How to navigate the commercial claims world. Wade Tutt President Paramount Adjusters

Transcription

1 How to navigate the commercial claims world Wade Tutt President Paramount Adjusters

2 Topics we will Cover Stating my purpose 3 different type of adjusters Terms Experts Paradigm Shift Indemnity/What do they owe Burden of proof-what is damage Lack of maintenance/ Wear and tear / Old roofs Xactware 360 Process for Temps Shrinkwrap vs.tarp vs. Foam Process for Replacement Full Depreciation O&P Time When to call the insured experts PA/Appraiser/Attorney Q&A

3 My purpose today Educate you on the Commercial Claims world Inform you so that you and your clients can make educated decisions Give you another tool in your tool belt

4 Getting to know each other Little about myself Insurance work? Non-Insurance/Bid/Retail? Commercial/Multifamily? Residential? Annual Revenue? >10mm >20mm >30mm

5 The three types of Adjusters

6 RCV Depreciation ACV Insured Insurer Insurance Policy Ordinance and Law Insurance Terms

7 Experts used in investigating claims Can interpret and discuss policy Staff Adjusters Independent Adjusters can discuss policy depending on state and license Public Adjuster Attorneys Cause and Origin Expert Certified Industrial Hygienist Insurance Agent has no influence in claims Forensic Meteorologist Appraiser Umpire Forensic Accountant Contents Appraisers Cannot interpret or discuss policy Roofing Contractors Engineers Roof Consultants

8 Paradigm Shift Today insurance in the US is a trillion dollar industry P&C insurers $440 Billion in premiums collected $250+ Billion in claims paid out $250+ Billion is the size of the insurance restoration industry 90 s Mckinsey & Company = Good Hands to Boxing Gloves

9 Indemnity / What they owe Compensation to a party for a loss or damage that has already occurred, or to guarantee through a contractual clause to repay another party for loss or damage that might occur in the future. The concept of indemnity is based on a contractual agreement made between two parties in which one party (the indemnitor) agrees to pay for potential losses or damages. IRMI.com

10 Indemnity / What they owe An RCV policy means that the carrier owes old for new. Functional vs. Cosmetic Damage Damage is damage unless specified in the policy Returning the property to the pre-loss condition If you did not have 30 patches or 200 of new seams before the loss then the property should not have that after the loss

11 Indemnity / What they owe

12 Indemnity / What they owe

13 Indemnity / What they owe Standard BOP Loss Payment Provision:

14 Burden of Proof / What is damage It is up the the insured to prove their extent of damage. Carrier has a legal responsibility to to a prompt investigation and payment (IL Statute) If there is a disagreement in that investigation or payment its on the insured to prove it

15 Burden of Proof / What is damage Roofs Fail in 3 places Seams Flashings Penetrations

16 Burden of Proof / What is damage

17 Burden of Proof / What is damage

18 Burden of Proof / What is damage

19 Burden of Proof / What is damage

20 Burden of Proof / What is damage

21 Burden of Proof / What is damage

22 Burden of Proof / What is damage

23 Burden of Proof / What is damage

24 Burden of Proof / What is damage Tile

25 Burden of Proof / What is damage

26 Burden of Proof / What is damage

27 Burden of Proof / What is damage

28 Burden of Proof / What is damage

29 Burden of Proof / What is damage

30 But it s a old roof? When a policy is put in place it insures the property for the condition that it is currently in If it is uninsurable then do not offer coverage or exclude coverage due to age Depreciation is the measure carriers use on old roofs Wear and Tear exclusions Underwriting

31 Underwriting Case Study

32 Underwriting Case Study DATE OF LOSS : 3/9/17 WIND STORM DAMAGES PROPERTY CLAIM FILED : 4/25/17 PROPERTY INSPECTED : 4/26/17

33 Underwriting Case Study WAS IT COVERED?

34 Commercial Claims Estimating Xactware 360 Where and where not to use Xactimate

35 Commercial Claims Estimating

36 Commercial Claims Estimating

37 Process for Temps / Drying in What do you currently do? Documenting what is temporary and why Duties after a loss Alternative materials for Temps

38 Process for Replacement Understanding the depreciation Ensure you go back with what is there or better

39 General Contractor Overhead and Profit Anyone know their exact overhead How GCO&P is calculated in premiums Why its owed

40 General Contractor Overhead and Profit

41 What s your most valuable asset? Time! Its really clear that the most precious resource we all have is time Steve Jobs Be an expert at what you are an expert at and surround yourself with experts with what you are not an expert at. Don t guess or try to figure it out with millions of dollars of your clients money.

42 When to call the experts Every time that you have a large potential loss A phone call costs nothing Understand that whatever that expert costs that value will increase significantly. National Average for a increase by a skilled Public Adjuster is over 700%. Sounds crazy but imagine..12, million

43 Remember that Revenue Question? If you are on 30 roofs a month and the average roof for a full replacement is $300k. And one of those has wind/hail damage that equates to: $3,600,000 in revenue!!!

44 Questions?

45 Thank you!!