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

 

Who to call for Property Damage this Monsoon Season.

Will you be able to rebuild if your home or business is damaged or destroyed by a fire? How long will it take you to bounce back if you are wiped out by a flood or hammered by a monsoon? Will you recover quickly from the losses you suffer from vandalism or theft?

arizona monsoon sunsetdreamstime_l_50196179

You might be unpleasantly surprised more than once if tragedy strikes where you live or work – first by the brutal force of Mother Nature and later by the realization that you are unprepared to do anything but accept whatever compensation your insurance company offers. You can avoid this problem by hiring a public insurance adjuster, a person with the knowledge and experience to help you obtain the most favorable settlement possible – someone who represents you and not your insurance company.

“We serve as an advocate for the policyholder, but it’s important to remember that the policyholder controls the settlement. We advise and assist.” said Bruce Horowitz, president of AJR Public Adjusters, who has been serving homeowners and businesses for over 30 years, the last 4 being here in Arizona.

In addition to estimating how much damage has been done, AJR also helps file the paperwork to complete the claim and negotiate with the insurance company. There is no up front retainer type cost like an attorney, for their services, AJR charges its clients a percentage of the settlement.

Horowitz can offer his clients the advantages of a wealth of training and more than 30 years as a public insurance adjuster. He and his wife Stacy, who serves as vice president of AJR, moved their family to Phoenix following Bruce’s lengthy career, first with one of the largest and oldest public insurance adjusting firms in the Philadelphia area, then in Charleston, South Carolina.

Stacy, who handles the marketing and accounting for AJR, has another important job that is critical for the property owner – determining exactly what was lost or damaged.

“We take hundreds or sometimes even thousands of pictures,” she explained. “We document everything, then we send it to the client for approval.”

Bruce Horowitz cautioned homeowners and businesspeople to hire only public insurance adjusters who are licensed in the states where they do business.  Also to be wary of people claiming to be in a position to negotiate with the insurance company.  Only a licensed Public Insurance Adjuster has this authority, not your contractor, mitigation specialist, handyman, etc.

AJR is unique as they are one of a few companies who are a member of the National Association of Public Insurance Adjusters (NAPIA) with an office in Arizona. NAPIA is a 60 year old organization that sets the standards for the industry and offers its members educational opportunities and certification in various aspects of the business.

To find out more about how AJR Public Adjusters, Inc. can help you recover from a natural disaster or other property loss by helping you obtain an equitable settlement from your insurance company, call (602) 795-5227, email info@betterclaimresults.com, or visit www.betterclaimresults.com

AJR Logo smaller picture

 

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

 

Mobile Insurance Apps You can Utilize to Document Inventory Prior to Next Insurance Claim

After a devastating loss is not the time you want to start thinking about “what did I own?”.

Insurance companies require you to document all that was lost in your claim and provide information as to the cost of each item.

Here is a link to a website that provides information how to obtain a mobile app that can help you inventory your possessions prior to that next claim.

Click here to see the mobile apps that help you inventory your possessions

Documenting and listing all that was owned prior to your loss  is something these apps can help with.   These apps if you take the time, can assist in the process to make sure no personal items are missed in the claim.

You may be thinking if I have all this already documented, why do I need a Public Adjuster?  The Public Adjuster can then  use this information, add more detail in the language that the insurance company requires and complete the inventory.  The Public Adjuster adds  their knowledge and skill to negotiate with the insurance company to make sure you are paid in full for all that was lost.  It should be an easy process, unfortunately walls are put up that prevent policyholders from recovering all that they are entitled to.  Adjusters with their expertise and experience are able to maximize your recovery from the insurance company.

The next time you find yourself with an insurance claim, even if you have used our suggestions and documented your possessions, its best to call AJR.  With our 28+ years experience we will use our knowledge and document your claim properly for maximum recovery, then use our mastery to negotiate your claim for maximum results.

AJR Public Adjusters – 602-795-5227 – www.betterclaimresults.com

 

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.

===========================================================

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.

How are Multi-family dwellings and vacancy handled with vandalism coverage?

Ever wonder how your property will be covered should vandalism occur?  What if you have a multi unit property and one unit is occupied and the others are not.  See answer below from Summit Business Systems, the leader in industry with how coverage applies.

QUESTION:

In a multi-family dwelling one unit was unoccupied & vacant for in excess of 60 days; the 2nd unit was vacated approximately 1 week before the loss. The vandals caused damage (vandalism/malicious mischief) to both units. Is the vandalism exclusion applicable to the 1st unit? Since the entire “building” was not vacant for in excess of 60 days- coverage should be applicable to all damages. Or, worded another way- if tenants were in the 2nd unit & vandalism damage was sustained in the 1st unit (vacant for in excess of 60 days) does the vacancy limitation apply?

ANSWER:

This is easier than it seems at first glance. The vandalism exclusion applies if the dwelling has been vacant for more than 60 days. The definition of residence premises states that the 2, 3, or 4 family dwelling where the named insured resides in one of the units is a residence premises. Therefore, even though the building is divided into separate living units, the entire structure is the dwelling. Therefore, since the entire dwelling wasn’t vacant, coverage applies for both units.

Rest assured that if at least one of your properties is inhabited, you are covered under the insurance policy.

AJR is the one Public Adjuster needed to assist with your coverages and make sure you are paid properly for your loss.  Give us a call 602-795-5227.  www.betterclaimresults.com