One thing that’s been coming up in the field lately during these inspections is the behavior the strange behavior of insurance adjusters field adjusters, the lower end level guys, not the managers that are pulling their strings, but the guys that are actually on the roofs or in the houses taking a look at the fire. Interestingly enough, we’ve seen a trend over the past few years, that is, is getting worse and worse. Claims departments are shrinking their firing experience guys or sorry, letting go of experienced guys who are making, you know, upwards towards 80 and six-figure 80,006 figures per year and they’re hiring these inexperienced guys to come and take their place for some reason, or just getting rid of these positions altogether. Case in point, an adjuster I met yesterday, we’re on the top of this building that has the roof damaged by storm damage, hail, wind-driven debris, God knows what else leaking inside the building a busted skylight. An independent insurance adjuster had already come out and met with me. He had determined that hail damaged the property, the insurance company opened coverage, this guy goes back he tells me that there’s hail damage to the metal around the building and the inside and things like that we get the estimate back and the estimates short it’s not covering the entire roof. So we send in our proof of loss, we send in our claim back, and basically proving the damage to the entire property. All the measurements needed all the photographs, probably about 300 photographs, I would say showing that the damage is in fact there. The insurance company then wants to send out an adjuster that works for them captive adjuster or a company adjuster to do a readjustment. So, I showed up and out man, I was about three minutes later. So he was already on the roof with a roofing contractor they had brought with him. So I noticed while I pull up, he’s just up there walking around. He doesn’t have a camera. He doesn’t have chalk. He doesn’t have a measuring tape. He doesn’t have a clipboard, he has nothing in his hands. That’s a red flag. Those of you guys that do Property Inspections already know that’s a red flag. So we get out he gets down off the roof with the flat roof. They reintroduce the ER selves to each other. He proceeds to tell me as we’re walking up on the roof that he didn’t know it was a tar and gravel roof because hail doesn’t damage tar and gravel. And so I’m just scratching my head and I say okay, well. Let’s go out there and take a look anyway. And so what we’ve got is we’ve got storm damage. We’ve got hail damage, we’ve got wind-driven debris. We’ve got dents in the metal that’s up there. We’ve got dents in the gutters. We have dents in the skylights, the broken skylight that leaked into the bathroom that caused all the interior damage that the insurance company already conceded to paying for. This guy proceeds to tell me that all of it looks like debris damage from the trees, the surrounding trees, and I’m scratching my head again. I said, Well, here’s the problem. Do you understand the definition of damage and the insurance policy? And he said, No, I’m here to look for hail damage. And this is a problem. There’s a point to this story. I asked him again, do you know the definition of damage in the insurance policy? And he says no, I’d have to read it. I said Well, let me tell you. property damage in this particular policy means direct physical injury to destruction of or loss of use of tangible property. And I said, nowhere in that definition does it say it has to be hail damage for you to go ahead and pay for what’s rightfully owed this policyholder? Oh, he didn’t like that. So I proceeded to point out damage as defined in the insurance policy, physical damage. property damage means physical and I printed this out too. So next time I’m going to probably laminate these pages for these guys that are out in the field. But physical injury to destruction of or loss of use of tangible property, physical injury to so here’s the issue, whether it’s called hail Whether it’s called wind-driven debris, whether it’s called the trees falling from the sky
doesn’t meet the definition of physical injury to. That’s the point. And that’s the point. I was trying to ask this guy. So you said it’s debris damage from the tree? Yes. He said, Yes. I said, Okay. What was to stop the wind from blowing these pre branches? This debris that you’re pointing out into this roof? He couldn’t answer me. I said well is debris damage from tree carried by wind excluded in the insurance policy. Because what we have here is a homeowner’s 0003 policy. It’s an 803 policy. So it’s a special foreign policy meaning all perils, and I know I might be talking gibberish to some of you guys, but I promise there’s a point here. My point is the adjusters in the field don’t understand what’s in the insurance policy. They’re just out there doing, what they’re being told by their supervisors, or their middle management, their upper management, things like that. The frustrating part for us though, in the field is, at what point are you negligent? At what point are you not doing your job? Where is the line drawn? And a lot of people will tell me, you know, take the high road, you know, they’re only doing their job, they’re trying to feed their family. Well, so is a Mafia Hitman. Okay? mafia Hitman is just doing his job. That doesn’t make it right. There’s still an ethical duty here. And I would say a sense of pride, where’s the sense of pride with people anymore, I would say that you would want to be good at the job you’re doing. That would be first and foremost in my mind. And if you don’t agree with ripping people off on purpose, then maybe you should be in a new line of work. I would tell some of these insurance adjusters that are on some of these files to, you know, switch sides try to work in public adjusting the problem is they wouldn’t qualify because they don’t know how to read a policy. I’m not trying to be mean, I’m just telling you what I’ve been observing in the field the past few years. The End, guy, the field adjuster on these properties is not equipped to handle the property claim. I know that’s a blanket statement. That’s not in every case. I’m not. But I’m not overly generalizing either. It’s the majority of the time that’s the case. When when we’re involved on a claim. Now, I do have a bit of bias there. We are public adjusters people pretty much only call us when they’re already upset. So there is that? Nobody calls us when their claim went, right. I do. I do concede that point. I understand that. But why are we being called at all is my point. And why are we being called in such an increasing number? Why are we getting so many phone calls? Last year, it was one particular insurance company the year before that it was another everything goes in cycles. So we’ve been noticing this pattern. I noticed that right after an insurance company has large Claims Department layoffs. All a sudden claims start getting denied left and right. I wonder why. It’s weird, right? I’m just showing a pattern. I mean, I mean, pointing out a pattern. But I go back to my point, you know, these guys are just doing their job. They’re just trying to feed their family. But when there’s blatant storm damage to a roof, and you’ve got a family who has interior leaking possible growth, because it’s being stalled by their insurance company. At what point do you look yourself in the mirror and say, hey, maybe I’m in the wrong line of work. I don’t know that I should be purposefully defrauding people out of their money as for a living, I, maybe I need to get better at my job. Maybe I need to go work somewhere else. If that doesn’t occur to you, then I guess you’re in the right line of work. But increasingly, I mean, like this example. I’m talking about yesterday. The guy kept saying he was up there to look for hail damage. And I said, Well, how is that? He said that’s just what I’m here to look for. I said, Well, we sent in proof of loss. Proof of last name, storm damage is the cause of loss. In storms, there is wind and hail. And you’ve already told me that you think this is debris damage from the trees. And I don’t disagree. I don’t know what exactly happened here because we weren’t standing here. But I will tell you that it’s not excluded in the policy. And again, he’s getting mad. He doesn’t know what’s in the policy. He’s telling me Well, we’re done here. I didn’t know we were done. I pointed out the fact that he wasn’t even holding a camera. He wasn’t taking pictures of anything that I was pointing out or anything that I was circling with the chalk he wasn’t taking pictures of any of the metals or the guttering or any of the things that he was calling tree damage or debris damage.
He wasn’t taking pictures of any of it. When I pointed that out to him, he said, Okay, okay, and this was 22 minutes into the actual meeting into the actual investigation. They said I’ll go downstairs and get it. I said, Well, yeah, you, that’s probably a good idea. In any case, the red flag that that throws up for me is he actually went out there to deny this claim, or to limit the claim as it was, he wasn’t going out there for a fresh set of eyes. He wasn’t going out there to do his own investigation, he went out there with an agenda. And his agenda was to backup whoever told him that hail doesn’t damage tar and gravel rocks. That’s the only explanation that I can think of. And it happens more and more often lately. The guys go out there with a preconceived notion or an agenda to do one thing or the other before they actually put their eyes on it and make a decision. And that’s part of my point, these guys in the field anymore. They’re not making decisions. They’re not authorized to do anything other than what they’re told. I asked the guy at one point if he was authorized, even settle $124,000 claim, and he kept ignoring the question. And finally, he said, No, I would have to call my supervisor. So what are we doing here? If you can’t even make a yes decision? You know, the insurance company has a duty to negotiate things in good faith. And negotiate might be a wrong word, but to settle their claims in good faith, good faith, meaning hold up their end of the bargain in the contract, they wrote that the policyholder agreed to their insurance policy, right? The insurance adjuster is there to seek and find coverage wherever coverage can be found. His job is to investigate the loss and find coverage, apply it, and pay it properly. How can he do that if he’s not authorized to do so? How can he do that if he has to answer to three other people to even get approval? That hail damages, tar and gravel roofing after another adjuster had already been out to say that hail damage this roof system, so much so that it busted a skylight and caused a bunch of interior leaks. Some of these situations are really bizarre, but one of my topics right now is I think we need to give these guys a little bit of a break. I understand they’re not mafia hitmen? I get that I know that it’s a strong analogy. But the point still remains that how can you be okay with withholding benefits that you know are owed to somebody. And so let’s go further than that, and give them the benefit of the doubt. Maybe they don’t know the benefits are owed to somebody because they don’t read the policies. So that popped into my head. So they’re being brainwashed by the people that are training them, nobody’s giving them the policy to read. And so they don’t understand what they’re doing is defrauding the homeowner or the policyholder or the building owner out of their contractual? More money that they’re owed the contractual, they’re defrauding the policyholders out of what they’re owed per contract by the policy. They don’t know. They don’t know it. So further than that, though. Let’s go down another rabbit hole if they don’t know it, because they haven’t read it. Why wouldn’t they take the effort to be really good at their job and learn how to read it? what’s to stop him from doing that? So now I’m back to it’s still their fault again, right? I don’t know. People could argue about that back and forth all day long from both sides of the aisle. I do know that it makes it really hard for a policyholder who is owed to be indemnified, according to their insurance policy. This entire situation makes it really hard on them to fix their property to fix their house to get back in their business. You’ve got adjusters that are stringing people along because they’re inexperienced with whatever they’re dealing with. There’s a fire in Texas we’re working on right now. The adjuster won’t even call anybody back three, four weeks later, we’ve confirmed he still works there. What the girl behind the desk that I talked to today can only surmise is he’s in over his head and doesn’t know how to adjust fire losses, which is fine. I get that if you don’t know how to adjust a fire loss, just let us know. But don’t tell us that our proof of loss we’re sending in is wrong. Because how would you know and I think stalling the policyholder’s benefits so they can get their life back together is wrong. I think Think that somebody somewhere needs to be held accountable. But then what do you do? Do you hire a lawyer?
Do you complain to the insurance commissioner? Do you hire a public adjuster? Do you take it to appraisal? What can you do? That’s what we have to deal with on a regular basis, every single day, we’re dealing with what comes next. What do we do? What can we do to make these people abide by their promises in the policy that they wrote? And sometimes that can be frustrating. And you think about it, if we’re frustrated, how do you think the frickin policyholder feels? How do we think the customer feels you contractors out there that are having to deal with this on a regular basis? You know, you know how this affects your customers, you know, how it affects you? What can be done about it? Now, there’s a question. I honestly think that these days, it’s shifting more towards public adjusting as a field. It’s, it’s, I’m not saying that as a shameless plug, or as an advertisement. I’m just saying that we’ve experienced tremendous growth over the last three years. And there’s a reason for it. Because the worst the insurance companies treat these policyholders the more they call for help, they got to call somebody. And now you’ve got associations and you’ve got insurance, regulatory committees and things like that trying to turn contractors in for public adjusting without a license. So where are they supposed to turn? So you know, that you can do the best you can do you want to meet the adjuster with a smile, understand that he’s probably not there to do anything wrong that he knows of because he doesn’t know how to do his job. The insurance company probably didn’t teach him correctly, or he’s new, or heat. Now, don’t get me wrong. There are genuinely bad guys out there that commit fraud on purpose. I know of two of them. And I as far as I know, there’s things in the works trying to get those guys what they deserve. But, you know, that’s that those are isolated cases. I don’t think most adjusters are out there being malicious. I don’t think they’re out there to defraud the policyholder from the get-go. I don’t think they’re doing it on purpose. I think that they’re not given the tools in some cases to do their job properly. Still doesn’t make it any, any less wrong way. Yeah. So here’s, here’s another side of that coin, who is responsible when an insurance company is not acting in good faith towards their policyholder? And if it’s not the end of the field guy’s fault, because he’s doing what he’s told. And it’s not the middle manager’s fault, because he’s doing what he’s told And whose fault is it? Whose fault is it when the insurance company is screwing over their policyholder when they’re actually committing fraud against their policyholder when they’re not abiding by their contract when they’re acting in bad faith when they’re breaking the law? By stalling and not providing correct investigations by sending out unlicensed adjusters. They’d like these latter assists. who’s who’s to blame for that? I think it’s a question we all need to think about. I’d like to hear some comments about that and what you guys think. I’ve got my own opinions, but if I set them all on one in one shot, then we wouldn’t have anything else to talk about later. As the market shifts towards needing help with property claims, just know that we are here to help. We’re not the only firm in town, but I am a little biased on that too. So I think we’re the best. Let us know what you think would feel. I’d like to know any questions you guys have any topics you want to touch on? And always remember, you’re in better hands with a public adjuster.