Is it Time for a Little Fall Cleaning?

by Mark Goldwich

Image courtesy of commons.wikimedia.org

As the Fall season is upon us, with more and more proof descending from the trees each day, I began to wonder why no one ever says, “Time for a good Fall cleaning” like they do each Spring. According to Wikipedia.com, “Spring cleaning is the practice of thoroughly cleaning a house in the springtime. The practice of spring cleaning is especially prevalent in climates with a cold winter.”

I read on to learn “It has been suggested that the origins of spring cleaning date back to the Iranian Norouz, the Persian new year, which falls on the first day of spring. Iranians continue the practice of "khooneh tekouni" which literally means "shaking the house" just before the new year. Everything in the house is thoroughly cleaned, from the drapes to the furniture. A similar tradition is the Scottish "New Year's cleaning" on Hogmanay (December 31), a practice now also widespread in Ireland, New Zealand, and to North America.

“Another possibility of the origin of spring cleaning can be traced to the ancient Jewish practice of thoroughly cleansing the home in anticipation of the spring-time memorial feast of Passover. In remembrance of the folktale of the Jews' hasty flight from Egypt following their captivity there, during the seven-day observance of the Passover memorial or remembrance, there are strict prohibitions against eating or drinking anything which may have been leavened or fermented with yeast. Jews are not only supposed to refrain from leavened foodstuffs, they are expressly commanded to rid their homes of even small remnants of chametz for the length of the holiday. Therefore, observant Jews conducted a thorough "spring cleaning" of the house, followed by a traditional hunt for chametz crumbs by candlelight (called bedikat chametz) on the evening before the holiday begins.

Image courtesy of commons.wikimedia.org

“In North America and northern Europe, the custom found an especially practical value due to those regions' continental and wet climates. During the 19th century in America, prior to the advent of the vacuum cleaner, March was often the best time for dusting because it was getting warm enough to open windows and doors (but not warm enough for insects to be a problem), and the high winds could carry the dust out of the house. For the same reason, modern rural households often use the month of March for cleaning projects involving the use of chemical products which generate fumes. The most common usage of spring cleaning refers to the yearly act of cleaning a house from top to bottom which would take place in the first warm days of the year typically in spring, hence the name.”

Now, I will admit that “Spring cleaning” typically refers to cleaning done inside the home, so perhaps “Fall cleaning” should refer to cleaning done outside the home. After all, the weather has cooled down (some, but not much yet), and there is plenty to clean up outside the home, the most obvious of which is the leaves. While Fall leaves make for great photographs, and great fun (if you like diving into a huge pile of them), for most property owners, the falling leaves represent a lot of work…work that has either got to be done yourself, or that you have to pay others to do.

image courtesy of pixabay.com

But now that we are thinking about cleaning up around the home, let’s go beyond raking leaves in the yard. Keep in mind, not all leaves that fall end up in the yard. Many land on the roof, and collect in valleys, or low spots, or gutters. I have seen roofs that have had so many leaves fall for such a long time without being cleaned up, that the leaves had decomposed into dirt, and small trees were sprouting up!

Leaves left on roofs can create a number of problems. They tend to gather, so the pile of leaves grows bigger and bigger (without any raking). When leaves gather on a roof, they invite pests of all kinds to nest and reproduce. Water flow is restricted by the leaves, which may allow water to make its way into your home, without ever “creating” an opening. The reason most roofs are sloped is so water (as well as snow) can flow quickly off the roof, fast enough so it does not find a way into the building. 

When you reduce the speed at which the water is attempting to exit the roof, you increase the opportunity for the water to find a way in. Also, decomposing piles of leaves stay wet longer, and can damage roof shingles.  The same goes for leaves that gather too long in gutters. The leaves eventually decompose, making room for more and more leaves, which also decompose, and after a while the gutters are full of a mushy organic material that supports insect life, plant growth, and weighs heavy on the gutters, as well as the pins that attach them to the roof structure.

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In other words, if you see a bunch of leaves on your roof, or in your gutters, it is best to clear them out as soon as possible. Your home will not only look better, but it will function better, and last longer. And you shouldn’t wait for “Fall cleaning” to do this, but do it anytime you see a “gathering” of leaves, twigs, or branches. This might also be a good time to trim back tree branches and shrubs from your roof or the walls of your home. There should never be tree branches close enough to scrape against your home in a breeze, and there should be a clear space of at least a foot between your home and any shrubs.

I was recently on a roof that had a flat portion in the back, under several huge trees of differing species, and it was literally covered in a 4 inch blanket of leaves in various states of decomposition, with some twigs and dead branches thrown in for good measure. I asked the owner (who was older than I am, and I am no Spring chicken) for a broom, and spent at least 30 minutes clearing off the leaves (a shovel would have done the job a lot faster, and with a lot less effort, but that could easily damage the roof, so don’t try this at home!). I was drenched with sweat, but did a good deed, and got in an extra workout for the day! Oh, Karma, where art thou!

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.   

Not Ready for Prime Time (viewer discretion advised)

by Marc Goldwich

I was reviewing the headlines this morning which were chock full of mayhem.  Everything from the aftermath of catastrophic flooding which resulted in numerous drowning deaths in the South Carolina, to more school shootings, along with a smattering of auto-related fatalities vied for my attention. This combined with Halloween being just around the corner was enough to cause my mind to entertain the dark side of life. So I began thinking about the job of cleaning up after a catastrophe.

Image from commons.wikimedia.org

In case you're not aware, there is an entire industry set up for handling these kinds of events. Typically called “Biohazard Clean-up” or “Crime Scene Clean-up”, these companies are e an offshoot of emergency restoration companies. Whether the hazard you need gone consists of  toxic waste, deadly mold, body fluids or most any other kind of nasty stuff that crop up after an emergency, there are trained professionals who are only too happy to roll up their sleeves and dive right in. 

The hit Discovery TV show “Dirty Jobs” is a favorite of mine, but I doubt you will ever see Mike Rowe tackling this type of job. While certainly “dirty” enough, my guess is it would simply be too disrespectful to find any humor in this line of work, and for his show, humor plays a major role.

There are other shows which depict and deal with death, usually CSI or homicide, but I have never seen one address the clean-up aspect that invariably needs to take place after the police finish their investigation. Since you can now watch shows on just about any occupation imaginable, I would not be surprised to find a show following biohazard clean-up teams around.

So what would that entail? First let’s think about the types of situations these companies and their crews might deal with. Things like:

-          Sewage backups

From commons.wikimedia.org

-          Crime scene residue

-          Suicide

-          Homicide cleanup

-          Blood cleanup

-          Accidental death cleanup

-          MRSA and H1N1 decontamination

-          Hoarding scenes

-          Animal waste/remains

-          Chemical spills

-          Tear gas cleanup

-          Meth lab cleanup

-       Radiological hazards

    

None of these events should be taken lightly, or undertaken by anyone except certified biohazard professionals. Not that most people would want to deal with any of these problems

.

These companies need to be well versed in applicable state and federal regulations, they need to be licensed and certified (where required), they need to use appropriate transportation and/or disposal protocols, and they may need to be registered with the states’ Department of Health. These companies can also expect to be regulated by governing and advisory bodies such as OSHA (Occupational Safety and Health Administration), NIOSH (National Institute for Occupational Safety and Health), DOT (Department of Transportation), and EPA (Environmental Protection Agency).

Image courtesy of townhall.com

The dirty work of these professionals usually begins when the coroner’s office, or other governmental entity officially releases the scene to the property owner or other responsible party. Depending on the type and severity of the “event”, the clean-up teams are required to wear protective clothing, may seal off rooms to prevent or minimize the spread of airborne or physical elements of the bio-hazard scene, and follow specified methods and practices to decontaminate such scenes.

The scenes must be meticulously cleaned of all harmful material, which typically includes the removal of any porous materials (whether personal belongings like clothing and sheets, or building materials such as carpeting, wood subfloor, or drywall) – which must all be properly disposed of, and then sanitized. You can only imagine the mess that will be left, even after the mess that was the biohazard is removed.

And many people are so distraught after dealing with such a loss, that they overlook the fact that insurance may cover the expense of the clean-up efforts. Just remember this rule of thumb, if property is damaged as a result, it is probably covered by insurance (either yours, or someone else’s).

ServPro.com provided the following bio-hazard and sewage emergency tips:

After any biohazard or sewage contamination in your home or business, your primary focus should be safety:

-          Is it safe to stay in the house?

-          Exposure to biological and chemical contaminants can pose serious health consequences.

-          Flood water can contain sewage, pesticides, and other contaminants.

-          Only do activities that are safe for you to perform.

Image courtesy of aftermath.com

What to Do After a Contamination

-          Stay out of affected areas.

-          Call emergency service personnel if the situation is life-threatening.

-          Treat all bodily fluids as if they are contaminated.

-          Turn off the HVAC system if there is sewage damage.

What Not to Do After a Contamination

-          Don’t leave wet fabrics in place. Hang furs and leather goods.

-          Don’t leave books, magazines, or other colored items on wet carpet or floors.

-          Don’t use your household vacuum to remove water.

-          Don’t use television or other household appliances.

-          Don’t turn on ceiling fixtures if ceiling is wet, and keep out of rooms where ceilings are sagging.

Let’s all hope we never need these tips, but as we can plainly see from watching the news, the fact is, biohazard clean-up is a grim reality for many families. As with anything else, the more you know in advance of an emergency, the better equipped you will be in handling that situation.

In this article I discussed the subject of biohazard clean-up, and the professionals that are trained to perform what just might be the dirtiest job of all. I mentioned some of the types of events this might involve, and included tips for dealing with such an event.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.   

Hurricane Season is Here

by Mark Goldwich

With so many other topics consuming the 24-hour news cycle lately, and so much time since a hurricane hit their usual targets, a pair of storms whipping up winds today are an important reminder we are in the midst of the height of hurricane season, and we must not be lulled into a false sense of security.

Courtesy en.wikipedia.org

Danny became the first named storm of the Atlantic Ocean Hurricane Season on Tuesday, and quickly became the first hurricane of the Atlantic season on Thursday, according to the National Hurricane Center. By Friday, just 1 day later, it strengthened from a Category 1 hurricane to a Category 3 hurricane, with winds reaching 115 MPH. And as I write this on Saturday morning, Danny has already begun to weaken. It is still a Category 2 hurricane, but is expected to be further downgraded to a tropical storm by tomorrow, and is not expected to have any impact on the United States.

This is not only a good reminder of the need to be prepared for such events, especially for those of us living in hurricane-prone regions, but of how quickly things can change. When Danny was first mentioned earlier in the week, it was simply a tropical storm to be watched, and weeks away from any possibility of affecting the U.S. Even when it reached Category 2 strength, some said it was expected to weaken, and not reach the Category 3 level. And keep in mind, a Category 3 hurricane is considered a “major” hurricane, and capable of catastrophic damage.

And while Danny has already begun to weaken, and meteorologists can opine about high pressure fronts and wind shear and all sorts of other reasons storms act the way they do,  in the end the storm is a living, breathing, and relatively unpredictable phenomenon. As a result, even professionals never know for sure what the storm will do.

Image courtesy of en.wikipedia.org

Eric Holthaus, a meteorologist writing for Slate.com on Thursday wrote, “Danny is currently struggling to strengthen and has a tough road ahead of it: Dry air blown in from the Sahara and a pocket of cyclone-killing wind shear over the Caribbean will probably offset the potential boost from increasingly warm water. It’s not possible to confidently predict Danny will even be a storm at all beyond five days from now. On the other hand, it’s perhaps equally as likely that Danny will be a formidable hurricane in 10 days. There are model runs to support both possibilities.”

Holthaus went on to say, “Though it’s borderline meteorological sacrilege to even discuss the possibility of a tropical cyclone landfall so far in advance, a Danny landfall in the mainland United States has the tenuous support of two of the leading weather forecast models, the Euro and the Global Forecast System, the flagship model of the U.S. National Oceanic and Atmospheric Administration. The Euro, widely regarded as the world’s most accurate weather model, has been relatively consistent over the last several model runs that a weak version of Danny could approach Florida in about 10 days. The GFS has been much more variable, showing a potentially stronger landfall anywhere on the East Coast—as well as the possibility of a much safer curve out to sea. But you should take this information with an Everest-sized grain of salt.”

Predictions are made, analyzed, evaluated, revised, and then reanalyzed in hindsight after events actually occurred. If the person making the prediction turns out to be correct, they are congratulated for “knowing” what would happen. If they are wrong, they simply explain what happened to cause the prediction (not “them”) to miss the mark.

Meanwhile, a depression in the Pacific Ocean strengthened into what is now called Tropical Storm Kilo on Friday, churning about 500 miles southeast of Hilo, Hawaii. Forecasters believe Kilo could grow in strength into a hurricane by Monday, the Central Pacific Hurricane Center said. One forecast track indicates it could move under Hawaii before changing course back toward Hawaii, and may threaten the state as a hurricane by Wednesday.

Image courtesy flickr.com

In the end, all we can do each time a depression, or storm, or hurricane is taking shape, is to pay attention and prepare for the worst based on information gathered from multiple sources. Of course, it is always better to be prepared (even if nothing happens) than to be unprepared, because when the rare instance of a major storm does happen, being unprepared can lead to disastrous consequences. 

There are so many resources to take advantage of today, and I do not want to bore anyone with disaster plans and safety kits (I’ve probably done this enough already), but I do want to remind you to take some time to at least contemplate what you would do if you had 24 hours to prepare for a large-scale natural disaster. Get on the computer, and find a disaster plan you like, complete with emergency supply kit, and at least print it out and review it with your family. This 30-60 minute exercise would not only create some “family time”, but would hopefully become a habit, and over time increase in everyone the confidence that comes from such repeated planning. The last thing you want to wind up doing is standing in a big box store as a hurricane bears down trying to grab the last couple of pieces of plywood, or the last few cans of food on the supermarket shelves.

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This type of exercise is good for much more than hurricane planning, I believe it helps shape the way people react and act in all kinds of stressful situations, allowing them to remain calm, prioritize needs, and take measured actions in coordination with others (or alone).

So thank Danny and Kilo, for the wake-up call to remind us that Hillary’s email scandal and pre-season football is not the most important news of the day. Remember that while the hurricane season has been quiet so far, it's far from over. Stay vigilant, my friends.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.   

Watch Your Step

by Mark Goldwich

Just as every rose has its thorn, every job has its hazards. In the world of insurance adjusting, depending on the type of adjusting being done, these hazards can range greatly (probably much like many other jobs). For anyone curious about the potential hazards of my industry, or for those who might be interested in a career in adjusting, the following will give you an idea of the risks we face.

First I’ll start with those adjusters who work primarily in an office setting (and yes, many insurance adjusters, especially as technology improves, never leave an office to settle your insurance claim). Besides the obvious hazards of getting into car accidents going to and from the office, or tripping on your own shoelaces, most in-office hazards come from repeated activities – staring at a computer screen all day, sitting in a chair all day, and typing for hours on end.

Image courtesy of flickr.com

Many corporate offices have access to ergonomics specialists within their Human Resources departments, or offer training videos on workplace safety. In addition to taking advantage of these resources, certainly it is wise to always be aware of things like tripping hazards (loose carpet, uneven surfaces, electrical cords, changes in floor elevations that are minor or difficult to see, or items placed on the floor near a corner). Then there are slipping hazards (water or other fluids dripping or leaking on a hard surface), sharp edges on furniture or accessories.  Las but least we come to the falling hazards (usually from a heavy or unstable object placed too close to the edge of a shelf or other piece of furniture). I'll bet you didn't know the work place could be such a hazard zone.

Get up from your desk on a regular basis and take a brief walk around, doing simple eye, wrist, back or neck exercises based on professional advice and your personal needs. Not only can you avoid some of the repetitive motion conditions, you may take this time to take note of other potential hazards in the office, and recharge your batteries.

Many insurance adjusters who work in an office, also work in the field, whether at private residences, commercial properties, or car repair shops. These adjusters not only spend more time in their cars trying to avoid getting hit by other drivers, but typically find themselves in unfamiliar surroundings, without the benefit of management and/or HR sanitizing every surface year-round. 

Once you venture outside, the number of hazards increase exponentially, and there are far too many to name here. I’ll just give an idea of a few I have encountered over the years.

Image courtesy of en.wikimedia.org

As field adjusters, and especially as catastrophe adjusters, a major component of the job is climbing onto roofs. Most people can appreciate the obvious hazard of falling off the roof, but that is only half the battle. The method for getting on and off the roof – the ladder – is the other half. You have to be careful to set up the ladder properly, facing the right direction (yes, most ladders have instructions printed right on them with illustrations to show how to set up the ladder safely), and on the right surfaces. I once set up my ladder in the trunk of my car because I just needed 2 more feet to get up on a roof. The smart thing would have been to leave and return with a ladder that would reach this particular roof, but when in a hurry, and having a appointments to keep, people tend to improvise. It looked like it would work fine, and in fact it looked like I was in the clear until I made it to the eaves. At that point, there was enough of a shift in the weight being placed on the ladder that the felt-like material in the trunk suddenly gave way, quickly taking the legs of the ladder out from under me. All I could do was react, placing one hand on the roof, and another on the gutter, expecting the ladder to drop away completely and leave me hanging until I could drop myself down as safely as possible. Fortunately, the ladder didn’t drop completely away, and I was able to climb down without any injury to myself – and I only had to pay the homeowner for a minor gutter repair.

One of my adjusters was not as lucky when the ladder he set up on the side of a home slipped out from under him. He was just getting back on the ladder to climb down from the roof when this happened, and his first instinct was to push himself away from the ladder so he could land a safe distance away on his feet. Except for the possibility of twisting an ankle upon landing, I think he would have been fine, but he didn’t see there was a clothesline behind him, and as he came down, the clothesline hit the back of his legs, causing his body to rotate backwards, and he landed hard on his upper back and head, nearly losing consciousness.

Over the years I’ve heard many stories of people who were so focused on reading their tape measures, or were too engrossed in trying to identify damage on a roof, that they simply stepped off the edge of the roof, sometimes resulting in serious injury or death.

Image courtesy of pixabay.com

Then there was the time I was on a wood shake roof in Oklahoma when I came upon a section of the roof that was home to a swarm of wasps, and they did not appreciate my trespassing in their space. This might have been just the right time to be scared stiff, because it gave me time to think about my next (slow) steps, and not get the wasps any more excited than they already were. Disaster averted!

In addition to the above, there are a host of dangers on roofs alone – high voltage electrical lines, slippery spots of mold or mildew, and rotten wood that can give way beneath you and land you in the attic, to name a few. And don’t forget the sun, lightning, and other weather conditions – I once got hailed on while inspecting a hail claim!

Then you have other critters you come across while doing property inspections, from bats to bees, to spiders and snakes, to overly protective and aggressive dogs. I even once found myself surrounded by a tribe (or trip) of goats on a farm in Texas. At first it was cool as a few gathered around to see what I was doing there. But before long they were all around me, nibbling and crowding and a few butting. Good thing I had my trusty ladder with me to help fend enough of them off so I could make my escape.

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Finally, you have all the hazards that are difficult to see when the destruction is especially heavy. After a severe disaster from fire, hurricane, flood, or tornado, there are many sharps pieces of debris that are literally everywhere. I have stepped on nails, been cut by glass, and poked by sharp or pointy spikes of wood or metal. Getting a tetanus shot every 10 years was not a problem for me. And most recently, I stepped into a quicksand-like mixture of sand and sewage, going from walking on solid ground to sinking to my knees in just 1 step. You hear about quicksand, or see it depicted on TV or in movies, but until you are in it, you can’t really imagine the holding power it has on you – I was stuck! And I stunk!

Overall, I have been very lucky throughout the years to escape any serious injury. Then again, except for a few times when lapses in judgement almost cost me dearly, I’d like to think I was pretty careful more often than not, considering my surroundings, taking  care to minimize the risks I was taking. Whatever your job, be careful, be observant, and listen to that little voice in your head (that grows louder as you grow older). 

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.  

Hold the Mold

by Mark Goldwich

If you are like me and many other people I know, you have been suffering from allergies due to especially high pollen levels. It is amazing how much aggravation those tiny little spores can inflict on people, especially if they are sensitive to it, as I am. While I usually like to be outdoors and enjoying the sunshine and fresh air, lately I just want to be in my home or office, windows shut tight, breathing nice stale air with minimal pollen.

Knowing there had to be a way to relate this to insurance claims, I quickly realized mold is a lot like pollen – itty bitty spores floating around when the environmental conditions are just right, wreaking havoc on those people who are most sensitive, and those items that are most difficult to get mold out of.

Image courtesy of blackmoldrepair.com

Mold damage to domestic and commercial properties can be both extremely dangerous from a personal health perspective and quite expensive to repair - far more expensive to repair than a lot of property owners realize. Especially if it’s that black mold we keep hearing about with the scary name - Stachybotrys chartarum. This variety of mold has been known to cause illnesses including brain damage, and has also been said to be linked to “sick building syndrome”.

Not surprisingly, perhaps, the insurance companies have not only figured out how much this kind of damage can cost ... they have also figured out how to avoid paying for the majority of the damage in the most severe cases.

Like most things, it used to be a lot simpler. In the situation where you have a sudden major loss that is covered by your policy and mold quickly ensues as a result of that loss, then historically, what has happened is that the policy simply kicked in to cover the damages. Whatever the insurance company had to pay to repair your property was simply what it would pay, whether it was a little, or a whole lot.

Courtesy of blackmoldmichigan.com

I actually had a claim just a couple of years ago where a couple had what was deemed a covered mold loss, and the insurance company ended up paying something close to a quarter of a million dollars – a huge amount – especially when compared to the $8,200 the insurance company offered before I got involved. Of course, that was what the couple had been paying healthy premiums for years to be protected from: that huge repair bill.  

Nowadays, that simple outcome is much less likely to happen, at least in my state. In almost every policy in the state of Florida, you will find something called a "mold endorsement." This is a very tricky piece of policy wording. Why do I say "tricky?" That’s because normally, an endorsement is something that gives you additional coverage within your policy above and beyond the boilerplate language. This passage is tricky because it leads you to expect you are getting coverage that you're not.

The policy seems to give you extra coverage for mold, but actually, under this endorsement, that coverage is severely limited, typically to a maximum of ten thousand dollars. That may sound like a lot of money if you've never been through the process, but as the experience of those homeowners I worked with a few years back suggests, it really isn't.

Notice once again what has happened here. The industry is not cutting your premium by 90% because you're suddenly getting a tenth of the coverage on mold damage that you might have imagined you were getting when you first became a customer. It's simply reducing your coverage by 90% and calling it a day.

Image from dreamstime.com

If we went to the supermarket, and found we had to pay the same amount for a gallon of milk that we had to pay last week … but then realized, as we put our groceries away, that the gallon container only contained a cup of milk … we might have cause to complain to the state consumer protection authorities. And we certainly would have cause for complaint if we noticed that every single provider of milk in the state had executed the same “adjustment” at roughly the same time! In such a situation, it would be very hard to believe that the local and national news outlets wouldn't devote heavy coverage to such an “adjustment,” and it would be hard to imagine, too, that politicians and regulators would sit still for such abuse of the consumer.

But this isn't milk we're talking about. It's insurance. It's not something you pour on your cereal. It's your ability to restore your life, your home, and your family after a disaster. So no one pays much attention. Except the individual consumers who find out the hard way that they have a problem.

The problem is that most homeowners a) don't know that ten thousand dollars may not be close to  solving a mold remediation problem, and b) would probably never bother to check the language anyway. So what has the industry done here? It has simply decided that it was paying too much on completely legitimate mold claims ... and found a way to pass the vast majority of the costs to repair the most serious cases on to consumers who don't know any better. The insurance companies needed no legal authorization to do this. They simply put it into their agreement, called it an "endorsement," and made your life significantly more difficult and expensive when the time comes to deal with the mold problem. Here again, we have a situation where you need a professional review of your policy before you sign on the dotted line, especially before you accept a claim settlement.

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I certainly hope this has enlightened you a little bit about mold endorsements. But, there is actually a whole lot more on the topic of endorsements that you should know about – maybe next time! Just remember, when it comes to mold, or endorsements, or anything insurance claim related, don’t assume the insurance company is on your side, and don’t accept what they tell you as the absolute truth. Seek professional help … just as you would for severe allergies.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.

The NHL Has Nothing on These Guys

by Mark Goldwich

With the bone chilling weather currently gripping the country the thought of ice hockey

gettyimages.com

seemed particularly appropriate when dealing with today's topic of deflection.  If you have been reading my posts, you now understand the basic principles behind what may well be the insurance industry’s ultimate weapon. As you should have noticed, it’s pretty mind-boggling.

Unfortunately, the process now gets even more complex. In addition to playing a kind of shell game involving you, the adjuster, and the engineering firm, the insurance company may bring other outsiders into the picture. When they do, the outcome, in far too many cases, is a game at a whole different level, a game that most policyholders can’t understand, and much less win. Just like the gambling casino in Vegas or Atlantic City, certain industries tend to promote games that it knows the House will win. Today I’m going to share one example of the kind of “advanced” deflection game you may well find yourself up against after a major property loss.

Q&A: What you should know

• What is “advanced” deflection on the part of the insurance industry? It’s deflection that uses a separate company that appears to be acting on behalf of the insurance company, but in your best interest.

• Why “appears”? Because, ultimately, the company may not be acting in your interest at all. Just like the insurance company, this company is best regarded as your adversary.

• Can you give an example of this? There are many examples, but perhaps the most dramatic involves special building contractors known as “preferred vendors.” As the name implies, these companies are “preferred” contractors recommended by the insurance company following a loss. But you should understand why the insurance company “prefers” to use them. The insurance company uses them because they’re cost-effective from the insurance company’s point of view. From your point of view, though, there may well be very expensive problems.

• How am I likely to come in contact with such a “preferred service provider”? It’s a distinct possibility, especially after a major natural disaster. (Keep in mind, though, that different insurance companies call these providers by different names.)

Here’s how it might happen: Let’s say your home has experienced significant water damage from a burst pipe, and your floor is ruined. The adjuster, or a representative of the insurance company, may say something like this: “We’ve got everything covered – you don’t even have to look around for a contractor. We’re going to send out a repair firm. They’re on our preferred list. They’ll handle everything. Just sign the paperwork they’ll give you when they show up and give them your deductible.” Those may not be the exact words you hear, but the gist of the message will probably be the same. “Don’t worry, we’ll take care of you.” How convenient it all seems!

• Then what happens? The contractor shows up at your doorstep … and you probably make a huge mistake.

• What mistake is that? You imagine that the contractor is working for the insurance company to fix your floor. But in fact, the contractor is operating as an independent business.

From a formal point of view, the contractor is now working for you, which means you, not the insurance company, are responsible for resolving any problems that arise.

• Wouldn’t that be true of any contractor I chose? Yes.

• Why is this relationship different? Because, even though the contractor is (technically) working for you, it’s been referred by the insurance company. In other words, that’s where it gets a good deal of its business from. So its priorities about things like quality, workmanship, timeliness, customer care, and even respect for your belongings may not be based on how happy you are with the job they do. Even though they may be legally working for you, some of these providers act as if the insurance company is the entity they’re most interested in keeping happy. This can lead to some very unfortunate situations.

Getting Hit with a Cheap Shot

• For instance? In one case I worked on, the homeowner had sustained significant water

Image courtesy of gazettenet.com

damage. The contractor showed up on the homeowner’s door, handed over some paperwork, and told the homeowner to “sign here.” The homeowner signed and paid the deductible, under the impression that the insurance company was actually performing the repairs, and would hold the contractor accountable. Not so!

As it happened, the job took three weeks, not the three to five days the homeowner had been promised. The quality of the work was slapdash, with paint splattered everywhere

and sub-par finish work. And as if that wasn’t enough, the contractor placed all of the homeowner’s furniture in a portable storage unit just outside the home … a portable storage unit that happened to have a leak.

Then the rain fell, but nobody knew that the furniture was being ruined. The family sustained thousands of dollars of additional losses to their furniture!

• Which the insurance company covered, right? No! (well, not right away) The insurance company claimed that, because the homeowner had “signed here,” the work of the contractor --- and the oversights of the contractor – were entirely the homeowner’s responsibility!

Once again, the insurance company’s response was an unwelcome one: “It’s not our responsibility.” That’s advanced deflection.

• What did the contractor do? It stonewalled, totally ignoring the homeowners.

• How likely am I to be able to turn around a situation similar to that on my own, as an individual homeowner? In my experience, not likely at all.

• So did this homeowner lose out? Fortunately, no. They came to me, and I was able to convince the insurance company to live up to its obligations.

• What was the result? The homeowners were compensated for the shoddy workmanship (enough for them to have all the work done again - properly this time), and the loss of their furniture.

In the end, I secured a $47,000 settlement for them over and above the $25,000 the insurance company had initially paid to the contractor to do the work.

• How the heck did you do that? Well now, that’s the “secret sauce”, isn’t it! The short of it is, I know what is important to insurance companies, how they develop and maintain relationships with “preferred” contractors, and how it can used against them. If there is anything an insurance company hates more than paying too much on a claim, it is looking bad and losing credibility – especially when dealing with a senior citizen customer of over 50 years!

By the way, I remember this homeowner saying “I don’t understand, they’ve always treated me so well.” And when I asked, “How many homeowners claims have you submitted in the past?,” I’ll never forget his answer…”none.” Nuff said!!

image courtesy of nytimes.com

• Are there other kinds of deflection I should watch out for? Sure. Every claim is different, and the ways insurance companies are handling them (and introducing other parties into the mix) changes all the time, so we can’t get into every type of deflection.

Ultimately when it comes to winning the game you need to understand the rules if you hope to protect the goal before a hockey game breaks out as you fight for your next insurance claim.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.

The Mad Hatter's New Gig

by Mark Goldwich

We're all familiar with the Mad Hatter of Alice in Wonderland.  He's the character that doesn't quite

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see the world the same as the rest of us.  While a work of fiction, he would feel right at home in the insurance industry as you will see in today's blog.

In a previous blog, I gave you an overview of the insurance industry’s third big “coincidence” – what you and I might call intentional avoidance of responsibility.

When you encounter this event, which can come about at any point in the process, you’ll learn that the industry is quite adept at shifting responsibility for taking action on a valid claim to some other organization, entity, or person. In this blog, we’ll get a close look at some of the simpler methods that the industry has established over the years for deflecting important questions. What follows is a thumbnail sketch of what might be called “low-level” or “basic” deflection. (We’ll look at some of the more advanced strategies the industry can put into play in the next blog.)

Q&A: What you should know:

• How does the insurance industry make deflection work in its favor at the most basic level? By taking full advantage of the coincidence of incompetence among the very people it hires as adjusters and other third-party representatives. I can’t tell you how many times policyholders have had an experience like the following:

- Call the insurance company. Get a recording with another number to call.

- Call the number (disaster call center). Hold for extended period.

- Get disconnected.

- Call the call center repeatedly. Hold for extended period. Find out it wasn’t the call center that you wanted to talk to.

- Get adjuster’s number to call.

- Call the adjuster. Fail to get a response.

- Call the adjuster. Fail to get a response.

- Call the adjuster several more times. Finally, get some unsatisfying response.

- Call the adjuster. Fail to get any response, even an unsatisfying one.

- Wait absurd amounts of time. After losing all patience with the adjuster, call the insurance company to complain.

- Upon reaching the insurance company, hear something like the following: “We’ve had problems with that adjuster – he’s no longer working for us. We’ve assigned someone else to your claim.”

- And so on.

I know it sounds absurd, but you can rest assured that this kind of thing really happens. Here is an actual call center conversation sent to me by a client:

Policyholder: “Hello, I'm calling about my claim.”

Insurance company: “The phone number for the claims department is no longer being answered by the claims department.”

Policyholder: “Why?”

Insurance company: “The claims department is not taking calls because they are too busy. You can leave a message and someone will call you back.”

Policyholder: “When?”

Insurance company: “We can't say, because they are just too busy.”

Policyholder: “Is there a number I can call for the claims department?”

Insurance company: “Yes, the number you just called.”

Policyholder: “But you said you were not the claims department.”

Insurance company: “Yes, that’s correct…Is there anything else I can help you with?”

Policyholder: “Well, I'm not sure, since you haven't helped me at all.”

What is the hatter with me?

Notice that, because the call center person or adjuster is often an independent contractor, rather than a full-time employee, the insurance company itself is very often not “at fault” for anything -- beyond selecting a poor contractor. “Besides,” they will tell you, “this was a major catastrophe.” As if your home being in ruins wasn’t a good enough hint.

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Note, too, the cumulative effect of this whole process, especially the insurance company’s assurance that someone else is now on the case … someone who will be equally hard to track down. The cumulative effect is to further exasperate and frustrate the policyholder. You’re one step closer to giving up on the whole process. Once again, people within the industry are likely to say that such a turn of events is entirely coincidental and beyond their control. But this coincidence, too, endlessly repeated in the lives of thousands upon thousands of policyholders who have recently experienced a disaster or accident, happens to benefit the bottom line of the industry as a whole.

And all the while, the company can claim that the dereliction of duty is not their responsibility, but someone else’s.

• Are “incompetent” adjusters the industry’s only means of deflecting responsibility for taking action on a valid claim? Not by a long shot. Think of it this way: if you wanted to go out hunting for bear, would you load only one bullet in your gun?

• What other varieties of low-level deflection do policyholders have to contend with? One of the most common is what I call the “Engineer’s Deflection.” In this shocking coincidence, the engineering firm the insurance company hires becomes the scapegoat.

The insurance company will say that it has to arrange for the opinion of an outside expert – typically an engineering firm – to assess a specific damage to your property. Time will pass. The engineer will be identified. More time will pass. The engineer will show up to look at your property. The engineer will make an inspection, take some photographs and notes, and leave. More time will pass (usually a lot more time). The engineer will file a report with the insurance company. More time will pass.

Having taken even more time to analyze the report, the insurance company will find something unusual, strange, or inadequate about an issue the engineer has raised, and will tell the adjuster about it. More time will pass. The adjuster will inform you that his or her “hands are tied” – that the engineer has found a problem or inconsistency that keeps the adjuster from processing the claim in your favor.

You might as well say "I eat what I see" is the same thing as "I see what I eat!"

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In these situations, it’s not at all uncommon for the adjuster to tell the homeowner something along the following lines: “In most cases where we encounter (storm damage/fire damage/whatever damage) like this, we pay the claim … but in your situation, the engineer found (Strange Situation We Hardly Ever Encounter). I wish I could pay the claim, but the engineer’s report won’t let me.”

What the adjuster won’t tell you in this situation is that the same speech, with slight variations, has been delivered to countless other policyholders who trusted that insurance company, and paid that insurance company, to protect them against a certain risk.

• Can the engineer really “tie the insurance company’s hands” in this way? No, absolutely not. The engineering firm is not driving the process, and the engineer’s report is not binding on the insurance company. It is one tool, and only one tool, the company uses to determine the cause, nature and extent of the damage to your property. A different engineering report from a different firm can (and often does) point toward a totally different conclusion. But the insurance company, and the adjuster it hires to represent it, often likes to pretend that a report from an engineer that “raises red flags” is like an edict from the U.S. Supreme Court.

Of course, it doesn’t have to be an engineer. The entity “tying the insurance company’s hands” can be a roofer, plumber, contractor, restoration company, weather service – the deflection list goes on and on.

• Who else can the insurance company use as an agent of “low-level” deflection? You.

• Me? Yes, you, the policyholder. In a lawsuit filed by Mississippi Attorney General Jim Hood, it was alleged that in the aftermath of Hurricane Katrina, and without drawing much attention to themselves, insurance industry representatives went around visiting homeowners and asked them to sign some (seemingly) routine paperwork before the adjuster could actually examine the property or pay for living expenses. Many of the homeowners, eager to get the wheels of the adjusting process moving, or out of desperation for the promise of financial assistance, simply signed these documents without reading them closely. Big mistake.

What the papers said was that the policyholders were acknowledging that they were victims of flood damage (for which they were not covered) rather than hurricane damage (for which they were). Thus, the final responsibility for nonpayment of the claim shifted to the all-too-compliant policyholder. Who made this deflection possible? You did!

• What’s the moral of these horror stories? There are three big lessons to take away from these stories. First, and most important, get a public adjuster working for you just as soon as you suspect you may have to file a claim for damage to your property (or, at the very least, once you find your claim going sour). Second, refer all questions about engineers and engineering reports to your public adjuster. And third, never, ever sign anything because you think you’re “supposed to” in order to get an insurance company adjuster to look at your property. There should never be any preliminary paperwork necessary to get an adjuster to assess damage to your home.

That’s “low-level” deflection. In the next blog, you’ll see some of the examples of advanced deflection from the insurance industry. They’re even scarier. What's the hatter with them?

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.