Property insurance coverage cases provide lessons for others to follow. A recent Oklahoma federal court decision1 following a fire loss reflects why my book, PayUP!, suggests that public adjusters should be considered for retention shortly after any significant loss. The language from the opinion that caught my attention was the following:
Continue Reading Court Implies That Policyholders Are Better Off With Professional Claims Help

The Florida Bar has taken a very proactive stance regarding wrongful solicitation of Hurricane Ian and Nicole policyholders. The Florida Bar filed an emergency Petition today for suspension of a Florida attorney working for an out of state law firm. The Petition alleges, among other items, deception in the solicitation of Hurricane Ian claimants:
Continue Reading Florida Bar Acts Against Wrongful Solicitation—Claimants Should Hire Reputable Attorneys With Credentials

This morning I was teaching over 200 adjusters about how to properly adjust claims with multiple causes of loss from wind and flood caused by a hurricane. This seminar, Slabbed: Making a Wind and Flood Claim on the Same Structure, was for members of the Florida Association of Public Insurance Adjusters (FAPIA). I have personally handled thousands of these unique claims. Unfortunately, many adjusters do not do it right. As a result, policyholders will often suffer because they fail to receive all benefits available under the policies covering this type of loss.
Continue Reading How To Adjust Hurricane Claims with Wind and Flood Damage—Start with the Basics of National Flood Insurance Claims

National Flood Insurance claims are exacting. I watched and listened to the National Flood adjuster briefing yesterday afternoon. Most policyholders have no clue that National Flood claims are the most difficult property insurance claims to be correctly completed and that the insurance adjuster from National Flood has no authority. The field flood adjuster is merely an accommodation to the policyholders and is there to assist in making the claim. National Flood claims are draconian because of technicalities that are very difficult to fight.
Continue Reading Hurricane Ian National Flood Insurance Claims—What to Expect

Today, I was at a property claims seminar that described the multiple adjuster problem as a game of “adjuster musical chairs.” Policyholders, contractors, and public adjusters with Hurricane Ian claims will often be faced with multiple insurance company adjusters who will be the primary adjuster before being replaced or going back to their other job. I hate to say this, but I have been involved with catastrophe fee claims since 1985, and this is a much more common problem today than in the past.
Continue Reading Multiple Catastrophe Adjusters—What Policyholders, Contractors, and Public Adjusters Should Do

Florida Governor Ron DeSantis is a lawyer. He correctly noted at a Hurricane Ian press conference that there will be insurance claims disputes. He explained that the flood carrier will try to argue the damage was caused by the hurricane winds, and the wind insurer will do the opposite. He then went too far and tried to explain to the press how to distinguish one from the other.
Continue Reading Do I Make A Wind Damage Or Flood Damage Claim? Public Adjusters Are Trained To Adjust Both Claims At The Same Time

Almost all property insurance policies require that the insured “assist and cooperate” in an insurer’s investigation. If an insured fails to “cooperate,” an insurer may have the right to deny a claim. However, the insurer cannot demand that an insured cooperate with every request. This blog discusses what requests you should ensure an insured cooperates with, what lack of cooperation may be grounds for a denial, and how to manage an insurer’s overbroad and unreasonable request. Most of the principles here are not unique to California and can serve as a general guide almost everywhere else.
Continue Reading What Constitutes Cooperation with an Insurer’s Claim Investigation in California – Ensuring Compliance and Avoiding Unnecessary Harassment

A California policyholder’s compliance with all insurance policy conditions is required for claim payment. Understanding the conditions will prevent an unnecessary claim denial and will often speed up claim payment. With yet another historic and tragic fire season occurring this year, let’s review the common policy conditions that are typically encountered during the claim adjustment and the best way to manage and ensure the policyholder’s compliance.
Continue Reading Ensuring the California Policyholder Complies with Policy Conditions During the Claim Adjustment

When properly documented and planned, the sale of a damaged property does not create an opening for the insurance company to escape liability from its insurance obligations. When selling your property during a pending insurance claim, policyholders can assign the claim to a new buyer or retain their right to receive insurance benefits under the policy.
Continue Reading Who Collects the Insurance Claim Proceeds If the Damaged Property Is Sold?

As discussed in my previous blog post, Should an Insurance Company Pay Adjustable Claim Amounts Not in Controversy While Another Amount Is Still In Dispute?, the payment of undisputed amounts is an issue that is frequently being argued in Puerto Rico courts for Hurricane Maria claims. As recent as this week (May 12, 2021) the First Instance Court of Carolina, Puerto Rico, granted a Partial Summary Judgement and ordered the carrier to pay the adjustable amounts not in controversy.
Continue Reading Another Win for Adjustable Claim Amounts Not in Controversy