Catastrophe Adjuster Orientation

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Presentation transcript:

Catastrophe Adjuster Orientation

Time and Service Standards Contact insured within 24 hours Inspection within 5 calendar days Estimates completed within 5 calendar days Submit final report within 10 calendar days Subsequent reports every 14 days claim is still open

Claims Handling Do not make any commitment to the insured on coverage or settlement. Do not include estimate totals in report. Do not provide estimate to anyone other than the Assurant adjuster. If requested, please refer to the Assurant adjuster.

Claims Handling Assurant Specialty Property will settle all losses. Depreciation is to be documented on all files. An explanation of age and condition must be included on all claim reports. Contact Assurant prior to closing any file for lack of activity.

Claims Handling Use of sub-contractors is prohibited. Experts, engineers, aerial diagramming, etc. must get prior approval from Assurant.

Claims Handling Date of Loss - Must Be Documented Cause of Loss – Must Be Specific Subrogation – Note in Report Multiple Perils – Document Unrelated Damage

Claims Handling Deductibles – Be Sure Deductible Matches Peril Minimum Charges – One Per Estimate Per Trade

Claims Handling – Property Solutions Mobile Home Claims Risk Identification – Be Sure to Include Photos of Data Plate and Any Other Identifying Information

Field Etiquette Appointments Arrive on time Do not over schedule Verify access information Never enter an occupied property without permission Proper Attire and Identification Required

Communication Etiquette Make prompt contact Check your voice mail Return all calls promptly Don’t avoid the ‘bad’ calls Return emails promptly

General Safety and Awareness Vacant property – Do Not Assume Utilities Are Turned Off Occupied property Must have adult present Maintain professional image

Assurant General Estimating Guidelines Appliances & Photos - Documentation: Document damaged and/or missing appliances with photos of the finishes surrounding the appliances or area where appliances were located, including the floor. Appliances are covered at ACV unless otherwise directed; exceptions are range hoods and garbage disposals. Code upgrades - Under the MSP policy (LS Hazard) – there is no coverage for ordinance and law. Microhoods are considered appliances and settled at ACV. Wall mounted A/C units are settled at ACV. Code upgrades – check with inside adjuster on non MSP policies.

Assurant General Estimating Guidelines Direct, Sudden, and Accidental vs. Long Term Damage First time leak is covered under the Hazard policies There is no coverage for leaks on Mobile Homes without a direct physical opening. There is no coverage for long term leaks on the named peril Renter policy There is no coverage for rot and deterioration under any policy Electronics – speakers and intercom system components should only be covered if they are built in. Coverage is available for a first time leak if the IA can document that the leak occurred during the policy period, unless otherwise excluded. All rot and deterioration associated with long-term and/or repeated leakage is not covered and should be denied. Document all decisions with good photos and a detailed description in the claim report. Electronics - Items such as home audio speakers, TVs, or other related items should only be covered if their removal defaces the property (i.e. installed in the wall). Coverage is not available for wall mounted TVs; however, patching the wall due to the removal of the brackets is covered.

Assurant General Estimating Guidelines Exit Theft – Covered unless the damage occurred outside of the policy period Theft vs. Incomplete Remodeling Line of Sight Pools, Pool Equipment, and Outdoor Equipment Theft vs. Incomplete Remodeling: The adjuster must investigate each loss individually and objectively. If wires are capped or outlets/switch plates are missing, look for signs of theft or incomplete remodeling in other parts of the dwelling. If theft is visible in other areas of the dwelling, consider the missing items a theft loss. If incomplete remodeling is present in the dwelling, the adjuster may consider the missing items as an incomplete remodel. Evaluate each loss individually using good judgment and always document the decision. Line of Sight   Floor, Walls, and Ceilings: Consider line of sight when estimating floors, walls, and ceiling finishes. Use doors that can be closed and 90-degree angles, when applicable, as guidelines to determine a stopping point. This applies only to areas that have the same finish. If painting a door creates a mismatch with the casing, the casing needs to be painted, and possibly, the baseboards. When deviating from this, support the reasons in the claim report and estimate. Siding and Roofing: Evaluate each loss on a case-by-case basis. When replacing one elevation of siding on a house, determine if painting the other elevations to match is an option. If not, replacement of all elevations may be warranted, if matching or line of sight is an issue. Always document your reasoning for painting, repairing versus replacing. In some cases, a roof repair may match the other slopes. If not, replacement of one or more slopes may be warranted for matching or line of sight purposes. Always document your reasoning for repair versus replacement. PS Claims - Line of Sight only applies in California and Montana. Coverage is afforded for the actual damage only in all other stats. Be sure to also reference the Pair and Set provision in the policy. Pools, Pool Equipment and Outdoor Equipment Under the MSP policy, pools are not covered, but pool equipment is covered under Coverage A. Pool equipment that services the described location is settled at actual cash value with non-recoverable depreciation. Solar panels for the pool, attached to the dwelling, are considered part of the dwelling and settled at replacement cost value (actual cash value with recoverable depreciation) Panels that are detached and on posts in the yard are settled at actual cash value with non-recoverable depreciation. PS Claims - Refer to the policy. Some policies provide coverage for above ground pools, but not for in ground pools.

Assurant General Estimating Guidelines Photographs Address, all exterior elevations, all mechanicals, room overviews Label photos correctly and clearly describe the damaged areas Take overview pictures of all rooms and structures at property Photos must be in same order as estimate Photos MUST include address, exterior elevations, all mechanicals including HWH, HVAC, Service Panel Room overviews of all rooms in property whether damaged or not Enough photos to document damage.

Assurant General Estimating Guidelines Pictures and Mirrors Theft – Reinstallation Wiring, HVAC, and Plumbing – SF Estimating Pictures and Mirrors Pictures and mirrors are considered part of the dwelling if they are attached permanently with clips or glue. Items that are hanging on the wall with a wire are not considered part of the dwelling. Theft Claim - Reinstallation of Items: Sometimes items, such as light fixtures and doors, are in a dwelling but not installed. If the condition of the dwelling supports an attempted theft, allow to reinstall the items. Wiring - Replacement & Measurements: The square foot cost should be used when replacing all of the wiring in a dwelling. This includes all runs, drops, and basic fixtures. If replacing only wiring for a particular area, the linear foot measurement should be used. This includes the wiring for down drops to outlets and switches.

Questions? Contact your IA company management with any questions related to handling Assurant claims. Ask participant what additional questions they have.