Property Specialists
How many years of property claims experience, combined, do the four Property Specialists possess?
DAILY DOUBLE
Vaughn 25
Adam 23
Austin 6
Mike 26
Total 80
Bo has 20
You are carrying a large claim inventory and you were just assigned a fire loss. The insured is expecting an inspection immediately. You feel overwhelmed. How do you manage the work?
Make time to contact the insured as soon as possible. Prioritize your work and inspect the fire as soon as you can.
There are a lot of things that need to happen to move the claim forward. Set reasonable expectations with the insured.
What is ISO? What types of property claims should be reported to ISO?
Insurance Services Office is run by Verisk. Provides member institutions with claims history data.
All claims. Including:
Fire
Theft
Water
Submitted automatically by ClaimsPro but manual searches are often necessary for more information.
Mrs. Insured no longer lives with Mr. Insured, they are separated. Both are listed as named insured on the policy and Mrs. Insured did not sign the Sworn Statement in Proof of Loss for the Dwelling or Personal Property packet. Can you accept their Proof of Loss paperwork?
Nope.
Does it matter if they are divorced instead of separated?
How can I write an estimate for plumbing, HVAC or electrical damage when I am not a licensed repair person?
$$$
We estimate for damage we can see and use the estimating system to determine the cost. We do not need to be a licensed repair person to estimate plumbing, HVAC, or Electrical damage.
This Specialist’s wife describes him as a hoarder. He enjoys collecting items from the 60’s and 70’s.
Mike Billington
There is questionable coverage on a water loss. You call your supervisor. How should that conversation go?
Summarize the reason for your call. Explain what your opinion of coverage is and site the appropriate policy language. The supervisor will confirm your coverage opinion or point you in a different direction.
The insured and her husband would like to take the statement together. What do you tell them?
No. We will get their statements independently and neither party should hear the other's statement.
The insured calls and states that they forgot to claim a number of personal property items a month after submitting the Sworn Statement of Proof of Loss. Do you accept their claim for additional personal property items?
Maybe. How clearly have you set expectations regarding the insured's Proof of Loss and Schedule Cs? How well is that documented in your file?
With all the different types of flooring available, how will you identify what the insured has and if it is truly damaged?
itel is the best option. Adjusters are encouraged to search online or visit big box stores for comparable materials and pricing.
There are several golfers on the Property Specialist team, this one scored an albatross in a golf tournament.
Austin Quinlan
Over the course of your investigation you learn that the reported loss date is incorrect. You can change the date in ClaimsPro or create a new claim. How will you decide?
The insured's house is mostly burned and there is not a good place to take the statement at the loss location. What are your options?
Somewhere private. Their hotel or temporary living situation. Agent's office if there is a closed door. Somewhere free from distractions but also safe.
You receive signed and notarized Schedule C. The insured did not complete the columns for Date Purchased or Acquired and for Current Cost to Replace. What should you do?
Reject it. Call the insured and follow up with a letter. Include all reasons for the rejection in the letter.
An insured is claiming their 14 year old air conditioner was completely fried by lightning over the winter as it does not work now that it is hot again. Other than a Strikenet report, what can I do to investigate this loss?
DAILY DOUBLE
Investigate to find out which parts are damaged.
Is the capacitor damaged?
Is there a company we can call? Yes. HVACi.
In order to focus his unlimited cheer and enthusiasm, this person spent time as the University of Missouri’s Truman the Tiger. His enthusiasm led him to be sanctioned by the school after an altercation with another mascot became violent.
Adam Smith
You recognize Subrogation potential on a claim you are investigating. You contact the Subrogation department for direction (Good job!). Who maintains ownership of a claim from this point forward?
The adjuster concludes the claim until coverage has been determined and all ACV payments are paid. The file should clearly state how much has been paid to date, the deductible amount that was withheld, non-recoverable depreciation and the amount available for recoverable depreciation.
Subrogation does not take ownership of the file until all reserves are closed. Until then, the adjuster maintains ownership of the file and works in conjunction with Subrogation.
While scoping a fire loss you ask the insured to open closets, dresser drawers, and the refrigerator. The insured wants to know why. What do you tell them?
It's a necessary part of the investigation. We can document what was and was not damaged. Also we can verify residency.
The insured has made a theft claim but refuses to sign our Authorization form. How do you handle that situation?
They do not have to sign our authorization form. They must cooperate with the investigation and they may need to provide us the information we need. They may provide it directly to us or bring it to their Examination Under Oath.
The insured has made a claim to replace a unique material that you have not seen before. The estimate the insured provided seems. Where can you get comparative pricing if it’s not in the CoreLogic database?
1. Step one is to find out what is included in the price that is being quoted. What are the exact materials being claimed? Are they the same as the ones that are damaged? How long with the job take? How many people will it take to do the job? Is there any special equipment needed to perform the repairs? How much is the contractor charging for labor costs?
2. Next you can get a bid from a different contractor. How does it compare to the above?
3. Lastly, should CoreLogic’s database include this item?
This Property Specialist was once gifted the rental of a mini excavator to do nothing but play in the dirt for the afternoon. He was not disappointed.
Vaughn Woolf
Adjusters visit agents often. What should you discuss with them while you are there?
$$$
Tell them about yourself. Answer questions they might have about policies, coverages, or endorsements. What are trends that you are seeing in the field? Protect property from further damage. Save the part!
Stay away from specific claim information that is privacy protected.
Can you tell the insured you have referred their file to SIU?
Yes. We have nothing to hide. At this point there are known concerns on the claim. We should refer to NICB Fraud Indicators as reasons for the referral. Also, the adjuster keeps the claim throughout the investigation. It is not reassigned to SIU. They HELP with our investigation, they do not take it over.
You will receive a work item from SIU:
SIU accepts referral and has assigned investigative tasks. Please perform the following:
Ensure that ISO has been uploaded.
Inform the Named Insured the file has been referred for investigation.
Advise the NI to expect contact from an investigative representative from Shelter Insurance.
Comply and cooperate with the investigation in accordance with the terms and conditions of the policy.
Ensure all statements in ClaimsPro have been transcribed.
You have received an invoice for a home that has had two hail claims in the last few months. The same HO-3 Policy was in force with the same deductible. You review the file to find out what we have paid to date. The second loss caused damage to the roof before it could be repaired. How should this be handled?
$$$
Per the policy. We should take more depreciation on the second loss than we did on the first loss because there is pre-existing damage. We still owe the ACV on the second loss, however.
The ACV amount paid on the first claim will be deducted from the recoverable depreciation settlement for the overlapping estimate line items.
There is damage to flooring and drywall as expected. The loss appears to have originated near an outlet and there is also damage to one light fixture and two light switches. You begin to write your estimate and consider leaving the electrical items open for a contractor's bid. Why would you do that?
You wouldn't. You should estimate for the known electrical items: One outlet, one light fixture, and two light switches can be added using CoreLogic's database.
Two of the four Property Specialists have a family member that currently works for or previously worked for Shelter. Who does not?
200 Point bonus question: Which Specialist has the most family members with Shelter ties?
200 Point Bonus: Mike Billington
You are assigned a gutter supplement on a storm claim that was originally handled by a different adjuster. What steps do you take to complete that assignment?
Take a new assignment of the CoreLogic claim file. Consider if a reinspection is needed by reviewing the requested supplement and previous adjuster photos. Create a revision for the approved supplement. Complete your estimate. Enter a Payment Tracker for the supplemental amount. Make your CA a participant. Create a new PaymentRevision letter.
Call the insured.
Make sure there is nothing else that can be done on that claim while you currently possess the file. ALE? Personal Property? Other supplements? Other invoices submitted?
Complete a new final journal entry. Close the claim. Complete your assignment.
The tenant accidently started the fire when they left their fryer unattended. They have accepted liability and have insurance. Do you need to hire an origin and cause engineer?
$$$
Yes. To document the cause of loss which supports our liability determination. Also, to protect our insured from any alleged liability.
My insured has a water damage claim in their basement. They have the Drainage Endorsement with a $10,000 limit. At the inspection of their partially finished basement, I see evidence of a wet floor around the drain and the sump pit. I also see evidence of surface water running down the wall from a basement egress window. How do I separate the damages and take care of the insured?
The damage near the drain and sump pump pit are covered due to the Drainage Endorsement. Damage caused by the ground water entering through an egress window is excluded.
The insured gets the benefit of the doubt where the covered damage and the excluded damage overlap.
HO-3 Policy. Insured’s large open floor plan basement has a drop ceiling with acoustic ceiling tiles. There was a covered water loss in the first-floor bathroom and water fell to the dropped ceiling. Four 2’x2’ tiles are damaged. Do we owe for the four damaged tiles or all the tiles in the ceiling?
$$$
Can we move some tiles and replace others?
Are ceilings included as “decorative fixtures?” no.