A Different Perspective on Payment of Profit and Overhead When Insureds Do Repairs

May 5, 2008

  • May 5, 2008 at 5:20 am
    Scott deLuise says:
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    State Farm, in a nationwide push to cut claims costs, litigated this issue in almost every state in the union. The only state in which State Farm prevailed was Kentucky.

    The reasonable approach is to pay the insured pro-rata OH&P on an ACV basis, then include the balance if and when the insured replaces the damaged property. This is a no brainer. I bet State Farm won’t try that kind of a move again!

  • May 31, 2008 at 12:14 pm
    Roger Poe says:
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    FBI Says Fighting Financial Crimes a Priority; Insurance Cases Top 200
    National News • May 23, 2008
    The Federal Bureau of Investigation pursued 529 financial crime cases in its most recent fiscal year, including 209 insurance fraud cases. During it fiscal year 2007, the 209 insurance fraud …
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    ClaimsJournal.com is not responsible for the content of the message below.
    Subject: Are Major Insurers Misleading Mineral Wells Texas Citizens?
    Posted On: May 27, 2008, 6:23 am CDT
    Posted By: Roger Poe
    Comment:
    FBI Says Fighting Financial Crimes a Priority; Insurance Cases Top 200
    National News • May 23, 2008
    The Federal Bureau of Investigation pursued 529 financial crime cases in its most recent fiscal year, including 209 insurance fraud cases. During it fiscal year 2007, the 209 insurance fraud …
    ____________________
    It has been noted after the April 17, 2008 hailstorm that much damage is being missed and understated by insurance adjusters, which is throwing off loss claim dollar values in Mineral Wells, Texas.

    According to some adjusters;

    1. Smashed AC units cooling foils are to be “combed” despite the fact that the combing process damages the protective factory coating on the foils, and never restores the foils to a predamaged / factory engineered condition.

    Honest AC contractors know about these issues.

    2. Damaged landscaping is being missed.

    3. Roofing, siding, sheet-rock, painting, etc. component systems / reconstruction products and restoration work procedures are [suddenly] missing, or understated.

    4. Premium collected and prepaid Primary-General AND sub-trade contractors business overhead and profit (Contractors O&P) values are construction component line item costs that are missing at the end of adjusters estimates.

    The Texas Department of Insurance Bulletin B0045-98 repeatedly clarifies and warns insurers that they collect money in premiums for [inherently] prospective Primary-General AND sub-trade contractors business O&P costs in ANY region of the USA, and internationally.

    Actuarially, the general replacement costs of structures would be synthetically undervalued if Primary-General AND sub-trade contractors business O&P costs were left out of the statistical replacement cost risk equation.

    For example, the value of a roofing system installed by a (primary-general) building contractor, using their roofing sub-contractor, contains both the primary and sub-trade contractors business costs, including their individual business O&P, woven into it.

    For adjusters to claim after a wind-hail-etc. event that a existing structures’ roofing system, or any other construction component put in place by a builder, does not suddenly contain primary-general contractor construction business O&P costs AND their roofing, painting, AC, etc. sub-contractors overhead and profit business costs, is ignoring the economics of how structures generally come into existence, and the similar O&P economics predetermined to REPLACE them.

    Not forwarding ACTUAL full loss values to claimants allows insurers to keep prospective general and sub-trade contractors O&P policyholders prepaid for in premium payments.

    Too, although 10% profit is a good pretax mark to aim for, 10% overhead can be a questionably understated accounting mark.

    5. Improperly recommending partial “line-of-sight” painting, flooring, etc. replacement procedures that can leave a property looking distressed / ill-valued, and give a contractor a bad name.

    6. Claiming the protective granular component being blasted off of fiberglass shingles by hard pea-small marble sized hail and debris is not damage to shingles.

    7. Claiming the high winds that shook a home or business did not contribute to fresh cracks in / on the structure.

    8. Broken brick siding and outdoor walkway tile is being missed.

    Please look over your property very, very carefully.

    Overlooked damage and missing reconstruction / repair procedures can be worth thousands of dollars to account for towards repairing a storm damaged property.

    rogerpoegc@gmail.com



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