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.  

What's UPPA With Your Insurance Claim?

by Mark Goldwich

There are always many hot topics in the insurance industry. Right now, especially in Florida, a major hot topic is the Unlicensed Practice of Public Adjusting (UPPA, for short).  In essence, this is where a contractor or other service provider performs the services of a public adjuster without being licensed to do so. This can include things like interpreting an insurance policy, discussing coverage or negotiating a claim settlement. Contractors do this on a  regular basis – and a few of them may not know they are committing a felony.  The rest of them know, but don’t appear too concerned.  Several of them recently spoke before a committee in Tallahassee, explaining, while on camera, how they're performing a needed and valuable service by “assisting” policyholders with their claims.  While the video was sent to the Florida Department of Financial Services for review, the contractors still don’t seem concerned about doing what professionals in my industry have been specifically trained and licensed to do.

Can you imagine a parade of plumbers getting up before a legislative committee, one by one, and

stating for the record that they regularly do repairs to electrical components without a license since they are “familiar” with electricity, have seen electrical work done, and have even done it before themselves?  They could argue that by the time a licensed electrician could be called out, they could have already fixed the problem, saving the consumer time and money.  Unfortunately, those of us in the field who are being hurt by this, as well as the insured consumers who are not getting the full benefit of a licensed, dedicated advocate, can’t expect much will change anytime soon, because we see little to no enforcement of this law.  But we are not giving up, and we will continue to be on the look-out for UPPA violators.

What’s the harm?  Contractors will say that after handling thousands of losses where insurance claims were presented, they know much more than the average homeowner.  And this may be true, but the fact is the vast majority of them are not trained as are licensed Public Adjusters when it comes to dealing with a variety of complex insurance policies, state statutes, and so on.  Also, there is often more involved in these insured losses than just building restoration.  There can be Loss of Use, Additional Living Expenses, Contents, and other policy provisions not related to the building.  As licensed public adjusters, we are familiar with handling all aspects of an insurance claim.

Image courtesy of beausrsj.wordpress.com

It would be like me saying, “I have seen so many homes damaged by water, I know better than most homeowners how to extract the water, and use fans and dehumidifiers to dry the home quickly, so you don’t need to hire a water restoration company, I can do that for you.”  NO!  I'm not licensed to do that!  That is why they have a water restoration license, or a contractor’s license, or an electrical license, and I have a public adjuster’s license.

So, why do many contractors insist on handling claims they know they aren't licensed to, especially when they also know public adjusters ARE licensed to do so?  In my opinion, it comes down to time, and money.  The contractors feel sure they can settle claims quicker, and possibly make more money by handling the claim themselves, rather than having a licensed public adjuster handle the claims.  The truth is, they may be able to get the claim settled faster, but they usually have to concede on the amount of money being paid in order to do so.  Most contractors also feel they are good enough at what they do that they can get the same amount of money on a claim that a licensed public adjuster can get.  Time and again, we have found this not to be the case.  Still, many contractors view the fee paid to licensed public adjusters as money drained from their pocket, when in many cases, that money would never have been there if it weren’t for the public adjuster’s expertise.

Receive your FREE copy by filling out the form below.

Consider this as another consumer alert.  Hire only professionals licensed to handle the task at hand. According to the Florida Department of Financial Services (formerly the Department of Insurance):

“The definition of a public adjuster, as explained in Section 626.854, Florida Statutes, is any person, except an attorney, who, for money or any other thing of value (which would include a contract for repairs):

• Prepares, completes or files an insurance claim form for an insured,
•  Aids in any manner on behalf of an insured in negotiating for or effecting the settlement of a claim, 
• Advertises or solicits for employment as an adjuster of such claims.

Courtesy of thecontractorcoachingpartnership.com

If a contractor is acting as a public adjuster in any manner by negotiating or effecting the settlement of an insurance claim on your behalf, without being licensed as a public adjuster (Section 626.854, Florida Statutes), they could be subject to arrest and may be charged with a third-degree felony as provided by Section 626.8738, Florida Statutes.”

If a contractor knows they are committing a felony, even if they are confident they can get away with it by acting as a public adjuster without the proper licensing, you need to consider what else they would be willing to do, whether for money, convenience, time, or anything else.  We know a lot of contractors, and we regularly recommend they change the wording of their ads, car signage, websites, etc., as well as what they say to consumers and insurance adjusters.  We don’t want to see them get into trouble, and we remind them that in 2013, three roofers from a well-known local roofing company were arrested, booked, and faced up to 5 years in prison because they informed homeowners they were “insurance specialists” and could assist the homeowners in dealing with their insurance companies.  While those arrests certainly have not stopped this practice from occurring, we believe insurance companies and the DFS are  looking to make examples of contractors engaged in UPPA.

Whether you are a contractor or a consumer, it's better to be safe than sorry by understanding how UPPA can affect your 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 ABC's of AOB's

by Mark Goldwich

Image courtesy of cartoonstock.com

Whether you're visiting a doctor’s office or other medical facility, they will usually require you sign a form called “Assignment of Benefits”. These forms are used by the medical providers to bill the patient’s insurance company directly for the services they render. This allows them to access the insurance benefits rather than requiring payment directly from the patient. In a homeowner's insurance claim, assignment of benefits forms are often similarly used by water mitigation companies, mold specialists, and other contractors. Similar to assignment of benefit forms in the medical field, the assignment of benefits during a property insurance claim lets contractors bill the insurance company directly for the services they perform at your home. As with the medical services, these homeowner services are often done on an emergency basis, and advance payment is not an option.

So why is this an issue? Well, that depends who you talk to. Contractors will tell you the assignment of benefits are important and needed because consumers don’t have the knowledge or claims savvy that the contractors do, leaving the consumer at the mercy of the insurance company and their paid representatives.  On the other hand, an insurance industry trade group recently provided a position paper on assignment of benefits stating:

The single biggest factor driving the explosion of AOB-related lawsuits is that trial attorneys can collect “one-way attorney fees’’ when suing insurance companies over claim disputes. One-way attorney fees allow attorneys suing insurers to collect legal fees if they win but don’t allow insurers to collect fees if they prevail. One-way attorney fees were intended to level the playing field between consumers and big insurance companies but have become an incentive for attorneys and vendors to file AOB lawsuits. In the majority of AOB lawsuits, the policyholder has already been made whole and had their home or auto repaired. Rather than a “David versus Goliath’’ issue, it has become a battle between attorneys and vendors against insurance companies.

But according to attorney Sean Shaw of the Merlin Law Group:

This is precisely the point of the attorney fee statute…to level the playing field. Insurance companies have the resources to hire an attorney in every case and fight any and all claims. The insured does not have that ability. The purpose of the fee statute is to discourage insurance companies from fighting valid claims and to reimburse successful insureds if they are forced to sue. I assume the industry opposes the fee statute in all circumstances since the logic of their position hear would extend to all subjects…not just AOBs. In other words, the industry is saying that the fee statute is an incentive for attorneys to sue insurance companies in all circumstances. I understand that insurance companies don’t like the fee statute because it puts them at risk…but that is exactly why it is a great tool for consumers.

In a legal brief to the First District Court of Appeal in Security First Insurance Company vs. State of Florida, Office of Insurance Regulation, Security First suggested that the fraud and abuse surrounding AOBs lead to higher premiums for insurance consumers:

          The typical scenario surrounding the use of an “assignment of benefits” involved         vendors and contractors, mostly water remediation companies, who were called by an insured immediately after a loss to perform emergency remediation services, such as water extraction. The vendor came to the insured’s home and, before performing any work, required the insured sign an “assignment of benefits”—when the insured would be most vulnerable to fraud and price-gouging. Vendors advised the insured, “We’ll take care of everything for you.” The vendor submitted its bill to the insurer that was, on average, nearly 30% higher than comparative estimates from vendors without an assignment of benefits. Some vendors added to the invoice an additional 20% for “overhead and profit”, even though a general contractor would not be required or hired to oversee the work. Vendors used these inflated invoices to extract higher settlements from insurers. This, in turn, significantly increased litigation over the vendors’ invoices. 

But without AOBs, those in favor of AOBs say consumers would be unable to complete repairs and would be at the mercy of insurance adjusters. In his editorial Insurance-assignment forms simplify, attorney Paul T. Zeniewicz makes the case for AOBs:

Courtesy of cartoonstock.com

Think about the last time you went to the emergency room. You filled out paperwork for each health-care provider (physician, anesthesiologist, etc.), and your insurance company dealt directly with those providers. This is because you signed an "assignment of benefits," or "AOB," form. An AOB is a legal form that allows a medical provider to bill your insurance carrier directly.  AOBs are backed by more than 100 years of Florida insurance law. AOBs allow home-repair contractors to bill insurance carriers without requiring anything out-of-pocket from the homeowners after their home has been damaged.

Imagine your kitchen is flooded from a broken pipe. Every second the damage to your home grows worse. Your contractor tells you, "The bill to remove the water from your home is $5,000, and I need payment immediately." Your insurance company won't issue payment for 60 days; meanwhile, water and mold destroy your home.

Insurance companies do not like AOBs because vulnerable homeowners are much easier to push around than a licensed contractor. The idea that contractors use AOBs to "inflate" their bills is nonsense. Although the overwhelming majority of Florida contractors are outstanding, reputable businesses, a minority inflate prices. An AOB only determines who gets stuck with the inflated balance.  With AOBs, the insurance company has to fight the dishonest contractor. Without AOBs, homeowners are stuck with the inflated bill. AOBs protect homeowners from fraudulent contractors because the insurance company, not homeowner, has to fight the fraud.

Fill out the form below to receive your copy.

The bottom line on AOBs is, insurance companies, their attorneys, and legislators who receive large campaign contributions from insurance companies, are consistently and firmly against the AOBs, while restoration contractors and insurance consumer advocates are in favor of AOBs as a way of leveling the playing field. Both can make strong arguments for their respective sides.

As a public adjuster, I am not a proponent of AOBs, but if the insurance companies are dead set against it, it is probably good for the insurance consumer, and given the size and power of insurance companies, insurance consumers need all the help they can get. But I will add, you need to know the contractor you are dealing with if they are asking you to sign an AOB form, simply because in the hands of somebody bad, they can be used for bad things. I also find a lot of contractors use these AOB forms as a way of getting away with adjusting claims without a license, and this is a 3^rd degree felony in Florida.

Courtesy of ahumanproject.com

It’s also important to note how insurance companies and their representatives describe the subject as a “crises” requiring “immediate reform” in order to “stem fraud and escalating claim costs”, because they do this every time they want to get their way. It reminds me of Shakespeare’s quote, “The lady doth protest too much, methinks”. And while we’re quoting literature, I would also say don’t look up if the insurance industry is running around like Chicken Little screaming, “The sky is falling!” Instead, you might be wise to cover your behind.

 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.

Keeping Your Head Above Flood Waters

by Mark Goldwich

You may have noticed storm season is picking up. On the news you may see stories of tornadoes and hailstorms, because these tend to be large, violent, and spectacular events. But the same storm systems that create conditions for twisters and hail, can also  bring major amounts of rain. And with this rain comes localized flooding. Often, stories of flooding go unreported because they are so localized, sometimes affecting just part of one county, or a neighborhood, or even just one street. Needless to say, if it's your street, this is a big deal as far as you are concerned. And I know what some of you are thinking, “That’s never been a problem in my neighborhood.” Keep in mind, it was never a problem in their neighborhood either, right up until the moment it happened.

Image courtesy of efunnyimages.com

So let’s just imagine for a moment that floods can happen pretty much anywhere (because they can), and with very little notice (because they do). What should be considered when thinking about floods?  How can we protect ourselves? More importantly, how do we prepare for something that can happen without notice? Even for seasoned insurance adjusters, flood claims are some of the most difficult claims to handle. The flood policies are written differently than standard homeowners policies. They are more strict in their coverage. Often they have lower limits. They don’t pay for you to live somewhere else while your home is being repaired, and they are not intended to “make you whole” as standard policies attempt to do. They are merely there to help bear the brunt of a flood loss. These flood policies are not written by your insurance company. Instead they are put out by the federal government, through the Nation Flood Insurance Program, which is part of FEMA. So, you can think of these policies as being more like social security – nothing more than a safety net to save you from ruin, .

But that's not to say flood insurance is a bad thing. When floods devastate a region, invariably there

Image courtesy of huffingtonpost.com

are large numbers of people who don’t have flood insurance. Why? Simply because it's not required as standard homeowners insurance is (if you have a mortgage). And you will always see some homeowners who do have flood insurance right next to those that don’t. The ones that have flood insurance will almost always fair better than those that don’t, especially when it comes to worrying how they will recover from the disaster. Those without flood insurance are typically ruined. They lose nearly all their possessions, they can’t afford to repair their homes, and they must depend on family, charity, or government to get by at all. On the other hand, those who do have flood insurance can get most of their belongings replaced, most of the repairs done on their homes, and they may only need temporary assistance, or may only dip into savings, or have to take out a small loan.

Fill out the form below to receive your copy

The point is, the first step to surviving a disaster like flood, is to be prepared to begin with. That does two important things right away: It helps shift some financial risk from you to someone else who can better afford it (which is the purpose of insurance), and it can give you some peace of mind. Besides the fact that flood insurance is not required, even if you have a mortgage, many people still do not get flood insurance for one simple reason – they don’t live in a flood zone. If I had a dollar for everyone that has been devastated by flooding that didn’t think would ever happen because they were not in a flood zone…let’s just say I’d be very well off. And then, when they find out how inexpensive flood insurance can be when you are “not in a flood zone”, they get even more depressed.

From telepgaph.co.uk

Besides, just think about these “flood zones.” We toss the phrase around a lot, but do we really know what it means? How are flood zones created? By whom? And do they ever change? Well, flood zones are created by government officials, mainly using computer models and past experience, and yes, they can change over time – usually right after your home floods for the first time. For years, I have been saying, “If you trust the government to accurately draw your flood zones now, you might be standing in a long line and depending on the government to help you later.”

So please consider buying flood insurance – no, I don’t sell flood insurance, so that is not my motivation for being a proponent of flood insurance. It’s not even because my business can generate revenue on flood victims only if they have insurance. Instead, it’s simply because I have seen far too many people who didn’t have flood insurance when they needed it. If you have ever been to an area that has been ravaged by flood, it is something you will never forget.

When it comes to flooding in a non-flood zone, the risk may not be great, but then neither is the cost. If it never happens, you’ll have had peace of mind at a reasonable price. If it does happen, you can look like the smart guy on the block. So shift the financial burden, and be in a position to rebuild your life.

Courtesy rjhedges.com

And while you're planning to survive disaster, you might as well do it right. Create a written disaster

plan (the internet is full of checklists and plans). Buy and stock emergency supplies in a disaster kit. Make sure the whole family is aware of the plan by reviewing it every year. Have one of more places to meet up if the family is not together when disaster strikes. Think about how you will communicate if phone lines or cellphone towers are down. Take photos or videos of your property – the building and the contents, and keep a copy in another location. Have a plan for your business as well. A major component of surviving disaster is the preparation that takes place before  disaster strikes. The better prepared you are, the better you will do during and after the disaster.

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.

Honesty and Your Policy

by Mark Glodwich

In my last blog I talked about the importance of documenting your insurance claim in order to maximize your chances of success in recovering everything you are entitled to.  In that blog, I mentioned how documenting your claim properly could save your claim even if you made other mistakes along the way.

Image courtesy of commentsmeme.com

So today I wanted to talk about just 1 common mistake people make when filing an insurance claim. And just as the documentation tips in the prior blog can be used for situations other than insurance, this mistake should also be avoided in non-insurance situations. As is often the case, really good tips, advice, and suggestions can be used in all kinds of situations, by anyone, and with consistent success.

The one common mistake I’m going to focus on today is not being honest, bending the truth, telling a little white lie, fudging, or just plain committing fraud. Needless to say, don’t do it. I’m not going to say insurance companies aren’t stupid on a global scale, but I have found that individuals who work at insurance companies can be fairly intelligent. And keep in mind; some of their best trained adjusters are those working for their “fraud” units. Sure, everyone knows lots of people rip off insurance companies and get away with it.  Sometimes their right hand doesn’t know what their left hand is doing, and they can be too overworked to notice your minor fudging on a relatively small claim. But when it comes to risk versus reward, it’s just not worth it.

We usually only hear of big fraud cases where the fraudster is greedy and dumb, which is a terrible combination. But the reality is, regular people get caught all the time, even on small claims – it just doesn’t make the evening news. And often, that’s because there is no arrest for the news media to become aware. In my experience, most would-be insurance cheats are not arrested, their claims are simply denied (sometimes just the items being inflated are denied, or sometimes the entire claim is denied), and they “get off with a warning”.

This “policy of honesty” starts from the time you fill out your application for insurance. Did you know, if you make what is called “a material misrepresentation” on an insurance application, years before a valid claim takes place, your insurance company can not only deny your claim, but they can rescind your policy entirely? When your policy is rescinded, it is as if you never had it, meaning you cannot collect on it. And just what is a “material misrepresentation?” In short, to an insurance company, it’s when you answer in such a way that they consider the answer to not only be untruthful, but that if you had told the truth, they would have never insured you to begin with.

Courtesy of rootinc.com

Now think about this…You’re sitting with an agent, and he or she is asking question after question on the insurance application, when out of the blue they ask if you had a DUI in the past 5 years. You’re embarrassed that it happened in the first place, and you can’t remember if it happened 4 years ago, or 6 years ago, but it was right around 5 years ago. So you think to yourself, that it has nothing to do with the homeowners insurance you are applying for. So you answer, “No.”

Years later, your home burns to the ground, with everything in it, and you submit a claim. To your surprise, instead of paying the claim, your adjuster tells you they need you to submit to an Examination Under Oath. “It’s no big deal,” the adjuster says, “it is very common to require this on large losses.” And besides, you know you had nothing to do with starting the fire. As you proceed with the EUO, an attorney for the insurance company introduces you to the court reporter who will be transcribing everything said. You are still not thinking about that day in the agent’s office until the attorney asks, “Have you ever been convicted or plead no contest to a DUI?” Still not putting 2 and 2 together, you answer, “Yes.” The attorney promptly follows up with, “In what year was that?” to which you reply, “I have no idea; that was nearly 10 years ago.” “Actually,” the attorney says, “our records show it was in such and such year, isn’t that correct?” Again you respond that you don’t remember, but that sounds about right. He then asks you if you remember the agent asking you the question about the DUI within the past 5 years, and he asks you to confirm your signature on the application, and the date, which you do. Now you start doing the math in your head, and your stomach starts to churn a bit, but you’re able to keep your lunch down because the attorney quickly goes on the next question, and the next…

Fill out the form to get a free copy of Mark's latest book.

With all the questions over all the hours, it still hasn’t sunk in. That is, until you get a letter about a week later, explaining that your policy has been rescinded, with no payment on your claim, and only your premium is being refunded, because your DUI was only 4 ½ years prior to your insurance application.

This happens a lot more often than you would ever imagine. I call this, “denial by rescission”. If the

Image by leisuremartini.com

insurance company can’t find another reason to deny the claim, they may look to the application for items they consider “material misrepresentations”. Sometimes this happens when the agent didn’t even ask the question, but completed the application for the client, thinking they were helping speed up the process, and maybe also being embarrassed about some of the questions, or thinking they know the answers.

This is why it’s critically important to review the policy application questions and answers before signing it. And don’t assume any answer is not relevant, or that it wouldn’t count if that’s what the agent wrote as the answer. In a situation like that, you should assume that if you sign it, they will hold you to it.

And certainly once a claim is made; stick with the policy of honesty. Even if the answer to a question is embarrassing, or if the fact that you don’t know the answer is embarrassing, be truthful anyway. If “I don’t know” is the answer, state it every bit as proudly as you would if you did know the answer. Offer to find the answer. Or, suggest they speak with the right person to get the answer.  It will be a lot better than trying to make up an answer, just to hide the fact that you didn’t know something. Remember, the penalty for not knowing something is never as harsh as the penalty for giving a bad, untruthful, or dishonest answer.

What we learned in kindergarten is still true today – honesty is the best policy.

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.