You’ve suffered a property insurance loss, do you know what your insurance policy really covers?

Homeowners purchase home insurance to protect their homes and personal property.  

After an insurance loss is not the time, you want to learn that it will not cover everything you have lost in your claim.

The article attached here explains a little further and discusses some common misunderstandings regarding insurance

https://www.nuco.com/fcs/2021/09/13/understanding-insurance-and-why-it-doesnt-cover-everything/?cmp_share

TakeAways

  1. Insurance is a for-profit industry providing services to those who buy a policy.
  2. Insurance does not pay for maintenance issues.
  3. Insureds sometimes look at cost and don’t look at coverage.
  4. Some agents take the easy way out and tell insureds they are covered for most catastrophic losses without providing details.
  5. Insureds may not understand that their policy is not a replacement cost policy and only covers actual cash value. — this comes into play when settlement is determined.  

This confusion reiterates the need for a licensed Public Adjuster to represent your interests from start to finish with your claim.

We are your A+ rated Better Business Bureau Public Insurance Adjuster here in Phoenix, Arizona, representing clients all over State 48.

AJR Public Adjusters — 602-795-5227 — info@ajrpa.com

Unauthorized Practice of Public Adjusting

Over the years we have encountered future clients who state, “Oh the contractor said they will assist with my claim.  They will talk to the Insurance Company and negotiate figures”

This is deemed as the UPPA — Unauthorized Practice of Public Adjusting and a  ruling was upheld in Texas pertaining to this act.  Read further a blog presented by NAPIA, (National Association of Public Insurance Adjusters), specifically spelling out how this ruling was reached and the ramifications of such practice.

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UPPA Verdict Upheld

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Continued

Policyholders always want to be informed by the individuals representing them, what their representation involves.  Always remember, only licensed Public Insurance Adjusters and lawyers are able to represent you with insurance property claims.

Denial of Coverage due to misrepresentation

Many times we are asked the question, What if I forgot to mention something in my application?

According to our research via FC&S, The National Underwriter Company, the application is the standard by which the policy was written.  If you do not disclose completely your situation, this is cause for voiding the policy, and gives the insurance company an out to pay for a loss.

Remember the obligation is on the potential policyholder to disclose all information.  If it is discovered you misled the insurance company, that policy is null and void.  Lesson learned, disclose any and all information when applying for property insurance.

Read Below analysis from the leading investigative agency in the industry, FC&S.

screen-shot-2017-01-19-at-1-39-43-pm-2Any questions always remember you can call AJR, 602-795-5227.

http://www.betterclaimresults.com

 

More FAQ for hiring a Public Adjuster for your next property loss.

Your property/community/business has suffered property damage (fire, hail, wind, flood, water), NOW WHAT?

Your first inclination might be to contact your insurance carrier, but this may not be in your best interests. With all your personal and work commitments it may not be feasible for you to monitor and ensure your claim is being handled properly. Why not level the playing field with the insurance company?

WHY HIRE A PUBLIC ADJUSTER?

 Your insurance company has professional adjusters to represent their interests. As a policyholder you are entitled to hire a professionally state licensed adjuster to represent your interests. The public adjuster has experience and knowledge to assist in preparing, documenting and negotiating claims. Adjusters have reviewed several policies prior to yours and know where to look in the policy to make sure your claim is filed for all the coverage’s you have paid for. Often times finding money that otherwise would have been overlooked.

The adjuster you hire should be experienced, licensed with the state and working for a reputable company who has a clean record with the insurance department. All adjusters need to be licensed and their company also needs to hold a license with the Arizona Department of Insurance.

FEE FOR PUBLIC ADJUSTER

The Public Adjuster is paid a contingency fee of the total monies received from the insurance company. The fee can range from 5% – 20% depending on the size of the claim, and is due at the time money is released from insurance company.

DUTIES OF PUBLIC ADJUSTER

 To act as your representative in negotiating and dealing with the insurance company adjuster. Relieve your stress by engaging in discussions and negotiations with the insurance company on your behalf to maximize your recovery. The public adjuster brings in their experts/contractors to estimate and measure the damage independent of the insurance companies estimate. This estimate then provides the framework for the negotiating the adjuster will do with the insurance company.

SOME GOOD QUESTIONS TO ASK PRIOR TO SIGNING CONTRACT:

  •  How many years have you been a licensed Public Insurance Adjuster?
  •  May I have references or see testimonials from previous clients?
  •  Will you personally handle my claim for me?
  •  Will you keep me in the loop and inform me of all outstanding issues   with my claim?

WHEN TO ENGAGE A PUBLIC ADJUSTER:

Ideally the public adjuster should be involved in the claim from the beginning including helping you report the claim.  This is not to say you should feel rushed or pressured after a claim occurs to immediately hire the first person that approaches you. Investigate the company and the individual who will be acting as your representative.

SOME THINGS TO LOOK OUT FOR:

 In the State of Arizona contractors are not authorized to represent you in insurance claim negotiations, nor are they professionally licensed or regulated by the state insurance/department agency to do so.

Relying on your insurance company to fairly calculate the amount of damage and what you are owed might not result in a full or fair settlement. The company adjuster who is sent out is measuring the loss for the insurance company not for you.   As the policyholder you are entitled to have the claim loss accurately measured and then be reimbursement for all that you have lost.

BENEFITS OF HIRING A GOOD PUBLIC ADJUSTER: 

  •  An experienced and skilled licensed professional to work on your team.
  •  Someone who understands intricacies of policy and assists in recovering all that you are entitled to
  • Strong advocate on your side to help provide more input and negotiating leverage for the final insurance settlement, more than you may have had on your own.

 

 

AJR Public Adjusters.

With close to 30 years licensed experience in the Public Adjusting field handling claims of all dollar amounts for losses due to fire, flood, water, hail, dust, theft, etc.

www.betterclaimsresults.com

 

Hey Arizona, Do You have 30 seconds?

Take 30 seconds to hear why YOU need a Public Adjuster for your next insurance claim.

Handling losses for claims including:

FIRE, WIND, WATER, THEFT-VANDALISM, HAIL, MONSOON, HABOOB,  COLLAPSE,  TORNADO, PLUMBING LEAKS,  SMOKE, EXPLOSION,  ROOF DAMAGE,  BUSINESS INTERRUPTION,  LIGHTNING STRIKE DAMAGE,  BUILDING CAR DAMAGE, ETC…

AJR PUBLIC ADJUSTERS   WWW.BETTERCLAIMRESULTS.COM

602-795-5227

When I have damage to my Roof, is Subsequent Interior Damage Covered?

Many times you may wonder how you are covered for a loss if you don’t discover damages for many months after an incident occurs.  Noting that normal wear and tear are not covered, here is an example of a covered loss due to an incident, but realized many months after occurrence.

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A few months ago, following a downpour, an insured noticed some wet patches on the ceiling and high up on the walls. When he called in a roofer, the roofer said that the roof had been damaged in a severe hailstorm that occurred about a year previously. 

We turned the claim in to the insurer, who denied the loss, saying that too much time had elapsed between the hailstorm and the resulting water damage. 

Is this denial correct?

Indiana Subscriber

There is no requirement in the HO 00 03 that the cause of loss and the resulting effect follow each other within minutes, days, or even months. It is difficult to recognize that a covered cause of loss has occurred unless the physical signs of that cause manifest themselves. So, until the insured noticed the wet patches, he had no idea there was a possible covered loss.

The HO 00 03 excludes losses caused by wear and tear, marring, and deterioration. That is because these are things that will happen over time, and so are uninsurable. However, the policy adds that “any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered.” In other words, had the roof simply worn out, the ensuing loss—water damage to the interior—would be covered because it is not excluded. But in this instance, the roof did not wear out. An event specific as to time and place—the verifiable hailstorm—caused the damage to the roof. 

Therefore, both the loss to the roof and the water damage to the ceiling and walls are covered.

Information supplied from Summit Business Systems.

Why you should have a Public Adjuster on YOUR side with your next insurance claim

Most people who have a claim have no idea how to prepare and adjust it. They more or less rely on their “insurance adjuster” to do that for them. BIG MISTAKE! What you must understand is, it is the “insurance adjusters” job to make company first-rate settlements with policyholders, most of whom lack the fundamental information and adjusting skills to be on a level playing field with the adjuster.

Knowledge is leverage. The more you know, the more power you have, and insurance adjusters are well trained to cut corners and save their company money and, more and more, look for ways to avoid paying claims. You need someone as well trained in your corner looking out for your interests. The objective in adjusting should be to get as good a result as possible, as quickly as possible, as trouble free as possible. Most policyholders will continue their fate of dealing ineffectively due to the fact that they lack ability, information, and understanding.

To adjust is to negotiate. An adjuster is a negotiator. Usually, only the person representing the insurance company is considered the adjuster, and the policyholder receives his/her adjustment, as previously stated, from a company inspired adjuster. In order to arrive at an adjusted settlement, each side has its own needs to satisfy. The less you know, the more likely you are to be forced to meet the needs of the insurance company.

You must know your needs! You must know your rights!

A Public Adjuster can help you with both of these. If you don’t know what to expect and how to get it, you may become overwhelmed and give in too easily.

No one knows the outcome of an adjustment beforehand. Therefore, it is impossible to anticipate to what extent either party will give in to the needs of the other. Bargaining power becomes the main ingredient in adjusting. It usually comes about naturally as facts come to the surface. Adjusting is a matter of give and take, and unless you are dealing from a position of strength and knowledge like a Public Adjuster can offer, you may be forced to give too much.

Insurance adjusters facing a knowledgeable public adjuster usually enter on a more cooperative basis, and there is a strong likelihood that each will strive for common goals.

Usually a policyholder has to deal with a claim at a time following a disaster. Disasters including fire, haboob, wind, water, theft, etc.  Psychologically, most people are not up to the task under these circumstances. It is very common to see people in a state of shock, confusion and helplessness. A professional public adjuster will be emotionally level and competent.

The time of a personal disaster is not the time to be thinking about all of this for the first time. Think about it now and take comfort in the knowledge that AJR can be there to protect your interest if indeed the unthinkable happens to you.

AJR PUBLIC ADJUSTERS –BRUCE/STACY HOROWITZ—602-795-5227

WWW.BETTERCLAIMRESULTS.COM

 

 

 

If only I knew about AJR Public Adjusters for my last insurance claim

As we go about our business day at AJR, many times we meet people who have never heard of a public adjuster, or what we do.  Often times we hear, “if I only knew about your industry/services prior to my last claim”.  We reached out to some of these people to get their viewpoint on their settlement process.  (THE COMMENTS IN BLUE IS INFORMATIVE INFORMATION FROM AJR ABOUT THE CLAIMS PROCESS)

Comments below are from Rick Kidder,                                                                                    Scottsdale Chamber of Commerce, CEO

WHAT WAS THE TYPE OF CLAIM THAT OCCURRED ON YOUR PROPERTY?

Hail damage, significant damage to roof, A/C and other property

Claims on property can range from fire, wind, water, hail, theft, monsoon, etc

WHAT TYPE OF EXPERIENCE DID YOU HAVE WITH THE INSURANCE ADJUSTER?

Friendly, courteous, relatively thorough BUT did not test A/C unit

Generally interactions are friendly and courteous, but as in this case all coverages were not explained or handled for the policyholder

WHAT/ IF ANY PROBLEM AROSE WITH THE INSURANCE COMPANY?

A/C unit outside fan and compressor had to be replaced, but knowledge of that fact came well after the insurance claim was settled

Here is a situation where the insurance company was not forthright with the policyholder, explaining coverages they were entitled to and policyholder settled claim without all the information pertinent to their situation.

WHAT KIND OF TIME FRAME DID IT TAKE TO SETTLE YOUR CLAIM?

Check on the spot

Anytime a check is given on the spot, that is not to the policyholder’s advantage. How does the insurance company even know all ramifications of the loss in a quick look at the damage?

WERE YOU SATISFIED WITH THE SETTLEMENT?

Yes, except, had I known of hail damage to A/C unit, I would have been able to replace the unit and not just patch it up.

Policyholder did not know about all clauses and features of their policy that they could take advantage of or taken proactive step and have the A/C unit tested.  This is where AJR is able to give the policyholder an edge, since we know of all things to do from the start, we can help  put your claim in the best position to maximize recovery from insurance company and not miss any claimable issues. 

DID YOU FEEL LIKE YOU WERE ON EQUAL GROUND WITH THE INSURANCE COMPANY, AS FAR AS KNOWLEDGE AND COVERAGE’S YOU WERE ENTITLED TO?

No

This is where AJR can assist, with over 28+ years experience, our knowledge and customer service are unsurpassed in the industry.  We have read policies cover to cover for many years and know where to look to ensure policyholder is receiving all that they are entitled to.  Our job maximizing recovery for policyholder is demonstrated over and over.  

Look at what some of our previous clients have said.

 

DID YOUR CLAIM TAKE AWAY FROM PERSONAL TIME?

No

Often on larger losses personal and work time are affected in dealing with the insurance company.  AJR takes on this burden for you.

HAD YOU KNOWN PRIOR TO YOUR CLAIM ABOUT A PROFESSIONAL ADJUSTER WHO WORKS FOR YOU, DO YOU THINK YOU WOULD HAVE HIRED THEM TO ASSIST WITH THE CLAIM?

Yes

Comments below are from Janet Robbins,                                                                              Greater Phoenix Chamber of Commerce,                                                                            Business Development Executive 

WHAT WAS THE TYPE OF CLAIM THAT OCCURRED ON YOUR PROPERTY?

Property damage due to weather.  It was a lightning strike.

Many different forms of weather can cause property damage.  Monsoons, hail storm damage, wind storms, lightening damage, haboobs, & wildfires are big ones here in Arizona.    Other locations in the country experience different types of weather damage from hurricanes &  tornadoes among others.

WHAT TYPE OF EXPERIENCE DID YOU HAVE WITH THE INSURANCE ADJUSTER?

It was all handled by phone

How can an insurance company assess and estimate a loss if they have never set foot on the property? Damages  can not correctly evaluated without an onsite inspection.

WHAT IF ANY PROBLEMS AROSE WITH THE INSURANCE COMPANY?

There weren’t necessarily problems except that I did not know that my coverage only was based on replacement costs (RC) and not what I paid originally.  Nor did it replace items over a certain amount and they had to be repaired instead and still don’t work properly.

This confusion could have been cleared up with AJR in your corner.  Policies have many different clauses which we are able to clearly clarify and explain your rights in the process.  Policy holders are entitled to “like” kind and “like” quality to be made whole, and we are able to negotiate on policyholders behalf to make sure insurance companies are paying for policies which clients have purchased.

WHAT KIND OF TIME FRAME DID IT TAKE TO SETTLE YOUR CLAIM?

I think over six (6) months.

Claim settlement depends on many factors.  AJR assists and in a timely manner submits your claim.  We have no control over the insurance companies timeliness in handling information once we submit on policyholders behalf.  However, we work hard to expedite the claim.

WERE YOU SATISFIED WITH THE SETTLEMENT?

No not at all.  One of the largest and most expensive items had to be repaired and still does not work to the quality of its original condition before the lightening strike.

AJR is in your corner through the whole claims process.  AJR assists and ensures that policyholders are not placed in a position to accept less than they deserve with their claim.

DID YOU FEEL LIKE YOU WERE ON AN EQUAL GROUND WITH THE INSURANCE COMPANY, AS FAR AS KNOWLEDGE AND COVERAGE’S YOU WERE ENTITLED TO?

Absolutely not.  Found out things as we went along actually costing insurance company more in the long run because they were not clear on what steps we had to take to get replacements and/or repairs.

AJR helps throughout the process making sure claim is submitted with correct information to ensure coverage.  AJR is in constant contact with the client, explaining steps along the way confirming understanding of steps to be taken.  Thorough documentation is kept for each claim to assist in negotiations with insurance company.

DID YOUR CLAIM TAKE TIME AWAY FROM WORK, PERSONAL TIME?

Yes, it did.

Understanding how stressful a property insurance claim can be,  AJR immediately steps in to alleviate some of the stress which lets you get back to work, and personal time not having to manage your insurance claim on a daily basis.

HAD YOU KNOWN PRIOR TO YOUR CLAIM ABOUT A PROFESSIONAL ADJUSTER WHO WORKS FOR YOU, DO YOU THINK YOU WOULD HAVE HIRED THEM TO ASSIST WITH THE CLAIM?

I absolutely would have. I didn’t know they existed.

Now that you know about this industry, AJR is your professional adjuster with over 28+ years experience.  Our knowledge and experience are unsurpassed in the Valley.  Our personal service enables you to get back to life as normal as possible after an event occurs.  With your next insurance loss, give us a call immediately for a no obligation consultation.

Once you hire AJR we will help you report your claim and take over from there, bringing in our experts to estimate all damages and monetary loss you have sustained.

Here is some guidance on what to do when your next claim occurs.

AJR Public Adjusters –602-795-5227

www.betterclaimresults.com

 

 

 

 

Pool Cover Insurance Coverage via Summit Business Systems

Sometimes you may wonder how your pool is handled in your insurance coverage. Here is a question regarding a pool cover coverage for a homeowner. As demonstrated below pool cover is not a structure and is considered for replacement cost coverage, which can be important.

Question:

We write a standard HO-3 on a client with a swimming pool. His policy also includes replacement cost coverage for personal property. Recently the pool and the pool cover suffered damage in a windstorm. We understand that the pool is not subject to replacement cost adjustment, because it is a “structure that is not a building.” However, we believe that the pool cover should be covered for replacement cost under the terms of the personal property replacement cost endorsement.

The adjuster maintains that the pool cover is part of the pool and, therefore, not eligible for replacement cost coverage. We disagree and would like your opinion.

North Dakota Subscriber

Answer:

There are two ways to look at the pool cover. One is as personal property, and the other is as outdoor equipment. In either case, by purchasing the HO 04 90 10 00 the insured got replacement cost coverage on both personal property and outdoor equipment. Granted, the swimming pool itself is not subject to replacement cost in case of a loss, because it is a structure that is not a building. However, the pool cover is not a structure. It can be picked up and moved. Since it qualifies as personal property or as outdoor equipment, the loss should be paid on a replacement cost basis.