We must determine whether an insurer can be liable for TPPCA damages when it initially denied the claim but later paid the insured in full according to the amount of loss determined through the policys appraisal process. We note at the outset that the insurance claim process is inherently adversarial. The adversarial process begins as soon as a claim is filed and ends only when the resolution of the claim is finally determined and accepted by the parties.
If you do not feel as if your claim has been paid fairly, you have options.
Turn on any device that broadcasts a signal. One of the very first things to be bombarded with is… commercial after commercial, telling us to purchase insurance from this Insurance Carrier Automation Solutions company, or that company, always accompanied by a promise…
If you pay us now, we will be there if you ever need us.
If you believe that, at all, I have some ocean front property smack dab in the middle of Arizona that you can only see if you are drinking the Kool-Aid that is spiked.
As Hurricane Michael barreled down on Florida, we prepared to deploy. We knew it would be bad, in all of our walls we have put Shoulder Bolts to secure them.
Not the hurricane, the aftermath. So many clients with ocean front homes and in desperate need of seawall repair. When it actually came time to honor all those promises backed by premium dollars. For those of us in this industry who do not get paid until, and unless… we perform, knew precisely what was about to occur, and yet, were completely powerless to stop it.
If we were praising insurance carriers, every media outlet in the country would be begging to interview us. We are not praising them. We are condemning them for the monsters they are, and the profit driven catastrophe after the physical catastrophe.
It has been whispered about for decades.
Deny, Delay, and Defend. The dreaded triple D’s.
Most folks believe, erroneously, that carriers make huge profits by denying claims. The answer, while lying in plain sight, is whispered even less. The following article specifically speaks about what carriers have done, and how they have changed the laws, over a period of time, to remove their responsibility to us, a little at a time.
“Today, nearly half of Florida’s home insurance is provided by companies whose primary profit comes not from insuring homes but from diverting premiums into a host of side ventures.
Investors and executives in 2008 moved $1.9 billion in policyholder money out of heavily regulated insurers, where profits are capped and dividends are restricted, to separate companies that are owned by the same people, housed at the same address and sometimes use the same employees.
As soon as the money is moved, it is beyond the reach of homeowners who might need it to rebuild after a disaster.
It is also free to be paid to investors and owners as profit without interference from regulators.
Meanwhile, insurance executives complained about losses and state-mandated discounts, and pressured state regulators for permission to charge homeowners more — even to end rate regulation altogether.
The payments to themselves, by and large, were legal.”
Photo credit: Jimmy Patronis Jr., Chief Financial Officer of the state of Florida, meets with residents of Mexico Beach during a press conference with Florida Gov. Ron DeSantis at Mexico Beach on Thursday, September 26, 2019. [DOUGLAS R. CLIFFORD | Tampa Bay Times]
As a multi-state licensed Public Insurance Adjuster, one of those states being Florida, his statements, and his outlook on who we are and what we do, is appalling. This is coming from a top state official, whose erroneous opinions are just that, his opinions. Facts, those pesky little rascals, are nowhere in sight as my profession, along with attorneys, are blamed for the very deeds insures deployed prior to ANY catastrophic event occurring. As per usual, a vague, derogatory narrative directed at the only two professional industries that can legally help an insured after a loss. Both of which require licensure, and are policed more than all the carriers combined.
Because we are the ONLY TWO entities that can legally STAND UP and FIGHT those he is protecting… Insurance Companies.
Protecting? Yes, PROTECTING.
I call on him, and the entire state, to prove what he states. To prove that Attorneys for the Insured, and Public Insurance Adjusters, are in fact, the problem and not the solution. (While there are a few bad actors, that holds true in any profession, in every walk of life. The number of folks caught on the carriers side, including, but not limited to the carriers themselves, far exceeds that of both of our professions, combined. Apples to apples, and oranges to oranges, there is no comparison.)
Meanwhile, a few things to think about. He claims he supports a 30 day right of rescission, instead of the current three days after a state of emergency has been declared…
This is how out of touch they are. Currently, in Florida, after an Emergency declaration has been made on a loss like Hurricane Michael, the rescission period is extended from three business days to five business days… Found here, in chapter 626.854 which states, in part… ” (6) An insured or claimant may cancel a public adjuster’s contract to adjust a claim without penalty or obligation within 3 business days after the date on which the contract is executed or within 3 business days after the date on which the insured or claimant has notified the insurer of the claim, whichever is later. The public adjuster’s contract must disclose to the insured or claimant his or her right to cancel the contract and advise the insured or claimant that notice of cancellation must be submitted in writing and sent by certified mail, return receipt requested, or other form of mailing that provides proof thereof, to the public adjuster at the address specified in the contract; provided, during any state of emergency as declared by the Governor and for 1 year after the date of loss, the insured or claimant has 5 business days after the date on which the contract is executed to cancel a public adjuster’s contract. “
In other words, he does not even know current restrictions.
Click on the hyper-link, and you can actually see, we are already heavily regulated with rules slanted towards giving an insurance company every benefit of the doubt… Was never supposed to happen that way. They already have all the premiums, large corporations, and an unlimited supply of attorneys who will defend them.
What does the Insured have?
A life changing problem after filing a claim, and facing their insurance company, who has all the resources listed above, and many more.
One has to remember why we purchased the insurance product in the first place.
To file legitimate insurance claims if/when the policy provides coverage. It was never meant to be a vehicle for insurers to use the premiums to make massive profits and not pay those same claims.
At this point, you have to ask yourself, “Who in the world can stand up to the corporate bullies who are destroying the very lives of the people who paid them in ADVANCE to Protect them from financial ruin if a claim were filed.”
The answer is much less complicated, especially after insurers successfully gutted the AOB/AOC provisions allowing contractors who were more successful than individuals, to pursue them when they failed to uphold their end?
Two guesses: 1.) Attorney duly licensed to practice law. 2.) Public Insurance Adjuster duly licensed to adjust claims.
Now, you can truthfully answer why the two industries are constantly being attacked by both governmental agencies and insurance companies… they are the only one’s standing between you, the insured, and their massive profits…
Unlike many who oppose the profession, we have facts. We have performed a substantial amount of claims the resulted from Hurricane Michael. Not our opinions, not what someone told us… facts. But no one wants to hear about those pesky little bits of information that annihilate any questions one may have…
One of the most simple. “Did the carrier pay for a permit? OSHA regulations?” No… Those are both legal requirements imposed upon an insured to do the work caused by the catastrophic loss…