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About: alicebrown

Name  :  Alice Young
E-mail  :  alice@brown-ohaver.com
Website  :  www.adjusteradvocate.com
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Posts by alicebrown:

Dangers of Smoke, Soot, and Heat

Most times, when people think of house fires, they probably imagine an entire house engulfed in flames or a pile of rubble where a home use to be. These types of fires are typically called large loss insurance claims or total losses. Not every house fire results in a total loss, though. Most house fires are smaller and usually contained in one area of the home. That part of the home can have extensive damage, whereas the other side of the home may appear to be undisturbed to the untrained eye.

Some might believe only the damaged rooms should be repaired, while others may believe the entire home should be accounted for repairs. Here’s the truth, fire claims are not black and white and leave some gray areas. This gray area is where the insurance company gets by with only paying the minimum on claims.

There are three aspects of a fire that cause damage in homes that should be addressed and paid for on every claim: smoke, soot, and heat. This doesn’t mean that everything in the home will be accounted for replacement, and the insurance company will write a check and walk away. Fire claims are not that simple. What this really means is that there is more to the claim than just the destroyed parts.

Smoke travels through the home, searching for a place to escape, leaving its smell behind. Soot follows and sticks to anything it touches. The heat from the fire reaches excessive temperatures and can alter anything in its reach. These three essentially determine the damage. Smoke, soot, and heat can cause irreversible damage but can also be cleaned depending on the extent of the damage.

Oklahoma Public Insurance Adjuster: Helping Clients to Settle The Insurance Claims

In general and more or less, all states impose some responsibility on insurance agents to assist their insureds in obtaining proper insurance coverage. This would be expected under the theory of “ reasonable expectation” which when applied in Arizona includes the theory that when insurance terms cannot be understood by the reasonably intelligent consumer, the court will interpret those terms in a manner that allows the benefit of those terms to inure to the consumer, even when there is no coverage. (Hanks v. American Family Mutual, Gordinier v. Aetna Casualty). “reasonable expectation”. This leads to the question of agent responsibility in helping an insured in obtaining coverage.

In Arizona, an auto body shop discovered that an employee had stolen a great deal of money. The company turned to its insurance agent to submit a claim to the insurer for this loss because the insured had thought he had purchased coverage for such a thing. The insured did purchase employee defalcation insurance in the past but, at the time of this devastating theft, the insured did not have such coverage. This brought to light a serious question: should the agent be charged with the obligation to obtain proper coverage? The Arizona Supreme Court thought so and, as a result, agents must take care in their discussions of needed insurance for their customers. If they fail to do this properly or mislead an insurance consumer, they can be held liable. This supreme court decision is diametrically opposed to the prevailing law in Oklahoma.

In Oklahoma, insurance producers only owe a limited duty of care to customers. A court of proper jurisdiction has ruled that imposing liability upon an agent to place proper coverage would remove all burden from the insured to take care of his/her own financial needs and expectations and would transform insurance companies from the competitive marketplace into personal financial counselors or guardians of the insured. (Mueggenborg v. Ellis). Such a decision greatly alters the ability of an insured to bring an action against an agent. (Cosper v. Farmers Insurance Company).

So in this examination of two states, Arizona and Oklahoma, we find two diametrically opposing court decisions. In one state an insurance agent has a great deal of responsibility and in the other, there is only limited responsibility imposed upon the agent. Please understand this is just a review of two states and a comprehensive review of other states could well lead to different conclusions regarding obligations imposed on insurance agents. However, the courts in many states have quoted the two separate decisions as they have pursued equity for agents and insurance consumers.

In all states, however, insurance companies wish to remain competitive and many people look to the costs of policies as a factor in making a decision as to what policy to purchase. (We have covered this issue in our blog in the past). It may not be a good decision to select insurance on price. One of our Brown – O’Haver employees recently received a letter from Liberty Mutual offering a policy for almost fifty percent less than what our employee was paying. However, from our experience, we know the difficulty of adjusting Liability Mutual claims and, regardless of cost, when based upon our experience in adjusting claims for our clients with Liberty Mutual, we passed on this cheaper alternative in obtaining an insurance policy.

One of the major problems we have with claims in Oklahoma involves the fact that there are many properties that are underinsured. Could such a problem come about because we have a “perfect storm” of two concepts: (1) being competitive and (2) an agent is not so much on the hook to help an insured obtain proper coverage? A policy with lesser policy limits is certainly cheaper than one with higher limits.

Check your policy limit on the properties you have insured. Such a thing is very important. At Brown – O’Haver, we stand ready to assist you in the adjustment of your insurance claims in a resolute and positive manner based upon our company experience of thirty-three years.

Do you Know What a Public Adjuster is?

When people ask me what I do for a living I know that I can’t just say “public adjuster” the same way that an accountant or attorney could state their job title without having to go in to description. After I say “public adjuster” and then go in to my prepared elevator speech, most people are already tuned out assuming they know what it means. Most people immediately assume that when they hear adjuster I work for an insurance company in some capacity. This could be as an independent contractor or employee of the insurance company. Over time I have found certain phrases to explain what I do so that people can tune back in. The following is my go to speech:

I am a public insurance adjuster. What that means is that I work for the insured not the insurance company. I am licensed by the state to be able to work on behalf of the insured to make sure that they get a fair settlement in a fair amount of time. This can be confusing because when a person has a loss and they file their claim the insurance company tells them that “your adjuster” will contact you for next steps. This is not accurate because the adjuster that is calling from the insurance company is an employee of the insurance company, which means that they are working as a paid employee for the insurance company. Therefore a person who has a loss has one of two choice. Work on their own behalf to adjust their claim and negotiate with the insurance company or hire a public adjuster to adjust the claim for them. As a public adjuster we typically receive at least 30% more insurance proceeds than an insured would be able to recover without the help of an expert advocate on their side.

So what is a public adjuster?

An adjuster that works as an advocate for the insured.
An adjuster that is licensed by the state they are in to be able to work on behalf of the insured.
An adjuster who measures and documents the claim to submit for consideration and payment on the claim.

So what is a public adjuster not?

A contractor or roofer.
A contract or company employee of the insurance company.

The sole duty of a public adjuster is to advocate on behalf of their client. A public adjuster has no obligation to an insurance company and is not financially invested in the construction or restoration resulting from the claim.

Difference Between Company, Independent and Public Adjuster

When a person has an insurance loss their insurance company will assign an adjuster to the handle the claim. Insurance departments in (almost) all states license three different kind of adjusters: company, independent, and public. It is important to understand the difference between these adjusters when handling your claim. This is a confusing concept for many people because in initial contact with the insurance company the insurance company representative will state that they are sending out “your” adjuster. However, what they actually mean is “their” adjuster who will be adjusting your claim.

What is a Company Adjuster?

A “company adjuster” means the insurance adjusters who are employees of an insurance company. They represent the interest of the insurance company and are paid by the insurance company. They will not charge you a fee. 

What is an Independent Adjuster?

An “independent adjuster” means the insurance adjusters who are hired on a contract basis by an insurance company to represent the insurance company’s interest in the settlement of the claim. They are paid by your insurance company. They will not charge you a fee.

What is a Public Adjuster?

A “public adjuster” means the insurance adjusters who do not work for any insurance company. They work for the insured to assist in the preparation, presentation and settlement of the claim. The insured hires them by signing a contract agreeing to pay them a fee or commission based on a percentage of the settlement, or other method of compensation. The insured is not required to hire a public adjuster to help the insured meet his or her obligations under the policy, but has the right to do so; The public adjuster is not a representative or employee of the insurer; and the salary, fee, commission or other consideration is the obligation of the insured, not the insurer.

The biggest difference between a company adjuster and an independent adjuster is that an independent adjuster works on a contract basis. Independent adjusters are typically used in catastrophe circumstances or for smaller insurance companies that do not have local offices. While they are hired on a contract basis they do work for the insurance company and they work on their behalf. If an insurance company hires an independent adjuster to adjust the claim for them and you do not hire a public adjuster you are representing yourself on the claim just as you would if it was a company adjuster.

The central difference between a company and independent adjuster and a public adjuster is that the insured hires a public adjuster directly. The company and independent adjuster is hired by the insurance company and they are paid by the insurance company. The public adjuster is hired and paid by the insured and therefore the public adjuster represents the insured’s interest whereas the company and independent adjuster represent the interest of the insurance carrier.

If you only have a company or independent adjuster on your claim you need to be heavily involved in your claim to make sure you are representing yourself on your claim. Alternatively, you can hire a public adjuster for Arizona and Oklahoma to handle the claim to represent your interest.

Insurance Issues Related to Working From Home.

Due to the Covid-19 Virus, many people are working from home.  I know, I am.  Even though our office is staffed behind a locked front door entrance with only two visitors allowed at any one time some of us are working from home.  We have purchased some great software that allows us to access our office computers from our homes.  However, since my business is adjusting claims for the benefit of insureds (as opposed to someone who adjusts claims for the benefit or insurance companies), I would pose the question: how does all of this working from home impact in relation to insurance?

As a public adjuster who has been around a long time, please know I have seen the underbelly of the insurance industry.  I have seen insurers deny claims because a business was run out of an insured’s home.  Particularly painful was an experience I witnessed when a major insurer denied a fire claim because the insured, who would become our client, sewed uniforms for the Old Tucson Amusement Park which her insurer considered as operating a business from her home.  It took me a year to get that one resolved in her favor but sometimes it is more difficult to do so.  

I can’t tell you of the difficulty I had with an insured’s claim when the insured hired us when her claim had gone to never-never land.  She had several horses and, yes, she sold one of those baby horses after it was born.  Her insurance company would not pay the claim because they said she was operating a horse business at her home.  My arguments didn’t amount to much to this insurer even though they were right on the law.  We eventually had to talk to a judge who taught the insurer a lesson.  Yes we won big on that one.

Of course you have all heard of the home marijuana-grower whose house has caught on fire.  Those claims are (nearly) always denied and not because of an illegal activity (in some states it is not illegal) but the claim is denied because the insured is “operating a business” out of his or her home.

As a result of my experience, I would recommend a quick email to your insurance agent just putting him or her on notice that you will be working from home.  Also, I would be very careful letting someone come into your home and not just because of fears of contracting the virus but because it gives the appearance of running a business out of your home.

There is also another risk to cause concern:  Cyber Attacks.

Everyone gets email phishing attacks and unless your like Leon Panetta who gave the “Phishers” his login info so they could get Hillary Clinton’s emails, you have probably just erased those phishing emails.  However, the “Phishers” are becoming more and more sophisticated in breaking into and otherwise hacking personal computers which we use to interface in our offices.  Here’s the deal: if you are working from home, you, or your employer, must secure your home internet connection that connects to your office computer.

Our Brown – O’Haver office is secure and is not conducive to anyone hacking in.  We have a VPN (Virtual Private Network) Connection and a router.  Our homes do not so in order to secure our home computers I contacted our friendly computer consultant.  He came to my home and installed a new router available from Amazon for around $70.00.  My home connection is now secure and tomorrow he will go to my assistant’s home to install a Router there. 

“It all comes down to access points,” CyberScout Chief Executive Officer Jennifer Leuer said in a prepared statement. “For every WiFi network that an employee signs on to, they are creating an additional access point for hackers to infiltrate your business systems.

Many business insurance policies address Cyber Security coverage but, if you can, you don’t want to go there.  You don’t want to expose yourself or your employees to another type of risk – cyber attacks. Due to the exposure of COVID-19, thousands of people in the U.S. are having to adjust from working around other people to working within the confines of their homes. Now they may also be exposing themselves to another type of risk – cyber attacks.

Protect yourself from the “evil-doers” who would hack your system and might even demand “ransom-ware” to get your system to come back on line after they have shut it down.