Dont get me wrong, Mold is a very serious problem, but MOST of the claims we have handled were preventable or at least could have been greatly reduced, I will not argue for a minute that there are some adjustors (usually independent) that are paid by the job, that will rush a claim and not properly adjust the damages, there is always the option of a supplement to the claim if there is additional funds needed to complete the job, but the insured is the one responsible for hiring the contractor to do the work, not the insurance company, they choose who they want and sign a contract with them, this should not be affected by a partial payment. Most claims are paid with recoverable depreciation withheld, We have had people that wont even call a contractor until they have the money in their hands, this is their decission not ours, if you want to live in a half blown away house for 6 months, have at it. What we are seeing is that insureds are not taking precautions that they could to prevent additional losses or increased payouts. It is a problem but it could be less of a problem if people helped. Now to Age Old, I figured you were one of the seasonal Florida residents, I have a hard time believing that you, having been in the industry, would side with a person that fails to abide by the policy provisions and think it is OK to wait 5 months to even check a probable hurricane loss. As an insured it is YOUR responsibilty to protect property and report claims in a reasonable time period. If you would like your agent to go check your property I am sure that he will be more than willing to set up a seperate business entity to perform inspections for a fee. It is not the agents responsibilty to inspect YOUR property, it is more of an E&O issue then I care to imagine. You call your agent to go check your house but he has no way to get in and see if their is any interior damage and because you are to cheap to have someone else do it on a regular basis, if he can’t get in and there is damage, I’m sure your attorney would love to have a chat with the agents carrier to get you a new house. Irresponsibility breeds irresponsible people and I have no use for it, I am sick of people looking for other people to take care of them and won’t do things for themselves. This is what scum bag attorneys live for and I wish the food supply would dry up. Just because a claim is paid does not make it right.
First off, I’m surprised to see such emotional exchanges regarding whether 5-month-delayed claims are or are not covered. For policies using ISO’s HO 00 03 form, the condition for covered losses reads:
2. Your Duties After Loss. In case of a loss to covered property, you must see that the following are done:
a. Give prompt notice to us or our agent;
Interpretation of that is strictly up to the individual’s company’s claims department, and possibly the courts. “Shoulda” and “shouldna” can be debated all day, but I personally will be interested in watching to see how the companies apply clause 2.a. to situations with significant property damage that has been left to sit until January.
On the Claim Settlement Delays, it seems a number of companies had to rely on independent adjusting firms due to the massive workload of four major storms. Unfortunately, we each experienced severe delays in both inspections and completed adjusting reports — far more than we would have hoped. This was a significant factor in the claim settlement delays many experienced, and unfortunately that did force haste in offering settlements near the deadline.
The company I work with is using this experience to plan for a similar situation (may it never come), to ensure these delays are avoided in the future. We’re also using the post-deadline time to re-evaluate claims and make further supplemental payments to ensure each insured receives a complete and fair settlement. I’m afraid I don’t work in the claims department so I can’t answer regarding the handling of mold arising from any delays, but I’ll venture that it will be covered up to the limitations we have filed with the state. I can ask them next week, and if it’s significantly different, I’ll try to come back and fill in more info.
In any event, congratulations to all of us in insurance here in Florida for surviving the last season, both figuratively and literally. It was a massive catastrophe, and I think overall we all pulled through pretty well!
Florida product analyst gives one duty of the insured but lets not forget paragraph 2-d
2. Your Duties After Loss. In case of a loss to covered property, you must see that the following are done:
d. Protect the property from further damage. If repairs to the property are required, you MUST:
(1) Make reasonable and necessary repairs to protect the property; and
(2) Keep an accurate record of repair expenses;
I’m not suggesting that companies won’t cover these losses, I am not aware of any denials so far based on timely filing of the claim, but I bet we will.
And lets not forget at renewal time, part of the increase we will all see is due to elevated claims cost due to such a high number of people waiting 5 months to file. As much as everyone hates it, Insurance companies are for profit, and if they pay out claims they will recoup that money in renewal premiums. There is still no excuse for not making a phone call to a neighbor or someone else to see if they could run over and check for damage. People are taking a gamble and some will hit the jackpot, as time goes on, I bet some won’t
John, once you get off your soap box… maybe you will see that if it were not for IA’s as you put it, there would be tens of thousands of claims still sitting there whether the insured made temporary repairs or not ! the numbers were and are staggering … many of the independent’s worked hard and took losses financially and emotionally. I resent your statement that it is usually “IA’s” who write the claim wrong etc…Independent Insurance Adjusters provide a valuable unappreciated service at times of chaos … many staffers would not even go to the disaster areas… I know as I am a provider … we busted our backs to help and in the final analysis we were financially the same as if we stayed in our home areas and worked our daily claim files. Who needed Florida claims handling? People did John … We help people get back to one piece with very limited resources, and by the way, as an industry do a darn good job… I am proud of the work we provided to people in Florida … Remember when a file is assigned to an Independent it is a partial assignment in most cases … The file is then finalized by the inside company staffer … the indepentdent is not given the authority to CLOSE the file … get over it John … most people, the public and the insurance community, did the best they could with a terrible onslaught of destruction and death …
*
How would you feel if a loved one experienced the trauma of coming to Florida and finding their home and all of it’s contents damaged or worse yet totally gone? Certainly a 5-6 month delay in checking out a large captial investment seems more than reasonable!
The nefarious actions of these obscenely profitbable insurance carriers demands immediate action by the Florida Insurance Dept. They may also wish to order a cease and desist order on all weather claims until the current claims have been handled. If this does not occur it must surely be the fault the insurance industry.
it is exactly for this reason that the American Trial Lawyers association is such an important part of American Society.
Roger, I am not suggesting we should get rid of or do away with Ind. adjustors. You are correct that if it were not for them we would have more like a few hundred thousands claims still waiting. BUT just like any other job or industry, some are great and handle each job with every intent of final satisfaction and completion and others fall way short. It is amazing at how many adjustors were licensed in Florida, mainly as emergency appointments. This is primarily where our problems started, It seems that instead of showing something other than the ability to breathe, individuals were employed by adjusting companies and had no idea how to spell adjustor, much less how to accurately adjust a claim. This is not a blast at ALL IA’s merely a very real and first hand experience that I am rather close to. A majority of our claims were handled in the upmost of care, but those that were handled by untrained rookies are still problems today. It did not help when the adjustors were hopping around from firm to firm in chase of the mighty dollar, this left thousands to claims dead in the water since they had been seen but NO reports were ever filed by the IA. We have files that have had as many as 7 (seven) different adjustors assigned to them. One of our carriers was paying $1000 per claim, they finally cut back because the adjustors were taking 15 a day but taking 3-4 weeks to get the report in. That is unacceptable. You probably did all that you said and all that you could and I appreciate all the good work that IA’s do we can’t live without them, but Florida companies and adjusting firms were not ready and won’t be ready for the next one. Quite a few carriers were paying based on the adjustors report just to get the claims thru. One carrier even said if the loss is under $10,000 send the check and don’t even look at the file. I do not know what the solution is, but I do know what some of the problems were. The biggest problem was lack of planning on everyones part. We learned and will hopefully improve on the next cat situation. I pointed out IA’s because they did handle probably 90% or more of the property claims, not because I hate them or want to do away with them, Sorry If I was not clear.
Are you suggesting that because natural disasters occur and Florida is prone to hurricane hits that companies should not continue to plan for such events, or should they stop writing coverage due to the history of hurricanes in the Florida area. If either of these is true, California will never be able to get earthquake coverage or fire loss due to wild fires, and Kansas can forget about tornado coverage. I am confused by your entire post, I think the planning John was talking about is how to deal with multiple cat situations at the same time and build an infrastructure that is better than the limp along plan most companies had for last years events.
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Dont get me wrong, Mold is a very serious problem, but MOST of the claims we have handled were preventable or at least could have been greatly reduced, I will not argue for a minute that there are some adjustors (usually independent) that are paid by the job, that will rush a claim and not properly adjust the damages, there is always the option of a supplement to the claim if there is additional funds needed to complete the job, but the insured is the one responsible for hiring the contractor to do the work, not the insurance company, they choose who they want and sign a contract with them, this should not be affected by a partial payment. Most claims are paid with recoverable depreciation withheld, We have had people that wont even call a contractor until they have the money in their hands, this is their decission not ours, if you want to live in a half blown away house for 6 months, have at it. What we are seeing is that insureds are not taking precautions that they could to prevent additional losses or increased payouts. It is a problem but it could be less of a problem if people helped. Now to Age Old, I figured you were one of the seasonal Florida residents, I have a hard time believing that you, having been in the industry, would side with a person that fails to abide by the policy provisions and think it is OK to wait 5 months to even check a probable hurricane loss. As an insured it is YOUR responsibilty to protect property and report claims in a reasonable time period. If you would like your agent to go check your property I am sure that he will be more than willing to set up a seperate business entity to perform inspections for a fee. It is not the agents responsibilty to inspect YOUR property, it is more of an E&O issue then I care to imagine. You call your agent to go check your house but he has no way to get in and see if their is any interior damage and because you are to cheap to have someone else do it on a regular basis, if he can’t get in and there is damage, I’m sure your attorney would love to have a chat with the agents carrier to get you a new house. Irresponsibility breeds irresponsible people and I have no use for it, I am sick of people looking for other people to take care of them and won’t do things for themselves. This is what scum bag attorneys live for and I wish the food supply would dry up. Just because a claim is paid does not make it right.
First off, I’m surprised to see such emotional exchanges regarding whether 5-month-delayed claims are or are not covered. For policies using ISO’s HO 00 03 form, the condition for covered losses reads:
2. Your Duties After Loss. In case of a loss to covered property, you must see that the following are done:
a. Give prompt notice to us or our agent;
Interpretation of that is strictly up to the individual’s company’s claims department, and possibly the courts. “Shoulda” and “shouldna” can be debated all day, but I personally will be interested in watching to see how the companies apply clause 2.a. to situations with significant property damage that has been left to sit until January.
On the Claim Settlement Delays, it seems a number of companies had to rely on independent adjusting firms due to the massive workload of four major storms. Unfortunately, we each experienced severe delays in both inspections and completed adjusting reports — far more than we would have hoped. This was a significant factor in the claim settlement delays many experienced, and unfortunately that did force haste in offering settlements near the deadline.
The company I work with is using this experience to plan for a similar situation (may it never come), to ensure these delays are avoided in the future. We’re also using the post-deadline time to re-evaluate claims and make further supplemental payments to ensure each insured receives a complete and fair settlement. I’m afraid I don’t work in the claims department so I can’t answer regarding the handling of mold arising from any delays, but I’ll venture that it will be covered up to the limitations we have filed with the state. I can ask them next week, and if it’s significantly different, I’ll try to come back and fill in more info.
In any event, congratulations to all of us in insurance here in Florida for surviving the last season, both figuratively and literally. It was a massive catastrophe, and I think overall we all pulled through pretty well!
Florida product analyst gives one duty of the insured but lets not forget paragraph 2-d
2. Your Duties After Loss. In case of a loss to covered property, you must see that the following are done:
d. Protect the property from further damage. If repairs to the property are required, you MUST:
(1) Make reasonable and necessary repairs to protect the property; and
(2) Keep an accurate record of repair expenses;
I’m not suggesting that companies won’t cover these losses, I am not aware of any denials so far based on timely filing of the claim, but I bet we will.
And lets not forget at renewal time, part of the increase we will all see is due to elevated claims cost due to such a high number of people waiting 5 months to file. As much as everyone hates it, Insurance companies are for profit, and if they pay out claims they will recoup that money in renewal premiums. There is still no excuse for not making a phone call to a neighbor or someone else to see if they could run over and check for damage. People are taking a gamble and some will hit the jackpot, as time goes on, I bet some won’t
John, once you get off your soap box… maybe you will see that if it were not for IA’s as you put it, there would be tens of thousands of claims still sitting there whether the insured made temporary repairs or not ! the numbers were and are staggering … many of the independent’s worked hard and took losses financially and emotionally. I resent your statement that it is usually “IA’s” who write the claim wrong etc…Independent Insurance Adjusters provide a valuable unappreciated service at times of chaos … many staffers would not even go to the disaster areas… I know as I am a provider … we busted our backs to help and in the final analysis we were financially the same as if we stayed in our home areas and worked our daily claim files. Who needed Florida claims handling? People did John … We help people get back to one piece with very limited resources, and by the way, as an industry do a darn good job… I am proud of the work we provided to people in Florida … Remember when a file is assigned to an Independent it is a partial assignment in most cases … The file is then finalized by the inside company staffer … the indepentdent is not given the authority to CLOSE the file … get over it John … most people, the public and the insurance community, did the best they could with a terrible onslaught of destruction and death …
*
How would you feel if a loved one experienced the trauma of coming to Florida and finding their home and all of it’s contents damaged or worse yet totally gone? Certainly a 5-6 month delay in checking out a large captial investment seems more than reasonable!
The nefarious actions of these obscenely profitbable insurance carriers demands immediate action by the Florida Insurance Dept. They may also wish to order a cease and desist order on all weather claims until the current claims have been handled. If this does not occur it must surely be the fault the insurance industry.
it is exactly for this reason that the American Trial Lawyers association is such an important part of American Society.
Lance, I love good sarcasm. I hope the others get it or this board will never die!
Roger, I am not suggesting we should get rid of or do away with Ind. adjustors. You are correct that if it were not for them we would have more like a few hundred thousands claims still waiting. BUT just like any other job or industry, some are great and handle each job with every intent of final satisfaction and completion and others fall way short. It is amazing at how many adjustors were licensed in Florida, mainly as emergency appointments. This is primarily where our problems started, It seems that instead of showing something other than the ability to breathe, individuals were employed by adjusting companies and had no idea how to spell adjustor, much less how to accurately adjust a claim. This is not a blast at ALL IA’s merely a very real and first hand experience that I am rather close to. A majority of our claims were handled in the upmost of care, but those that were handled by untrained rookies are still problems today. It did not help when the adjustors were hopping around from firm to firm in chase of the mighty dollar, this left thousands to claims dead in the water since they had been seen but NO reports were ever filed by the IA. We have files that have had as many as 7 (seven) different adjustors assigned to them. One of our carriers was paying $1000 per claim, they finally cut back because the adjustors were taking 15 a day but taking 3-4 weeks to get the report in. That is unacceptable. You probably did all that you said and all that you could and I appreciate all the good work that IA’s do we can’t live without them, but Florida companies and adjusting firms were not ready and won’t be ready for the next one. Quite a few carriers were paying based on the adjustors report just to get the claims thru. One carrier even said if the loss is under $10,000 send the check and don’t even look at the file. I do not know what the solution is, but I do know what some of the problems were. The biggest problem was lack of planning on everyones part. We learned and will hopefully improve on the next cat situation. I pointed out IA’s because they did handle probably 90% or more of the property claims, not because I hate them or want to do away with them, Sorry If I was not clear.
John,
I would be curious as to the “planning process” you reference. How do you plan for 4 major storms in a single season.
If you are planning for this then why would you be investing surplus in this area of the country?
Are you suggesting that because natural disasters occur and Florida is prone to hurricane hits that companies should not continue to plan for such events, or should they stop writing coverage due to the history of hurricanes in the Florida area. If either of these is true, California will never be able to get earthquake coverage or fire loss due to wild fires, and Kansas can forget about tornado coverage. I am confused by your entire post, I think the planning John was talking about is how to deal with multiple cat situations at the same time and build an infrastructure that is better than the limp along plan most companies had for last years events.