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314 1st Ave SW, Park City, MT 59063 TIPS FOR POLICY HOLDERS! INSURANCE POLICY CONDITIONS
An insurance policy is a "Conditional Contract". Meaning you need to comply with the "Conditions" in order to receive the "Benefits". There are several conditions in the various policy forms and many require different duties be met before coverage is owed. Common provisions require you mitigat
e the damage ("stop the bleeding") and provide additional coverage for those services. Another Common one is that you submit a "SWORN PROOF OF LOSS" or "PROOF OF LOSS". Some say upon our request and some do not. Most SPOL's will require the Proof to contain Specific Information to that policy or policy holder's loss. INSURANCE IS A BUSINESS
The insurance industry is the only industry in the world that the person who owes you money sends one of their representatives on over to tell you how much they will pay you for your loss. What would happen if I went to Walmart and told them how much I wanted to pay for a jar of Pickles? If I didn't pay what they wanted me to pay I wouldn't have the pickles or I'd be in jail for stealing. Often the Rep the insurance company sends to determine the amount of damage to your property has very limited and minimal estimating experience. There is also zero obligation for the insurance Company to provide you an estimate that is in compliance with IRC and IBC building codes. I've never once seen an estimate written right the first inspection by an insurance carrier's representative. WHAT TO DO IF YOU HAVE A LOSS? If a Loss has occurred or is occurring than your first obligation is to Mitigate the Loss and stop more damage to the property. Then Call GFPA immediately. If you have a preferred contractor call them as well. If shingles blew off call a contractor to tarp your roof. They need to be covered with a board to stop the elements from getting in your home. DOCUMENT EVERYTHING & CLEARLY PHOTOGRAPH ALL DAMAGED PROPERTY. Include as many identifying details that you can not only of the event that caused the loss but also to the damaged property as soon as possible after the loss. IF YOU CAN SAFETLY TAKE A VIDEO OF THE LOSS AS IT IS OCCURING- This is Huge! If a photo speaks a 1,000 words than a video speaks a 1,000,000. Video's of hailstones, wind gusts, and fires blazing can help substantially. Video's and photos of the property prior to the loss, pre-home appraisal inspection and home inspection reports also can be valuable documentation attesting to the pre-loss condition of your property. From here on out think detective. Think, how can I Prove and Document what is happening or what did happen? If you have a fire and lose everything and you have photos of all your personal property I can't even begin to tell you how much struggle, work, and likely money that you will save yourself! DOCUMENTATION IS KING before the loss.... and after. DOCUMENTING HAIL? As soon as possible Measure the Hail and Take a Photo of the Hail Stone with the Measure Tape on it to Document Size. Wonder the property and find the largest Stone, an averaged sized stone, and the smallest stone and put them in the freezer. If the hail and or wind was extreme and you have missing shingles clearly take photos of ALL Exterior Damage AS WELL AS THE CONDITION OF THE INTERIOR IMMEDIATLY FOLLOWING OR DURING IF NEED BE THE EXISTING CONDITION OF THE INTERIOR. Photo it all. Walls, ceiling, carpet, personal property because when the roof starts leaking and things start getting damaged it's much better to have them than to not. DOCUMENTING WATER DAMAGE FROM STORM? Have a rain gauge? check it. How hard was the wind blowing? Did it change directions? Do you have missing singles? Is there water in the attic? photo it all. BEFORE YOU CALL IN THE CLAIM-----
TAKE NOTES WITH AS MANY DETAILS AS POSSIBLE
Date/Time/Details of Peril or thing that caused the loss/ Your Location if other than loss location/Witnesses & their contact info. IF POSSIBLE, FIND YOUR INSURANCE POLICY(S) & CALL GOOD FAITH PUBLIC ADJUSTING 406-939-3509 FOR A FREE CONSULT BEFORE YOUR CALL YOUR INSURANCE COMPANY. CALL EVEN IF YOU DON'T HAVE YOUR POLICY. REPORTING THE LOSS AND SETTING THE RESERVE
Prior to the Initial Call/Email to the insurance company get your facts straight and write them down. If you can't get a hold of GFPA by phone you should email me the notes/photos/documentation at [email protected]. If I don't respond shortly to either of those 2 methods get a hold of a GC and see if he can come out or provide you with an idea of a ballpark amount of the loss so you can REPORT that AMOUNT to the INSURER when you FILE the CLAIM. Tell them EVERYTHING that was damaged. If you can give them a rough idea of the amount of the loss and a detailed report of what is damaged at that time you may set or help to set the Reserve for Your claim appropriately. The Reserves are what the insurer sets aside or money they may pull from the market to cover your loss. If reserves are set too low you could have a much more difficult time getting it paid than you'd like. Each adjuster has a limit of authority and if your loss goes over his limit of authority they will have to go to his supervisor. If it goes above the supervisors authority she/he will have to go to their supervisor. . . Therefore, it is important to be concise when making the initial report of the claim. Explain how the claim happened, and a summary of all the damages. If there was both hail and extreme wind tell them about both potential perils. You may have damage from both and not know it yet, and Be sure and be ACCURATE about When the loss happened. FROM HERE I WOULD DOCUMENT ALL COMMUNICATIONS WITH THE INSURANCE COMPANY AS THE MT STATE DOI SUGGESTS. Take Note of the date and time you made the phone call. Also, get the representatives name and contact info and be sure to ask them if you need to report the loss in writing. If they do not provide an email address and say someone will be in touch soon that is fine. If you do not have a "Certified Copy" of your policy be sure and tell him that you'll need to review it and the coverages before an inspector can come to your house. If the Loss is over $101,000 request a Large Loss Adjuster. While you're speaking with the adjuster you should be taking down all his responses as well. If he gave you an email send these notes to that email immediately. If he didn't email them to yourself and your agent immediately. If you don't have an agent send the notes to yourself and anyone that is a good account of the truth. Often people think they have their policy but only have the renewal paperwork. It usually consists of a few pages of privacy information and disclosures, your declarations page, and info on how they determined the premiums. Maybe 10-20 pages. A "Certified Policy" means it has been signed and attested that the documentation contains the full and complete policy and usually has a cover letter with a signature or it may be within the policy jacket. If the form says "sample" or has a watermark it is not certified. Certified Residential Policies are usually 30 to 100 pages long and Commercial are usually 150 to 350 pages. There are 2 sections. Section 1 for property damage and section 2 for liability/3rd party claims that we don't help with. Section one has many sections and sub sections within it. To name a few the Declarations page will always be first before section 1 and then you'll have the declarations page, insuring agreement, conditions, exclusions, loss settlement provisions, and exclusions to name a few. THE INSPECTION
Do not allow the adjuster to come to your property when you are not there. Make sure he is licensed, ask for his credentials, ask if he is insured by the insurance company and if he is covered if he falls of the roof. Get his adjuster license number. Make sure your representative is watching him close. If he will allow it I will ask him if I can record. I like to circle up the damage prior to them arriving so the damage is evidenced in their overview photos of the property they take before they start the inspection. Ask a lot of "HOW" and "WHAT" questions that incite an open ended response to your questions. Ask them about any denials using the magic question, "please show me in my policy where it says I don't have coverage for that." If he does, get a second non biased opinion. I TAKE DETAILED NOTES OF THE INSPECTION and Email the notes to your adjuster time stamping and summarizing the inspection and the questions as well as documenting the time of the inspection and your concerns or questions. REPLACEMENT COST
You likely have 180 days to notify the insurer of your intention to fix the damage and make the claim based off the replacement cost provisions of your insurance. If you do not they may try to with hold your depreciation and only pay you the ACV. ACV (actual cash value) = Replacement Cost of the damages immediately after the storm - Minus Depreciation (age, condition, and deterioration). COMMERCIAL POLICIES
- Timeliness is key! Get your policy and review it. Have me review it! There are some new provisions relating to additional building codes coverage that can be very problematic if you have them. The earlier that you know the better. metal and cosmetic damage exclusions that are NOT COOL are also common. The earlier you know about these things, the Better! Caution:
Some contractors do not care weather or not they help you get all of your damage covered or not. I have OFTEN seen contractors purposely disregard storm damage to windows, doors, and garage doors because they don't want to do that work. Roofing is quick and easy money and many companies just come to do the roof and gutters and bounce out with the fast money. This leaves many policy holders who don't pay attention in a state of disrepair. If he's a good contractor he will find all the damage from the loss and tell you of all future damage not caused yet because of the process of the repair and building codes enforcement. Not just the damages to the roof or just the siding that he specializes in. DISCLAIMER:
This post and any legal information herein is public information found using a Google Search. I'm not a lawyer nor am I purporting to be one. Questions regarding any of the legal information referenced on this page and on this post should be directed to an attorney.
