I don’t know how I forgot I had it, 85 pages of the most riveting claims adjusting procedures a policyholder lawyer could want courtesy of your hosts Sop and Nowdy. I also put it on Scribd:
[scribd id=19263355 key=key-14lpcdl1m4tjvsayv2gv]
Update:
A reader sent in a short synopysis of some points that stood out – it shows that the industry does indeed know established law when it comes to adjusting claims. Maybe someone can get this to Judges Engelhardt and Berrigan in NOLA:
1) p. 29 the sub-section titled “Burden of Proof” under the section titled “General”
An insured with an “all risks” (open perils) policy only needs to prove that a loss occurred and is not expected or required to establish the cause of the loss. This is far less involved for the insured as he or she must simply establish that the property is damaged. Since the insurer covers all risks not otherwise excluded, the burden of proof is on the insurer to determine the claim is excluded from coverage. In the case of “Losses Insured”, the insurer must show that the loss was proximately caused by an excluded event.
The burden of proof greatly affects the adjuster investigating the loss, for after all, it is the role of the adjuster to fulfill actions and duties of the insurer in the investigation, evaluation and conclusion of a loss. “All-risks” or “open peril” policies place a heavy burden on the adjuster to prove that there is no coverage for the cause of the damage. When the insurer and therefore, the adjuster, has the burden of proof and cannot prove what caused the loss, an exclusion defense cannot be utilized and coverage will apply.
2) p. 23 under the section titled “General” the following is stated:
The adjuster is the foundation upon which an insurer is built…. if the adjuster does not provide the service promised by the insurer, the promise made by the policy is broken and the insurer will lose customers and fail.
The property adjuster has a duty to help the insured to (1) prove the loss to the insurer and (2) understand the terms and conditions of the policy.
3) p. 30 under the sub-section “Types of Catastrophes” within the section titled “General” the following is stated:
Hurricanes
Most structures can withstand with minor damage a relatively low-velocity hurricane with winds between 75 and 90 mph. However, as wind speeds increase, hurricane destruction becomes severe. In August, 1992 Hurricane Andrew crossed southern Florida with sustained wnds in excess of 130 mph, obliterating homes and essntially causing the same damage as a thirty mile wide tornado.
4) p. 33 under the sub-section “Interruption or Shortage of Services” within the section titled “General” the following is states:
Building supplies are often unavailable immediately following a catastrophe. Supplies usally become available within a few weeks, but prices remain high and remain so for months. Adjusters preparing estimates in catastrophe environments must be aware of prevailing prices. Estimating losses based on prices that prevail only during normal times is unrealistic.
sop
Let me know when you get your hands on or can post the plaintiff lawyer’s manual? Would love to read that one!!!!
Plaintiffs lawyers are a notoriously fractious bunch. While I suspect some of the larger firms like Anderson Kill& Olick have developed in house materials I doubt there is a trial lawyers handbook. That said I was given the book on appraisals and have become our in house expert on that process but it was broken down by chapter and would be unwieldy to publish.
We’re happy to have a home girl show up here and hope you stick around. Surely if we can enjoy Mardi Gras and the Saints together we’ll be able to find common ground on the insurance situation. We’ll be certain to add you to our blogroll along with our new friend Mr Liberty Mutual.
Also if you can get me or Nowdy your addy I’ll be certain you get a signed copy of Professor Feinman’s book. Cheers.
sop
I join Sop in the welcome and have enjoyed reading your blog – and also join him in doubting there is a “trial lawyers handbook” although, certainly, there must be a textbook book on insurance law.
In fact, one of the most disturbing things I’ve come across since Katrina is the lack of a handbook for attorney’s representing plaintiffs in litigation with defendant WYO companies.
Not only does the Federal Insurance Administration
I thank you for the warm welcome. Rest assured, I will stick around. I do “enjoy” reading some of your posts, and while I do not “enjoy” all of them they certainly do give me another view and perspective, exactly what makes it all worth while and fires me up, as I can see your partner in crime, nowdoucit was ultimately sent on a tangent over the NFIP manual. By the way, from my flood experience, they are easy to come by but you would not want one as they change so often, it is a constant taking some pages out and replacing them with others. The key with all manuals is they are simply to be used as a guideline and not strictly taken word for word. As for those “greedy trial lawyers” yes they do pick up the expense for their client until paid, so as to keep the client constrained to the dependency of their lawyer and await settlement while the process is drug out in an expansive time frame that no one could wait out without the financial aid. I do know this first hand as I spent my day working for one of the most notorious plaintiff’s lawyers. I will save that for another blog. On the other hand, did I mention that as an adjuster I seemed to get paid the same no matter the outcome of the claim. You would have thought that if I saved the company all of that money I would have at least received a 33 and 1/3 percent bonus or more if it went to trial. I look forward to our new relationship.
Clarifying my tangent is not a lack of any manual but the “Digest and Guide on Litigation Concerning the National Flood Insurance Program” – if you have one of those, please share, and I’ll save my soapbox for other tangents. 🙂
Will do!