Tricks of the Trade
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Take Inventory:
Before-and-after pictures are great evidence. Long before you need to file a claim, make a complete physical inventory of your property. Take notes and use photos or videos. If you have to prepare a Loss Summary, yours will include solid evidence.

Secure and Survey: After a loss event, safeguard your family and secure your property. This can reduce further damage to people and property and will continue to protect both. However, don’t remove or clean anything. You want the adjuster to see the results of your loss. Take new photographs for the before-and-after comparison.

Beware of Insurance Company Estimates: Things begin to happen after your loss: the adjuster’s examination, the review of your Loss Summary, presentations of your receipts and affidavits, more forms, possible depositions, the questioning of your neighbors and more examinations of your damage. Then your adjuster gives you his detailed assessment of your damage.

A proper estimate should line-item every unit cost, from painting per square foot to every replaced light fixture to resealing your swimming pool. An estimate without unit costs is called a “scope only” estimate. And it’s worthless. Without unit costs you won’t be able to compare it against other estimates or the true costs of repair.

There is a big difference between new construction costs and those for insurance restoration, and it’s very important that your representative (e.g., a contractor) understand. After a hurricane, for example, construction prices can shoot up 600% over what they were before the storm.

Ask your adjuster for names of general contractors who will guarantee the unit costs in his estimate. Your insurance company’s settlement offer is based on his estimate. If the estimate is not reasonable the settlement won’t be either.

Reservation of Rights – A legal document used by insurance companies to give you formal notice that they believe there is a problem with your loss. They admit no liability to you, and that even by investigating your claim they admit no liability.

Denial: There is always a possibility that the insurance company may deny your claim. They may not believe you had an actual loss, as stated in your policy. They may not agree with the dollar amount you or a third party submitted. Perhaps they feel you filled out your Sworn Proof of Loss incorrectly.

To safeguard against potential denial, ask the adjuster to help you correctly fill out your proof of loss, for everything but the amount. Follow their rules. If you receive a denial, here are some options:

1. Contact your insurance adjuster and his supervisor and state that you are willing to do anything, except take less     money, to resolve the situation.
2. Demand an appraisal. This will add at least a month to the claim and will cost 50% of an umpire’s fee.
3. Tell them you are going to hire an attorney and file suit.
Then do it.


Immediately Following a Loss: Make sure your family is safe. Have a professional assess your damage to determine if it’s safe to stay in your property. Notify your insurance agent as soon as possible. If the property is uninhabitable, request an “advance of funds.” You are entitled to “Additional Living Expenses” if your property is uninhabitable. Even though those funds are part of the indemnification clause in your policy, no insurance company comes forward and offers them. You have to ask.

Proof of Loss: There are two types. Agreed Upon Proof – a document signed in accordance with your insurance company agreeing to its amount of the loss. It does not prohibit you from reopening the claim. Hostile Proof – a document you sign when you dispute the amount of the settlement. With a hostile proof your claim is just starting. It requires that your insurance company respond within certain time limits or they forfeit certain rights. Those limits appear in your policy under the provisions of Loss Payment. If your Insurance company rejects a Hostile Proof of Loss, you have the right to file suit against them. Insurance companies do not expect you to know this. They will try to avoid litigation.

Policy Holder’s Release: The only document that will preclude you from reopening a claim. It’s most often used following a court-enforced settlement. It ensures that the parties can never come back and make additional claims for damages on the same loss.

Appraisal: A form of arbitration that can be invoked by you or the company if either party feels negotiations have reached an impasse. Whichever side invokes this process must notify the other as soon as possible, usually allowing them 20 days to choose a representative. Representatives from both sides will choose a neutral third party to resolve the impasse.

 
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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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