Public Adjusters Archives

A new law, signifying a significant development for policyholders in Louisiana, has passed, forbidding property insurance policies from containing provisions that deny an insured individual’s right to hire a public adjuster. Before the introduction of this new law, insurance policies with anti-public adjuster clauses prevented policyholders from hiring a public adjuster. The legislation aims to provide all policyholders and businesses with greater control and expertise in navigating insurance claims.

On June 12, 2023, Louisiana Governor John Bel Edwards signed into law a bill from Sen. Royce Duplessis, D-New Orleans, and Rep. Ray Garafalo, R-Chalmette, that prohibits insurance carriers from inserting anti-public adjuster clauses into property insurance policies. The new law (SB156) in Louisiana will take effect on August 1, 2023, and allow all policyholders to hire public adjusters.

Benefits for Policyholders:

Removing the anti-public adjuster clauses is a significant win for policyholders in Louisiana. Here are some key benefits that policyholders can expect:

Expertise and Representation:

Licensed professionals with in-depth knowledge of insurance policies and claims processes, public adjusters actively operate. They can assess the full extent of damages, and strive for fair compensation per the policy.

Time & Stress Reduction:

Navigating an insurance claim can be a complex and time-consuming process. By engaging a public adjuster, policyholders can offload the burden of handling paperwork, documentation, and negotiations. This allows them to focus on other important aspects of recovery, such as restoring their property or business.

Maximizing Claim Settlements:

Public adjusters skillfully value losses accurately and ensure fair compensation for policyholders. They can help policyholders avoid potential underpayments or claim denials, leading to maximized settlements.

Rules and Regulations for Public Adjusters in Louisiana:

While the new law in Louisiana enables policyholders to hire public adjusters, it’s important to understand the existing rules and regulations governing their operations. Here are some key points to note:

Licensing:

Public adjusters in Louisiana are required to obtain a license from the Louisiana Department of Insurance (LDI). Additionally, the licensing process involves meeting certain criteria, including background checks and the successful completion of an examination.

Fee Limitations:

Public adjusters charge fees for their services, typically calculated as a percentage of the insurance claim settlement. In Louisiana, these fees are regulated and should conform to state guidelines. Policyholders should discuss fee arrangements with the public adjuster before signing any contract.

Contractual Agreements:

Public adjusters must provide written contracts to policyholders, outlining the terms and conditions of their services. The contract must clearly state the fees, scope of work, and any additional expenses that policyholders may incur during the claims process.

Prohibited Activities:

Public adjusters are prohibited from participating in any deceptive or fraudulent practices. Furthermore, they have a fiduciary responsibility, must act ethically and in the best interests of the policyholders they represent. Violations of these regulations can lead to disciplinary actions by the LDI.

Louisiana’s new law granting policyholders the ability to hire public adjusters is a significant step toward empowering individuals and businesses when dealing with insurance claims. With the expertise and representation provided by public adjusters, policyholders can expect a smoother and more favorable claims experience. By leveraging this new legislation, policyholders can navigate the complexities of the insurance world with confidence, knowing they have dedicated professionals on their side.

Premier Claims Louisiana #765044

Garner Industries

Lincoln, Nebraska
Hail & Wind Damage
December 2021

Our team stepped in after the initial claim had already been filed with the insurance carrier. Following a deep-dive investigation and thorough research, we discovered previously overlooked damage to another section of the roof. We also pinpointed a more accurate date of loss that aligned better with favorable deductible terms. After fine-tuning the claim and negotiating up-to-date costs for materials and labor, we achieved a 570% increase in the claim’s value—all within just 5 months.

Insurance Carrier Offer: $162,000

Premier Claims Settlement: $1,085,000

Luxtor Self-Storage

Prescott, Arizona
Hail Damage
February 2022

Before even filing a claim for hail damage to a high-end self-storage facility, our team was already on the case. Within a week of initiating the claim, we coordinated a joint inspection with the insurance carrier. Despite receiving a ‘reservation of rights’ letter from the carrier—a common delay tactic—we pressed on. We assessed the damage to all four buildings and submitted a comprehensive estimate. Although the insurance carrier countered with lower estimates, we stood our ground. The result? A robust final settlement of $1,428,000 in just 3 months, which even included the cost of private security during the restoration process.

Insurance Carrier Offer: Stated No Coverage Available

Premier Claims Settlement: $1,428,000

When dealing with water damage, it’s crucial to understand the severity and potential risks involved. Water loss is classified by contamination level. Its class denotes damage extent and evaporation rate. As your trusted public adjusters, we provide crucial information about water loss categories and classes, guiding you through challenges.

Water Loss Categories:

Category 1:

Category 1 water loss is considered the least severe, as it originates from a sanitary water source with minimal health risks if ingested or inhaled. Common examples include broken water supply lines, sink or tub overflows with no contaminants, melting ice, and broken toilet tanks.

Category 2:

Category 2 water loss involves water with contamination, posing a potential risk of illness upon contact or consumption. This type of water may harbor unsafe levels of microorganisms, nutrients, and organic or inorganic matter. For instance, overflows from washing machines, discharge from dishwashers, or toilet bowl overflows can fall into this category.

Category 3:

The most severe category, category 3 water loss, contains highly contaminated water with pathogenic, toxigenic, or harmful agents, such as sewage or floodwater from external sources. It can be caused by events like tropical storms or weather-related disasters.

Water Loss Classes:

Class 1:

As for Class 1 water losses, they impact a limited part of a room or area, or involve larger spaces with minimal moisture absorption. Moreover, this class presents the least amount of water, absorption, and evaporation.

Class 2:

Category 2 water loss, also known as gray water, involves water containing contamination, posing potential health risks. It may harbor unsafe levels of microorganisms, nutrients, and organic or inorganic matter. Examples of this type include overflows from washing machines, discharge from dishwashers or washing machines, and overflows from toilet bowls.

Class 3:

In a class 3 water loss, water may have come from overhead, resulting in saturated ceilings, walls, carpets, insulation, and sub-flooring throughout the entire area. Consequently, this class involves the greatest amount of water.

Class 4:

Class 4 water losses occur when materials with low permeance porosity, such as hardwood, plaster, brick, and concrete, are affected. These cases often have deep pockets of saturation, necessitating longer drying times and specialized methods.

Jimmy Marlow from Action News Jax reported in Jacksonville, Florida that “Regency Square Mall, once a bustling retail destination in the 90s and early 2000s, has now fallen into a state of disrepair. The mall’s roof has caved in, leading to extensive water damage and the spread of mold, raising concerns for both tenants and the local community.” Being proactive when it comes to water damage is imperative. Understanding the categories and classes of water loss is essential for assessing the severity of damage and implementing the appropriate recovery measures. As your premier public adjusting firm, we are here to support you through the challenges of water damage, providing expert guidance and compassionate assistance every step of the way. Together, we’ll navigate the complexities of water loss and ensure we restore your property to its fullest potential.

Confidential Religious Center

Orlando, Florida
Hail Damage
April 2021

From the start, our team uncovered undeniable evidence of hail damage to the 1,020-square metal roof. In an attempt to stall the process, the insurance carrier issued a ‘reservation of rights’ letter, suggesting the claim might not be sufficiently covered by the policy. They also sent an engineer and their own adjuster for further evaluation. To counter this delay tactic, we conducted a thorough legal review of the policy to confirm coverage and compiled a comprehensive estimate based on our investigations. Despite an ACV policy with endorsements, we successfully negotiated a final settlement of $1,162,000 for a complete roof replacement. After the settlement, and considering the property’s age, we advised the policyholder on upgrading to an RCV policy for more comprehensive future coverage.

Insurance Carrier Offer: Stated No Coverage Available

Premier Claims Settlement: $1,162,000

The Coronavirus has significantly affected the stock market, leading to a sharp and rapid decline in average returns. The forecast indicates further deterioration before any improvement. Given the indefinite duration of the pandemic, the market is likely to continue its decline, contributing to a global economic recession expected to be fully established by the end of 2020. In this article, I’ll discuss how the stock market trend impacts insurance claim payments.

S&P 500 2020 Average Annual Return to Date: -17.55%

NASDAQ 2020 Average Annual Return to Date: -11.81%

Dow Jones 2020 Average Annual Return to Date: -20.53%

According to Marco Trends the market has an average annual return rate of -16.63%, compared to a 11.08-15.4% average return in the previous decade within the same indexes. And while the current rate of return for these markets has stabilized, somewhat – according to Market Watch, the current average rate for the three indexes is 1.05%, and it will take the market some time to recover.

Forecasters predict a further drop in stock market returns by the end of Q2 and the beginning of Q3, which is causing concern. Analyst Charles Dumas suggests that we should regard the notion of the economy rebounding swiftly once the pandemic subsides as unlikely and counterintuitive. This perspective rests on the reality of more than 700,000 jobs lost solely in the United States.

Stock Market impact to insurance and property claims

A common belief is that insurance carriers make their profits by charging and accepting premiums. These premiums are then taken into a pool from which both claims are paid and profits are drawn. And while this isn’t entirely inaccurate, insurance carriers are only marginally profitable if they rely on premiums alone. Insurance carriers, like any business and investor, have shareholders and rely upon the stock market. Insurance carriers profit by investing premiums in stocks for returns before paying claims from the premium pool.

Ultimately, with the stock market in a current downtrend, insurance carriers must find another way to keep profits up. This means the industry is likely to see an increase in denied claims and underpaid claims.

What can a policyholder do? Premier Claims offers not only complimentary policy reviews, but risk-free denied and underpaid claim reviews. Premier Claims offers a comprehensive service, including pre-contract legal and insurance review. Once a client contracts with us, our services encompass legal oversight, meticulous estimating using professional software, and persistent negotiation until claims are maximized.

Concerned your claim was underpaid, or receive a denial?

Need to make sure your policy covers what’s needed?

Contact us at info@premier-claims.com or 877.219.0049, or use our Claims Intake page to upload your documents and request your free review today!

Louisiana New Law: Allows for Public Adjusters