuster” along with your city or zip code.
2. Look in the Yellow Pages under “Public Adjusters.”
3. Go to: www.napia.com which is the website for the National Association of Public Insurance Adjusters and get referrals in your area.

Contact at least two PAs in your area and interview them with these questions:

1. Are you licensed in your state?
2. How many years have you been a PA?
3. Do you have a specialty?
4. Can you provide a list of at least ten satisfied customers with phone numbers?
5. Do you have documentation of your success in insurance settlements?
6. Have you ever had a complaint filed against you with the Department of Insurance?
7. Please explain your fees and how you are paid.
8. Please provide a copy of your retainer contract.

Based upon the information you receive from each PA, and how you get along with them, make your choice which PA will be on your team. Then work together to collect every dollar that you are entitled to collect.

Property Damage Attorneys are lawyers that assist policyholders in their property claims. Customarily, they are not Personal Injury attorneys, who represent policyholders and claimants who are seeking recovery from damages or injury.

In my hot-selling book, “Insurance Claim Secrets REVEALED!” I have a chapter entitled “Should I Get A Lawyer?” I recommend that anyone who is preparing a claim should consult an attorney.

When I say “consult an attorney,” I don’t necessarily mean retain an attorney. But you should consult an attorney at every step of the claims process. You do not want to give up any of your rights just because you are unfamiliar with the law. Such an incident could bar you from recovery of your full claim.

You should have your attorney present, or on a conference call, when the adjuster asks for a recorded statement. You should also have your attorney review every document that the insurance company requests that you sign, such as a Sworn Statement in Proof of Loss or a Release Form.

So, here is how to choose the right property damage attorney:

1. Using your computer’s search engine, look for “Property Damage Law” and your zip code or name of your state. That search should give you names of attorneys in your area.
2. Contact at least two Personal Injury attorneys in your area and ask them for referrals to attorneys practicing Property Damage Law.

Once you’ve found Property Damage Attorneys in your area, interview them with the following questions:

1. Are you licensed in your state?
2. How many years have you been a Property Damage Attorney?
3. Do you have a specialty?
4. Can you provide a list of at least ten satisfied customers with phone numbers?
5. Do you have documentation of your success in insurance settlements?
6. Have you ever had a complaint filed against you with the Department of Insurance or the State Bar Association?
7. Please explain your fees and how you are paid.
8. Please provide a copy of your retainer contract.

Based upon the information you glean from your interviews, you can make a choice of the best Property Damage Attorney to consult.

If you are the victim of an insured loss, such as a fire, flood, tornado or hurricane, you will likely have to hire a restoration contractor to complete repairs on your home. However, here is an issue that most property owners never consider...until it’s too late.

That issue is the liability insurance of the restoration contractor. No matter if you are the owner of residential or commercial property, you could have major liability issues in the process of the restoration.

Restoration contractors are customarily general contractors. That means that they manage the work of sub-contractors. They may hire plumbers, framing crews, roofers, electricians, drywall crews, painters and other artisans to complete the work on your property. Many times, the restoration contractor has a crew of workers on his payroll. But, there are some restoration contractors that only act as construction managers.

There’s nothing wrong with that arrangement if the job gets done on time and on budget.

You’ll be entering into a contract with the contractor you choose. In addition, you will be granting authority for your contractor to work on your premises, as well as his sub-contractors. Here is where you must take care to protect yourself.

In the pre-contract process of verifying your chosen contractor’s credentials, you will have required the contractor to provide you with a current copy of his insurance certificate. Take a few minutes and phone the insurance company and confirm that the coverage is in effect, and that the policy dates are correct.

You must insist that the restoration contractor carry General Liability, Completed Operations and Workers Compensation insurance (if he has employees). In addition, you must insist that each sub-contractor furnish the same insurance certificates. The only exception would be a contractor who worked alone and had no employees. That fellow would not need Workers Compensation insurance.

Another very important strategy is to insist that ALL the contractors place you on their insurance policies as an “Additional Named Insured.” That way, if anything were to happen in the course of repairs, such as a worker injury or some other liability issue for which they are liable, THEIR insurance policy would defend and indemnify on your behalf.

This one strategy could save you hundreds of thousands of dollars in a lawsuit award, and thousands in legal fees defending the suit.

Don’t leave yourself vulnerable to liability and lawsuits. Use this strategy!

Hurricane preparedness goes beyond making sure your insurance policies are up to date. There are some practical things you can do around your property, whether home or business, that can lower the risk of storm damage.

The National Climactic Data Center published statistics for 2007 that showed property damage from storms at over $7.4 billion. 2008 totals were higher with the Texas hurricanes. I imagine that you do not want to be part of the 2009 storm statistics.

Let’s concentrate on the simplest remedies. When storms arise, the exterior of your home can be damaged by those high winds and heavy rain. So, roofs, siding and windows are the first line of defense in a storm scenario.

Here are some tips for lowering your risk exposure:

• Make sure that your roofing is in good repair. Well-installed roofs are less susceptible to damage.
• Make sure that your siding is tightly attached to the building.
• If a storm is heading your way, consider boarding up your windows to protect them from being broken by flying debris.
• Caulk windows and doors to prevent wind-driven rain from entering around the openings.
• Cut down unhealthy trees on your property.
• Prune tree limbs that overhang your home or power lines, or overhang your neighbor’s property.
• Clean out roof gutters so rain doesn’t back up and cause interior water damage.
• Move your outside furniture and other personal property into inside storage so it is not blown against your building or a neighbor’s building.

With these tips accomplished, your property has much less exposure to damage from wind and rain. Of course, if your area is struck by a Category 4 or 5 hurricane, missing shingles and siding will be the least of your worries.

At that point, you’ll be glad you updated your insurance policy.

You DID update your policy, didn’t you?

I’ve written before about how to hire restoration contractors, and things to watch for. Now, here are a few tips on how to get the best prices for the restoration work you need to have completed.

• Make sure that the scope of damages is correct. You can usually get a copy of the scope of damages from your adjuster. The scope of damages lists the necessary work to be performed, not the prices.

• Make sure you get at least three estimates from three separate contractors. Inform the contractors that they are competing against other contractors.

• If any contractor finds needed repairs that are not listed on the scope of damage, insist that these repairs be listed on a supplemental estimate separate from the main estimate.

• Make sure that the general contractor bids include Overhead and Profit.

• Negotiate your claim with the insurance adjuster using the highest contractor bid. Many times, adjusters will use estimating software that has unit pricing far below market pricing. This is especially true after a major disaster such as a widespread hailstorm, tornado or hurricane.

• Once you have successfully negotiated the claim amount, go back to the three contractors and suggest that his contractors or suppliers offer better pricing. Economic times what they are today, some companies will drastically shave profits just to have the work.

• Ask your contractors to offer their professional input on ways to get the job done at reduced prices. He might recommend different floor covering, or different cabinets, or different countertops or light fixtures.

• Make a discounted offer to a contractor. Then shut your mouth. The first one who speaks loses.

• Tell the winning contractor that you prefer paying subcontractors and suppliers directly. This can be a win-win situation, since the contractor won’t have to front the money for materials. You can pay for materials out of the insurance proceeds. You can win because you won’t have to pay his overhead or profit for just paying bills.

• Don’t forget to have all vendors sign a Lien Waiver before receiving payment. No signature, no payment.

These strategies can save you thousands of dollars if you’re careful.

Perhaps someday I will write an entire book just about Workers Compensation (WC) Insurance. Many experts before me have already done so, and I’m reluctant to plow that ground again. But I do have some comments about WC that you should know.

Workers Compensation Insurance is a very flawed system in every state of the United States. It began with the lofty intentions of politicians in each state who enacted laws to protect injured workers and get them medical benefits and treatment for their injuries. But, like most laws enacted by politicians, there are unintended consequences. Further, business lobbies, insurance companies, trial lawyers and medical lobbyists contribute huge amounts of money to the politicians at both state and Federal levels. Injured workers are individuals for the most part, and don’t have lobbyists.

Would it be too difficult for you to guess which side gets the political favors in Workers Compensation legislation?

Here’s an example of a system stacked against the injured worker. In most states, injured workers are barred from filing lawsuits against employers for their injuries. The injured worker has only the Workers Compensation system in which to receive benefits.

There are two narrow exceptions where the Workers Compensation preemption might not apply, and an employer might be subject to lawsuit:

• The employer intentionally causes injury to an employee. This exception for intentional acts is very narrow. It is not ordinarily enough that an employer creates conditions where there is a very high probability that an employee will be injured. Customarily, the employer must have committed a specific negligent act intended to cause injury to the employee.

• The employer is required to carry Workers Compensation coverage but fails to do so.

In my opinion, the Workers Compensation laws that prohibit lawsuits against employers violates the 7th Amendment, which guarantees citizens a jury trial in civil cases.

The deck may be stacked against injured workers in another way, which is that the injured worker may only seek medical treatment from a list of doctors approved by the employer or his Workers Compensation carrier.

Most injured workers receive medical treatment for their injuries and recover quickly. But whether your injuries are minor or major, the process of filing for benefits and receiving benefits can be complicated and frustrating. Most employees have no real awareness about how the system works, and only become familiar with it once they are sucked into the system by an injury.

If you are an employee who has sustained an injury, you would be well served to consult with a personal injury attorney soon after the injury. Workers Compensation is usually simpler than regular litigation since it takes place in an administrative setting and may have relaxed evidentiary rules. Also, attorney fees are often limited by state statute.

Injured workers typically need to seek legal counsel when they are refused benefits, or are told that they can return to work before they are medically able to work, or are denied disability in spite of disabling injury.

If your employer sends you to a doctor that declares you fit to return to work, even if you do not believe that you are yet able to work again, I recommend consulting a WC attorney before returning to work.

One of the tactics used occasionally by employers is to bring the recovered worker back to a position specially created for that employee to accommodate their injury. Then two or three weeks later, the employer eliminates that position and lays off the employee, ending his eligibility for workers compensation. Presto...no WC claim.

Another tactic is to refer the injured worker to doctors who are more motivated by a long-term business relationship with the WC carrier than accurately diagnosing and treating employees. In that scenario, if the doctor declares too many injured workers to have continuing disability, the carrier will terminate the business relationship and send workers to another doctor who will play the game.

A personal injury attorney specializing in WC can help protect your rights. If you seek counsel from a WC specialist, he or she will typically know the local administrative judges or hearings officers who preside over WC hearings. He will likely also know the doctors and insurance defense attorneys who are trying to block or diminish your claim. An attorney who is plugged in to the WC system in your area is your best resource to help you collect the benefits that you are due.

Insurance applications are the first forms you’ll see when buying insurance. But if you’re not careful, that application could get your claim denied.

One of the first things that a claims adjuster will do when he receives your claim is ask the Underwriting Department to send him a copy of your application. Why? Because part of his investigation of your claim is to verify the information found on your application. Lots of times, adjusters find incorrect information on applications that allow the insurance company to deny the claim and even void the policy like it never occurred.

Let me give you a couple examples of denial that actually happened:

Example #1. A man bought car insurance in 2002. At the time their application was accepted, the only drivers were himself and his wife. They had a 10 year old daughter. In 2008, they had an automobile accident. The daughter is now 16 but does not drive. After the adjuster did his investigation, they received a letter from the insurance company that denied their claim. The letter said that the insured had failed to disclose a potential driver in the household. Even though they disclosed their daughters name and age in 2002, and the policy had renewed six times, the insurance company used a misinterpretation of policy language to deny a claim.

Example #2. A man applies for car insurance while married but separated. The application asks marital status, married or single. The man checks the box for “married.” He lists both himself and his wife as drivers. A few months later, he has an at-fault car wreck. His car is a total loss, he is being sued for negligence, and has medical bills of $5,000. The investigation finds that he was separated at the time of the acceptance of the application. The insurance company sends him a check for $525, which is his returned premium, and denies the claim, stating that the company would not have given the policyholder the “marriage discount” had they known he was separated.

So, how can you protect yourself from application errors? Here are six ways.

1. Fill out the application completely. Do not leave any boxes or lines blank

2. Do not sign the application until all of the information is completed.

3. Do not sign an application and allow the agent to complete it after you leave.

4. Once you sign the application, have the agent make you a copy of the application right then.

5. Once you receive your new policy, compare the information on your application with the terms and conditions of the policy.

6. Report changes in your policy promptly to your agent, like added drivers, deleted cars, or address changes.

If you will be very careful to do these six things, you can be confident that you will not have problems with your insurance company at claims time over your application.

Insurance claims adjusters are, for the most part, very nice people in a tough job. They are caught in between the insurance company that wants them to control the claim settlement amount, and you, the policyholder or claimant, who wants the very highest settlement amount possible.

But I’m not nearly as concerned about them. If they don’t like their job, they can quit. Nobody is forcing them to be claims adjusters.

I’m mostly concerned about you, the policyholder.

The book that I wrote, “Insurance Claim Secrets REVEALED!” shows consumers all the ways that they can take control of their insurance claims, and add hundreds or even thousands more dollars to their claim settlements. Many of the strategies in the book are confrontational. But you can learn to confront honestly without unpleasantness.

Insurance companies have games and scams that they use to delay claims and minimize settlements. Policyholders and claimants are usually placed under financial hardship when they have an insured loss. Few of the people I’ve ever met who had a claim could afford to repair or replace their damaged goods out of their bank account. Most of the time, people depend upon the restitution they receive from the insurance company.

Insurance companies know this, and rely upon it. They know that delays will place pressure on policyholders and claimants, and that makes them more willing to accept lower settlements.

Back in September 2008 I wrote and posted an article about “Dealing with Adjusters.” It has been one of my most popular articles. Thousands of people have read it. But today I want to put a spin on that article and make an even more obvious point.

When you are dealing with claims adjusters, make sure that you are ALWAYS pleasant, well-mannered, and polite. You can’t control them, but you CAN control YOU.

You need to “nice them to death!” Make sure you are doing the following:

1. Speak calmly whether in person or by phone, no matter what your level of frustration may be.

2. Make your requests for payment, documents or any other requests politely, and make them in writing.

3. Be firm but respectful when you are using a claim strategy. Being demanding will only make the adjuster feel threatened, and he will want to resist your demand to prove he cannot be controlled by you.

4. When you write a letter, be sure that you are polite and respectful. Simply state what you want them to do and remember to say “please” and “thank you”...just like your mother taught you.

5. Do not, under any circumstances, lose your temper! Words said in anger are impossible to retract. You can apologize as much as you want, but better to say things for which you will not have to apologize. Be in control. If you feel like blowing up at your adjuster, end the meeting or phone conversation and come back another time to finish your business.

I promise you that you will never regret maintaining your composure when you are immersed in the claims process.

What's a CLUE Report, and why should you care? If you're buying or selling a property, you will care a lot.

You've searched for far too long, and you've finally found a house that you want to buy. You've fallen in love with this house and you're already dreaming of the ways you'll decorate it.

But, what if you found out that your dream house had suffered a major fire three years ago, and extensive repairs were required? Or what if you learned that the house was flooded and rebuilt? Would that change your opinion of your dream house? Not only that, would this new knowledge change the purchase price you would offer for the home? Could the damages cause an insurance company to charge you a higher premium for your homeowner's insurance?

Now, think about this situation. You live on a street of homes that are comparable in size and value to one another. Your house is one of four homes on your street for sale. All four are priced the same. However, one of the four homes on your street had a major fire and rebuild three years ago. Do you think that the value of the repaired home should be the same as yours?

That's why ChoiceTrust offers the C.L.U.E. Home Seller's Disclosure Report. "C.L.U.E." stands for Comprehensive Loss Underwriting Exchange, which is a database featuring loss information compiled by the insurance companies. A C.L.U.E. report provides a five-year history of losses that have been filed against insurance policies covering a given property. The report provides information including the dates and types of losses and the amounts paid for each loss.

It's a report that you purchase as the home seller. It can give prospective home buyers valuable information about losses associated with your home. Then the buyers can make an informed decision when buying your home. If the report shows prior claims, a buyer could ask for evidence that the damages were properly repaired.

A C.L.U.E. report that shows no losses can give you, the home seller, an advantage when your home is compared with similar properties.

Real Estate Agents: Ask the property seller for a C.L.U.E. Report! Furnishing loss information to a potential buyer that makes the home you are selling more attractive gives you a competitive advantage. When you order the C.L.U.E. Report at the time of listing, the smart seller and his/her smart agent are ready for buyers immediately.

Question: May I order a C.L.U.E. Report on a property I want to buy?

Answer: Sorry, you may not. Only property owners (business or individual) can access a consumer report like the C.L.U.E. Report.

Question: How may I obtain my own report?

Answer: Order from http://www.choicetrust.com, and you can view your report online immediately. The report only costs $19.50 per address. You can also order reports on properties that are not your primary residence, such as rental property or vacation homes.

If you are a home buyer you should require home sellers to provide a C.L.U.E. Report as a contingency to a purchase offer. Your best friend in your real estate purchase could be the C.L.U.E. Report.

P.S. I wrote a book that YOU need!
check out: http://www.insurance-claim-secrets.com
NUMBER ONE at Amazon.com in its category!
My blog is at: http://insurance-claim-secrets.blogspot.com/
Nominated for Georgia Author of the Year Award 2008
My philosophy: I give value first. I help other people. I strive
to be the best at what I love to do. I establish long-term
relationships with everyone. I have fun...
and I do that every day.

CONTENTS, or UNSCHEDULED PERSONAL PROPERTY

Picture a homeowner couple in Southern California. They had a home in a wooded area, and wildfires began. The local Fire Department came to their home and required that they evacuate because the winds shifted and the fire was coming straight for their home. They gather up their most valuable possessions and leave their home. Three days later, they return to find a smouldering pile of ashes...a total loss.

This article is about the Contents portion of the claim. The insurance company will not just write you a check for the policy limits in your Homeowners policy. You're going to have to prove your loss.

The insurance company adjuster MIGHT give you an inventory form to fill out. They might not. But, they ARE going to expect you to submit a complete, accurate inventory list.

I hope that you videotaped all of the interior of your home PRIOR to the loss, and have secured that videotape in a safe deposit box off-site. Then, you could view the tape and write out the inventory.

But let's just assume that all you have is ashes. What to do next?

Get a copy of a JC Penney catalog. Better, get two...one Fall/Winter, one Spring/Summer. Get your hands on as many other catalogs as you can find. As you look at the pages of the catalogs, you'll remember the things that you had in your home. You will find hundreds or thousands of dollars in personal property that you likely would not have remembered owning. Not only will you remember dozens and dozens of items, but you'll have a retail price from a reputable retailer right at your fingertips.

Please don't misunderstand what I'm telling you to do here. I'm NOT telling you to write down items on your inventory list that you did not own. That's fraud, and you can go to jail for fraud. I'm simply showing you a way to remind yourself of things long ago purchased, and possibly stored and forgotten. For example, how many parents bought a vaporizer to run in their childrens' rooms at night when the children were sick? That vaporizer might not have been used in years, but you owned it, and you have a right to collect for it under the terms of your policy.

Write down EVERYTHING. Your inventory list will likely take dozens of pages. Remember to show (1) replacement cost, (2) age of the item, (3) Price paid.

When I say "write down EVERYTHING," I mean it. Thumbtacks, Q tips, makeup, bobby pins, tools, extension cords, light bulbs....if you owned it, record it.

You can be certain that the personal property you DO NOT INVENTORY will NOT be paid for.

Next article will discuss what happens next, when the adjuster begins to apply depreciation to your Contents Inventory. How can you win this fight?

Additional Living Expense (ALE) Claims

HERE'S A SUPER IMPORTANT A.L.E. TIP!!

Over the past few years, wildfires in the Western United States have been horrendous, displacing tens of thousands of people from their homes and businesses, and causing billions of dollars in fire damages. But what happens when the local authorities force you to evaluate when fire gets too close?

There's coverage in the ALE portion of the policy! I promise that the insurance companies are not running radio and TV ads, alerting their policyholders about THIS coverage!

Here's a exact quote from the ISO homeowners policy:

"If a civil authority prohibits you from use of the "residence premises" as a result of direct damage to neighboring premises by a Peril Insured Against in this policy, We cover the Additional Living Expense and Fair Rental Value loss.....for no more than two weeks." (1)

In a Homeowner insurance policy, you'll usually see ALE coverage listed as Coverage D. Sometimes, it's called Loss of Use.

Additional Living Expense (ALE) coverage is just what you might think it is. When you have a covered loss that makes the place you reside unfit to live in, and it forces you to spend more on normal operating costs than you usually spend, ALE coverage pays.

Your policy probably reads just like the following: "Additional Living Expense, meaning any necessary increases in living expenses incurred by you so that your household can maintain its normal standard of living."

ALE covers things like:

a. Temporary housing, like in a hotel, an apartment or rental house. If you lived in a modest home, don't expect the insurance company to pay for the finest hotel room in town. But on the other hand, if you lived in an expensive home, you should EXPECT AND DEMAND that the insurance company pay for temporary accommodations of like kind and quality. Remember, if you had a mortgage on your home, you still have to pay the mortgage payment while the home is being repaired. Lots of times the loss is severe and the adjuster knows you'll be out of your home for weeks or months. The insurance company will save money if it places your family in an extended stay hotel, or in a short term apartment or house lease. In addition to saving money on rent, the insurance company can pay advances on Contents, and if you're in an apartment or house, you'll have a place to store your new contents, like furniture, clothing and kitchenware.

b. Laundry and dry cleaning. If you had laundry facilities at your residence, it will cost you more to get your clothes cleaned. The extra cost you incur is covered.

c. Meals. This is where many people misunderstand their claim. Certainly, if you cannot buy and prepare your own meals, you'll incur higher food prices. But insurance companies won't usually pay for costly steak dinners and high bar tabs. You're going to have to be able to explain your meal purchases, so don't go overboard. You'll have to make an accurate estimate of what your family normally spends per month on food. That can certainly include restaurant meals that you normally buy. Just remember that ALE is paying for items OVER your normal standard of living. Keep METICULOUS RECORDS of your food purchases. If the insurance company places you into a temporary apartment or efficiency hotel that has a kitchen, they'll stop paying for most extra meals.

d. Boarding costs for pets. Someone has to take care of your pets while you cannot live in your home. This is covered.

e. Increased transportation costs for all your vehicles. Do you have to drive your children to school, since your temporary accommodations are not in the old school district? That's covered. Do you have to drive further to and from work? Covered. Do you have further to drive to doctors, dentists, ballet classes, soccer games, etc.? The increased cost is covered. Did I say KEEP METICULOUS RECORDS? Most office supply stores have automobile expense logbooks for sale for a dollar or two. Stop by and pick up one for each car you drive, and write down EVERY TRIP. Keep all receipts for every penny you spend on transportation.

f. Furniture rental for a temporary residence. You have to have chairs and beds and other stuff...even pots and pans, dishes and temporary electronics. However, don't try to get them to pay for a 60" plasma flat screen TV rental if you had a 27" color TV at home.

g. Relocation and storage expenses. Perhaps some of your personal property was not damaged. Perhaps some was damaged, but the restoration contractor is cleaning and repairing it. Once it's cleaned and repaired, it's got to be stored somewhere until you can move back home. Covered.

h. Costs of telephone or utility installation at your temporary residence. This would include deposits that the utility companies might require. Don't forget garbage pickup at your temporary place. It's all covered. Even cable TV hookups would be covered if you had cable at home prior to the loss.

What if you stayed with relatives, and did not incur increased rent, and many of the other expenses shown above? Another scenario is that you just simply do not want to go through the process of documenting all of your extra expenses. The policy gives you the option to be paid "Fair Rental Value", which is: "the fair rental value of that part of the 'residence premises' where you reside less any expenses that do not continue while the premises is not fit to live in."

How much would your house rent for? That's the question.

You'll need to make a comparison between your residence, like it was before the loss, and properties in the neighborhood that are comparable to yours. A good real estate broker can be very helpful in substantiating these comparable properties and the monthly costs of them. Once you determine the Fair Rental Value of your home, you must subtract expenses that do not continue during the restoration period, such as some utilities, garbage pickup, landscaping services or maid services.

Some insurance companies will still pay for extra transportation costs, relocation expenses, storage of contents and utilities in addition to Fair Rental Value. Some will make you choose either ALE or Fair Rental Value. Find out from your insurance company what they are going to do, and make your decision.

Go to the website at: www.insurance-claim-secrets.com and find the Resources tab. Download the ALE worksheet and make as many copies as you need. Use it as your guide to record and submit your ALE claim.

If your records and receipts were damaged in your loss, contact your utility companies, credit card companies and other creditors and get copies of the last couple months' bills. You'll need these records to confirm your normal operating expenses.

Finally: Don't be surprised if your adjuster or claims examiner tries to disqualify some of your legitimate expenses. Don't just accept what the adjuster says. If it's a truly legitimate expense, FIGHT FOR IT!! Go over the adjuster's head to his supervisor. Keep fighting. Send them a letter that insists that they give you written denial of any legitimate expenses. Once you have that in your possession, call your state Department of Insurance (DOI) and register a written complaint. You never know what impact a DOI complaint will have on your claim.

(1) Insurance Service Office, Inc., "Policy Kit for Insurance Professionals," 1990.

The Southern California wildfires are causing the largest population evacuation in California’s history, and over $1 billion dollars sofar in property damage. Once the TV cameras leave the damaged areas, the property owners and policyholders will have to get busy with the process of filing insurance claims.

I’m Russell D. Longcore, the nation’s foremost authority on property insurance claims. I’m the author of the book “Insurance Claim Secrets REVEALED!” My book shows consumers how to take control of their insurance claims, and collect hundreds or even thousands more dollars in their claim settlements.

I spent the last 15 years of my 34-year insurance career in the claims adjusting side of the business. I became increasingly sickened by the ways that insurance companies minimized, shrunk, depreciated and flat-out denied claims that they knew were legitimate claims. So, I wrote a book showing consumers how to take control AWAY from the insurance companies. I know ALL the tricks, and I reveal them in my book.

Writing that manuscript got me fired from an international claims adjusting company! What kinds of information is in this book that scares the adjusters and insurance companies so much?

So for you, the reader of this article, I have posted a Top Ten List of crucial steps in the claims process. Then, I wrote and posted a complete article about each of the Top Ten.

Most people don’t read their insurance policies. Even when they try to read them, they find them frustratingly complicated. Insurance policies list what you must do to file a claim, but they NEVER tell policyholders HOW to do it.

The “devil” of the claim is in the details of the claims PROCESS, and the insurance companies hardly EVER explain the process. If they did, it would cost them millions more. Insurance companies do whatever they can to control the CLAIMS PROCESS. But, if you learn the CLAIMS PROCESS from me, you'll be able to take control of the process away from the insurance companies, and add hundreds or even thousands more dollars to your claim settlements!

Insurance companies will pay the least amount of money that the policyholder will accept to settle the claim. But, if you allow the insurance company to handle your claim for you, how will you ever know whether you got ALL you were entitled to collect?

Let me share some of these strategies with you.

1. For the hundreds of thousands displaced from their homes, there is coverage in the homeowners or renters insurance policy for living expenses while you were displaced. In that coverage, there is a whole list of eligible expenses that you don’t know about and it’s not listed in the policy. The insurance companies will likely not tell you this, but I’ll tell you.
2. How will you reconstruct your inventory of personal property? I’ll show you how.
3. The insurance company will depreciate your dwelling and personal property, even if you have replacement cost coverage. Let me tell you how to beat this process.
4. Are you underinsured? If you don’t FIGHT THIS PROCESS, the insurance company will determine how much your dwelling is worth, and if you have enough insurance. If THEY say you’re underinsured, they’ll hit you with a penalty. I can show you how to fight and get the correct valuation on your property.

Watch for my next four articles. In them, I'll expand on each one of the four points listed above. In addition, read each of the articles about the Top Ten List.

You can win the insurance game when you have the right tools!!

"Notify The Insurance Company." Seems sort of obvious, doesn’t it? But, there are different ways to notify the company that you’ve had a loss. And when you notify the insurance company can make a big difference in how your claim is handled.

This is an excerpt from the book "Insurance Claim Secrets REVEALED!"

The first place to look for information is on your policy. Many policies will have a telephone number listed for reporting a claim. However, I’ve seen policies that require the policyholder to notify the company in writing. So, make sure that the method of reporting your claim is acceptable to the insurance company. Likely, your agent has his name and telephone number on the policy. If so, call him and report the loss also.

Sometimes, an agent will have settlement authority to handle small losses, such as homeowner’s losses under $2,000.00. In that kind of instance, the agent could handle the claim for you. I’ve found this situation to be rare, though. Occasionally, captive agents (agents that work for only one company, like State Farm or Allstate) will have a small amount of settlement authority.

The first thing you should remember is that the agent is licensed by the Department of Insurance in his state to be an agent. There is a separate license for claims adjusters. It's actually a violation of insurance regulations for an agent to do claims adjusting. It’s not his job to handle your claim, but to assist you in buying the coverage that’s right for you. Agents can be very helpful by making calls on your behalf if you’re having problems in your claim. They can be helpful in finding out key names and phone numbers for insurance company personnel that are handling your claim. If the agent has a large number of policyholders with that company, and his clientele represents a large amount of premium to that insurance company, it can be very helpful to have the agent call on your behalf when you’re having problems.

After all, it’s all about customer service, and keeping the promises made in the insurance policy.

Sometimes, the agent or an office secretary/customer service representative will fill out a claim form (called an ACORD form), and submit the claim form to the insurance company on your behalf. In this age of the Internet, frequently the claim form is electronic, and the agent will submit the electronic form by computer.

If the agent notifies the company on your behalf, and uses some type of form, ask the agent to send you a copy of the completed form. Then, you’ll be certain that the claim was submitted, and the date the claim was submitted.

Many times, however, the agent will have to refer you to the claims department of the insurance company. Your policy may have a telephone number for the claims department listed on the policy, and instructions how to make a claim.

Your policy requires you to notify the insurance company “in a timely manner” after you’ve had a claim. What is timely? It varies policy to policy. But each state has statutes of limitation that limit the amount of time after a claim occurrence that a claim can be made. Check with your state’s Department of Insurance to determine the statute of limitation where you live…or where the loss occurred. You’ll find a list of all of the Insurance Departments of all 50 U.S. states and their phone numbers in the Appendix, and at the website at: www.insurance-claim-secrets.com .

For example: you live in Minnesota, and own a retirement home in Florida. The Florida house gets hit by a hurricane. The statutes for Florida would apply.

WARNING: If you wait more than a month after your loss to notify the insurance company, they will be instantly suspicious. In those cases, you should expect to receive one of two forms from the insurance company before they begin their investigation of the loss:

Non-Waiver Agreement. This basically states that the insurance company is going to do a thorough investigation of the claim, but that their investigation does not commit them to pay the claim. It states that they do not waive any of their rights under the policy, and that the insured does not waive any of his rights by cooperating with the investigation. The insurance company wants the insured to sign this form. However, if the Insured refuses to sign the form, the insurance company will send him a….
Reservation of Rights letter. This states basically the same thing as a Non-Waiver Agreement, but the Insured does not have to sign it.

Don’t forget to write in your claim journal the date, time, who you spoke with, the phone number you called, and what was said when you reported your claim. That information could be very valuable later if you have problems with your claim.

Most likely, you’ll receive a claim number from the company when you report the loss. Write the claim number in your journal!!! Don’t expect the insurance company to quickly send you a form that has the claim number on it. Sometimes, it may be many days before the claims department sends you any correspondence, and you will likely need to speak with them before then.

WARNING: What about a situation in which someone else is at fault, and you’re making a claim against the other person’s insurance company? This could happen in an auto accident, or if someone causes damage to your house, or your contents. EVEN IN THIS SITUATION, you must notify your own insurance company that you’re involved in a claim.

The reason is that third party claims don’t always turn out well for you, the claimant. Sometimes, the other person’s insurance company denies liability or denies coverage. Sometimes, the other person’s insurance company drags the process out. Sometimes, the other person’s insurance company makes a settlement offer far below the fair value of the claim. Months may pass, and you have suffered a financial loss that is not getting paid.

What if you, or someone in your family, is injured in the claim…and the other guy’s insurance company won’t accept liability?

Those things might occur weeks or months after a loss. In many cases, you can short-cut that process and make a claim against your own insurance policy to repair the damages. Then your insurance company will do something called “Subrogation.” That is, they will pay your claim, and then contact the other person’s insurance company and demand reimbursement, including your deductible.

So, if you don’t report your claim right away, the policy might allow that insurance company to deny your claim based upon late reporting.

Besides, your policy REQUIRES you to notify the insurance company “promptly” after you have a loss of covered property. That requirement is there no matter who is at fault for the damages.

Don’t get caught in this technicality! Don’t lose your right to collect what you deserve.

Copyright 2008, by Russell Longcore. All rights reserved.