Things Adjusters Say: We don't pay for that
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- Опубліковано 13 тра 2016
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"We don't pay for that."
"That's included in...."
Many times, especially in roof claims, adjusters try to argue that certain items are either "included" as part of other line items, or are "not paid for" as a matter of "company policy."
Here's my argument for that.
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Thanks all. I have been led to believe it is the carrier denying the items and not the adjuster. But now that you have cleared it up for me I can better understand. You all are awesome. I am learning as I go and having the expertise of you all really helps.
The carriers pay for things that these dudes are denying. I bet they get sued all the time.
Thats a great video. Lot's of information and ideas. Thank you
Alina Polly thanks. I appreciate your feedback.
Have you read Jay M. Feinman book - Delay Deny Defend? It's a great read. This book tells how the insurance industry went from customer base platform in the 1990’s to making profits platform where it’s designed to give homeowners a low ball offer on there Claim as quickly as possible in hopes that homeowners will except the low ball offer and increase the insurance company stock holders shares in the Billions of dollars. Yes Billions. It’s a great way for homeowners to understanding how to play the Claim Game.
I have read Jay's book. It is one of the best books for our industry. Those who want to know why things are the way they are, should absolutely pick up a copy: amzn.to/2CklDnJ
In water mitigation. We rely on s500 guidelines. We put our foot down if adjuster complains about something that should be necessary. Usually theres a little back and fourth, but eventually theres an agreement between business owner and adjuster.
Correct me if im wrong But, the adjuster isnt the final decision. Usually he reports to a boss or more experienced overseers and requests ultimate denials or approvals
Final decision is what the insured accepts as final. With the number of appraisals I'm doing these days, the final decision is more often with the Umpire.
Never, ever, ever accept the adjuster's first "offer". It will be 50% of what the carrier is willing to pay without a fuss.
Claims Delegates my process isnt the same. I do a job. I write up the estimate on xactimate. On rare occasion, we get a dispute back on negotiate . Usually trying to nickle and dime on labor minimums, etc
Your honest brother
Thanks David, I try.
I renovate homes and this last 7 year dealing with insurance is he'll they don't have the funds but the pay millions on dumb commercial
Ive had the same conversation with adjusters about ridge cap and starter shingles. I simply ask the adjuster to print out the material components sheet and give me a takeoff. Ok now show me where the starter shingle and ridge cap is.
The program is called xactimate.😂😂
Any advise on vandalism claim? The adjuster is not being fair when it comes to labor cost.
"We all lose when the customer doesn't have a choice."
As an independent insurance adjuster that contracted for a few years prior I disagree and would like to refute these accusations but “You can’t fix stupid and you really can’t argue with stupid.” So Ill just say have a good day and good luck getting the most for your home owners with that ignorant attitude.
Thanks for stopping by anyway.
The way for good honest general contractors and contractors can fight back is to get the homeowners insurance agent involved with the claim before build and if you let the agent know that if their customer doesn’t have a great claim experience the homeowner will cancel their policy and take there business to another carrier who love to take there business. Agents have all the carriers extensions to escalate the claim to hire ups. Agents don’t want to loose commissions or bonuses if there customers start to leave because of bad claim experiences.
I’ve been an adjuster for 14 years, large and small loss, and IDC if the contractor writes his estimate on a napkin, but if there’s a substantial difference he’ll need to explain it in writing. If it’s legitimate, then it should be added. As for ridge cap, if it’s a simple gable 3 tab w no dormers, there is enough for ridge within 10%, but if there’s dormers, valleys, etc, you’ll be tight or run out even. Ridge on lam is certainly not included, although I’ve seen some silly roofer use field shingles to make the ridge/hip... even on a 8/12... yep, silly
Why is is onus on the contractor and not the adjuster to prove it's not needed? Quit putting the work back onto the contractor.
Restoration Education I was assuming you were asking the insurance company to pay for repairs. Yea, you’re right. If you’re not asking for anything from anyone, then of course you don’t owe ANYONE any answers.
If you knew anything about roofing you would know that on the face slopes 5 percent waste is sufficient with a decent crew. I order face slopes material as such an I'm never short. The additional waste of either 10 or 15 percent covers the amount for the ridge and starter. Do the math on a gable or hip, or three tab vs laminate. I've been a roofer and adjuster for 30 years combined. Most insurance companies pay a damned good price on roofing. Thus the amount of storm chasers.
any adjuster looking to deny any portion of a claim that is covered is a moron and does not belong in the field
if you can prove it report them to the DoI for bad faith handling of claims.....or go to mediation if enough money is on the line.
Dark Light any more advise on bad faith handling ?
Bad faith entails a licensed adjuster knowingly denying a claim followed by two additional denials for the attributed item denied. In other words, it's not as simple as your statement implies. They are there to help the PH, not deny claims for actual damage. No gain by calling them morons followed by reporting them. No gain, just negative energy.
"unwritten rules"....no YOU are incorrect
good luck getting preferred contractor status.....the POLICY is the POLICY...and yes, IT DOES DIFFER FROM POLICY TO POLICY....you need to learn policies.....and not make stupid videos because you can't understand policies and CCCR regs
Dark Light Easy there mystery man. Maybe you should try using your real name before insulting strangers on a public forum.
Dark Light Spot on! It’s not a matter of being a contractor it’s a matter of ignorance and little education
So an adjuster is a snake 🐍
no, not all. Most just want to do their job and not get killed by their audits.