There Goes the Neighborhood

by Mark Goldwich

I can’t remember the last time I heard about an extreme weather event in West Virgina, but I sure did today. And if you were on any major news network, you probably saw it too. Video footage of an entire home, floating down a swollen river while ON FIRE! It was absolutely remarkable to watch - the power of the water, and the contrast of water and fire. It was just spectacular, but in the worst possible way.

Image courtesy of en.wikipedia.org

Now imagine you are the owner of that home. When you can finally return to your former neighborhood, which could be in just a few days, or it might not be for several weeks, it will be almost impossible to recognize. Street signs could be gone, major landmarks might be missing, and if you can find where your home used to be, we already know the home will not be there. Just a clean slab, next to several other clean slabs. It must be absolutely devastating to the mental state of the family.

For younger children, it might have been the only home they have ever known. For older kids, it might represent their childhood and friends. For the parents, it was where they started their family, and built their lives. And for older folks, it may literally be their entire world. But for all of them, it is time to start over, ready or not, but definitely not by choice.

So where do you start when that is not just something happening on the news, but it is your reality? My suggestion would be to start by reaching out to loved ones. Get help, if at all possible, because you are going to need it. And then, in no particular order, take pictures or video. Grab a pad of paper and start taking notes. List your activities and your expenses. Call your insurance agent and report the claim. Go online and learn what you can about what just happened to you, and what you can expect to go through in the coming months and years (note – I did not bother to include “days” or “weeks”, because that is simply not how you are going to be measuring this journey – sorry, trust me). Figure out what assistance is available to you (Red Cross, FEMA, etc.).

Image courtesy of flickr.com

And I would always recommend professional insurance claim assistance, but especially in this case, where you have damage caused by flood AND fire. Maybe you have insurance that protects against both flood and fire – it would be great if you did, but you could still use help to determine which policy you would  want to use to cover which of the items damaged. Just knowing that could make a significant difference as to what damages you attributed to which policy. This alone could more than pay for the fee charged by the insurance adjuster.

But what if you only had insurance that would protect you against one of the two events (flood and fire)? Then you really are going to need help, because imagine this scenario: you have fire insurance, but your insurance company tells you ALL the damage to your property is caused by flood – even though there is plenty of news footage showing your home floating down the river, fully engulfed in flames. While I don’t think there would be an argument for the slab, or maybe even the flooring, or even the baseboards, I would certainly argue a lot of other items were damaged by fire alone. They could still argue if not for the flooding, there would have been no fire. They could also argue that even if the home never caught fire at all, the home and everything in it, would have eventually been destroyed by the flood. As you might guess, I would take on that fight every day of the week.

Conversely, if you only had a flood policy, but no insurance to cover your home for fire, they could argue the majority of the damage to your home, and the belongings inside, were damaged by fire and not flood. If so, I would simply argue the opposite. Is it wrong that I changed my position just like that? I would say no. My job is to fight for the insurance coverage you paid for, not to accept the exclusions they raise. You paid good money for that insurance coverage, and you certainly did not intend any of your premium to be spent on policy exclusions – those just seem to come free with the policy. So yes, quite plainly and openly, I will fight to find any applicable coverage I can, based on the facts of the loss. In other words, if two homes were floating down the river on fire, and one of them only had flood insurance while the other only had fire insurance, I would argue both should be covered, for opposite reasons. And if that sounds like I “want my cake and eat it too”, I’d counter that cliché with “what’s good for the goose is good for the gander!” Anyone who has ever had to wrestle with an insurance company over a claim knows exactly from where I speak.

Once coverage is secured, it is time to start proving your loss. This is going to be difficult as well, since there would be little left to identify, making it difficult to assign a value to it. But it has all been done before. It’s a step by step process, and it does take time, but with the right assistance, you can get back on your feet again. And one day (too long for most people to imagine), you are relocated to a new neighborhood, or your old neighborhood starts to slowly return. Here comes the neighborhood!

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.

How to Write Your Way To Celebrity (Maybe)

by Mark Goldwich

Back in 2005, about a year into my new career as a Public Adjuster, I was telling my wife’s boss “war stories” about claims I was handling in the Florida Panhandle following Hurricane Ivan. After hearing me recount how adjusters would miss appointments without as much as a phone call, write horribly low estimates one after the other, attempt to deny items that were clearly covered by the policy…not to mention the delays! One delay after another, month after agonizing month. It was unbelievable, yet I could recite the details for what seemed like hours on end.

My wife’s boss, a motivational speaker and author of multiple books who goes simply by “Pegine”, stopped me mid-sentence and said, “Is this true? Do the insurance companies really do these things?” Absolutely, I told her. After all, I wasn’t just repeating what I heard from someone else, I was talking about actual claims I was personally working on. These things were really happening, and on a regular basis. While it was not how I was taught as a company adjuster, I quickly saw it as the status quo, especially after a catastrophe. But she was completely beside herself, and emphatically told me, “You need to write a book – people need to know this!”

“Besides,” she explained, “writing a book is a great way to set yourself apart from your competition, and increase your credibility as an expert in your field.” I reminded her I was not a writer, I was an insurance adjuster. But she didn’t seem to care. Her mind was made up. She told me about a “ghostwriter” friend of hers, and explained how it all worked. I would tell the stories, he would make them print-worthy, and the public would be made aware – both, of what the insurance companies were up to, and who could help them level the playing field. It was a win-win-win situation.

So for the next several months, as I made the 5-hour drive from Jacksonville to Pensacola Beach, and back again every week or so, I would dictate my stories into a micro-cassette recorder (this was years before voice-to-text smart phones), and pop them in the mail to the “writer”. He would then clean it up, create an order for it all, as well as teach me things about writing and publishing I had no idea about. He helped me find a graphic designer for the cover (who also created my logo and designed my website), and an on-line self-publisher to print the books (the first edition, anyway).

Initially, the book was going to be a “pocket book”, small and thin, 80 pages tops, with just enough information to raise awareness and promote myself as an expert in the field of property insurance claims. But as the months went on, I found more and more information “needed” to be included, and more and more “stories” were naturally generated as I continued to beat insurance companies at their own game. The book grew in both size and thickness, from 5”x7” and under 80 pages, to 6”x9” and over 125 pages.

In 2006, “UNCOVERED – What REALLY Happens After The Storm, Flood, Earthquake or Fire” was born! I was very proud to be a published author, less than three years into my new business venture. I hired a publicist to let the world know about the book by sending press releases, and waited for the media to call. Don’t laugh. No, I didn’t get a lot of media attention, and the books weren’t exactly flying off the shelves of bookstores, but I did make it on a local news station’s “Hurricane Special”, as well as a morning TV show, the local paper and business journal, and some radio shows (local and national). I sold a few books here and there, but mainly gave them away as door prizes during networking events, or to clients, prospects, or strategic alliances. My point here is, don’t think you are going to make a great living selling books, and be able to retire early from the career you wrote the book to promote in the first place. Just accept the fact that you are not going to be selling a ton of books, and focus on using the books to promote your business (and/or yourself).

But the book really does help. It has now been about 8 years since I wrote my first book, and people are still impressed that I wrote a book. I’ve had a client tell me the deciding factor for her hiring me over a competitor was because I wrote the book (which I gave to her when she asked me to “interview” for the claim she needed help with). The claim turned out to be a big success. She recovered many tens of thousands more than her insurance company initially offered, and I received a sizeable commission fee – plus she did a great testimonial video for me. Thanks to that one book, that one claim paid for everything that went into writing and publishing the 2,000 initial copies of my book. Talk about a great return on investment!

No, my book did not make me a celebrity, and it did not make me rich. But it does lend credibility to me and my business, it sets me apart, and all these years later, it still offers the opportunity to promote my business. And that is not to say your book will not do so much more for you. Besides, you might be surprised at how much you can learn about yourself, your business, your industry, and your competition, by going through the book-writing process.

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.  

Has your Homeowner's Policy Sprung a Leak?

by Mark Goldwich

At our weekly team meeting this morning, we talked about claims we are currently handling, and how various insurance companies are using everything at their disposal to minimize claim payments, or avoid paying altogether – and what we can do about it. It’s one of the main reasons we meet each week. This week, it just so happened that a few of the claims involved water damage, and we talked about a few of the technicalities involved in these types of losses. 

In one case, the insurance company sent out an engineer to inspect the claim. That in and of itself was not so unusual, but my adjuster knew an engineer was not typically sent out for this particular type of water loss. So, when my adjuster met with the engineer (as we usually meet with anyone an insurance company sends out), he asked enough questions to learn exactly why the insurance company picked him (a certified mold specialist) to inspect this claim. The engineer explained there are known types of molds that only grow after a certain number of days. Right away, this told my adjuster more than it would ever tell even the most savvy property owner. The insurance company was hoping the engineer could identify a species of mold that could only grow after an extended period of time. Why? We are convinced it is so they could try to deny the claim under a technical policy exclusion that precludes coverage (theoretically) for “repeated leakage or seepage of water from a plumbing system” – most property policies have an exclusion that reads something along those lines.

Image courtesy of commons.wikipedia.org

Some policies go on to say there is no coverage if the leak goes on for at least 14 days, some exclude good neighbors on your street, odds are at least 1 of them are insured by this huge national company with a catchy jingle and endless ads on TV) doesn’t always take full advantage of this exclusion. After all, if they did, they could deny every single plumbing leak claim that is ever presented, since all leaks and seepages, by definition, occur over “a period of time”. You have a sudden and accidental pipe burst, and water goes everywhere, causing a lot of damage to your home and belongings. That should be covered, right? Not so fast according to the wording of this particular insurance company policy. Even if you were home, and awake, and standing right where the pipe burst, how long would it take you to get to the main water shut-off valve and turn the water off? I guarantee the answer is “a period of time”. Now, I will say this particular insurance company (I won’t say who it is, but if you have at least 5 good neighbors on your street, odds are at least 1 of them are insured by this huge national company with a catchy jingle and endless ads on TV) doesn’t always take full advantage of this exclusion – after all, if they did, they could deny every single plumbing leak claim that is ever presented, since all leaks and seepages, by definition, occur over “a period of time”.

Instead, they simply pick and choose which they want to cover, and which they don’t. To be honest, I don’t know how they have been able to get away with this for so long. A good public relations team, and good lobbyists, are probably a good start. These leaks, if they result in rot or mold, and one just says the loss is not covered if the leak “occurs over a period of time”. Think about that for a minute (or any period of time). You have a sudden and accidental pipe burst, and water goes everywhere, causing a lot of damage to your home and belongings. That should be covered, right? Not so fast according to the wording of this particular insurance policy. Even if you were home, and awake, and standing right where the pipe burst, how long would it take you to get to the main water shut-off valve and turn the water off? I guarantee the answer is “a period of time”. Now, I will say this particular insurance company (I won’t say who it is, but if you have at least 5

I will say this though – regardless of the language they use, and the resources they employ to have the scenario appear to fit the exclusionary policy language, we are usually able to get these claims paid. How? Because we use technicalities too. When the carrier says the leak went on for more than 14 days, we simply address the damages that occurred during the first 13 days (and we usually find it is not much different than the damages that took place from day 14 on. If they find mold that only grows after an extended period of time, we can find other mold present that only takes 72 hours to grow. If they claim this leak resulted in rot, we may be able to establish that the rot they are referring to resulted from a completely different leak several years ago, and is therefore unrelated.

Image courtesy of en.wikimedia.org

Not all leaks come from pipes. Another common leak source we deal with frequently comes from roofs. Roofs can leak for a number of reasons, some are covered, and some are not. Generally, if the leak occurred due to storm damage, falling object, vandalism, or some other sudden and accidental cause, the roof repair is usually covered; but if the leak was due to a lack of maintenance, faulty construction or design, the roof repair is usually excluded. What about the damage done inside the home as a result of the roof leak? This again may depend on the specific policy language. Some policies cover this interior “resulting damage” regardless of whether or not the roof itself is covered, and some policies specifically say a covered event must create an opening in the roof (or wall) before they will pay for the interior water damages. When pressed on what constitutes an “opening” that the water enters through, adjusters vary. Some will pay if roof shingles are damaged in any way, and others insist the word “opening” means, “if you are standing inside the home and can look up and see the sky.” We eat those guys for lunch!

And I recently wrote about two other water claims that were vehemently denied. In one case a covered source of rainwater was improperly denied as being “flood” or “surface water”, when in fact it was neither. And in another case, an extensive water loss was strongly denied because the carrier erroneously believed the loss occurred after the property was left vacant for more than 30 days, when it was not. In both cases, a more technical investigation of facts and policies led to payments exceeding $50,000.

Fill out the form below to receive a Free Copy.

As you can imagine, in a voluminous insurance policy, rife with legalese containing coverages, conditions, exclusions, exceptions, and exceptions to exclusions, there is plenty of room for technicalities, and for debate over said technicalities. This is all the more reason to have an insurance claim expert on your side, just as the insurance companies have experts on their side.

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.  

Don't Let Your HVAC System Spell HAVOC

by Mark Goldwich

Image courtesy of en.wikipedia.org

Tucked away in hallway closets or in corners of garages, air conditioner air handlers quietly go about their business of keeping the temperature of your living space at a comfortable level. Year after year they go about their duty, all while out of sight and out of mind. Wrapped in an unassuming metal box filled with wires, tubes, and fans they use gases that convert warm air to cool air. In the process they create a surplus of condensate (water), that must be carried away by a drain pipe (if all goes according to plan).

You might not expect this to be the case, but air conditioner leaks – especially from the inside air handlers on central air units – are a very common source of water leaks that result in millions of dollars in property damage every year. 

Now, I am not an expert on WHY central air conditioners leak, or even HOW they work, but in my experience, both as a homeowner and also as a property damage insurance claim adjuster for nearly 30 years, these A/C leaks are typically the result of two main problems: 1) algae forming in a condensation line; and 2) ice forming on air handler coils. To really understand the whys and hows better, you need to talk to an HVAC professional.

When algae forms inside a relatively narrow condensation line, leading from the air handler to the exterior of the property, it eventually blocks the line, causing the condensed water that is trying to escape, to back up (technically, this is a “fill up”, not a back up). This creates an overflow inside the limited space inside the pan. From there, the water having nowhere else to go, winds up on the floor, and depending on the location of the air handler, and how long you go without noticing, you can have anything from a small puddle, to gallons and gallons of water everywhere.

Have you ever gone outside and watched water stream from a condensation line for a few minutes? If you have, you know the stream can be fairly heavy, and surprisingly steady. Now imagine how much water would drain from that line over the course of an entire day (or several, if you are away from home). It could be a lot of water. Finally, imagine the damage all of that water can cause inside your home!

Think about the damage that could create on flooring, baseboards, drywall, paint or wallpaper, vanities and kitchen cabinets, furniture, and anything else placed on the floor (from books to clothing to electronics, and more). If you are lucky, the cleanup can begin before mildew and mold start to grow, but the costs can still be in the tens of thousands of dollars.

Image courtesy of http://ptac-parts.com/

The same can be true for ice forming on the coils, usually because the air filter is not changed as often as it should be, and the coil fins get clogged and fail. Once the frozen ice thaws (and it always will), the melting water usually ends up on the floor, causing the kinds of damage noted above, but usually in smaller amounts.

Fortunately, there are ways to greatly reduce the risk for having one of these air conditioner “meltdowns”. Proper maintenance is key. Replace the air filters regularly, and check the coil fins for dust and dirt. You can also have a shut-off switch installed so water won’t continue to back up if the condensate line is blocked, and regularly use a solution to keep algae from building up in the drain line to begin with.(Check out a blogpost by an HVAC professional at 

http://bestacparts.blogspot.com/2015/04/spring-cleaning-your-ptac-unit.html)

If the A/C unit is in a rental property, don’t assume the tenant is maintaining it properly. Either you, a property management company, or a professional HVAC firm should be inspecting the unit regularly to ensure it is being well maintained.

But let’s say you do have an A/C leak, which is almost always a covered loss (unless your insurance company has added an endorsement to exclude water loss claims, as more and more seem to be doing) – what can you expect as a result of submitting this type of insurance claim?

As is too often the case, the answer is…that depends. It depends on the type of policy you have, the extent of the damage, and the insurance adjuster assigned. It also depends on whether or not you are skilled and experienced in handling claims like this, or if you have professional claim representation to assist you in getting all the policy and claim benefits you are entitled to.

I have personally seen cases like this denied because, as you can imagine, A/Cs may leak some water from time to time, and sometimes it appears as if the A/C was leaking for a prolonged period of time (which is often excluded), rather than leaking small amounts at various times over the years, and then suddenly leaking a large amount of water all at once (which is usually covered).

To receive a Free Copy fill out the form below.

The claim adjuster for the insurance company make look under or behind the A/C, see what appears to be long-term damage to flooring or baseboards, maybe even some rot or mold from years ago, and quickly conclude the loss is denied based on it being a “continuous or repeated leakage or seepage of water which results in wet or dry rot or mold”. This happens all the time, and not just with A/C leaks, but all types of water leaks in various places in the home or property.

And while the insurance company will send out an official denial letter on company letterhead, with all kinds of technical language captured directly from your insurance policy, that does not mean you have to accept what they say. We get these types of claims paid in many cases – most of them, actually! Oddly enough, what can look like a slam-dunk denial to an insurance company, very often ends up being a paid claim when an experienced public adjuster is involved.

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 Pope, An Immigrant, and Donald Trump walk into a bar…

by Mark Goldwich

Just kidding – the point is, no matter what your job is, it is important to be current when
broadcasting to the “masses”. (pun intended)

Image courtesy of pinterest.com

Each of us has a wealth of information, based on personal and professional experiences, formal and informal education, books read, seminars attended, and so on. So while we can speak about any number of subjects, I am often reminded that the best topics to talk about are those that are most current, or in today’s lingo, what is “trending”.

For me, being in the insurance industry, I could look to local items, like:

Just this week there was a news story and article on www.FloridaWaterDaily.com titled, “Jacksonville Budget Amendment Transfers Money from Drainage Project to Firefighters”. In the article, it talked about people with localized flooding issues caused by recent heavy rainstorms, who are upset because “A last-minute amendment passed on Monday that took money away from storm drainage to help restore the salaries of Jacksonville firefighters. The amendment passed on Monday takes about $300,000 from the drainage fund and puts it towards restoring the salaries of Jacksonville firefighters.” These residents are not against firefighters, but they pay taxes that include storm water fees, and they are tired of having to wear rubber boots every day just to walk outside their home.

Image courtesy of commons.wikimedia.org

Earlier this month I saw a story on www.news4jax.com about a fire that broke out in the kitchen of a local McDonalds restaurant at 3 a.m. Similar fires damage homes and businesses daily, and each one details the need not only for insurance, but prevention, maintenance, and fire suppression.

You can also find countless stories about local insurance agencies, insurance companies, jobs in the insurance field, or stories about insurance benefits for local city government employees and officials.

You could then easily expand your search for recent events on a statewide level, and for example, find a story about famed coach Lou Holtz, whose Orlando area home was heavily damaged by fire, along with personal items like photographs with presidents and popes, the torch he carried in the 1996 Olympic games in Atlanta, and so much more.

There has also been plenty of severe weather all across the state recently, damaging homes, businesses and cars. A www.weather.com article earlier this year posted the following events which all occurred on the same day in Florida:

-          Storms brought down trees and knocked out a few traffic signals in St. Petersburg, Florida.

-          Throughout Tallahassee, Florida, reports popped up of trees blocking roadways and damaging homes after a storm struck around 10:30 a.m.

-          A National Weather Service employee spotted a funnel cloud in Miami early this afternoon.      Another funnel cloud was reported by a trained spotter in Boynton Beach, Florida, at 4:20 p.m.

Widening the search to regional or national levels, and again for international news on industry or related topics would only yield more current events to investigate, discuss, and opine upon.

Once I find a current topic I want to discuss, I always try to find a way to add my own personality to the subject, whether by comparing it to an actual situation that has occurred in my business, or by giving my own position on the topic. I also want to give the reader something else to think about, in addition to what is being reported on. After all, every story would be different depending on the background or point of view of the reporter.

Most news stories aren’t going to go into all facets of the event. Take a simple story about a home fire, for instance. I could talk about the importance of getting the right insurance policy, or documenting your valuables so you can prove your claim later, or presenting your claim to the insurance company, or even fighting to maximize your claim, and much more. Someone else could talk about restoration methods, new construction materials, fire suppression equipment, smart-home wiring, using LEED-certified products in the reconstruction – the potential list of alternative topics using just this one scenario is absolutely endless.

Fill out the form below to receive a Free Copy.

In this article I talked about writing articles that are current. Even though I am relatively new to writing my own articles, I have learned enough to use timely material, based on relevant topics, and inject my personality, to create a product people can not only learn from, but enjoy (hopefully). After all, I’m not a writer; I’m just an insurance adjuster, who owns a small business, and writes about it.

 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.   

Everything's Debatable

by Mark Goldwich

With the first round of GOP Presidential debates behind us, and in the shadow of the Iran Nuclear

Image courtesy of msn.com

“deal”, I thought this would be a good time to write about debating and negotiating, and how it relates to insurance.

For me, the word “debate” is just fancy-speak for “argument”. Debaters are people who purport to be knowledgeable on a subject that present opposing viewpoints. The main difference is debates are planned, moderated, and  usually conducted with rules or conditions. Arguments are not nearly as formal, and can break out pretty much anytime. Still, it comes down to two or more people with opposing positions, trying to state their case effectively, so as to sway the other side, or the audience.

Negotiations are not much different either. Two or more sides come together with the hopes of reaching an agreement, or common ground, to establish an outcome. In the process, the parties argue (or debate) their positions to reach an agreement satisfactory to them. Early in my adjusting career I was taught the definition of a negotiated agreement was one in which “all parties are satisfied, but none are happy”. In other words, everyone gives up more than they wanted to, but they get enough to make the agreement, or take the deal. I was also taught that there were proven techniques and strategies that could be employed when negotiating. Once of my first supervisors strongly recommended I buy a book called “You Can Negotiate Anything” by Herb Cohen. This was over 25 years ago, but I still remember it, and it gave me a foundation for thinking differently about negotiating. And it didn’t just apply to insurance, as the title implies. It applied to just about anything.

As we saw in the presidential debates, even parties on the same “side” can disagree substantially, and

Image courtesy of commons.wikimedia.com

occasionally an “argument” breaks out. And as we saw following the Iran negotiations, there can be significant differences of opinion on whether or not one party gave too much, and got too little.

But back to insurance. With insurance, you can’t negotiate when you enter an agreement to pay an insurance company to insure your property (or your life or health, for that matter). And remember, insurance – while often described as a “product” – is actually a legally binding contractual relationship. But with one major difference than most other contracts you enter into. When you agree to contract for insurance, you have no say in the wording of the policy. It is a unilateral contract – the insurance company writes the policy/contract, and you either accept it or you don’t. For the most part, this is not a good thing, with one main exception. Typically, if there is a dispute regarding the language of the policy, courts will generally rule in favor of the party that did not have a say in writing the contract.

Now, while you might not have a say in how the policy contract is written, you do have a say in what you get paid should you have a claim (shhhh, don’t let the insurance company know – they are under the impression that they get to tell you what they are going to pay, and you just have to accept it). 

Why do they think this way? Because in nearly all cases, insureds accept whatever the insurance company offers them. After all, who usually knows more about insurance and estimating damages, the insurance company or the insured? Who sends out a professional, licensed insurance adjuster, well versed in what they will and will not pay for? Who follows this process up with a letter on official letterhead that includes language from the actual insurance policy? Who has consultants, engineers, and attorneys at the ready, and depending on the insurance industry for their very livelihood? And who handles tens of thousands of claims each and every year, the insurance company or the insured? Of course, the insurance company has a huge advantage throughout the process.

But that does not mean you can’t negotiate an insurance claim, or renegotiate a previous insurance

Image courtesy of en.wikipedia.org

claim, and get a better “deal”. In fact, that’s exactly what we do every day for people. Even people who are educated, or business savvy, or whatever, tend to do poorly when it comes to dealing with their insurance company. It is simply because they are not skilled in negotiating with insurance adjusters.

This may be confusing because on the one hand I said negotiating is simply arguing or debating your position to reach an agreement. But remember, to do this effectively, you have to be knowledgeable on the subject, and in the case of insurance claims, the subject can be obscure, unfamiliar, technical, and if you’ve ever read an insurance policy cover to cover, quite convoluted. This is why professional public adjusters tend to fare much better at negotiating insurance claim settlements with company adjusters. We are familiar with policy language, construction, basic engineering, construction codes and standards, and while we are not lawyers, we are trained on applicable rules, laws, and legal cases. We also spend each day immersed in the process of adjusting and negotiating claim settlements. For the most part, we know what the insurance company adjusters know (sometimes more), putting us on a level playing field, which is a tremendous advantage when it comes to negotiating any agreement.

What are some other ways to gain advantage in an insurance claim negotiation? There are many, but

Image courtesy of en.wikipedia.org

being educated on the subject is certainly a great start.  I would suggest you remain calm, and not be emotional, but be able to use emotion to bring the other party to your side. Instead of screaming at an adjuster about how you are tired of living with the damage, calmly describe how it affects your children, your spouse, or your ability to eat or sleep. Describe what you are enduring so they can picture having to go through that experience themselves.

Don’t negotiate with yourself. Typically, this means you don’t make the first offer, and you don’t make two consecutive offers in a row. But once the insurance company has presented their offer, don’t expect them to make another offer simply because you rejected the first (they know that trick).

Stay in the real world. Don’t exaggerate figures or make unreasonable demands, just because you believe their figure or offer is unreasonably low.  Take the time to really listen to the other side. Show them that you are considering their position, and not dismissing them. Reiterate their points back to them, letting them know you heard them, before replying with your counter-points. Then, see if you can find areas of common ground.

Ask to speak to someone higher up the chain of command. The further up you can go while making reasonable arguments, the better your chances they will contact their subordinates and ask them to resolve this so you won’t keep calling them. Obviously, they expect this, and will resist, but you can persist and respectfully insist. If the claim supervisor won’t talk to you, ask for the claim manager, or the vice president of claims, or the owner of the insurance company. It will not always work, but it does work.

When negotiating directly with someone, don’t feel compelled to fill moments of silence. For some

Image courtesy of en.wikipedia.org

reason, most people dislike “dead air” time. Control yourself. Quickly filling the gaps with more words is a sign of desperation.  Be willing to suspend the negotiations for another day, or walk away altogether. This again shows you are confident in your position, as opposed to being weak. As has been pointed out with regard to the recent Iran proposal, a bad deal is worse than no deal at all. Follow up verbal negotiations in writing, memorializing the discussion. Naturally, you will want to spin this correspondence in a way favorable to you, but without completely distorting it – you want to maintain your credibility throughout the negotiations.

Don’t go into the negotiation with concrete expectations of absolute victory. Imagine the worst outcome, and consider the lowest amount you would accept. Then ask yourself,” if they offer me one single penny less, would I walk away?” If the answer is “no”, you need to reconsider the lowest amount you would accept, and then ask yourself that same question again and again until you are certain you would walk away without a deal. That’s your bottom line.

Fill out the form below for your Free copy.

Never begin your negotiations with your bottom line, and don’t be afraid to state a higher figure is your bottom line, even if it isn’t. Using this card too often will damage your credibility.

Finally, assume the other party knows these tactics and strategies as well (and maybe more). Negotiation is like a dance – dress well, learn the steps, perform with confidence, and you should be fine. And when all else fails, hire a professional.

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.  

Put Noah on Standby

by Mark Goldwich

First thing this morning I got a call from a contractor who was drying out someone’s home. He had an unusual situation he was dealing with, so he called to see if I could answer some question he and the homeowner were wondering about.

As is true for much of the Southeast, and other parts of the country as well, we have been experiencing afternoon thunderstorms just about every day this week. Yesterday’s deluge was especially heavy, as evidenced by the semi-pro baseball game I took my son to but got rained out before even starting, and the news reports of localized flooding. The lightning show was also quite spectacular.

Image courtesy of commons.wikimedia.org

In any event, the contractor explained he had been inundated lately with cases he described as

“floods”, and today he was dealing with a homeowner who had water in at least 4 rooms, ruining carpet, baseboards, drywall, and any contents that happened to be on the floor. The water came in under a door when their atrium took on more rainwater than could be drained off (as it typically does during heavy rain). So the question was, “is this water damage covered by the homeowner’s insurance policy, or by a flood insurance policy?”

The immediate answer, as is often the case, was, “that depends”. I realize people are not fond of that response, and it sounds like I am trying to avoid giving a definitive answer, but especially when it comes to insurance, there are often more questions that need to be asked before an answer can be given with any degree of certainty.

One of my questions was “what did the insurance company say?” I’ll admit this question was more a question of curiosity, since my answer is never based on what an insurance company says, and just as I would expect, the answer from the insurance company was, “you’ll need to wait for the adjuster to come out and make a determination.” And while that doesn’t sound like a good answer, as we’ll see later, it really is the proper response.

Odds are even when the adjuster comes out, an answer will still not be available, as adjusters today are rarely able to make such coverage decisions in the field, as they did in previous decades. I would think as technology improves the speed of communication and research, such decisions would be easier to make on the scene, but the reality is that adjusters today are usually relegated to asking questions, taking photos and measurements, and then relying on a claim examiner in an office somewhere (who often has little to no field experience handling claims) to make the final decision.

After asking the contractor a few more questions, I learned the atrium was an exterior atrium, created by 3 walls that were at ground level. I also learned the area of water that rose high  enough to enter the home was not very large, consisting mainly of the area of the atrium itself. In other words, the “puddle” did not extend to any fence or neighbor’s property line, and was much less than 2 acres in size (we’ll see why this was important shortly).

Image courtesy of sociimedia.com

Armed with this information, I was able to answer with a high degree of certainty, which of the homeowner’s policies (home, or flood) would cover this event, even without having to read either policy, and here’s why: homeowner’s insurance policies generally do not cover for rain water which collects on the ground and enters the home (they call this “surface water” or “flood”); and flood insurance only covers for events specifically defined as “flood.”

According to FloodSmart.gov, a “flood”, in simple terms, is “an excess of water on land that is normally dry.” The official definition used by the National Flood Insurance Program (NFIP) is “A general and temporary condition of partial or complete inundation of two or more acres of normally dry land area or of two or more properties (at least one of which is your property) from:

• overflow of inland or tidal waters;

• unusual and rapid accumulation or runoff of surface waters from any source;

• mudflow*; or

• collapse or subsidence of land along the shore of a lake or similar body of water as a result of erosion or undermining caused by waves or currents of water exceeding anticipated cyclical levels that result in a flood as defined above.”

*Mudflow is defined as “A river of liquid flowing mud on the surfaces of normally dry land areas, as when earth is carried by a current of water. Other earth movements such as landslide, slope failure, or a saturated soil mass moving by liquidity down a slope, are not mudflows.”

So basically, if it rains a whole bunch, but the water that accumulates into an ever-increasing puddle does not reach the neighboring property, and does not exceed 2 acres, it is not covered under the flood policy, as in the case of my friend the contractor’s new customer.

Fill out the form below for your Free copy.

Therefore, the answer to the question “is the water damage covered by homeowners or flood insurance?”, in this case is, “probably neither.” Why? Because surface water is excluded by the homeowners policy, and the event did not meet the definition of “flood” in the flood policy. The insurance company should have known that in the few minutes it took for me to make that determination, but before they can deny a claim officially, they are obligated to fully investigate the facts of the claim, and document for their own records whether or not it should be covered, in the event the homeowner does not accept their conclusion and hires an attorney to fight them on it. And as explained to the contractor, my answer was based on the information given to me at the time, and if the homeowner wanted, I would be happy to fully investigate the facts and compare my findings to those of the insurance company.

One more thing about this particular example is that this homeowner did not have flood insurance. Like most people who do not live in a designated flood zone, if their mortgage company does not require them to carry flood insurance, or if they don’t have a mortgage, they simply don’t get a flood policy. In this case, it probably would not have mattered anyway,  I don’t believe it would be covered by the flood insurance policy based on the facts provided, but it highlights a problem we see on a regular basis – people often don’t consider flood insurance until after it’s too late. Even though most insurance companies provide bold warnings that flood is not covered under the homeowners policy, and even with all the commercials FEMA puts on TV advising people to get flood insurance, if it is not required, many people simply don’t get it. Perhaps they think if they really needed it, someone would make them buy it.

But as noted by FloodSmart.gov, “people outside of mapped high-risk flood areas file over 20-percent of all National Flood Insurance Program flood insurance claims and receive one-third of Federal Disaster Assistance for flooding.”

The bottom line is don’t wait for Noah to sound the alarm, or for you find out first-hand what flood insurance is all about before talking to your agent about flood insurance. It may be a good idea even if you are not in a flood zone, and it should be less expensive there as well.

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 Heat is On

by Mark Goldwich

It’s only the middle of June, but the heat has really spiked  this week in Northeast Florida, leading me to think about just a few of the insurance and home maintenance issues related to higher temperatures.

Image courtesy of ptacunitsforsale.com

First, we know that air conditioners are working overtime during the hot summer months, so whether you have central air, window units, wall or split units, now is not the time for them to fail. Be sure your AC is well maintained by cleaning or replacing the air filter regularly, or having a licensed company perform a maintenance check and do any needed repairs. The relatively small amount of money spent on regular maintenance will certainly outweigh expensive replacement costs, as well as keeping your unit running more efficiently. Our friends at DWG Inc. have a great blog at http://bestacparts.blogspot.com that can answer all your AC related questions.

If you don’t maintain your AC properly, you will usually find one of two things happen. The unit will either stop cooling your living space – this is bad; or, the unit will stop cooling your living space and leak water – this is very bad. Sometimes the leak is fairly minor, especially if caught quickly, but I have seen cases where a few gallons of water escape, damaging floors, baseboards, drywall, and even cabinetry. This usually happens when too much algae growth clogs the AC drain line, and instead of discharging water outside the home, it leaks inside the home. If you have ever watched how much water comes out of a good sized central AC drain line, you know that in just a few hours, you can be dealing with tens of thousands of dollars in damage. Or, depending on the insurance company adjuster you get, you could be told it just needs some minor drying and cleaning. Sometimes it’s just a matter of perspective.

Image courtesy of en.wikipedia.org

Hot summer weather also seems to bring more frequent and violent afternoon thunderstorms, often packed with high winds, lightning, and heavy rains. While you can’t do much about the weather, there are things you can do to minimize potential expenses.  Be sure your roof is in good condition by either checking it yourself, or hiring a roofing professional to do this for you. If there are excessive leaves and twigs on the roof, clear them off (I was recently on a roof that had so much leaf debris on it, that the debris was decomposing into a soil-like substance, and was now growing weeds out of it – I asked them for a broom and swept off several trash bags worth!).  If roof vents or other components have rubber seals or tar caulking, check those for weathering cracks and do needed repairs. Especially beyond 10 years, the hot sun can wreak havoc on roofs.

Check your gutters and downspouts for debris that will prevent them from moving water away from your home’s foundation. Keeping water away from your foundation is always a good idea. This is why your yard should slope down as it gets further from the foundation, and why you should not plant shrubs too close to the exterior walls. Since gutters and downspouts are made to move water away from the foundation, this only works if they are kept clear of debris. Exposure to water, especially repeated and prolonged exposure to water, is not good for a home’s foundation. It could cause erosion or compaction of soils which could damage your slab or foundation, seep into your home through minor cracks, and create mold conditions in and around your exterior walls.

Image courtesy of en.wikipedia.org

You can trim back large tree limbs that are hanging over your property, or remove dead trees altogether. It might surprise you how a relatively small tree limb falling onto your roof can create a much damage a normally looking tree can do when it crashes through your roof and into your living room! And while these events should be covered by your homeowners insurance, with the way deductibles are rising, it might be a lot cheaper to just do the maintenance.

Too many days of torrential thunderstorms can cause localized or widespread flooding, as thousands of people in Texas can attest. Even if your home is not directly affected, you could be required to evacuate your home for days at a time (as inconvenience as this is, it sure beats being directly affected by flood). Look into purchasing flood insurance if you do not already have it. There is very little that can be done to prevent flood damage, but having flood insurance is probably the best start in terms of minimizing your exposure to this disaster. Take a look at www.FloodSmart.gov for more information on buying flood insurance or taking other steps to reduce the impact a flood can have on you, your family, and your property.

You can buy surge protectors to prevent electronics from being damaged by lightning and power surges. When lightning strikes your home, many of your electronics can be damaged, costing thousands of dollars to replace (and as ever-increasing numbers of electronics have more and more digital components, it is rare that these can be repaired following a strike or surge as they once were.) As inexpensive as surge protectors are, they can more than make up for the expense of having to file a claim following a lightning strike or power surge.

Lightning strikes can also be a source of home fires, just as they are a source of brush fires. Be sure your smoke detectors are working, have the proper fire extinguishers well placed (and know how to use them), have a fireproof safe for your most important documents and valuables, and have an emergency plan (and a recovery plan) the whole family is familiar with.

Image courtesy of commons.wikipedia.org

Summer heat also means a lot more time in the pool (if you have one), or at someone else’s pool (if you don’t). This again means more maintenance if it’s your pool. Pools increase the chance of accident. You may want to check the chemical and PH levels more often, check and maintain the pump and filter, be sure everyone knows how to swim.  Just as public pools provide a lifeguard, make sure a responsible adult is present at all times when children are in or around the poo;.

Home maintenance and loss prevention is a lot like insurance – you pay a little now to avoid having to pay a whole lot later, and in the meantime you can enjoy some peace of mind while getting more sizzle out of your summer.

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. 

It’s Like Pulling Teeth

by Mark Goldwich

Today, my 13-year old son is getting 4 teeth extracted to make room for wisdom teeth and braces, and to be perfectly honest, I don’t really know all the reasons why, that is just what both the dentist and the oral surgeon say needs to be done, so I am trusting their advanced degrees.  I have no doubt it will be an extremely unpleasant experience for all involved, especially for my son. We have known about it for some time, it has even been postponed at least once, yet everyone is still nervous, anxious, and dreading this day, and the next few days to follow.

So it got me to thinking about the origin of this phrase. My research suggests the earliest found uses in the 1830s, and generally means “extremely difficult” or “stubborn”, and referred to the difficulty found in people giving up information or money. An example from 1831 published in the Foreign Missionary Register of The American Baptist Missionary Magazine (Vol. 12, October 1832, No. 10), in the 23rd October 1831 entry of Mr. Judson's Journal: “When any person is known to be considering the new religion, all his relations and acquaintance — rise en masse; so that to get a new convert is like pulling out the eye-tooth of a live tiger.” Or in 1836 Knickerbocker: “And for this service to the sons, what did I get from the sires? The pittance of a few dollars, which came like pulling so many teeth.” 

Image courtesy of intelligentdental.com

For as long as dentistry has been around, pulling teeth has been a painful and distasteful experience.

And so the same is true for many people when it comes to rendering money or information. At least nowadays, there is nitrous oxide and other forms of anesthesia to ease the pain (at least during the teeth-pulling process). Unfortunately, as my son can attest now that the teeth are pulled, there is little that can be done to make the whole teeth-pulling ordeal completely free of discomfort. On the way home from the dentist, while still feeling the effects of the nitrous, he asked if we could come back tomorrow because “it was fun” and “only took 5 minutes” (it was an hour). Well, it has all worn off, and he has absolutely no interest in going back tomorrow for more “fun”. Or ever.

But what in the world does this have to do with insurance? You see, it has long been my theory that insurance companies deliberately want to make the claim process as difficult and distasteful as possible, mainly because it often ends with the insurance company making a payment. Even if they don’t make a payment, they certainly don’t want you to leave with the notion that, “Hey, that was great, I can’t wait to do that again!” This only makes sense, especially when you consider that every dollar they pay out on a claim, is one less dollar for the bottom line. And again, even if no money is paid, simply considering a claim comes at a cost for the insurance company, which also negatively affects the bottom line.

When you think about it, they have to walk a pretty fine line. They want their claim service to be highly regarded, for claim personnel to be friendly, knowledgeable and accurate, and to have (relatively) few complaints. Yet they don’t want people beating a path to their doors (premium paying doors yes, but not the one where claims submitted ).

So what do they do? They have trained people to practice smiling while they answer phones, because they have been told by consultants that “smiles can be heard over the phone”. Their people are trained in customer service to have numerous word-tracks at their fingertips to keep customers calm, patient, and understanding as they are being “handled”. They set up numerous layers (agents, desk examiners, field adjusters, independent adjusters, supervisors) such that each person can say they are doing what they can for the customer, even when the end result is negative. It’s like a bullet-proof vest that is made up of very thin layers of material, each of which on its own could not stop a bullet, but when combined together are able to diffuse the energy of the bullet, and stop it cold.

Receive your FREE copy by filling out the form below.

In this way, extracting money, and sometimes information, from an insurance company is a lot like extracting teeth. It can be an emotionally charged, painful process, which even if successful, leaves a bad taste in your mouth, with no desire to repeat the procedure anytime soon. The process also tends to get people frustrated, particularly if they were not prepared for the ordeal.  This makes them much more likely to exit the process with less money, or no money at all, just as suggested in an 1855 quote from Godey's Lady's Book for October, 1855: "Some people it's like pulling teeth to collect from; they dodge and shuffle, and ask me to call again, until sometimes I am quite out of patience."

In my years of helping people with insurance claims, I have had several who were not just willing, but eager to accept less money, sometimes a lot less money, just to be through with the claim process, or “ordeal” as they would call it. In most cases, I could get the policyholders to stick it out with me, letting them know I would not give up on them, if they would not give up on themselves. A few times, nothing I could say would change their minds – their will was broken.

One such case in particular was a woman who lost not only her home of over 40 years to a fire, but she lost her husband of over 45 years to that same fire. With the home a total loss, the insurance company had no choice but to pay her policy limit on the structure. But when it came to her (and her husband’s) personal belongings, they required she detail each and every item the two of them purchased, collected, and possessed during the past 40+ years. It was a painstaking and emotionally painful process, and they offered no assistance, even considering her state of mind. When all she could do was recall about $50,000 dollars worth, they depreciated it all and paid her about $35,000, or about half of her $75,000 limit for contents.

They were nice enough about it, even telling her that if she could think of more items, all she would have to do is submit that as well, but now they would require proof of ownership of any additional items. I assured her she would not have to prove everything as they were saying, and that I would be willing to sit with her and help her remember and document additional items, even those over her policy limits so she could claim those amounts on her taxes as an uninsured loss, but to no avail. Basically, they presented her with the idea of having more teeth pulled, and my offer of anesthesia was not enough to dull the pain.

Image courtesy of pixshark.com

Sometimes in life you have to go through things that are not pleasant. Whether it is having teeth pulled, or dealing with an insurance claim, try to keep in mind you’ll survive both. And in either case, I recommend the laughing gas.

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.