Claims Assistance: Take Charge and Manage the Disaster Yourself….
When you suffer any form of disaster, can you trust the insurer to pay you all you are entitled quickly or will your grief be extended and your life be put on hold until you learn that recovery is not simple and takes its toll on your nerves, time and finances?? For centuries, insurance consumers like you have been trained by their insurers to go directly to them when seeking claims assistance.
Not one insurance company has a financial incentive to pay you quickly or fairly. To the contrary, their incentive is to pay you low or slow. Without a support system, you and your claim are one in a million and treated like a grain of sand on the beach of the insurance company’s paradise.
WHAT DO YOU DO FIRST?
Try managing your Disaster Recovery Misery Index. The discussion below outlines various plans of attack,
MANAGING YOUR DISASTER RECOVERY MISERY INDEX
Many months after Hurricane Sandy tore through the North Atlantic, thousands of home and business owners were still waiting for their insurance companies to tell them how much damage they have. Why?
Contrary to popular belief, the single most important issue to understand about the disaster recovery process is that it is your responsibility to prove to your insurer how much damage occurred to your property. It is not their job to tell you.
This means that you must take a very pro-active position to prove your losses to your insurance company. Doing this will require you to become a very effective manager. If you fail to take charge and manage the disaster, the disaster will manage you and there is not much you can do about it.
Insurance companies are in business to make a profit. They collect premiums from you and give you a contract in return for your money. If you have a claim, your contract clearly explains WHAT you must do in order to prove your loss to the insurance company, however it does not tell you HOW to do WHAT you are supposed to do. If they told you HOW to do WHAT you are supposed to do, it would be a conflict of interest.
The amount of money you get from your insurance company and the quality of the contractor that does your work is 100% your responsibility. Period! Therefore, you cannot afford to leave your destiny up to your insurance company or inexperienced contractors who do not understand the insurance claim process any more than you do.
Expecting that the insurance company’s adjuster will assist you in the recovery process is simply wishful thinking. This philosophy only serves to waste enormous amounts of your uncompensated time.
When this occurs, your frustration level can immediately become so great that the stress will foster anger. When anger overtakes your ability to think clearly, your ability to manage the process becomes increasingly more difficult. If your stress becomes great enough, you may lose your ability to manage even ordinary activities, causing compounded problems.
In such cases, the end result is that you become so frustrated and angry that you can only focus on revenge, not recovery. When this occurs, you stand to lose years of your life waiting for the government and lawyers on both sides to make you whole again. You may get the money, but you will never regain the time you lost.
FOUR CATEGORIES OF LOSSES
For the purpose of this material, I intend to address two of the four categories of losses, which are damage to structures and to out-buildings. When a structure is damaged, it is the insurance company’s responsibility to pay for the damage. Your responsibility is to prove how much the damage costs. The question is: How do you do that?
This can only be done when you understanding how to screen and then hire the service providers whose fees for services rendered will ultimately determine the amount of your loss.
The speed in which you manage this task will determine the cost of your lost time and the level of your Misery Index. To reduce your Misery Index, you must clearly understand the Who, What, When, Where, Why and How for recovery; i.e., Who is ultimately responsible to do, What in the recovery process, How and When are these responsibilities to be carried out? These are the critical questions that must be answered.
Since insurance policies do not come with a set of instructions entitled “How to Collect Money from Us”, you can be assured that recovering from a disaster is a new skill which must be learned. To help you get a true understanding of the degree of difficulty you face, let’s focus for a moment on what I mean by new skill.
It is extremely important for you to realize that before you can learn a new skill, you must be exposed to the overall concept at least five times before you can get a clear understanding in your mind of what that new skill will require of you. If you are under stress, it may take ten or more times before you finally get the big picture of the new skill. If you are under severe stress, you may never see the big picture because of an unalterable basic rule of human behavior which is; “During times of stress, humans revert to habit”. In order for you to become proficient at disaster recovery or any new skill, you must repeat the process at least 72 times before you can be considered to be truly adept at the task.
(The source of these facts comes from ongoing human behavior studies at the Department of Psychology, Mind Extension Unit, Colorado State University in Ft. Collins, Colorado.)
A reasonable solution to this time-intensive learning process is to hire an experienced Disaster Manager to act in your stead to manage your problem from end to end. The investment in professional advice and guidance can make the difference between quick success and a year or more of lost time. The only alternative is to deal with the problem yourself.
Disaster recovery is a multistage process that can be equated to being forced to go on a journey through a jungle. If you have not been there before, you can expect to run into all sorts of obstacles that will confound and mystify you to the point of exhaustion. Given a choice, most people choose to have an experienced guide who knows the jungle inside and out.
In absence of the above, or if you don’t have an instruction manual that explains jungle survival, a map and the appropriate supplies, you are doomed to get lost several times in your quest for survival. Too many wrong turns and you stand a chance of having to be rescued or failing to survive altogether.
To successfully manage your trip through the disaster recovery jungle, you will need to follow the following eight steps very carefully. When followed, your chances of receiving under payment, losing time, getting into disputes, and being dissatisfied at the end of the road will be substantially minimized. You have the responsibility to establish and prove to the insurance company the “Scope of Loss” and produce a fair and defendable bid from competent service providers to restore the structure back to its original condition. The agreement between you and the service providers will be strictly between you and them.
SUFFERED A DISASTER?? – WHAT TO DO IN CHRONOLOGICAL ORDER
- You notify the insurance company and request an adjuster to review your loss.
- Your next step is to choose a competent professional damage appraisal expert.
- Your appraiser makes an on-site inspection and creates a “Comprehensive Damage Appraisal”.
- The insurance company opens a claim file, sends an adjuster out to the site to make an on-site inspection and documents your loss.
- Both your appraiser and the adjuster will have to do some homework.
- You arrange for your appraiser and the insurance company’s adjuster to meet at the site to compare conclusions. Their task is to establish what needs to be done. At this meeting, no discussion should be had by anyone on any issue other than the structure and the damage. The cost of repairs is impossible to determine at this point in time. The only object of this meeting is to get the insurance company adjuster and your appraiser to agree on the “Scope of Loss”. Your job is to listen, learn and take notes while they come to an agreed “Scope of Loss”.
- Once the “Scope of Loss” has been determined and agreed upon by both the insurance adjuster and your appraiser, your appraiser will create a document which details what needs to be done by the repair people. This document is then used by you to solicit bids from the appropriate, experienced service providers. In the meantime, you need to identify potential service providers to render bids on your project which may include your damage appraisal expert.
- After you have gotten a bid from a well-qualified professional service provider, the next step is to have that service provider meet the insurance adjuster again at the site and go over the “Scope of Loss” and the costs to complete the necessary work. You can expect that the adjuster will want to reduce this cost no matter what the bid. The bottom line is that you get to choose the service provider that you want to do your work, providing he can demonstrate that his prices are within reason, not necessarily the cheapest. If you choose a low price you need to be aware of “extras” later on, or the failure of the provider to complete the project.
- If you intend to have any changes (remodeling) in the work to be done by the contractor, it is imperative that you require that he provide you with a new bid and agreement to reflect exactly what you want done and the exact costs to do it. This extra step prevents you and the contractor from getting into a dispute later on because he was not aware of your intentions. Living and working with a contractor can become a nightmare that can last for months, unless you establish a rapport at the outset. The better you communicate at the beginning, the faster the job will be completed.
- Enter a contract with the contractor based on what you want the contractor do and for heaven’s sake, make sure that the agreement between you and the contractor is detailed in every way to prevent misunderstandings between you during the rebuilding process. You can write your own contract, or make changes to the contractor’s agreement, in writing, and be sure this is acknowledged by the signature of the contractor before the project begins. When I am retained to manage a disaster recovery project, I utilize the following criteria to carefully qualify service providers to work on my client’s project.
HOW TO CHOOSE PROFESSIONALS
To successfully conclude the disaster recovery process, you must choose competent professionals to advise, guide and to serve your interests. These professionals should be able to demonstrate their special training and skills in fire, water and wind damage repair.
These people include certain architects, professional engineers and general contractors; however, the very best people are members of the Insurance Repair Institute or “Certified Restorers” who are certified by the National Institute of Fire Restoration.
For example: Hiring a licensed general contractor to do insurance repair work can be likened to hiring a brain surgeon to perform foot surgery! Although they are both licensed doctors who practice surgery, the similarity stops there.
Architects, engineers or general contractors should be able to provide you with a minimum of five projects that they have recently completed. In absence of these requirements they may not possess the required skills to adequately provide you with quality or uninterrupted restoration services.
Your most important responsibility in the disaster recovery process is choosing the right service providers.
The outcome is going to rest with you and not your insurance company. Although your insurance policy says that the insurance company has the right to restore or replace, they rarely accept the responsibility of hiring contractors, who must completely satisfy the victim. If you fail to retain an experienced insurance restoration specialist, you are virtually guaranteed that the contractor’s and your understandings will be different for the work that will be done. The end result will be another kind of disaster that can end up in costly waste of uncompensated time on your part and perhaps lengthy litigation.
To protect yourself from this dilemma, the following screening rules should be closely followed (The issues are ranked in the order of importance. Any trade-offs or compromises must not be at the expense of a higher listed item).
- Does the contractor have extensive knowledge in water, wind or fire damaged buildings and dealing with victims who are under stress? If not, is the contractor setting you up for delays and/or increases in costs by discovering, after the contract has been signed, hidden damage that the insurance company may not pay for?
- Can the contractor demonstrate that he has the management skills and resources to successfully complete the work that is being sold? In catastrophic situations such as hurricanes, if the contractor is an owner operator, how many days can this person work until he is physically exhausted?
- Does the contractor have the financial savvy and support services to control sub-contractors and material suppliers through the project? If not, will you end up with a partially completed project and possibly a mechanic’s or supplier’s lien on your property, in addition to lost time and money?
- Is the contractor an active member of an association of insurance restoration contractors, such as the Insurance Repair Institute or the National Institute of Fire Restoration? If not, then what qualifies the contractor to determine the “Scope of Loss” or to negotiate with insurance adjusters? If a professional restoration expert does not negotiate the “Scope of Loss” on behalf of the owner the insurance company’s adjuster will use the insurance company’s figures to “cash out” with the owner. This leaves you open to major problems down the road if you take the money from the insurance company and then attempt to hire the service providers for equal to or less than you were paid. More often than not, this is a lesson that will cost you dearly in time and money and is rarely rectified.
- How does the contractor hire, control, train and supervise his employees for quality control? Without the quality assurance system in place, you may end up with delays, faulty workmanship and expensive litigation.
- What are the contract stipulations concerning commencement and completion dates, the specific work to be performed, change order procedures, payment schedules, conflict resolution, delay penalties, insurance, warranties, liens, permits, inspections, Gantt charts, etc. Without all of these issues addressed at the outset in the agreement with the contractor, you are guaranteeing that something will not meet your expectations during the process. Your choice is to do it now at no cost, or resolve it later with lengthy litigation.
- Does the contractor provide a room-by-room and line-by-line, detailed bid that describes the specifications for all materials to be used on the project, including: make and model numbers of electrical devices; plumbing fixtures; appliances; the style, quality, thickness of tiles; cabinets; floor coverings; colors; quantities; etc., etc., etc.
- Does the contractor have adequate contingency provisions in the event of his disability, death, financial difficulty, or bankruptcy, to protect you?
- Is the contractor properly licensed?
- Is the contractor insured by an insurance company licensed to do business in your state? If not, your State Insurance Commissioner does not have adequate jurisdiction or control to protect your interest in the event of default or accident.
- What is the price? If the contractor does not have enough profit built into your project, the chances are that the job will not be finished. Beware of low-ball prices. They can create a larger disaster than the first one.
In closing, I’d like to remind you that once you decide to educate yourself, take control and stay on top of things, the project should run smoothly. Keep this booklet handy as your summary checklist of things to do, and always keep in mind:
- Your dealings with the service providers are fully and ultimately your responsibility. You must live with the quantity and quality of work they provide.
- The only responsibility of the insurance company is to fund that work – one time.
- The key to your success will be in direct proportion to how you are able to take charge and MANAGE, MANAGE, MANAGE.
CAP Program Features