Property damage claims that are a result of fire, windstorm, tornadoes, water, flooding, hurricanes, and even theft are tragic on there own. It’s worse when the insurance company sends an unqualified insurance adjuster to assess your damages.
In many situations the insurance adjuster who inspects a property damage claim is not, nor has ever been, a contractor. For this reason the policyholder is now faced with an insurance company estimate that is missing many property damage repair items, or the item prices are lower than those required to complete the actual repairs.
As a result, the insurance company’s estimate and the contractor’s estimate can be thousands, tens of thousands, or even hundreds of thousands of dollars apart. In reality, most insurance adjusters take classes to learn about insurance policies – and classes to lean about building materials… but have never been a roofer, carpenter, painter, or carpet installer. They have very little or absolutely no hands-on experience, no on-the-job experience, or any experience with the materials or procedures for the property damage claim they are estimating.
They lack the hands-on experience and knowledge of a person who has many years experience repairing or replacing such damages. It’s easy to see how disputes can arise from property damage insurance claims.
Property Damage Claim Scenario
Many policyholders run into situations that go something like this. The insurance company sends an adjuster to the property damage location. The adjuster seems to spend very little time inspecting the claim and determines the property damage to be $150,000. However, the policyholder has several bids from different contractors with estimates of repair for $250,000 and higher. Many times it seems the insurance company is trying to repair or clean damaged items and the contractors have provided pricing to replace them. It’s not long before a dispute between the cost of repairs begins and an agreement on the costs of property damage cannot be reached.
Property Damage Appraisal Clause
When such a dispute arises there is a clause in most insurance policies called Appraisal. The insurance appraisal clause is usually a new term to most policyholders. However, more and more policyholders find themselves disagreeing with their insurance company adjuster’s estimate of their property damage claims. Those who do; should educate themselves on the insurance appraisal clause, how to use it, when to use it, and why to use it. For many property damage claims the only available option to resolve a dispute is the clause buried in the “Conditions” or “What to do after a loss,” sections of their policy. It’s called The Appraisal Clause – also know as The Appraisal Provision.
Property Damage Appraisal By The Insurance Carrier
In most cases the insurance company invokes the insurance appraisal clause more often than policyholders do. Only because they have a better understanding of the terms and conditions of their property damage policies. If your insurance company has invoked appraisal on your claim, or if they advised you that if you disagree you can invoke or demand an appraisal, you’re in the right place. Even if you’re just searching for information on what your options are if you disagree with them – you’re still in the right place. It may seem like a fancy clause that would take a law degree to understand. The simplest way to understand it is that it’s the insurance industries version of an arbitration. However, a property damage appraisal is not actually an arbitration, it’s just similar to one.
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
Simple insurance advice after a fire, flood or tornado is critical to obtaining a fair settlement.
Unexpected events really do occur, in spite of our natural tendency to anticipate or prevent them. Dealing with damages caused by fire, water or tornadoes is one of those unpredictable incidents that no one wishes to endure. Due to their unforeseen nature, such events are the most alarming and destructive, both from a financial point of view and from a generally human one. Flooding, due to astronomically influenced phenomena such as high tides and heavy rainfall, while fire damage mainly occurs in deadly combinations of grease, open burner fire, water and electricity that causes heat combustion. In most cases, these incidents can be accidental, or involuntary, even premeditated. Tornadoes are more unpredictable. No matter what form or fashion, these events can be catastrophic.Read the rest of this entry »
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(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
In the event that a policyholder or the insurance company invoke appraisal via the insurance appraisal clause, the two appraisers must choose an umpire. Most policies require that the two independent appraisers must attempt to select and agree upon the Insurance Appraisal Umpire within 15-days of the two appraisers being named. The chosen appraisal umpire must be an impartial, unbiased, and disinterested party in the outcome of the appraisal award. Read the rest of this entry »
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(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
The majority of policyholders who have ever been a victim of a fire or has suffered damages to their property (home, business, etc.) from fire damage claims will make costly mistakes during and after the claim has been settled. Unfortunately there always seems to be one grossly expensive mistake that most all policyholders make. It’s so simple that it’s hard to believe that people don’t even realize they have done it. Can you even imagine that many policyholder’s who has suffered a fire will rely solely on the insurance company adjuster’s opinion? They allow their adjuster to inspect their property, evaluate and process the claim, and create an estimate for the entire fire insurance claim… Without Any Questions. Read the rest of this entry »
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(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
In the event of an insurance claims dispute, the Insurance Appraisal Clause within an insurance policy allows the two parties to settle the dispute using independent appraisers. The policyholder contracts an insurance appraiser, who is independent, to assess the value to the damages to their property. The insurance company hires a separate appraiser as well. The two appraisers together will select an appraisal umpire. The umpire is sort of like an arbitrator or judge. If the two appraisers cannot agree on a certain damages, the umpire makes a verdict. As long as one of the appraisers agrees with the umpire, that disagreement is settled. The umpire may agree with one independent appraiser about one point and agree with the other appraiser on another point. Eventually all points and disagreements are settled. Read the rest of this entry »
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(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
A house catching fire can be a life changing event that no homeowner should ever have to endure. If you find yourself in this unfortunate situation, it’s very important to advise your insurance company of the fire as soon as possible. Here are five critical steps you should know and take after suffering fire insurance claims. Read the rest of this entry »
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(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
An increasing number of insurance policyholders have found themselves involved deeply in an insurance dispute about claim damage. Insurance disputes can be financially devastating. A common feeling of most policyholders is that insurance companies are there to actually help them in times of need. Sometimes, that is completely true, however with larger claims, it can feel like you are being taken advantage of. Read the rest of this entry »
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(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
Independent Appraiser Uses Policy To Protect Policyholders
Almost all insurance policies have an appraisal clause that allows the parties of the insurance contract to resolve disputes that may arise during a claim. Appraisal is for the “amount of loss,” only. This is the amount of monies it will cost to fully complete the repairs caused by the claim damages. For instance; policyholders could be forced to use an independent appraiser to settle their differences with the insurance company, using the appraisal process to protect their interests.
In a recent Texas case, JM Walker, LLC v. Acadia Insurance Company, reveals how an independent appraiser and the appraisal process protected a policyholder from mistakes made by the insurance company. Mistakes that could have cost the policyholder “hundreds of thousands of dollars!” Each situation can be a bit different simply by how the appraisal clause is worded in the policy, by the type of damage that occurred, and by all the facts pertaining to the loss.
In this situation, JM Walker owned five buildings in North Richland Hills, Texas. A hailstorm caused damages to the roofs of the five buildings. Walker submitted a claim to his insurance company, Acadia. However, at first Acadia denied the claim after their adjuster determined that the roofs did not need to be fully replaced, and that the damage that was caused by the hail, did not reach the $5,000 deductible that applied to the policy.
Mr. Walker disagreed with that assessment from the insurance company’s adjuster. The two parties could not agree, so Acadia executed its contractual right to appraisal. At first, Mr. Walker tried to litigate the matter in court by filing a lawsuit. However, the Judge advised that the parties should continue with the appraisal process. It is not uncommon for judicial courts to suggest this process, as most policies require that all policy provisions be exhausted before entering the courtroom.
Independent Appraiser Were Used
The appraisal process includes two independent appraisers (one hired by each party) and an appraisal umpire. If the independent appraisers cannot agree on an amount of loss they can submit their differences to the umpire. The umpire in this appraisal process found on behalf of JM Walker and produced an award for the amount of loss at $423,053.96. Appraisal awards are binding, therefore, Acadia paid the amount. (You may recall that their first offer was $0, because they determined the loss to be below the $5,000 deductible.)
JM Walker tried filing an appeal to the United States Fifth Circuit. It was Walker’s belief that he was entitled to more hail damage proceeds and was also seeking additional money for what he believed was “bad faith” actions by Acadia with their miss handling of the claim.
The Court ruled that under Texas law, “appraisal awards made pursuant to the provisions of an insurance contract are binding and enforceable, and every reasonable presumption will be indulged to sustain an appraisal award.” The Court also ruled that an otherwise binding appraisal may only be overturned in only three situations:
(1) when the award was made without authority;
(2) when the award was made as a result of fraud, accident, or mistake; or
(3) when the award was not in compliance with the requirements of the policy.”
Mr. Walker diligently tried to argue on all three points. However, the court dismissed his rebuttal on all three. This appraisal and case is a good resource showing the respect the Texas courts have for the appraisal process. It is my opinion that the Independent Appraiser and the insurance appraisal process protected the policyholder in this situation. Mr. Walker should be happy the policy had such a clause. The work that the Independent Appraiser did during this Appraisal was responsible for Walker receiving $418,053.96 over what the insurance carrier said they owe on the claim.
Independent Appraiser Assistance
If you should ever find yourself in an insurance claim dispute with your insurance company, you should truly consider calling an Independent Appraiser to explore your options with the insurance appraisal process. Independent Insurance Appraisal Services is all we do. Feel free to call Insurance Claims Group, Inc. at 919-669-9111 to have all your independent appraiser questions answered at NO COST.
(C) Joe Brennan is President and owner/operator of Insurance Claims Group, Inc., a national independent adjusting, appraisal, and umpiring firm. We will answer your claim questions FREE as part of our FREE Insurance Advice and Insurance Claim Consulting Services.
Property damage claims that are a result of fire, windstorm, tornadoes, water, flooding, hurricanes, and even theft are tragic on there own. It’s worse when the insurance company sends an unqualified insurance adjuster to assess your damages.
