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Published 30.06.2014 | Author : admin | Category : What Do Guys Really Want In A Woman

How do you create a business letter that offers a sincere apology that will help support the business relationship? The bill takes the adjustment of the claim out of the hands of insurance company adjusters and puts it into those of third-party adjusters. Another significant problem concerns some insurance company lawyers routinely hiding documents and evidence of wrongful claims practices. In the Superstorm Sandy claims saga, I have to credit colorful Louisiana lawyer John Houghtaling for standing up to the barrage of allegations by the WYO attorneys. Judges and the legal profession should take note of stonewalling discovery and evidence evasion commonplace by insurance lawyers in civil litigation.
My father was in the United States Coast Guard and eventually rose to the rank of Rear Admiral. FEMA leadership is deeply troubled by recent allegations that FEMA and the Write Your Own companies may have relied on questionable and subpar engineering reports when adjusting claims.
While I am unable to speak to the veracity of the allegations regarding the engineering reports, I do know our policyholders now question the integrity of the NFIP claims process. I am certain Merlin Law Group's Javier Delgado who is Co-Plaintiff's liaison counsel will look forward to these discussions.
Another common theme during my conversations involved carriers citing reason after reason to deny paying the claim.
If you are or represent a Georgia policyholder and are dealing with an insurance carrier not acting in good faith, read the policy to know when the demand letter must be filed so you don’t lose your ability to pursue a claim for unfair claims handling. If you have ever had an insurance claim or negotiated a loss on behalf of a property owner, you would probably agree that one of the most frustrating aspects of the claims investigation process is the virtually endless set of documents requested from the insurance company.
Many people do not realize that every insurer authorized to conduct business in the State of Florida is required by law to provide a clear explanation as to why it is requesting these documents. Naragansett was found in violation of New York Insurance Law §2601, Insurance Regulation 64, and the Twelfth Amendment to Insurance Regulation 64, as a result of an investigation conducted by DFS. Naragansett received more than 10,000 Super Storm Sandy claims between October 26, 2012, and November 15, 2012, in an area covering the New York State counties of Bronx, Kings, Nassau, New York, Orange, Queens, Richmond, Rockland, Suffolk, and Westchester. Many of these claims where not timely adjusted or investigated resulting in violations of New York State Insurance Law and significant financial and personal hardship to the insureds. In order to avoid a lawsuit, Naragansett agreed to enter into a Consent Order requiring it to implement substantial new procedures to insure it would be in a position to deal with the remaining, and any future, claims. Importantly, the Consent Order does not in any way preclude consumers affected by Naragansett’s defective claims handling procedures from pursuing any right or remedy available under the law, including bringing suit. If you or someone you know initiated a claim resulting from Super Storm Sandy with Naragansett Bay Insurance Company or another carrier and believe the claim was not timely or properly investigated, it would be a good idea to consult with a professional regarding your rights and potential remedies. 1 Consent Order, New York State Department of Financial Services, Financial Frauds & Consumer Protection Division in the matter of Narragansett Bay Insurance Company. Stephen Hadhazi, a Texas public adjuster, recently wrote of a relatively new adjustment practice.
However, we are not given that opportunity because most field adjusters will not discuss the criteria of what they consider to be hail or wind damage. This practice of field adjusters not being allowed assess damages is nothing more than a shell game by the insurance carriers and it needs to be exposed. I wonder what my colleague Steven Badger, who represents various insurers with hailstorm claims, would think about this practice if his clients were doing this?
With several significant hail storms pummeling Nebraska in the last several weeks, my colleague Larry Bache and I are receiving inquiries about claims handling statutes in Nebraska. Writing a blog post remains the best way I know to get information to a large audience as quickly as possible, so I thought it best to start a Nebraska Coverage Series.
It remains to be seen, of course, whether Nebraska policyholders' recent hail damage claims will be properly and timely paid. I have previously blogged about the decisions coming out of the United States District Court of Arizona in the Barten v.
State Farm informed Barten that because he believes ACE was designed to increase profits at the expense of the insureds and because State Farm rejects the interpretation of the ACE program, none of State Farm’s programs include the principles of ACE as Barten understands them. Any program that encourages claims department personnel to lower claim payout in order to increase corporate profit is a major no-no. Upon my arrival, the hundreds of slot machines (first at the airport and then at the hotel) immediately caught my attention. In my research involving casinos that have had property damage claims, I found a case with a connection to Reno.
The following Premises Coverages apply only at those premises for which a Limit Of Insurance applicable to such coverages is shown in the Declarations. This actual or potential impairment of operations must be caused by or result from direct physical loss or damage by a covered peril to property, unless otherwise stated. This actual or potential impairment of operations must be caused by or result from direct physical loss or damage by a covered peril to property or personal property of a dependent business premises at a dependent business premises. Here, the parties did not contend that the policy was ambiguous; they each just had different interpretations of the language. Chip Merlin wrote about water losses earlier this week in his post, A Reasonable Investigation of a Water Loss Requires Using Tools to Find the Damage.
If you are a policyholder with damage to your property, you have obligations and duties under the policy when reporting the loss, but your insurance company also has obligations to you.
Once the representative arrives on site, ask for identification; a business card with a license number is preferred. In Florida, we know that certain insurance companies do not send licensed adjusters out on the claim, and one company sends out a representative who is not an adjuster, but if pressed offers to have an adjuster available via Skype.
Having an independent license number means that the adjuster can work for many different insurance companies at the same time and is not tied to just one particular company. Unfortunately, it is becoming prevalent for adjusters to only assess the areas specifically pointed out to them by the insured and to deny that they saw other damage to the building. I had a call from policyholder yesterday who found our blog and called looking for more information about hiring a public adjuster in another state. If you feel that your insurance company is not properly handing your loss, the worst thing you can do is wait, hope, and wish.
Former Divisional Claim Superintendent Ron Middler, who was in the claims unit that handled the Singh Claims, was examined at length in deposition concerning the operation of the Senior Referral Unit that handled the Singh’s Claim and its use by STATE FARM to discriminate against ethnic minorities. For those who study State Farm from a claims practice standpoint, I suggest you investigate Hindin's case.
We must believe that we are gifted for something, and that this thing, at whatever cost, must be attained. A case that exemplifies this type of practice, and illustrates the current state of the law in New York, is Marsel Mirror & Glass Products v. Marsel subsequently sued the carrier for unfair claims settlement practices, seeking punitive and compensatory (bad faith) damages claiming the carrier had fraudulently induced Marsel to settle the claim for substantially less than its actual value. This is reflective of New York’s strict and, in my view, anti-consumer treatment of causes of action sounding in bad faith. Note) The email address provided here will be asked for, in case if the password is forgotten for things like revoking account. 10) In case you are using Skype, Ripplex Address Book imports your Skype contacts automatically so that you can link with your Skype contacts on Ripplex network. Lawsuits naming insurance company lawyers and law firms for their complicity with aiding wrongful underpayments to their clients will undoubtedly be one of the consequences of Superstorm Sandy litigation. To those of us in the insurance claims business, the problem of biased and outcome oriented experts and engineering firms providing reports and opinions of loss which reduce the amounts policyholders are fairly entitled is a recurrent and serious problem. Their conscious avoidance by shutting their eyes or even ratifying the wrongful and fraudulent behavior is unethical.

Not only did flood WYO attorneys threaten and harass John's clients who were complaining of the altered reports, they tried to disqualify John Houghtaling from representing his clients.
If it were a criminal matter, those doing these activities would be subject to obstruction of justice charges. So, I was happy to learn that FEMA's Craig Fugate appointed a distinguished former Coast Guard Officer, Brad J. The Administrator has assigned me to lead the effort to identify and address aggressively the root causes underlying these concerns.
To that end, FEMA is committed to establishing a process to resolve all Hurricane Sandy insurance claims where there is evidence of questionable engineering practices and I am committed to ensuring NFIP business practices going forward are fair and transparent. I hope Brad Kieserman will also come down to the Jersey Shore and visit with the rest of our team litigating WYO flood claims--it is not just a New York issue. If FEMA really wants to be transparent, original estimates of damage made by the field adjusters should be compared to subsequent revisions and the justification for those changes. In researching some of the many issues surrounding these claims for my presentation at the recent Windstorm Insurance Conference, several challenges seemed to consistently appear within the items listed from each person I contacted.
Unfortunately, there may be no choice but to refer your clients to a legal professional if you continually face these delays after delays when presenting the claim.
The action for bad faith shall not be abated by payment after the 60 day period nor shall the testimony or opinion of an expert witness be the sole basis for a summary judgment or directed verdict on the issue of bad faith.
Unfortunately for most policyholders, by the time they realize the carrier is not acting in good faith, the clock is ticking and the insured has limited time to submit this required demand. While no magic language is required, the demand letter must at least notify the carrier of the insured’s intent to file a claim for unfair claims handling.
When an insurance carrier does not provide a clear explanation as to why the information is necessary for the processing of the claim within its request, ask them for it. For claims filed on or after November 29, 2012, the Twelfth Amendment required an investigation be commenced within six (6) business days of receiving notice of claim. These remedial measures include upgrading procedures for collecting, maintaining, and updating catastrophe data, claims handling, and capacity building.
Good faith performance requires that this be done in a prompt, thorough, and honest manner.
When inspecting roof damage from hailstorm, some insurers are sending out either incompetent field adjusters or those with no authority, who merely take photographs of hailstorm damage.
These adjusters then send the photos into a desk adjuster, potentially hundreds or thousands of miles away to be reviewed to see whether the damages in the pictures are wind, hail or whatever type of damage is being claimed. This sounds really great - until you ask the opinion of one of the field adjusters and he tells you that he is not there to give an opinion. They just want to take a few representative photos and send them to the desk adjuster thousands of miles away – which many times leads to a speedy denial. I'll cover additional important Nebraska property damage claims handling topics in the future, but for today I'll focus on carrier timelines and deadlines. While ever hopeful, recent history around the country leads us to believe that many Nebraska policyholders may face the same frustrations regarding insurance carriers undue delays, gross underpayments, and improper denials. Accordingly, State Farm explained to Barten it has no documents responsive to this request. So, this is why the progress of the Barten case is important and why I continue to keep readers in the loop … stay tuned. Consider the scenario of a tree falling on your home or a hurricane damaging the roof of your business (the type of peril really doesn’t matter).
You want to see if this person is a licensed insurance adjuster – and keep this contact information at your finger tips.
Don’t assume that someone who introduces themselves as an independent adjuster is unbiased.
The insurance company will ask you for the areas that concern you, and you should show them your concerns but then the insurance adjuster should do his own investigation and scope the property and the damage.
This is often the point in the claim when policyholders becomes so frustrated that they inquire about hiring their own public insurance adjusters, someone who does know about building damage, construction build back techniques, and can fully scope a claim to return the property back to its pre-loss condition, or they look into hiring an attorney who will help. You need to call to get help, ask questions, and take notes – including the names and license numbers of every person you encounter on the phone and in person.
We had no idea that his $34,000 contract claim resulted in a $30 million bad faith case settlement until State Farm made a huge blunder and filed a suit against Hindin and others asking for its $30 million back. He also testified as to the existence of the Jewish Lawyers list utilized by STATE FARM to discriminate against lawyers of the Jewish faith and their clients and how it was used.
The appellate court upheld a dismissal of this lengthy litigation because Hindin failed to get the case to trial.
Assuming the case is not resurrected with another appeal, it is an end to 1990's era of claims practice litigation against the leading personal lines insurer. This is done in the hopes that the policy holder will accept the offer because they need money immediately to mitigate their loss or are unaware of the actual value of their claim. American International Underwriters Insurance Company.1 In this case, the plaintiff, Marsel Mirror, had taken out an insurance policy to protect its interests in the event one of its major customers went bankrupt. The Court opined that Marsel Mirror had failed to establish the requisite elements necessary to set aside a release.
Decisions of this kind strengthen the already strong hand of insurance carriers against their insureds and encourage unfair practices like low balling. Ripplex Address Book automatically imports the contact list from several most commonly used address books.
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These bought-for experts sell themselves to maintain and obtain extraordinary amounts of revenue from insurers. Sadly, the practice seems to becoming more commonplace as some attorneys participate in the adjustment and pre-litigation activities and then do everything in their power to evade the truth and disclosure of incriminating documents. The insurer acting in bad faith has its attorneys threaten and harass the innocent policyholder—usually with allegations of failing to cooperate and technical defenses to coverage. In the civil arena, the sanction is usually money, and insurers have more of that than God.
Instances to short-change policyholders are not limited to altered engineering draft reports; revised estimates of benefits due are much more common. Hopefully, as we saw at the Windstorm Conference, meaningful dialogue can continue to help avoid the many common challenges currently faced when presenting claims of this nature. Most policies in Georgia require the insured to file suit within one or two years of the date of loss. This six (6) day period also applied to claims where Naragansett wanted to include an inspection of damaged or destroyed property. In addition, the above mentioned penalty of $327, 400 was agreed to by Naragansett and DFS. Most adjusters are taught to document what they see in the field through photographs, video, and the collection of evidence. The obvious problem with this is that unless we know how the field adjuster feels about the damages that you are showing him then how do we know when to stop showing him damage – or more accurately, when to stop prodding him to look at damages. We will not know until we get the report from the insurance carrier – which many times is a denial that what was shown to the adjuster was, in fact, hail or wind damage. In regard to your property damage insurance claims in Nebraska, read your policy and be aware of the statutory timelines outlined above. Recall, my Barten blogs have largely concerned State Farm’s corporate profit augmentation programs, whether the programs are called ACE or something else. If a contract contains ambiguous or unclear language, then ambiguities must be resolved in favor of the non-drafting party.

Adjusters can’t ignore damage by turning a blind eye but all too often this is exactly what we find in litigated claims.
Once you realize that you have a problem with the property, you do your part by calling your insurance company right away, and mitigating the loss.
I have discussed the different kinds of adjusters in my post, North Carolina Coverage: Understanding the Different Types of Adjusters.
You should not have to insist the insurance representative perform a thorough inspection, but it will behoove you to tell the adjuster that you are not sure of the extent of the damage and explain that is why you contacted them to evaluate the claim. Even a sophisticated or savvy business person is not a damage investigator but that’s okay because insurance companies are supposed to know damage. Thus, the insurer may not simply place the entire burden of establishing the claim on the insured. She is now going to call several of those adjusters to interview them and ask about their credentials and how they can assist her and her family.
It is particularly insidious (and effective) when used against an individual or small business that has suffered a catastrophic loss and does not have the resources or time to fight the carrier in order to get an adequate settlement. When this occurred the carrier refused to pay the claim until it was approved by the bankruptcy receiver, a process which could take up to two years. Barring fraud, illegality, mutual mistake, or ambiguous language, the Court ruled that the release would stand and Marsel Mirror’s claim for unfair claims settlement practices had to be dismissed. Please review the list of address book carefully and select all the ones that you would like Ripplex to import contacts from (A) and then Click "Finish" (B). Some insurer clients hide behind the attorney-client privilege and work product protections as excuses to prevent disclosure of wrongful conduct. At the same time, I am initiating a thorough and multi-disciplinary assessment of FEMA’s delivery and oversight of the Write Your Own Program and adjustment processes, including hiring and relying upon engineering reports to resolve flood insurance claims.
But if the insurer realizes that it cannot articulate a clear reason for the document request, then it should (at least in theory) withdraw the request. Good faith also requires that the adjusters undertaking this important job be qualified to adjust the loss they are assigned. Federal Insurance Company,1 a manufacturer of electronic slot machines, WMS Industries, Inc.
Ambiguities exist when a policy can be logically interpreted in two or more ways, where one logical interpretation provides for coverage.
Larry Bache also wrote about this topic in his post, Are You Aware of Your Insurance Company's Obligations When You Report a Loss? The insurance company pays very close attention to what you say when you report the issue them (be accurate, details matter, don’t assume and be sure to tell them you need help to understand the extent of damages you are claiming). Allow access and encourage the insurance company representative to inspect every part of the property, whether you see obvious damage or not. The policyholders, the everyday people our firm represents, are not trained in the business of adjusting and investigating claims. Marsel Mirror decided to settle and executed a release of related claims against the carrier. Please note that the email you entered is the one that would be registered with this account. Shipping Information:ALASKA, HAWAII, PUERTO RICO, We will only ship these via USPS, so Please make sure your address is a USPS address.
When you or an employee causes a problem with a customer, a supplier, or a vendor, it is important to take steps to rectify the situation and to make sure the relationship stays strong. I am likewise committed to referring for investigation any appropriate matters we may encounter in the course of the assessment. However, ambiguities do not exist simply because two parties disagree over the interpretation of a policy. Yes, they should know their properties, but the extent of damage caused by a hurricane, hail storm, fire, or even a failed garbage disposal, is often complicated and requires evaluations by trained professionals.
If it was a more personal infraction, then the letter is addressed to the wronged person directly. Some honest experts complain that an honest opinion costing an insurer significant money leads to them being de-listed. For insureds with a one-year policy they must submit the demand letter only 10 months after the date of loss. I am curious how claims executives would explain their decision to adjust hailstorm claims in this manner. WMS centrally managed electronic slot machines in Gulfport, Mississippi, and networked these slot machines across multiple casinos which leased the slot machines. The next thing that the insurance company usually does is send out a person to meet you at the property. Unfortunately, the supposed trained professionals are now admitting that they do not LOOK for DAMAGE! Frank Taylor, an experienced economist with a doctorate and a former college professor of economics, insurance and finance, to investigate the religious background of the persons whose names were on the list. This is a very difficult deadline to meet, especially for insureds that might not even realize a remedy for the carrier’s delay and misrepresentations even exists. Language in exclusionary clauses must be clear and unmistakable, as those clauses are strictly interpreted.
Stress to the insurance company that you want a prompt response, and to send someone experienced without delay.
There were a total of 240 separate names that appear on the two Jewish Lawyers Lists provided to Dr. Nevertheless, a court must refrain from altering or changing a policy where terms are unambiguous, despite resulting hardship on the insured. They repaired the physical damage to the Gulfport facility in November and then moved their operations back to the Gulfport facility on December 2, 2005. Taylor was able to obtain the necessary information on one hundred ninety-three (193) of the two hundred-forty (240) listed attorneys or eighty (80%) per cent. There were a total of one hundred fifteen (115) of the total of 193 attorneys on the combined list whose information he could obtain who were Jewish. There were twenty-eight (28) non Jewish members of a racial or ethnic minority on the combined list from whom he was able to obtain the necessary information or fifteen (15%). Thus there were a total of one hundred forty-eight (148) of the one hundred ninety-three (193) attorneys on the combined list who were either Jewish or members of a racial or ethnic minority. The Jewish composition of the STATE FARM attorneys lists [62% Jewish on the Combined List, 77% Jewish on the Consolidated Suit Unit List and 65% on the Select Unit List is more than ten times the percentage you would expect as a result of the Jewish composition of the general Los Angeles County population and more than 20 times what you would expect as a result of the Jewish composition of the general population of the State of California.
HINDIN asked Taylor to assume that insurance claims of clients represented by attorneys whose names appear on these lists are assigned to these special claims handling units operated at STATE FARM because the attorneys names appear on one or more of these lists and experience substantial delays in the processing of their claims and receive substantially smaller offers to settle their claims than they would have received had they not been assigned one of these special units. HINDIN has asked him to assume, there is very substantial evidence that STATE FARM discriminates against Jewish lawyers and their clients in the operation of the special units. Taylor’s opinion is that based upon his knowledge of statistics and the insurance industry, it is highly unlikely that these lists of names could be constructed with predominantly Jewish attorneys being listed by chance. Rather, it is clear that the insertion of predominantly Jewish names on these lists for special claims handling is the result of a conscious intent. It is highly unlikely such a predominately Jewish list of attorneys would be submitted to the special claims units if Jewish discrimination were not a primary factor.

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