Federal Judge in Mississippi 'Storm Surge' Case Upholds Home Insurance Flood Exclusion
National News • April 13, 2006
A federal judge in Mississippi has upheld the water damage exclusion in homeowners insurance policies in a ruling welcomed by insurers.
U.S. District Judge L.T. Senter, Jr. of the Southern ...
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Subject: Insurers and adjusters are playing with consumers.
Posted On: May 18, 2006, 3:57 pm CDT
Posted By: ClaimHawk
Comment:
Posted On: May 7, 2006, 5:53 pm CDT
Posted By: Martha Kirwin
Comment:Federal Judge in Mississippi 'Storm Surge' Case Upholds Home Insurance Flood Exclusion
Gentlemen,
I have been an adjuster for six years. Having grown up with a homebuilder and insurance agent for parents, it was a natural choice after grad school.
Until December '05, I worked for a large catastrophe adjusting firm. My husband and I worked together while traveling the country, earning a fabulous income, and meeting extraordinary people.
Prior to 2004 I experienced very few instances of practices by insurers that I would have labeled negligent, illegal, or deceptive.
In general, most insurers appeared to have an interest in settling claims quickly and fairly within the boundaries of their contracts. In order to achieve good will, I have seen insurers pay for losses(food replacement, etc.) that were not legitimatly covered under the policy.
During this period, one of the most difficult aspects of my job was explaining coverage to the insureds.
After grad school, I took a three week, 120-hour course on policy coverage, after which I felt as though I had obtained an acceptable level of understanding on how to interpret property coverage language.
Yet, on many occasions thereafter, I made mistakes. It soon became evident that the vast majority of policy holders had an extremely limited knowledge of their coverages.
Not surprising, given that they do not take three week courses.
In 100% of the scenarios in which I have adjusted losses, the insureds were either surprised to learn that some portion of their property was not covered or limited to some degree below that which they understood to be limited.
Prior to 2004 however, these situations did not typically result in tragic outcomes for the insureds. In each instance, I encouraged the insureds to contact their agents for clarification and recommendations for updating or upgrading their coverages.
Unfortunately, beginning with the four hurricanes in 2004, claims adjusting practices have changed dramatically. Suddenly, roofs, carpets, awnings, and a litany of other trades are no longer allowed to be considered for Overhead and Profit by many insurers.
Taxes and O&P are no longer are part of the calculation for ACV. We "negotiate" different prices with individual insureds as if we were purchasing an automobile.
My neighbor might have been paid $1400 per Square for the same roof that I was only allowed $900 from the same insurer.
To my astonishment, I have come to know that most of the claims that I have adjusted were estimated with a price database that is 70-110% below actual market pricing.
And worse, these people who I left "knowing" that I had worked diligently to find all the coverage available to them, were taking the proceeds of those claims and settling for those amounts.
The majority had no inclination that they had alternatives or could file supplements or dispute in any manner, the amounts of the settlements.
Needless to say, after two years of struggling with the ever increasing restraints and borderline illegal practices to which I was forced to impose on these uninformed consumers, I resigned my position as an independent adjuster.
In December of 2005, I opened a public adjusting firm in South Florida. Now, we experience on a daily basis the abhorrent practices of insurance companies and those adjusters who represent them.
Understand that it is my position that there are companies that handle their claims quickly, precisely, and professional in total compliance with the contract.
However, those companies are in the vast minority.
Last week, we filed a Civil Remedy on behalf of one of our clents siting 19 violations of statutes by one of the largest insurers in the state. My firm is representing over 300 clients currently and this is our current statistical compilation:
287 claims open in excess of 180 days.
143 in violation of at least five Florida statutes relating to adjusting practices.
These numbers represent staggering figures. On the average, we collect 293% more money from the insurance companies than was estimated originally and we achieve this by using the same adjusting practices that I have used for six years.
Mr. Poe, on behalf of those in this profession who take pride in said profession, I will apologize on behalf of these representatives of our industry, who with obvious disdain and disregard for the wide-spread consequences of their arrogance and flagrantly, biased disrespect for their insureds, contractors, attorneys or any others who oppose or even call into question their righteousness, honor, or the finality of their opinions.
Their defensive, territorial chest-beating and sophomoric, belittling statements are a clear indication of exactly why consumers need protection. Whether or not your business practices are ethical is completely beyond my discernment; however, I appreciate your seemingly sincere interest and dedication to making a difference in our industry.
Subject: Insurers and adjusters are playing with consumers.
Posted By: Martha Kirwin
Comment:Federal Judge in Mississippi 'Storm Surge' Case Upholds Home Insurance Flood Exclusion
Gentlemen,
I have been an adjuster for six years. Having grown up with a homebuilder and insurance agent for parents, it was a natural choice after grad school.
Until December '05, I worked for a large catastrophe adjusting firm. My husband and I worked together while traveling the country, earning a fabulous income, and meeting extraordinary people.
Prior to 2004 I experienced very few instances of practices by insurers that I would have labeled negligent, illegal, or deceptive.
In general, most insurers appeared to have an interest in settling claims quickly and fairly within the boundaries of their contracts. In order to achieve good will, I have seen insurers pay for losses(food replacement, etc.) that were not legitimatly covered under the policy.
During this period, one of the most difficult aspects of my job was explaining coverage to the insureds.
After grad school, I took a three week, 120-hour course on policy coverage, after which I felt as though I had obtained an acceptable level of understanding on how to interpret property coverage language.
Yet, on many occasions thereafter, I made mistakes. It soon became evident that the vast majority of policy holders had an extremely limited knowledge of their coverages.
Not surprising, given that they do not take three week courses.
In 100% of the scenarios in which I have adjusted losses, the insureds were either surprised to learn that some portion of their property was not covered or limited to some degree below that which they understood to be limited.
Prior to 2004 however, these situations did not typically result in tragic outcomes for the insureds. In each instance, I encouraged the insureds to contact their agents for clarification and recommendations for updating or upgrading their coverages.
Unfortunately, beginning with the four hurricanes in 2004, claims adjusting practices have changed dramatically. Suddenly, roofs, carpets, awnings, and a litany of other trades are no longer allowed to be considered for Overhead and Profit by many insurers.
Taxes and O&P are no longer are part of the calculation for ACV. We "negotiate" different prices with individual insureds as if we were purchasing an automobile.
My neighbor might have been paid $1400 per Square for the same roof that I was only allowed $900 from the same insurer.
To my astonishment, I have come to know that most of the claims that I have adjusted were estimated with a price database that is 70-110% below actual market pricing.
And worse, these people who I left "knowing" that I had worked diligently to find all the coverage available to them, were taking the proceeds of those claims and settling for those amounts.
The majority had no inclination that they had alternatives or could file supplements or dispute in any manner, the amounts of the settlements.
Needless to say, after two years of struggling with the ever increasing restraints and borderline illegal practices to which I was forced to impose on these uninformed consumers, I resigned my position as an independent adjuster.
In December of 2005, I opened a public adjusting firm in South Florida. Now, we experience on a daily basis the abhorrent practices of insurance companies and those adjusters who represent them.
Understand that it is my position that there are companies that handle their claims quickly, precisely, and professional in total compliance with the contract.
However, those companies are in the vast minority.
Last week, we filed a Civil Remedy on behalf of one of our clents siting 19 violations of statutes by one of the largest insurers in the state. My firm is representing over 300 clients currently and this is our current statistical compilation:
287 claims open in excess of 180 days.
143 in violation of at least five Florida statutes relating to adjusting practices.
These numbers represent staggering figures. On the average, we collect 293% more money from the insurance companies than was estimated originally and we achieve this by using the same adjusting practices that I have used for six years.
Mr. Poe, on behalf of those in this profession who take pride in said profession, I will apologize on behalf of these representatives of our industry, who with obvious disdain and disregard for the wide-spread consequences of their arrogance and flagrantly, biased disrespect for their insureds, contractors, attorneys or any others who oppose or even call into question their righteousness, honor, or the finality of their opinions.
Their defensive, territorial chest-beating and sophomoric, belittling statements are a clear indication of exactly why consumers need protection. Whether or not your business practices are ethical is completely beyond my discernment; however, I appreciate your seemingly sincere interest and dedication to making a difference in our industry.