On Friday, one hundred and forty-eight Texas public insurance adjusters attended a seminar our law firm sponsored in Houston. I am pretty sure it was the largest ever gathering in Texas of people dedicating themselves to the study of helping property insurance policyholders. It was thrilling, exciting, and taxing for me. I loved every minute of it, and several public adjusters have asked us to hold another seminar this summer.

Representing policyholders in the presentation and adjustment of a claim is very demanding. Public adjusters have to be experts at coverage interpretation, construction methodologies, construction pricing, contents pricing, understand how statutes and case law effect recovery, negotiation, and hundreds of other technical fields. A person could spend a lifetime on just one aspect. It takes dedication and experience to do the job right.

A number of the public adjusters in the audience were former insurance company adjusters. The experience of working for, and being trained by, an insurance company is invaluable to a public adjuster. I paid former State Farm adjusters who switched to the "side of angels" a compliment by remarking that I believe State Farm has more thorough training available for its first party property adjusters than any other personal lines insurer. States need to make certain Public Adjusters have rigorous requirements for continuing education. As in any trade dealing with the public where serious issues are at stake, the consumer can be harmed by those who ineffectively perform their job. Public adjusters need more education–especially those with minimal experience in the insurance industry.

Ethics was the first topic of the seminar. Public adjusters have a tendency to practice law without realizing they do it. It is hard to prevent because insurance contract interpretation requires an understanding of statutes and cases interpreting insurance regulations and policies. Public Adjusters must understand insurance contracts. Knowing how they effect an adjustment can be used to provide greater benefits to the policyholder, and is the public adjuster’s job. However, the interpretation and providing legal advice to consumers is not adjustment, but the practice of law.

Many insurance adjustment issues involve overlapping practical and legal coverage issues. Here are some of the other topics we covered in Friday’s seminar:
 

  • Flood Insurance Claims and Regulations
  • Proofs of Loss
  • Replacement Cost
  • Replacement at Another Location
  • Overhead and Profit Calculations
  • Increased Cost of Construction Calculations
  • Roof Losses
  • Getting Coverage for Matching of Damaged Structural Parts
  • Depreciation
  • Actual Cash Value Determinations
  • Sales Tax of Labor
  • Building Codes
  • The Use of Engineers and Architects in Claim Submittal
  • Appraisal
  • Selection of the Best Appraiser for a Claim
  • Appraisal Process, Procedures and Forms
  • Question and Answer on Adjustment

Based on past experience and seeing the misinformation regarding wind speeds from Hurricane Ike, we thought a presentation by a meteorologist would be interesting and relevant. We are finding that some insurance companies are providing engineers with low estimates of wind and gusts in the Houston area. The insurance company engineers seem to rely upon these outcome-biased reports of wind speed to come up with improper findings that damages were not caused by Hurricane Ike . We wanted to show the public adjusters the value of having an experienced meteorologist who can dispel those reports.

Texas has some unique issues regarding construction, building codes, and building regulations. An engineer with experience in certified wind inspections gave a presentation on these issues. Retaining engineers, meteorologists, architects, estimators, and other experts should be common place in claim presentation of serious loss cases. Frankly, the insurance companies should be doing this as well, if they truly want to fulfill their obligation to conduct a full investigation.

Most policyholders hope their company insurance adjusters have the motivation of public adjusters to fully investigate a loss to find every penny that should be paid under the policy. Our seminar was intended to help public adjusters with the tools to use that motivation. While the listed topics may seem strange and boring to most, they must be fully understood if policyholders are to receive full coverage benefits. I believe that most policyholders have no business trying to learn these issues by themselves when so much is at stake.

The next wind insurance event for insurance adjusters and vendors of all types will be hosted on April 2nd in Houston by the Windstorm Network. I strongly urge those in the industry handling Hurricane Ike claims to register for this symposium of experts analyzing many of the day to day issues adjusters face in the field.

  • The Merlin Team,

    I would like to thank the entire Merlin staff on behalf of my team for the wonderful conference that was held in Houston yesterday!

    We are already looking forward to the next conference!

    Very Best Regards,

    Andy Bruce
    President
    South Wind Public Adjusters Inc.

  • Kevin Kramer

    Thanks for the recognition on your BLOG Chip, your team did an outstanding job with the entire presentation.

    I was in fact State Farm staff for six years and an independent adjuster w/them for another five when I departed from their ranks last December.

    I am the author of a 200 pg Adjuster (E-Book) “The OJT Catastraining Training Manual” that I sell on-line and would be happy to send you a free copy of provided that you give me an e-mail address that I can send it to. You may find it helpful to understanding State Farm’s training process as well as the undocumented expectations that are placed on their property claims adjusters.

    I look forward to our next chance to get together and learn more about the legal aspects of our profession.

    Kevin Kramer
    k.squared@earthlink.net

  • Andy,

    Your team should get an honorable mention for Best Question by raising the difficult issues of repairing parts of roofs with shingles that need to comply with higher wind speeds.

    I was happy that I had a structural engineer I could refer to as a panelist on that issue.

  • Kevin,

    FREE?! Send it to wmerlin@merlinlawgroup.com.

    I would be happy to give it a review on my Blog for everybody to learn from it.

    Glad to see experienced adjusters as yourself coming into the public adjuster ranks. Your views are very valuable.

    Thanks for the kind words.

  • Terry Sershion

    As a public adjuster I appreciate your comments regarding the difficulty one faces when dealing with issues of coverage and interpretation of same.

    I have never provided an assessment and coverage opinion for a consumer thus I take exception with the recent inquiry as to my involvement with the unauthorized practice of the law. After being the victim of the freeze for 2.5 years my goal is simply to help consumers that have insurance losses receive the benefits that they are entitled to under their insurance policies. In fact yesterday I visited a loss which was clearly covered yet the carrier denied coverage and as the contractor was late I had no problems in quickly contacting extra contractual counsel to alert him that this client might need more than my public adjustment expertise.

    I believe many carriers had excellent training programs however, with pay for performance those are not the programs that corporate insurance now supports.

    I like and appreciate your blog.

    As Charles Darnay said it is a far far better thing I do than I have ever done before.

  • shirley heflin

    One just can’t lose sight of the poor ole’ policyholder who, at first, just thought they would figure out how to properly file a loss claim only to later learn they’re (virtually) wasting their time. They have no idea (yet) that their claim is going to be DENIED, that this PEACE OF MIND they paid for is a myth.

    They have yet to learn that before they get their rightful claim paid, they (most likely) will have to hire a Public Adjuster to present their claim and if the P.A. can’t get the case settled, the insured will then have to hire an attorney.

    But blessed are the Public Adjusters, Attorneys, supporting staff, and all others associated with helping the insurance consumer that cannot obtain benefits rightfully due them.

    SHIRLEY HEFLIN

  • Terry,

    The truth is that many professions must engage in a psuedo practice of law just to practice in their non-legal profession. We all have laws that have to be followed and these laws are very entangled in some professions–especially insurance adjusting.

    I appreciate the kind words.

  • Shirley,

    “Blessed” are the good insurers that do get their customers paid on time and for the truly fair amount. “Blessed” are the adjusters that somehow work the system to get the same fair results even though their claims management has a different agenda.

    And the rest of us will take your blessings anyday. Thanks.

  • Greetings,

    As many of you, we attended the Merlin Law Group seminar on Friday March 13th. Everyone I had the pleasure of chatting with during and after the seminar expressed the same concern concerning general contractors acting as public adjusters. No one in our peer group understood what, exactly, should be done about it.

    This issue has not been clearly addressed by the authorities. For the last few weeks I have been trying to contact the TDI via e-mail explaining that companies such as http://myglobalprofile.com/casteph-contractors-llc should be closely monitored. To date, no clear response has been provided.

    At the seminar, Mr. Chip Merlin asked us an important question, one he obviously knew the answer to himself,

    “Who regulates general contractors and prevents them from acting as PA’s?”

    Out of the 200 attendees, no one offered an answer. I believe that with the reinvigoration of TAPIA, with assistance and guidance from professionals like the Merlin Law Group, our industry, in Texas, will finally be protected.

    Let’s all join forces and help Mary Fortsen of the Merlin Law Group by providing her with copies of advertisements from various newspapers and internet articles which should be investigated by the proper authorities. In addition, we should all send e-mails to TDI with copies of those advertisements and insurance contingency fee contracts from GC’s which so clearly appear to be in violation of TDI regulations.

    With respect to all,

    Dimitry Manasov
    President/Adjuster
    United States Public Adjusters®

  • Dimitry,

    You have raised a very valid point.

    The individuals doing the construction should have no part of adjusting the loss. They are not licensed to do so, they are breaking the law, and there is an inherent conflict with getting paid to adjust a loss and doing the construction which the Texas law recognizes.

    Yet, authorities are doing nothing about this.

  • Fred Hall

    Mr. Merlin,

    I was one of the public adjusters lucky enough to attend the seminar last Friday in Houston. I want to extend my personal thanks for the opportunities that this has opened to me. I am a first-year public adjuster, with much to learn, and everyone there contributed in some way to my personal knowledge base.

    Like Erika “That TWIA Girl” I completed the TWIA files during Ike, and that experience in large part has propelled me into being a public adjuster. I have been an independent adjuster for about 15 years, and never have I felt that the insureds have been treated as poorly as they were during Ike, by TWIA.

    Anyway thanks again for your hospitality, and the opportunity to learn at the feet of the Masters.

    Fred B Hall