Quickly Settle Insurance Disputes

Posted by admin | Posted in Fire Insurance Claims, Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 08-06-2010-05-2008

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To the highest degree all people purchase an insurance policy  – whether it is homeowners insurance or another – without reflecting much about what they are actually purchasing. The most common thing is the premium or the cost one pays. Premium is the biggest cause of the insurance coverage purchase that seems to concern most people. When it comes to other basics of the insurance product people buy, the concerns are usually absent. Many purchasers seem to think that the policy we shop for is the same, no matter which company you buy it from. This attitude is based from a fundamental misunderstanding of what an insurance product is – and how the insurance underground is functioning. It can also cause insurance disputes.

Of course it is of the utmost importance not to pay more for any insurance products than is necessary. However, on occasion we are unaware of the coverage we have with our property until we file a claim. That is when you discover that there was not an efficient amount of coverage available for the loss. Unfortunately, many people find this out after it’s too late. Such large loss claims like fire or flooding can lead to very costly repairs in the tens of thousands and even hundreds of thousands of dollars. Owners of motorcycles, boats or motor-homes can be surprised to learn that neither their homeowners policy nor their auto insurance policy covers them for any damage affiliated with such property.

Non-traditional (or inland marine as some are called) policies is a custom sector of insurance. Such type of insurance deals with property and items that would not traditionally fall under the typical property or automobile insurance policies. Such items include boats, snowmobiles, ATV’s and non commercial watercraft. You will find that your current insurance company does not issue coverage for these types of goods, in this case you should inquire about a specialty insurance company.

Accidents happen, be it in your home, car or even riding our ATV. By making sure you have adequate coverage we can prevent a small accident from causing a financial nightmare. Imagine having a large fire or tornado claim that cost $250,000… and only being covered for $150,000. We encounter such tragic events everyday when we assist families with their insurance disputes. Educating yourself about your policy can protect you from costly situations at a later date.

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Oklahoma sees Record Hail Damage and Insurance Claims

Posted by admin | Posted in Home Owners Insurance Claims, Insurance Claims Dispute, Insurance Claims Help | Posted on 24-05-2010-05-2008

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Oklahomans, who already pay among the highest insurance rates for homeowners insurance, have a couple of reasons to take comfort despite recent hail storms that caused millions of dollars of damage.

HOW OKLAHOMA COMPARES

Average premiums for homeowners insurance, 2007 by State

Average premium

→Florida … $1,534                                      →Texas … $1,448

→Louisiana … $1,400                                →Washington, D.C. … $1,089

→Oklahoma … $1,054                                →U.S. average … $822

Source: National Association of Insurance Commissioners

A state law prohibits insurance companies from canceling or failing to renew a homeowners policy or raising the premium because the property owner filed a first claim against the policy.

OK hail storms“That first claim you have an opportunity to file without any impact on the policy,” said Marc Young, state assistant insurance commissioner. “That’s why it’s important that you view that policy as an insurance policy for umbrella protection, and not simply as a maintenance policy.”

Insurance companies providing coverage in Oklahoma are prepared for major storm damage claims, Young said.

“In Oklahoma, we also have a very competitive market, particularly on the property and casualty side,” he said. That provides Oklahomans with an opportunity to shop around if an insurance provider does raise rates.

The Sunday hailstorm potentially could produce greater insured losses than last week’s tornadoes because much of the hail damage was in heavily urban areas, Young said.

Jerry Johns, president of Southwest Insurance Information Service, estimated last week’s tornadoes will amount to “tens of millions of dollars” in insured losses.

Insurance companies typically set rates by evaluating losses over a period of several years. Oklahoma’s turbulent weather is the major reason its residents already pay among the highest homeowners rates in the nation.

“We might see modest increases. It’s dependent upon the company and their exposure in these recent events,” Young said. “They do price for these events over a three- to five-year period of time so I don’t anticipate any disruption at all to the Oklahoma insurance market.”

Oklahomans in 2007 paid the fifth-highest rates for homeowners and renters insurance, according to a survey by the National Association of Insurance Commissioners. The average premium for homeowners insurance paid in Oklahoma was $1,054; nationally, the average premium was $822.

Johns said while each individual company will determine, based on its losses over time, whether to raise rates, Oklahomans will continue to pay more than most.

“Oklahoma is subject to just about every weather-related disaster known to man,” Johns said, “including earthquakes.

“It’s a state that has and probably will continue to be ravaged by severe weather.”

If you have suffered hail damage from hail stroms, tornado damage or any other weather damage insurance claims in Oklahoma, (OK) and need help with your insurance claim or to dispute your insurance companys estimate, please contact Joe Brennan at the numbers below.

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Insurance Advice After A Fire, Flood or Tornado

Posted by admin | Posted in Fire Insurance Claims, Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 28-04-2010-05-2008

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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. Due to their foreseen 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 frequently coinciding with the occurrence of heavy rainfall, while fire damage mainly occurs in deadly combination of grease, open burner fire, water and electricity that causes heat combustion. In most cases, these incidents can be accidental, or involuntary, even premeditated.  Where Tornadoes are more unpredictable.

Unfortunately, once the damage is done, there is no turning back. Fire damage, water, flooding, and tornado damages are usually covered under most insurance policies. Some insurance companies give you the feeling of protection, but wen you need them the most, they fall short of providing the services and coverage you believed you had.  Many policyholders unfortunately find out too late that they are NOT… “In good hands,” there is NO… “Like a good neighbor,” and there is NOT… anyone “On your side.”

Many insurance companies have been know under estimate the damages associated with fire damage, flood damage, and tornado damage. This is know in the industry as “low-balling.”  It’s essential that a proper repair is carried out on your property, so all traces of damage associated with the insurance claim will be fixed.  You have paid to have all damages repaired by a professional contractor to a pre-loss condition. Many insurance companies will use engineers to “sister,” beams or trusses, using the “band-aid,” approach. Prior to the loss you did not have a repaired or sistered beam, you had a full, undamaged beam. The policy you purchased provides you with a repair to a pre-loos condition. Prior to the fire, flood, or tornado you did not have a band-aid… and you should be sure you do not have one after.

If you have suffered a fire damage claim, a water or flood claim, even tornado damage, you may find yourself fighting with your insurance company on the repairs. Your insurance policy can actually protect you via the Insurance Appraisal Clause. Get free information and insurance advice on how to use an independent appraiser to settle your insurance claim dispute by visiting Insurance Claims Group, Inc. or Insurance Appraisal Process .com

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Lightning Strike Damage Disputes With Insurance Company

Posted by admin | Posted in Fire Insurance Claims, Home Owners Insurance Claims, Insurance Claims Dispute, Insurance Claims Help | Posted on 24-04-2010-05-2008

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Not only are people confused about lightning strike damage claims, many do not even realize that their insurance policy covers lightning strike damages. Lightning can damage the electrical system, cause damages to roofing and framing, can penetrate and damage brick chimneys, and can enter a building and damage finishes like carpet, tile, walls, cabinets, and more. Lightning can also tople trees that fall on homes and buildings, and worse, cause serious fires. It’s bad enought to have had  damage caused by lightning, without having to fight with your insurance company about the damages.

Lightning usually strikes the highest elevation above the ground, but can “run” or jump to adjacent objects, such as houses, power lines, or even people or animals. Most lightning strikes enter homes and buildings through the electrical system. Such strikes can cause a multitude of issues to your home or building… that are sight unseen. Insurance compaies are infamouse for leaving unseen damages out of their estimates. If they can’t see it, they’re covinced it must not be damaged. Lightning can damage underground water lines, underground electical systems, sprinkler systems, and even foundations. Sometimes convincing the insurance company that there was no problems with these items prior to the lightning storm is a daunting task.

When it comes to lightning strike claims many people find themselves disagreeing with the estimate and analysis from their insurance company adjuster. Most of the time the insurance company’s estimate is much lower than estimates provided by local contractors. What can a policyholder do when this happens? How do you fight back? How do you find help in such a situation?

Almost all policyholders are unaware of a very powerful clause in their policy that allows then to invoke The Insurance Appraisal Process. For many insurance claim disputes the only available option to resolve such disagreements is a clause buried in the “Conditions” and/or “What to do after a loss,” sections of the insurace policy. It’s called The Appraisal Clause – also know as The Appraisal Provision.

More information is available about lightning strike claims by contacting Insurance Claims Group, Inc.  They will provide a FREE Consultation and Free Claim File Review. They can analyze your claim, your policy, the insurance company estimates, and your contractors bids to let you know where you stand. Is their more money available in your policy? Has the adjuster or contractor left out items that are covered? Be in the “Know,” and don’t be pushed around.  You didin’t let the lightning stop you… why let the insurance company?

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

How to Hire an Independent Appraiser

Posted by admin | Posted in Appraisal Umpire, Fire Insurance Claims, Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 16-04-2010-05-2008

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An independent appraiser will be needed to dispute your insurance claim damage with your insurance company. In many cases the insurance company has invoked Appraisal on a policyholder… who is left wondering what they need to do.What are independent appraisers?

Independent insurance appraisers provide an unbiased evaluation of claim damage based upon what the policy provides. Individuals and businesses purchase insurance policies to protect against monetary losses. In the event of a loss, policyholders submit claims, or requests for payment, seeking compensation for their loss. When a disagreement on the amount the repairs will cost arises; each party can hire an independent appraiser via he insurance appraisal clause.

Their main role is to investigate claims, negotiate settlements, and reach an agreement on the amount of loss. Some even investigate claims by interviewing the claimant and witnesses, consulting police and hospital records, and inspecting property damage to determine how much the company should pay for the loss. They may consult with other professionals, such as accountants, architects, construction workers, engineers, lawyers, and physicians, who can offer a more expert evaluation of a claim. The information gathered—including photographs and statements, either written, or recorded audio or video—is set down in a report that is then used to evaluate the claim.

When is the right time to hire an independent appraiser?

An independent appraiser is not needed until you actually have a dispute. Most of the time an independent appraiser is needed hen serious damages occur from fire, floods, earthquake,tornados, lightning strikes and hail.  If you want an independent opinion or are having problems collecting money on your loss, you can consult with an Independent Insurance Appraiser to determine if you should consider the appraisal process.

If you find your self in this unfortunate situation, Insurance Claims Group, Inc. provides a Free Insurance Claim Review.

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Lightning Strike Damage Disputes With Insurance Company

Posted by admin | Posted in Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 12-04-2010-05-2008

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Not only are people confused about lightning strike damage claims, many do not even realize that their insurance policy covers lightning strike damages. Lightning can damage the electrical system, cause damages to roofing and framing, can penetrate and damage brick chimneys, and can enter a building and damage finishes like carpet, tile, walls, cabinets, and more. Lightning can also tople trees that fall on homes and buildings, and worse, cause serious fires. It’s bad enought to have had  damage caused by lightning, without having to fight with your insurance company about the damages.

Lightning usually strikes the highest elevation above the ground, but can “run” or jump to adjacent objects, such as houses, power lines, or even people or animals. Most lightning strikes enter homes and buildings through the electrical system. Such strikes can cause a multitude of issues to your home or building… that are sight unseen. Insurance compaies are infamouse for leaving unseen damages out of their estimates. If they can’t see it, they’re covinced it must not be damaged. Lightning can damage underground water lines, underground electical systems, sprinkler systems, and even foundations. Sometimes convincing the insurance company that there was no problems with these items prior to the lightning storm is a daunting task.

When it comes to lightning strike claims many people find themselves disagreeing with the estimate and analysis from their insurance company adjuster. Most of the time the insurance company’s estimate is much lower than estimates provided by local contractors. What can a policyholder do when this happens? How do you fight back? How do you find help in such a situation?

Almost all policyholders are unaware of a very powerful clause in their policy that allows then to invoke The Insurance Appraisal Process. For many insurance claim disputes the only available option to resolve such disagreements is a clause buried in the “Conditions” and/or “What to do after a loss,” sections of the insurace policy. It’s called The Appraisal Clause – also know as The Appraisal Provision.

More information is available about lightning strike claims by contacting Insurance Claims Group, Inc.  They will provide a FREE Consultation and Free Claim File Review. They can analyze your claim, your policy, the insurance company estimates, and your contractors bids to let you know where you stand. Is their more money available in your policy? Has the adjuster or contractor left out items that are covered? Be in the “Know,” and don’t be pushed around.  You didin’t let the lightning stop you… why let the insurance company?

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

A Natural Disaster can lead to an Insurance Claims Dispute

Posted by admin | Posted in Fire Insurance Claims, Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 20-03-2010-05-2008

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Natural disasters can change the face of the world. Believe it or not, the strongest earthquake ever recorded in the United States was located in Missouri, not California. This earthquake was so powerful that it actually changed the Mississippi River’s course. We do not have the power to stop them from happening, but we can do a much better job preparing ourselves from the consequences and protect ourselves from an insurance claims dispute.

Every state that borders the Gulf of Mexico and Atlantic Ocean, which is twenty states including Hawaii face hurricane threats on a yearly basis. The population of the United States continues to grow exponentially, and so does the threat of facing a catastrophe. Tornado, Hurricanes, Floods, and Earthquakes happen all over the United States.

Home values have decreased in some areas that have a lot of natural disasters. Most homeowners have a large amount of their money tied up in their homes. This puts them at huge risk with their finances. Recent natural disasters, such as Hurricanes Rita and Katrina showed us that we are not prepared for natural disasters.

There are many great ideas to help Americans prepare for these natural disasters, and national coalitions like protectingamerica.org advocate these. These organizations are made up of first responders as well as emergency management officials.

One basic solution to this is the emergency of privately funded, but sponsored by government funds for catastrophe. This money would accumulate before a disaster occurred, and is a combination of insurance premiums and government money. This way, the states can fund their own restoration from natural disasters. If property owners can’t be covered by one state, then the federal government would step in. Money would be designated for this one purpose, and could grow every year it wasn’t used.

Another solution includes training and strengthening first responders, better land use policies, and better building codes. A better solution is not going to happen overnight, so here is what you can do in the meantime to prepare yourself:

  1. Familiarize yourself with your town’s disaster plans and come up with a family disaster plan.
  2. Create an emergency supply kit that has plenty of nonperishable food, can opener, paper plates and utensils, lots of bottled water, first-aid kids, flashlight and radio, and plenty of batteries
  3. Put everything important in water and fire proof containers; wills, insurance policies, passports, birth certificates, financial information, phone numbers, etc.
  4. Create a video inventory of your personal property and keep as many receipts as possible.

As stated earlier, “We do not have the power to stop Natural Disaters from happening, but we can do a much better job preparing ourselves from the consequences and protect ourselves from an insurance claims dispute.

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Insurance Disputes Solved by the Insurance Appraisal Process

Posted by admin | Posted in Appraisal Umpire, Fire Insurance Claims, Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 12-03-2010-05-2008

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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.

A house fire, tornado, tree through the roof, or busted pipe can cause large amounts of damage to a home and it’s belongings. People often feel reassured because they have homeowners insurance coverage or business owners insurance. That relief could be premature. Yes, your damages are covered by your insurance policy, but how much will your company pay versus what you have to pay out of pocket?

The policyholder often thinks that if they have been with a company for a number of years and never submitted claim, they will get a fair settlement. It should be that easy. You pay timely premiums, you find a good contractor and submit your claim properly, and it should be paid. However, larger claims dig deeper into the insurance company’s pockets. With more to pay out, any policyholders find out that they are NOT “in good hands,” the insurance company is NOT always “on your side,” and “like a good neighbor… there NOT always there.”

Everyone wants to believe that they will be taken care of in a time of need. That is not always true with more costly claims. These large claims become a huge, costly battle over what should and shouldn’t be replaced or repaired. Many insurance companies do wish to take care of their clients and give them a fair claim settlement for the needed repairs. Unfortunately, there are just as many companies who will do everything in their power to protect themselves financially… instead of protecting and taking care of their clients.

Not many policyholders are aware that there is a clause within their policy that protects them from insurance company greed. It’s called the insurance Appraisal Clause. The clause has a set process to settle insurance disputes that involve the “amount of loss.” If the two parties have two separate estimates and different opinions on how much money it will take to complete repairs or replacement, appraisal is the next step.

Appraisal settles disputes about damage to your home or property. If you suffer a natural disaster that destroys your home, the insurance company will send an adjuster. Disputes begin for many reasons. However, as an example, let’s say the adjuster estimates a fire damage claim at $300,000. Your contractor gives an estimate to repair the damage for $450,000. Obviously there is a dispute on the “amount of loss.” This results in a dispute between the two parties for both repairs and damages. An agreement can not be reached, as neither party is willing to budge. At that time, either party can demand appraisal in writing. Each party must appoint an Independent Appraiser to settle the insurance dispute.

For a more detailed breakdown of the Insurance Appraisal Process policyholders can educate themselves and obtain insurance dispute assistance from Insurance Claims Group.

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Insurance Claims from Water Damage

Posted by admin | Posted in Home Owners Insurance Claims, Insurance Claims Dispute, Insurance Claims Help | Posted on 16-02-2010-05-2008

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Water is something that we all can’t live without, it covers over 70% of the earth.  It is ironic that water also causes around 70% of all insurance claims.  Heavy, torrential rains, hurricanes, winter storms, and flood all are culprits of water damage.  Having water in your home is very stressful expensive for homeowners, property owners, and even the insurance companies.

Although it is somewhat common for a homeowner to find themselves with some water damage at one time or another, not all kinds of water damage are covered by insurance.  For example, if there is a rainstorm and rivers overflow and floods your basement, such an event is not covered in a regular homeowner’s Flood coverage is an add-on service you must purchase separately in many instances.

It also makes a difference on how the flooding occurred.  If a homeowner has a standard insurance policy and the water damage occurred because a tornado ripped off the roof, then your insurance will would take care of the water damages associated with the claim.  However, if it happened due to a storm surge, there’s a chance it won’t be covered.

Flooding and Natural disasters cause water-related insurance losses on a regular basis.  They are covered in the news quite often.  $40 billion dollars worth of damage in Hurricane Katrina is a shocking number.  On a smaller scale, there are practically daily water related insurance claims that amount to significant losses of money and property lost each year.

According to the Insurance Information Institute, “water damage and freezing claims occur about 1.5 times for each 100 home owner’s policies per year”.  That average is much higher than other homeowner claims like fire or theft.

There are ways to prevent some of these water damage claims.  You cannot control natural disasters, but you can prevent other types of water claims with regular maintenance.  Inspect your basement and roof on a regular basis.If you stay on top of home repairs, the odds of something catastrophic like water damage are smaller.  You can also clean out your gutters, which will help the water drain off of your roof.

It is important to utilize some tools to prevent damage as well.  If you live in a colder climate, insulate your water pipes.  It will make a big difference in them not freezing and bursting. You can also run your water very slowly overnight when it is really cold, or leave cabinets open by pipes.  If you live in a place where there are earthquakes, strap in your water heater.

You can also buy a sump pump and keep it handy in your basement.  You could hire a service to slant your lawn so water doesn’t collect against your house. Educate all members of your family how to turn off the main water shut-off valve, it is important to take action quickly if a problem is spotted.

Water is essential.  We can’t live without it.  It flows through our oceans and through our homes.  It is important to remember the disaster that water can cause, take preventative measures, and remember how to file a water damage claim if needed.

(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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims

Independent Appraiser Uses Policy To Protect Policyholders

Posted by admin | Posted in Appraisal Umpire, Fire Insurance Claims, Home Owners Insurance Claims, Insurance Appraisal Services, Insurance Claims Dispute, Insurance Claims Help | Posted on 05-02-2010-05-2008

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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.

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.

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 insurance appraisal 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 Claim Consulting Service – Ph: 919-669-9111 . Insurance Claim Help and questions about Independent Appraiser Services is available by visiting Insurance Claims Group | Insurance Appraisal Services | Insurance Appraisal Process | Insurance Appraisal Umpire | Fire Insurance Claims