Think taking a terror-filled
ride on Zumanjaro is the
ultimate scariest you could
possibly feel? Then you
probably have not been
through the life-changing horror of a major
insurance claim. No doubt about it, the
Six Flags Great Adventure ride in New
Jersey is sure to suck the life out of you with
its 415-foot drop reaching 90 miles per
hour in just 10 seconds. Getting a phone
call explaining that your building is on fire
or the roof collapsed, however, will overcome
any fears of Zumanjaro.
There are so many angles to an insurance
claim that it is virtually impossible to
write a guidance manual on what to do,
how to do it, or – even more importantly
– how to avoid the possibility of seeing your
hard-earned work collapse in rubble. But
there are ways and means to help prevent
insurance catastrophes and I’d like to
share some with you.
Protecting your investment
Every establishment has some type of insurance
policy, but coverage is such a
boring and mundane topic most of us do
not dwell on it and quickly file documents
away once established. Business interruption
coverage is very common, but if a
claim is made there is plenty of work the
insured must do to prove the loss and this
may come as a surprise to some. First
suggestion: Keep good records and keep
those records updated and in a safe place.
Over the years, I have worked on both
sides of an insurance claim. I’ve been hired
by insurance firms, adjusters, forensic investigators,
public adjusters, as well as the
insured themselves. Having seen both
sides of the equation, it becomes quite
clear how much knowledge and communication
is lacking.
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A good example is a file on which I was
engaged by the insured. This company
runs a profitable and well-organized business.
A major weather-related structural
failure in part of the company’s plant
caused half of its machinery to become
involved in a serious claim due to water
and falling infrastructure. Months later, I
was called to come and access some of the
damaged machinery. The claim had gone
nowhere and, as is quite typical, the insured
called in a public adjuster. Public
adjusters are firms that work specifically
for the insured and not the insurance
company. This happens quite often when
things get testy between parties. They are
well versed on the protocols of a claim and
the mechanics required to settle one. Public
adjusters typically work for a percentage
of the claim and this comes out of the insured’s
settlement. In this case, the machinery
sat exposed and rusting in the
elements. To make matters worse, the
surrounding areas were dangerous and
essentially off limits.
At the on-site meeting about the accident,
you could cut the tension and anger
with a knife. Adjusters are firms that are
hired by insurance companies to access
and recommend needed steps to get the
insured back up and running. Although
the majority of adjusters are competent, as
with any industry, there are also some
disappointments and blow-hards that
work to grind the claim process to a virtual
halt. Obviously, insurance companies
know they have responsibilities but they
also want to mitigate the claims and pay
out as little as they can. The word mitigate
is important here, because it is not as well
discussed that the insured must also try to
mitigate their claim too, taking any steps
to preserve or reduce damage to equipment
and furnishings. |
In this case, we had a disturbing adjuster
who seemed to relish his role and enjoy
the fact he was being paid handsomely to
travel across the country, write reports,
argue the merits of visible damage and
drive just about everyone – especially the
insured – to look for sharp objects.
Dealing with claims
After months of deadlock, thousands of
dollars spent to argue the claim, total disruption
of their scheduling, lack of key
machinery. which in this case was very
specific and hard to replace, it came down
to total anger. Usually a competent adjuster
can come up with a good plan. He or she
knows, that when it comes to machinery,
the best the manufacturer can do is provide
a ballpark repair quote and a new replacement
price. But what happens when
the repair comes without a firm warranty?
In almost all cases, it does not. And so the
claim discussion moves forward around
getting new replacement machinery,
which is a significant discussion point to
understand.
Talk to your agent and tell them you
wish to be covered for full new replacement.
If not, the claim continues down a
rabbit hole: “The press is 12 years old?
Then we need to value such an asset prior
to the claim.” This is the essential problem
and an active files quickly becomes a
bickering and depressing period that can
take years to settle and will in the end,
probably – surely – mean you will come
out of the whole ordeal worse off than you
were before. Even with various opinions
and quotations (for repairs), if the adjuster
is lacking in specific knowledge and does
not go out and seek someone who can
provide this, then it may be impossible for
both the insurer and the insured to agree
on a fair settlement.
There is, of course, another side to the
insurance business in faulty claims or at
the very least a case of very suspicious
origins. We were called in by an insurance
company over a claim to do with one machine
– almost brand new. The story was
an apparent break-in and vandalism on
the press. Rags and paper were set alight
placed on various parts of the press and a
few control cabinets were tipped over. The
heat activated the sprinklers which then
put out the fire but drenched everything in
the plant including offices.
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