Hurricane Irene Insurance Claims Guidelines for Public Adjusters--The Merlin Guide for North Carolina
Hurricane Irene insurance claims will be the talk of the insurance adjusting community for awhile. Ruck Deminico, the Merlin Law Group Knowledge Manager has put together our first Merlin Guide for public adjusters in North Carolina which is available here.
We will have more information regarding insurance claims handling along the eastern seaboard and specific information regarding National Flood Insurance claims.
Given the extensive amount of media coverage of Hurricane Irene, policyholders (even ones who did not suffer damages associated from Hurricane Irene) should review their insurance policies to understand their coverage for "Hurricane Damage".
The typical home-owner's policy can be confusing when determining the extent of coverage for damages resulting from hurricanes, such as Hurricane Irene. As most private insurance companies offer coverage for wind damage, and resulting damages of such, flood damage is often a confusing element faced by property owners after a hurricane. Of course, as an Insurance Company will go through extensive measures to limit the amount offered during settlement, their adjusters typically rely on blaming damages on "non covered" perils, such as storm surges.
Wind-and-Rain vs a Full-Blown Flood
While Hurricane Irene moves north, leaving trails of damaged and destroyed homes in her path, insurance adjusters are gearing up to handle the out pour of property clams caused by Irene. Policyholders should understand that one of the primary goals of their insurance company adjusters will be to "determine" whether wind or water caused the damages. This causation determination can make the difference between receiving a settlement check of several hundred thousand dollars, or, being denied and having to suffer financial devastation. The obvious conflict of interest in allowing the insurance company's adjuster to make this determination should make all homeowners very, very, concerned. Insurance Company adjusters are specially trained to protect the financial interests of their company, and coupled with their "one sided" training on determining the difference between flood and hurricane damage, policyholders may find themselves on the losing end of a battle of policy interpretation and damage estimation. Policyholders victim to Hurricane Irene should refer to their policy's "water damage exclusion" for explanation of coverage available. The typical water damage exclusion contains language such as below:
The Water Damage Exclusion
"We do not insure for loss caused directly or indirectly by [water damage]... regardless of any other cause or event contributing concurrently [and] whether or not the loss event results in widespread damage... "Water damage" means: a. Flood, surface water, waves, tidal water, overflow of a body of water, or spray from any of these, whether or not driven by wind... caused by or resulting from human or animal forces or any act of nature."
Policyholders must be prepared for disputes regarding the interpretation of these provisions after the wake of Hurricane Irene. Fortunately, the terms relating to causation are not specifically defined and are ambiguous, which means that interpretation should be in favor of the policyholder. A knowledgeable Public Insurance Adjuster or Attorney would prove very advantageous to the homeowner when attempting to make this argument.
Hurricane Irene victims should consult a policyholder insurance professional, such as a Public Insurance Adjuster or Attorney.
Additionally, complaints should be filed with a State Insurance Department, in order to keep record of such issues in case of later claim denial.
Greetings Chip!
Just when I thought I've seen it all (which, come to think of, that thought has never crossed my mind), you come up w/a title that's worthy of a comment:
"Merlin Law Group Knowledge Manager "
wow, been there done that......and still manage to manage the knowledge. :)
SHIRLEY HEFLIN
Shirley,
Greetings back to you!
Ruck is our firm's secret weapon. He is a licensed attorney. He is also a legal librarian.
Most law libraries are on-line. He accumulate and indexes all kinds of information we gather regarding the insurance companies we litigate against. He performs all kinds of specialized research which helps gives us an edge in our lawsuits.
So, "knowledge manager" is a lot more appropriate than law librarian as a title.