Folks, buckle up! It is going to be a bumpy ride for every single tax paying citizen, as well as insured, who pays premiums on ANY type of insurance. While our focus is on Property and Casualty, the actual model is for carriers is consistent throughout.
This was my comment for the thread, and pretty much sums it up in a brief format. We have done the math, the homework… and the actual work, for over seven years now in Public Adjusting alone, not counting the many, many years in catastrophic reconstruction on the coasts, to being a “Premiere Service Provider” for one of the largest carriers in the world before firing them after a few years.
“The problem is not Public Adjusters or Attorneys… It is insurance companies who have continually contrived ways to cut payments on legitimate, valid claims. Before you file them… that is exactly what they will attempt at this session. Instead of fighting you after a loss, they are trying to win before you ever have a loss… think about that.”
I would like to know who paid for the study? Carriers or Insureds, via the Department of Insurance and hard earned tax dollars?
Also, I will state the obvious. From the article, and what little bit of information given, it would appear that the numbers actually prove both Public Adjusters and Attorneys have successfully helped enough insured’s to actually get on the radar, thus proving their worth. So again, this legislative session, insurers will spend more on lobbyist, politicians and outright calls for leaving the state than actually paying valid, legitimate claims, like they promise in the policy. It is really that simple. They have actually been made to pay a few claims correctly, and they are now hollering wolf.
If it has not changed, Texas is the 10th largest insurance market… in the world. They are not going anywhere. They will do as they have always done, attempt to mitigate claim payments to insureds.
Why did you buy the insurance in the first place? Why do you pay outrageous premiums? Oh yeah… the.03% “claimed loss”. When the Super Bowl is played this year, take a look, and count all the commercials, the endorsements, the back boards, the digital media… all will have a slogan from local Lloyd’s Provider. Then, when they descend upon Austin for what is sure to be an absolute war for insureds rights and coverages.
This year alone, Texas and Oklahoma have seen some the worst catastrophic events known to man. Unfortunately, those catastrophes will eventually become claims, that will eventually be underpaid, on average, by a 100% of what was actually owed. After years of case study, this has become apparent. In fact, I have personally sat thru multiple depositions, under oath, with the hired gun attorneys of the insurance industry, grilling me on everything under the sun, stammering when I repeat it. Mr. Spoon, you are under oath, you are aware of that, correct? Absolutely. I am absolutely aware of the fact, and reiterate my statement. We have found, that on average, a 100% of all insurance claims in property and casualty are underpaid by a 100%. (Those numbers are often in 1000% range.) What does this mean to you, the insured? It means your claim, whether you are a large corporation with multiple large properties, (Normally, these are the ones where we see the 1000% increase from original.) A homeowner, or member of the church, school or any other insured property, and you file a claim… Odds are a 100% you will be underpaid by at least a 100%. I know this is a very hard pill to swallow… because it means we are getting duped, every time. None of us like to hear someone got the better of us, especially if it was over something we paid for, and took the seller’s word that if we needed them, they would be there, and pay what they owed. Not more, but certainly not less… especially by a 100%! It also means that they knew they were going to do this before you ever purchased the insurance. This is why most people absolutely need help with insurance claims from people who have either dealt with these companies before or insiders who truly know what’s going on. Do a simple Google search for your insurance company, only add the name Lloyd’s at the end. Example: State Farm Lloyd’s, Farmers Lloyd’s, Allstate Lloyd’s, Travelers Lloyd’s… etc, ad infinity. Then, when you are satisfied that all these companies have one thing in common…. Lloyd’s. Here is a disclaimer for the US. Notice their use of the word “syndicate”, as well as the fact that there is no singular responsible entity.
a group of individuals or organizations combined to promote some common interest.
“large-scale buyouts involving a syndicate of financial institutions”
control or manage by a syndicate.
“the loans are syndicated to a group of banks
Trillions of dollars have been spent to make us believe that these folks have our best interest in mind. Fact is, they have our money’s best interest in mind, and they feel the best place for it is with them. You must ask yourself one simple question, as an insurer, how do you make money on insurance claims? Remember… the only reason anyone buys insurance, is to file a legitimate claim, if one were to occur. Ergo, the single reason you purchased, is the only business they are in… claims. Answer: You cut the cost of claims. How? My ways and means that have been devised, as Lloyd’s disclaimer boldly states, for over a century.This means they have had all our money for research on how to pay us less money, BEFORE we ever purchased our first policy… regardless of which Lloyds Syndicate sold it to us.It is not rocket science… its simple economics. Whatever we can keep from paying you, we keep. I have written numerous articles over the years, and will add a few links in, for those who want to learn more, it is there for the scouring. All of the links inside the articles go to the actual source, so all the proof needed is very easy to access.
If you were affected by the Tornadoes, or any of the recent bad weather events to hit Rowlett or Garland, Texas… or anywhere else, and you have found this page, you are in the right place, at the right time. All we do is insurance claims, for you, the Unprotected Insured.
Why do I say that. It is actually quite simple. Call your insurance company, or ask the adjuster when he is face to face… Do they work for YOU, the insured, or the insurance company? If they tell you anything but your insurance company, you have already caught them in lie number one. They do not work for you. In Texas, there are only three people who can legitimately work for you, the Insured. #1, You, the Insured, which I do not recommend anymore than I recommend you being your own defense counsel… even if you are an attorney. #2, a licensed attorney. It is my belief that there is a time and a place where an attorney may be needed. Not now, not in the beginning, not until you have recovered all money available. (An attorney can only charge on new money, anything we have recovered prior to their involvement, is off limits.) #3, a Licensed Public Adjuster. The difference between a Licensed Public Adjuster and the adjuster you insurance company sends could not be clearer. They work for the insurance company, we work ONLY for You, the Insured!
Good Will – If you had what looked like a total loss to the average person, your insurance carrier may have come out within a few days, and issued the full payment of the aggregate limit of your policy. While this may look like they are attempting to “do the right thing”, it is actually a very specific Texas Law that states an insurer MUST pay the Aggregate Limit shown on the declarations page of the policy if the Dwelling was considered a total loss… Within FIVE Business Days of the loss. By doing this, insurers abide by the law, and create a a false sense of “good will”. Why do I feel this way? Facts. Thousands of claims. Ask yourself this one question. Did they pay 100% of my CONTENTS upfront? No… Why not? Because it is not included in the law.
Contents – Have you received all the proceeds towards your contents… or just a portion.
ALE or Additional Living Expenses – Are you staying somewhere comparable to the home that was damaged? For how long? Is it farther to work, to school… to anywhere? Your policy accounts for every single aspect of a loss, whether your adjuster tells you this or not. (It is very easy and very profitable for an insurer to conveniently forget these things…)
Debris Removal – Normally additional monies are set aside… notice the keyword ADDITIONAL. These are amounts in EXCESS of the aggregate limit the adjuster did not tell you about.
Landscaping – Again… normally additional.
Special limits – Did your adjuster sit down, and explain things like jewelry, antiques… guns… all have limits. Example: You have 10 guns worth $500.00 a pieces totaling $5,000.00. You put all on contents, believing they are all covered. There is normally a $2,500.00 limit. This would automatically cut that price on your inventory by $2,500.00.
Replacement Cost and Contents – If you bought a couch for $800.00 dollars two years ago. And you list the couch at that price. Then, when you purchase, you realize with inflation, the same sofa is now $1,100.00. When you submit for “reimbursement”, the adjuster on the other end of the phone… the bean counter… asks you why you are trying to profit from this… The couch only cost $800.00 and you charged $1,100.00… SHAME on you! REALITY CHECK, REPLACEMENT COST COVERS THE COST TO PURCHASE THE ITEM TODAY, NOT TWO YEARS AGO. THIS IS COVERED TO THE FULL $1,100.00 OR THE LIMITS OF YOUR POLICY, WHICHEVER COMES FIRST. (Shame on them for attempting to use your morals to shame you into less than you are owed!)
Inflation Guard/Index – When was your policy purchased? It makes a huge difference. If you purchased your policy in January of 2015, and received a total loss on December 26, 2015 your policy was at a high level of maturity. This can mean many things depending on the policy, but most equate to the same bottom line. The Aggregate Limit of your policy will INCREASE according to the index used at the time of policy inception. Again, in simple terms, when the Aggregate Limit raises, almost every single limit in the policy raises, because they are all directly tied to that limit.
Building Ordinance and Law vs. Warranty and Common Practice – This is probably one of the trickiest portions of a policy. Too much to even attempt to explain with a bullet. 😉
Overhead and Profit – Do they owe it… Of course they do. Unless the policy specifically states otherwise… and I will need to see that one for myself.
Increased Coverage – Do you have a very commonly up-sold endorsement that increases the limits… I had a gentleman walk in the other day who thought he was completely underwater with what was paid. When I checked his declarations page, and pointed out there was an additional 50% of the stated Aggregate Limit available… he about fainted. The additional limit mounted to at least $105,500.00 ADDITIONAL!
To Rebuild or Not to Rebuild – In reality, that is no one’s business but your own. A decision that cannot be known until all the facts are uncovered and all monies available are accounted for. Then, and only then, should an Insured make that type of decision. Once they have all the tools.
Time lines – Texas has very, very specific timelines for an insurer to complete a claim… in short 15 days to acknowledge, 15 business days to investigate, and 5 business days to pay any “undisputed” amounts. There was not a declaration by Governor Greg Abbott extending the insurance companies time lines, therefore these are in effect. Keep in mind, like speed limits, these are not merely “suggestions”, they are laws, and they are broken as easily and frequently as we all break the speed limit.
It is not my job to get you more money. It is my job to perform every aspect of the claim to the best of my abilities. When that is done properly, the end result is more money… that was owed. I do not want them to ever pay more than they owe… I just want them to do what they promised…
Okay, okay… but how much if you do collect? 10% – Less than you tip you waitstaff…. who gets paid whether they perform or not… we ONLY GET PAID IF YOU GET PAID!
We have these, and many more answers to all the questions that you have.
An aerial image taken Sunday, December 27, 2015 shows the path of a tornado in Rowlett, Texas. Violent storms ripped through the North Texas area late Saturday, spawning tornados that killed 11 people. (G.J. McCarthy/The Dallas Morning News)
Feel free to come see us at the local office here in Rowlett, or Abilene, or Galveston… or the Norman, Oklahoma Office.