Meet All Your Obligations

1. Protect against damage Following

   structural damage from wind, earthquake, or any other calamity, you must ensure that you do everything to the best of your ability to mitigate any further damage. This is non-negotiable. It includes boarding up your doors and windows, tarping your roof, drying out the floor, and ensuring every emergency repair has been instigated to protect against further damage. Most often your policy professional mitigation services following a loss

2. Provide prompt notification of your loss to the Insurance provider

   It’s important to provide notification of the damage to your insurance company as soon as possible. Most insurance companies have 24/7 toll-free helpline numbers. Just give them a call and notify them of the loss. You might also consider notifying your insurance broker or agent about the damage. They might help you with some Do’s and Don’ts of the claim process, but they cannot directly influence the claim in any way.You must provide honest, detailed information about the loss that was incurred and refrain from making any exaggeration or speculation, as giving a dramatic overstatement can significantly impact your claim.All insurance providers have a specific timeline for reporting an insurance claim, and you must be aware of your specific policy. There are specific time limits on how long you have, after incurring the damage, to file your claim. The longer you wait from the initial date of loss, the more challenging it is to certify the full extent of the damage.If you have minor property damage, like after a severe hailstorm, you can call your insurer to report the damage and follow up with photographs of the damage. If your deductibles are greater than the actual damages you will receive for damage repair, just cancel your claim and proceed with out-of-pocket repairs.

3. Complete a thorough inspection of the damage

   Your insurance provider has every right to investigate your damage and come up with a suitable claim amount. It is their obligation to conduct a thorough investigation of the site shortly following the initial report. You must leave your damaged property unchanged until they conduct this investigative assessment. Apart from the initial repairs, to mitigate undue damage you must leave everything in and around the affected property unchanged.It’s quite common for insurance companies to investigate the claim and use additional investigative measures that may include visual observation, background checks, monitoring of social media, and more. You may even be asked to submit to an Examination Under Oath EUO. EUO is a legal proceeding in which you are made to swear testimony to the facts of your claim, gathered and entered into the record.If you are ever called to enter a EUO, consider hiring a professional for your own legal protection. If your commercial property has suffered a loss and you are claiming business interruption losses, expect an additional investigation into your books. The time frames of these investigations can vary and may include research of financials from the past 10 years.There are strict laws to what comes under the purview of an insurance loss investigation and what permissions you can allow or deny. This is especially critical. If you ever feel that the insurance company is misusing its right to investigate, you must resist denying their requests and hire a The Public’s Adjuster for professional guidance.

4. Documenting Damages

   An important part of the post-disaster recovery process is cleaning up after the loss. But, like a crime scene, cleaning can often damage a lot of evidence. Before moving, mitigating, or removing anything from the property, you must make sure that you document the damages to the best of your ability. Some important evidence you must document:
   • Take multiple photographs from both inside and outside your property and keep them with you in a binder or on your cell phone. You must include all angles, equipment, roofs, and walls affected along with the damaged personal contents.
   • Keep a video recording of the damages with yourself. It must be slow, and every detail must be recorded.
   • Write down how the loss has been occurred and the resulting damage caused by the same. Do this while the details are fresh in your mind. Never speculate about the things you don’t know are facts.
   • Keep inventory logs of the damaged items. In the log, you must include every item affected including its age, condition, and purchase price to accurately calculate the valuations for the claim. The most important point to remember is to NEVER throw out any item until you have documented the damage and your insurer has given a “go ahead” to discard the damaged items.

5. Reach an Agreement with the Insurer on the Scope of Loss

   It’s important to reach an agreement with your insurer over the scope of work and the cost of repairs before you begin with any reconstruction. An agreement helps establish trust and mitigate financial disputes. Identifying the scope of work means identifying: > Type and extent of the loss incurred by the home or office building. > The specified quantity and quality of material needed to repair or rebuild the structure to its pre-existing condition. > Labor for the work needed to perform the repairs > Current market costs for all construction materials An ideal scope of work includes photographs of the damage, diagrams or floor plan drawings, and a detailed estimate of the work required, including the construction trades and material requirements. Oftentimes the policyholder is assured by the insurance provider to start with the repairs and that additional compensation due to increased scope will be disbursed as and when it is discovered during the repair process. But that is often NOT TRUE. More often than note, the policyholder ends up paying a lot more than what he is supposed to pay out of pocket for and does not get full compensation for additional repairs. This is when the comprehensive agreement for the scope of work comes in handy and you never end up being harassed for money by the general contractors. The Public’s Adjuster ensure that you get the scope of work agreed upon before repairs commence so that the policyholder is fully compensated for their loss.

6. Proof of Valuations

   You must prove the valuations of the damage to get the claim, and this process takes both time and effort. Determining the actual value of the damage to your property can be tricky. Here’s when you can also consider hiring a professional valuation expert or The Public’s Adjuster for his/her services. An accurate valuation means keeping a personal inventory of your contents, or you can try and recall everything that you owned and the price you paid for it when you bought the item. Needless to say, you have to differentiate between the items which were destroyed and the ones that are fine, along with the total value of the loss. This distinction comes in handy when applying for your claim and determines directly how your claim pays out. In the repair phase, you must hire professional contractors who are in compliance with the terms of your insurance policy. It is not imperative to hire the contractors that come recommended by your insurance provider, but whoever you DO select must be compliant. Construction is a price-competitive trade and hiring the right construction firm at the right price is extremely important. During the bid process, significant price differences mean differences in material quality, craftsmanship, and/or warranty. You must be diligent in reviewing bids and selecting the right contractor that will do the right work at a fair value.

7. Calculate the ACV (Actual Cash Value) or RCV (Replacement Cost Value)

   Insurance policies pay for damages on an Actual Cost Value basis. This ensures that you receive an upfront payment equal to the replacement value of your damaged property. This equals the cost to replace a similar item, – minus the depreciation. Often, the claim adjusters for the insurance company use standard depreciation tables that work on the principle of a fixed reduction in valuation year on year. Suffice it to say, depreciation is more of an art than plain mathematics or statistics. These standard depreciation tables simply do not consider how your asset was used, its wear, durability, and practical applications in the profession. A sofa placed in a vacant showroom area would not depreciate at the same level as a sofa in the living room of a large family. A fair ACV valuation requires exhaustive negotiations over inventory details, including which items were damaged or destroyed. In case your policy supports a Replacement Cost value, you are entitled to get a sum over and above the ACV. For this you must maintain receipts of the purchases made to replace the damaged items. ACV and RCV are areas where policyholders are frequently underpaid for the damages. Some of the reasons for underpayment are:
   • Accepting a lowball ACV settlement that dramatically undervalued the damage.
   • You might fail to prove a full valuation for the property.
   • Agreeing to their depreciation table and an unfair valuation.
   • Trusting the insurance company and believing that they have your best interests at heart.
   Some policies split the hair of ACV/RCV even thinner through multiple provisions such as, “Functional Replacement Cost”. Now, what does this new term mean? We understand your pain. That’s why reading your policy and conducting adequate research is extremely important. Functional replacement means that the replacement is eligible only to the extent of the item being able to function as before. For example, if you experience water damage to your hardwood floor. If your hardwood floor has been damaged, you will only be compensated enough to get that floor laminated and if you wish to replace the complete floor, you will have to shell out additional money from your own pocket. Now there are “Guaranteed Replacement Costs” which pay to replace damaged property at RCV, even when the total costs exceed the policy limit. These types of coverage illustrate some of the different verbiage used in insurance policies. These differences are the reason why it’s so important to understand the provisions contained in your actual policy.

8. Tracking Additional Living Expenses (ALE)

   In the event that property damage displaces you from your home, check if your policy covers the extra expenses you incur when displaced. This includes temporary housing, food bills, travel, animal boarding, storage, and many other claims which can be reimbursed through ALE (Additional Living expenses coverage). Your insurance provider can also consider paying the bill directly for some added expenses such as temporary housing or content storage. You must ensure that you keep all the receipts for out-of-pocket or cash expenses incurred during your stay, with you.

9. Planning for Business Interruption Losses

   A smart business owner always buys a policy that covers business interruption losses. Business interruption losses occur when the damage halts your day-to-day business activity and revenue stream. The smartest move is to hire The Public’s Adjuster who has expertise in business operations and forensic accounting. These claims are complex and can be hard to manage. Our team takes care of the strict time limits at play, along with collecting adequate proof of receipts for submission. You must ensure that you hire the right public adjuster with relevant experience and expertise in settling business interruption claims successfully.

10. Never Settle for the First Estimate

    It’s not necessary for you as a policyholder to submit a formal “loss of claim settlement” statement. But you must refuse to accept any lowball claim settlement proposal from the insurance company. As the owner, you must be aware of your losses and, ideally, have a list of items and external property damage that sums up the actual loss incurred. The insurance company’s representatives are bound to come up with a dollar amount for your loss, which most certainly is way less than the actual amount. Here’s when your list and the calculated dollar amount comes into play. You should never settle for a lowball claim. Instead call The Public’s Adjuster to take expert advice when required. Each step towards your insurance claim predicts the outcome of the final settlement. If you follow the basic steps from understanding your insurance policy to submitting the claim and refusing a lowball claim, the end result will most certainly be in your favour.

11. Dispute Resolution

    There are multiple reasons for a dispute to arise between the insurance provider and the insured. From lowball settlement offers to the widespread policy of delay, deny and defend, the reasons to dispute are endless. The policyholder has every legitimate right to put up his argument and defend his claim. Your insurance policy as well as the state’s legal regulations have the provisions to settle home and commercial claim disputes over coverage, cause, and the value of damages. This does not in any way ensure dispute mediation in one party’s favour but does often provide a process for resolution. In case of a dispute on coverage concerns, the best solution is to find words in the policy that support your claim. Your insurance provider will point out that the exclusions apply. You must read the exclusions form closely to ensure that the applicable clause does not match your circumstance exactly. If it does not match “The Coverage Is Presumed”. Valuation disputes are very common. The insurance providers rarely agree on a reasonable valuation. These can be resolved with the photographs and videos you took at the outset to prove the original condition of the items or the property prior to the damage. You can show the original receipts if you have them, to fight for a higher valuation of the damaged items. Some other ways to resolve a dispute is through a mediator, where a policyholder and an insurer sit together in his presence to settle their differences. When a policyholder and the insurer are unable to resolve the dispute, the former can invoke his right for appraisal. When a claim goes for appraisal, the value of the claim is rightfully established, and the court’s decision is required to override it.

12. Know Your Rights

    An insurance commissioner is someone whose job is to oversee the insurance companies and their services to the customer in his state. You are entitled to file a formal complaint against your insurance provider to the Commissioner’s office. Every state has an insurance commissioner and you, the policyholder, have every right to approach them directly. Roping in the commissioner’s office will likely initiate a third party review of the dispute. For links to the insurance commissioner for New Jersey, click the links below:
    
    New Jersey Department of Banking and Insurance (state.nj.us)