Tricks of the Trade
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Insurance Policies: Any insurance policy is a contract between you and your insurance company with conditions that regulate the relationship. Most policies are confusing and adversarial. Under the contract, the insurance company has no obligation to explain any of your rights.
 
Indemnification: Is the act of “making things right”—a reasonable best effort to restore things as they were before your loss. It may not mean putting more money in your pocket. Now and then, some things are more important than money.

There are two exceptions to indemnification. One applies if there is a replacement cost provision in your policy. The other applies if your state has a Value Policy Law. Your goal is to make things as right as possible. Aim for true indemnification from your insurance company.
 
Types of Property Insurance
 
Owner Purchased: Commonly, insurance on a home and/or property bought by the owner. Under typical arrangements, a portion of your monthly check to the mortgage holder automatically pays the monthly insurance premium.
The Role of an Agent: If you ask your agent for help following a loss, forget it. He’s a salesman. He has nothing to do with your settlement. You were on your own as soon as you signed the policy. The policy he persuaded you to sign pays him an annual percentage of your premiums.

He also can earn large bonuses every year, depending on his loss ratios. If all of your agent’s clients have no losses in a given year, he gets a big bonus. The company uses a sliding scale—the more it pays out in claims, the smaller the bonus for your agent. Theoretically, he could reach a point where he gets nothing. Will your agent help you? Or himself.
 
Binding Authority: Legal permissions and obligations that apply when adjusters settle claims. Binding authority literally binds the insurance company to your settlement.

You can believe, and rely on, statements your adjuster makes regarding your loss. For example, if your adjuster writes that your roof needs to be replaced, a later adjuster cannot overrule or reverse that conclusion.

 

Forced Placed Insurance: Insurance bought on your behalf by your mortgage company, which will notify you in advance. Act immediately to avoid this. Coverage is always less comprehensive and it usually costs 200 to 300 percent more than what you can buy yourself.

Adjusters: An adjuster employed by your insurance company is their contact with you following a loss. He evaluates the damage and writes you a check. But he’s paid by the insurance company, so it’s impossible for him to be fair. He can’t satisfy your interests if his job is to limit costs for his employer.

If you are poorly informed about his procedures, you might approve his performance. But he won’t “make things right” as described above under Indemnification. It simply is not in his job description at the insurance company, his employer.

Good Faith: Insurance companies should act in Good Faith, as every state requires with laws that protect you from bad behavior. Each state defines those laws differently, but here are examples of acting in bad faith:

• Your insurance company fails to adjust a claim in a timely manner.
• Your insurance company fails to investigate a claim before denying payment.
• Your insurance company has no standard practice for adjusting all claims in the same manner.
• Any misrepresentation by a representative of your insurance company.


 
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MySmartClaims is not a public adjuster and does not act on behalf of an insured in negotiating for or effecting the settlement of a claim or claims for loss or damage under any policy of insurance. MySmartClaims provides the customer software that they can use to generate a report and assess whether their insurance company’s loss estimate was appropriate.
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