Remedies for the Underinsured and Settling Valuation Disputes

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1 Remedies for the Underinsured and Settling Valuation Disputes Roadmap to Recovery Workshop #10 Unitarian Universalist Church 547 Mendocino Ave., Santa Rosa United Policyholders 2018 ALL RIGHTS RESERVED

2 Thank you to our partners and volunteers Tipping Point Community Emergency Relief Fund City of Santa Rosa Sonoma County California Department of Insurance California H.O.P.E. Unitarian Universalist Church Fred Booker Kian Nobari, Integrous Financial

3 About United Policyholders 501(c)3 non profit organization. A voice and an information resource for consumers in all 50 states. A 26+ year track-record and subject matter expertise in insurance and disaster recovery Not for profit not for sale. Funded by donations and grants. A volunteer corps with personal and/or professional expertise in disaster recovery and insurance.

4 The Fine Print This workshop is intended to be general guidance only, not legal advice. We don t endorse or warrant any of the sponsors listed at or speakers at our workshops. Our speakers are volunteering their time as educators.

5 Schedule of upcoming events Useful publications and articles Videos of previous workshops at bottom of page

6 Upcoming Events 1 on 1 appointments with volunteer lawyers Saturday, June 9 th -10am 144 South E Street, Santa Rosa (Legal Aid offices) RSVP to Kjarvis@LegalAidSC.com Roadmap to Recovery Workshop Thursday, July 19 th, 2018 Unitarian Universalist Church 547 Mendocino Ave., Santa Rosa

7 FREE FINANCIAL PLANNING 1 hour sessions hosted by the FPA Saturday, June 2nd, 11am-3pm Abacus Wealth Partners, 101 S Main Street, Sebastopol Saturday, June 9th, 10am-2pm Ameriprise office, 611 Humboldt St, Santa Rosa Saturday, June 21st, 11am-3pm Ameriprise office, 611 Humboldt St, Santa Rosa Book 1-hr appt

8 Ask an Expert Forum Register. It s free. Write in your questions. Get an answer from an expert in construction, insurance, laws and disaster recovery. Your name stays private

9 Here tonight: Amy Bach, Policyholder Advocate, former plaintiff s litigator Sandra Watts, ResolvedSF, former 25+ year claim professional Hon. Paul L. Beeman, Mediator, ADR Services Susan Feder, Mediator, Judicate West Tony Cignarale, Deputy Commissioner, CA Dept. of Insurance Kendall Jarvis, Legal Aid Sonoma County, Disaster Relief Attorney Gabe Osburn, City of Santa Rosa, Deputy Director of Development Services in Planning & Economic Development

10 Remedies for the Underinsured: Find/use leverage and convince insurer to pay above limits Their fault, they gave you reason to believe your limits were adequate Their mistake, their faulty underwriting They undertook duty to set limits adequately Seek a retroactive reformation of policy limits and offer to pay the difference in premiums Sue your agent/broker/insurer as an individual or in a group suit Sue another at-fault party

11 Step 1 Check your policy for obvious errors Your insurer may have insured the wrong address or the wrong square footage. If you can establish the error was not your fault, you will have a strong case for increasing your limits to where they should have been.

12 Step 2 Calculate cost to rebuild as-was (what your home should have been insured for)

13 Step 3 Review history of how/when your dwelling limits were set Did you remodel? Re-finance? Change insurers/agents? Did something trigger you to contact insurer to seek reassurance? Did you get reassurance of adequacy of your limits?

14 How often did you speak with your agent/insurer or did you buy your policy online? What, if any, specific conversations do you remember? How did your insurer/agent explain your coverage (including ads, mailers, orally and in writing)? Did you fully cooperate with all requests for information and requests for inspection from your agent/insurance company? Did you ever refuse a recommended increase in coverage? Did you notify your insurer of major improvements or remodeling?

15 Step 4 If possible, seek out and compare notes with other property owners who are or were underinsured by your same agent and/or insurance company. If others got your agent or insurance company to retroactively increase their limits, find out what evidence and arguments won the day for them.

16 Step 5 Make a clear, written demand that your insurance company and/or agent or broker honor the promises that were made to put you back where you were before a loss. Go up the chain of command, and take all steps necessary to enforce that demand.

17 Let your insurer know that you are underinsured through no fault of your own. Tell them the exact amounts by which you are underinsured. Provide them with the documentation outlined in Step Two, above. If your insurer responds by sending you a written questionnaire with questions that get at how your limits were set, see Step 6.

18 Step 6 Consult with an experienced policyholder attorney. Ideally, before allowing your insurer to interview you, take your recorded statement, examine you under oath or get you to answer a series of written questions about the history of your policy. Visit the Find Help section of United Policyholders website as a starting point to find the right lawyer.

19 Getting an insurer to pay more than their contract says they owe you is not easy. But although a contract is a legal written document, there are invisible terms that our laws add to them to make sure they re enforced fairly. Every insurance policy sold in the State of California and most other states, has an invisible clause that the insurance company must act in good faith and deal fairly with you. Insurance companies and their agents cannot deceive or mislead you, and they must live up to promises they made to you.

20 Step 7 When UP conducts a recovery survey, participate! File a complaint with the CA Department of Insurance. Keep your complaint simple and general. Don t go into specifics about your dealings with the agent/broker/insurance company. Identify your company and the approximate amount of the shortfall.

21 Negotiation - Best Practices Keep it professional Be concise and to the point Bold or bullet point your requests Avoid long paragraphs Use good grammar and punctuation Promptly respond to letters and reasonable requests Point out unreasonable requests common sense is on your side Avoid venting frustrations and emotions to your adjuster

22 Aim for an agreed upon scope of loss In-person meeting with adjuster can be productive Your contractor/subs should be able to stand behind his/her numbers Know the areas where you differ, and why

23 Honorable Paul L. Beeman (Ret.) ADR Services, Inc. With nearly 18 years of judicial service, Judge Beeman has presided over a wide variety of civil matters and brings that wealth of experience to his dispute resolution services. Judge Beeman served as Presiding Judge and Supervising Civil Judge of the Solano County Superior Court, and was the chairman of the Court s Alternative Dispute Resolution Committee for 12 years. Prior to his years on the bench, Judge Beeman spent over 26 years as a trial lawyer in private practice, where he tried more than 30 civil and criminal jury trials, and arbitrated and mediated more than 150 cases.

24 Susan G. Feder, Esq. Judicate West Susan has been a full time mediator since Before becoming a mediator, Susan was a business litigator with an international law firm, practiced in-house as litigation counsel for a large national bank, and since 1985, has closely followed personal injury cases of all types. Susan has the ability to skillfully uncover the real issues fueling the dispute and redirect the parties towards settlement. She guides the negotiation with empathy and exhibits genuine care and concern for the embattled parties. When not mediating privately, Susan assists the burdened Court system by settling cases of all types, and works with schools and parents to resolve educational conflicts.

25 Settling insurance disputes When negotiations stall/fail Mediation option All items in dispute Some items in dispute Dispute must be ripe Agreed scope of mediation

26 The Big Three Underinsurance Valuation Disputes Coverage questions

27 Mediation Mediation is an informal, voluntary, non-binding process for conducting settlement negotiations between you and your insurance company. You must PREPARE

28 Inexpensive Mediation Pros If you don t like the result, you can walk away Efficient way of putting the dispute behind you and moving forward Educates both sides about the strengths and weaknesses of their positions

29 Mediation Cons Insurance company may not be seriously interested in settling, but uses mediation to gather evidence and test the strength of your legal case Mediator may inappropriately discourage/scare the policyholder to force a settlement Mediator may tell insurance company things you ask them to keep secret Insurance rep may take advantage of your inexperience with the mediation process and legal concepts You may leave the mediation feeling it was a waste of time and money

30 California Department of Insurance Tony Cignarale Deputy Commissioner - Consumer requests for assistance - Insurance company oversight - A statutorily created mediation program

31 Legal Aid of Sonoma County Kendall Jarvis, Disaster Relief Attorney FEMA appeal clinics 1 on 1 clinics w/volunteer attorneys

32 Guidance available in the UP Claim Help Library at Speak UP: Going up the chain of command Insurance Appraisal Simplified A Policyholders Guide to Mediation Hiring Professional Help Sample Letters (

33 Q&A with tonight s speakers and guests Amy Bach, Policyholder Advocate Sandra Watts, ResolvedSF, former State Farm claim professional Hon. Paul Beeman, Retired Judge, ADR Services Susan Feder, Mediator Judicate West Tony Cignarale, Deputy Commissioner, CA Dept. of Insurance Kendall Jarvis, Legal Aid of Sonoma County Gabe Osburn, City of Santa Rosa, Deputy Director of Development Services in Planning & Economic Development