NO ONE CAN IMAGINE
THE FEELING OF COMPLETE
The last thing you need now is
YOUR FRIENDS AND NEIGHBORS AT
POLICYHOLDERS OF AMERICA WANT
YOU TO KNOW
WE’RE HERE TO
Because only someone who
has walked in YOUR shoes
knows what you are going
THERE ARE PITFALLS TO
AVOID WHEN FILING A
KNOW YOUR COVERAGE
Read and understand your policy. Get copy from agent.
Coverage A: The Dwelling (usually REPLACEMENT
Coverage B: Other Structures (fences, walls, driveway,
swimming pools, unattached garage, etc)
Coverage C: Personal Property (clothes, furniture, etc)
Other coverages: Additional living expenses or “ALE”, debris
removal, code upgrades, landscaping
List EVERYTHING that was destroyed.
Additional Living Expenses (or “ALE”) - Get advance or
direct pay to hotel, etc.
KNOW YOUR DUTIES
Report your claim immediately.
List your losses (damaged or destroyed property).
Protect your property from further damage if it’s not
a total loss.
Cooperate with adjuster (scheduling, presenting
property, providing information, etc).
Document Additional Living Expenses (ongoing).
KNOW THEIR DUTIES
Respond promptly to claim.
Inform you of all coverage, time limits and potential
exclusions from coverage.
Affirm or deny your claim in writing.
Provide ALE advance or direct pay to hotel, etc.
Prepare detailed Scope of Loss (list of damages and repair or
Assist in presentation of claim.
Provide needed forms.
Pay documented benefits (or undisputed amounts they
KNOW they owe) promptly.
Act in GOOD FAITH.
COMMON TOOLS USED TO REDUCE
AMOUNTS PAID TO POLICYHOLDERS
Lowball repair or replacement estimates by adjusters or
insurance company contractors.
Substandard ALE arrangements that do not reflect your
normal standard of living.
Demands for excessively detailed lists of contents –
Requests for unnecessary Examination Under Oath
Applying depreciation and hold-back.
Delaying the claims payment while you rack-up
expenses putting you in a very vulnerable position.
EXAMINATION UNDER OATH
Provided for in the policy but it’s a sign your claim is
taking a nose-dive.
Usually requested only when insured fails or refuses to
cooperate or provide documents OR when there is a
large difference between your bids and their bids.
They CANNOT badger or try to intimidate you and they
must ask “relevant and reasonable necessary”
An EUO may be used to delay the final resolution of a
You are allowed to have your attorney present.
WILL YOU BE SUBJECT TO
UNDER- or OVER- INSURED
Some policies are limited to stated policy limits.
Some policies will pay full replacement cost without regard to
Some policies will pay up to a certain percent over stated limits
if certain conditions are met.
Some pay full replacement costs if insured trusted
the agent/company to establish value/stated limits.
Usually applies to contents only.
Absent policy language, CA uses “market value” rule.
Policy language governs what happens which is why you
should carefully read your policy.
No real set standards for depreciation.
Adjuster’s estimates will probably differ greatly from your
contractor’s estimates. Why? If they can get away with
paying less, that’s what they will try.
Adjuster’s Scope of Loss may be inadequate.
Insured should review and agree on Scope of Loss before
estimates are prepared.
If water was used to douse the fire, and the property was only
damaged (not a complete loss), be certain that mold is not
present as a costly clean up may be required.
NOT PROVIDING FULL
ADDITIONAL LIVING EXPENSES
Company should offer an advance.
Should set up direct pay with hotel, etc.
Should reimburse promptly when incurred.
The insurance company is entitled to deduct normal expenses.
SHOULD PROVIDE SIMILAR STANDARD OF LIVING.
Your house: The house they put you in:
OTHER THINGS TO EXPECT
Insurers will attempt, perhaps with some success,
to dramatically raise all homeowners’ rates in
California and they will blame the victims for such
increases. This pits neighbor against neighbor and
the industry’s position is not rational because
wildfires are something insurers plan for in their rate
making process. In other words, insurers will use the
wildfires as an EXCUSE to raise rates throughout
California, which may cause non-victims to blame
victims for rate increases.
Public adjusters will be swarming victims.
CONSIDERATIONS BEFORE HIRING A
A public adjuster can help document the inventory of a home,
construction costs and interface with the adjuster. Only YOU
can decide if it’s worth paying a public adjuster 10 – 15% of
what is rightfully YOURS.
Public adjusters operate in a rather unregulated area.
A public adjuster is NOT an attorney and may even ruin your
claim because of what they do or don’t do. A public adjuster is
YOUR agent so you are bound by what they do.
Our rule of thumb: if you can afford to do without a public
adjuster, you can’t afford a public adjuster.
THE PUBLIC ADJUSTER GAME
WATCH OUT FOR THESE COMMON
Do not sign a contract that forces you to pay anything
unless money is actually collected.
If the public adjuster cannot get your claim settled within a
specific period of time, make certain his/her contract can
be terminated and the public adjuster does not have a lien
on your claim. If an adjuster has a lien on your claim,
many reputable attorneys will not take your case.
Do not hire a public adjuster if there is any way your
insurer will honor their policy as the adjuster will take 10 –
15% of YOUR money.
We will be hosting two FREE seminars in
SAN DIEGO SEMINAR
When: Saturday, November 15, 2003
Time: 9:00 am – 12:00 noon
Where: Scottish Rite Center at 1895 Camino del Rio South,
When: Saturday, November 15, 2003
Time: 2:30 pm – 4:30 pm
Where: Doubletree Hotel, Big Bear Room, 222 North Vineyard
RSVP required: 888-648-8823
POLICYHOLDERS OF AMERICA
Empowering the Policyholder