Insurance Claims Secrets - The INSIDE STORY

Insurance claims can be a first class PITA!

With that in mind, this little bit of INSIDE INFORMATION is offered.

EVERY CLAIM HAS:

1. An Adjuster (human type)
   
2. A File (either electronic or paper or both)
3. A Supervisor (also the human type)

The claim process looks like this (considering the three above items)

1. The Adjuster mediates and calculates the value of the claim. (Why? Because that's what he's paid to do)
   
2. The Adjuster documents The File. (Why? Because The Supervisor is going to check that file)
3. The Supervisor reviews the file. (Why? Because once a year, the state insurance commission will audit the insurance company and randomly review claim files to be sure that the money paid out was justified, documented and in accordance with state insurance law. When there's an issue, the insurance company is fined -- HEAVILY! )

Here is the extremely valuable information ! When you're negotiating with the insurance company to settle your claim, remember while making you happy is important to them, passing the eventual audit is more important. A badly documented or poorly calculated claim can cost the insurance company -- MANY MORE DOLLARS than giving you a couple hundred extra for your bent fender.

Generally, the adjuster does not personally care how much they pay to settle the claim. Let me say that again.

Generally, the adjuster does not personally care how much they pay to settle the claim.

I say generally because you will occasionally run into that young buck, fresh out of 'ADJUSTER SCHOOL" who wants to save the world and treats the insurance company money like his own. THAT'S a discussion for another day. They're paid employees with families, bills, problems, vacation plans, and a host of other issues just like you and I face everyday.

The claim adjuster doesn't really care what he pays to settle the claim.
The claim adjuster wants to get the file closed as much as you do.

As long as he can document the amount paid, he'll write the check now and be done with it.

THEREFORE......

Whatever assistance you can offer to document a better value for your claim, the faster you'll get paid.

1. When you think your car is worth more than they're offering, get some documentation that supports that additional value.
2. When your repair job exceeds the insurance company estimate, get a letter or itemized estimate explaining the difference.
3. When the replacement cost of your kitchen exceeds what the insurance company is willing to pay, get pictures of your old kitchen and an itemized bid from the contractor that clearly indicates that you're putting yourself back as you were -- No better, no worse.
4. When the 'facts of the accident' are not clear, get witness statements or police report clarification.

The more you're willing to work WITH the claim adjuster to properly document their file to justify higher payments, the more you'll get paid for your claim.

Contact me if I can help you in any way.

After all..... it's what I do.

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:mailto:Dennis@DennisVolz.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

I've had a FIRE! What do I do now?

Fire can be one of the most traumatic and devastating losses anyone can experience.

If you've had a fire and there were injuries or a death, my sincere condolences. If you've experienced just loss to property, please take a moment to be thankful that there we no injuries or death.

You're probably still in shock that this has happened to you and bewildered by the seemingly endless task ahead of you. This is going to be a ONE DAY AT A TIME process. If you can settle into that thinking, this will be much easier. Every day that you make progress toward rebuilding your life is a WIN. Ask yourself at the start of each day, "What does WIN THE DAY look like TODAY?" Make a VERY SHORT list of a few things that will get you to that WIN THE DAY feeling and be happy with that.

FIRST THINGS FIRST
If your loss is a severe one (a total loss or one where SUBSTANTIAL work is required to get you back into your home) then you need to first think about some long-term living arrangements.

This should be your first priority. You might be put up with friends or in a hotel at first and you may need to get some basic items like clothing, personal items (toothbrush, etc) but don't get involved with any other stuff until you're settled into where you're going to live.
Your insurance company should be very generous here. You can usually rent a place similar to yours at their expense. They won't pay you any extra though.

For example, if you were renting a house or apartment, you won't be required to pay rent while you're out of your home, so you'll just be paying rent someplace else. The insurance company might make up the difference if there's nothing available similar to yours. The goal is to keep your monthly expense about the same.

If you owned a house, you'll still be responsible for your mortgage so the insurance company should pick up the entire cost of renting another place.

Just rent some furniture for now and then SLOWLY, replace it with items you purchase along the way. You'll have plenty of time to shop for furniture once the contractor gets busy rebuilding your home.

OK. So now you have a "home base" from which to rebuild your life. Its important to have this so you can focus on gathering, replacing, purchasing the things, memories and items necessary for daily living.

DON'T BE TOO HASTY TO "HIRE" THE SERVICES of a 'PUBLIC ADJUSTER'. This is someone who will show up EARLY. (like while the fire department is putting the hoses back on their truck) They will tell you that they will do all the negotiating with the "big bad" insurance company for you for a small fee. SAY NO FOR NOW.... (you can always go to them later and their "small fee" is THOUSANDS of dollars....) You're better of without them.

Your claim adjuster is going to be your new best friend. That's an important mind-set to adopt. Look to him as a source of information, encouragement and ideas to get the most out of your insurance policy. The company I'm with (and most companies) will look for ways to BE ABLE TO PAY YOU rather than looking for ways to get out of paying you. Remember, losses are calculated into what they charge and a good claim experience and positive results serve them much better than saving a couple thousand dollars by nickel and diming you to death.

GET ORGANIZED
TAKE NOTES. You should pick up a 3-ring binder w/ some paper. You might want to get some tabbed pages to keep track of THINGS TO DO, NOTES ON CALLS, CONTACT INFORMATION, etc. Remember think MARATHON not SPRINT. You're going to need a central location (the notebook and maybe a small file box) to keep track of your information.

They're going to start by giving you an overview of the entire process. There will be a contractor to find, plans to draw up, lists to create, receipts to keep, and plans to make. Take good notes and remember to keep thinking 'just one day at a time.'
KEEP YOUR PERSPECTIVE AND HAVE FUN! Yeah, I know that sounds a little off. But this is such a once-in-a-lifetime opportunity. You get to start all over. Fresh! New!

Make a decision to enjoy this process -- This curve ball that life has thrown your way. If you're married you can play 'newlyweds' all over again. If you're single you can make a substantial change in your lifestyle, your look, anything you want.

Decide to be BETTER not bitter because of it.

Yes.... Make a conscious decision that this is probably one of the most exciting adventures you'll ever have. Get just a few things and relish in how simple life can be. You'll "clutter back up" soon enough so just enjoy the spartan simplicity.

Buy a different brand of underwear, splurge on some really plush socks, or get a pair of just THE COOLEST JEANS EVER! Try out new ways of cooking with new dishes. Get back to enjoying the simple things in life. You'll be a bigger and better person because of it.

Don't forget to let your friends help you. You'll deepen your relationships and forge new friendships along the way. Just let it all happen.

THOUGHTS ON REBUILDING
There's way too many variations and possibilities to go into within the scope of this blog. But here's a few things to think about as you begin to work with your adjuster and contractor.

1. The insurance company will generally pay to build the house just like the one you lost but YOU DON'T HAVE TO BUILD IT THE SAME WAY. If you've always wanted a big picture window on the west side... then GET ONE!
   
2. Take your time with your architect or making your own sketches of how you want your house rebuilt. You might even be able to change the "footprint" of the slab (the basic shape and orientation of the house) One of my clients who lost their home in the San Diego fires of 2003 had always lamented that the side of the house with the best view had just one little tiny window. Well.... They fixed that w/ 4 huge picture windows and instead of having the bathroom there, it was their den and fireplace area. Turned out BEAUTIFULLY!
   
3. Have a plan to refurnish your home. Just slowly replace your rented furniture with your new stuff as the "building the home" process unfolds.

The process of rebuilding your home can be the most challenging event you've ever experienced. It can also (at the same time) be the most rewarding and life-changing! After all, if you can survive this, sitting in traffic or having to replace your refrigerator just won't phase you any more.

Contact me if you have any questions.

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

A word about DEDUCTIBLES...

Simply stated: A deductible is the amount that you pay toward a loss or claim before the insurance company begins to pay. The higher your deductible, the lower your premium.

• The more you are willing to participate in your loss, the greater the savings on your premium.

The insurance company will offer your a lower premium if you take a higher deductible because your LOSS FREQUENCY and your LOSS SEVERITY will be lower. Consider if you have a $2000 deductible instead of a $500 deductible:

1. You'll make fewer claims because you won't be making claims for $600, $900 or $1995 losses. You'll simply pay those yourself. (FREQUENCY)
2. When you do submit a claim the insurance company will be paying $1500 LESS than if you had the $500 deductible. (SEVERITY)

There is no "correct" deductible to choose. It depends on what I like to call your personal LOSS THRESHOLD. So before we get too far ahead, lets take a moment to diagnose your "loss threshold."

Lets say you go out and buy a $3 picture to hang in your bathroom. Are you going to insure it? Of course not! Now you go out and buy a famous $252,000 masterpiece painting. Are you going to insure it? Unless you are a multi-millionaire, you certainly will. Somewhere in between the $3 print and the $252,000 masterpiece is your loss threshold. Your loss threshold is the amount of money you can stand to lose without doing any great harm to your daily lifestyle or your peace-of-mind. In the above example, different people will have different thresholds. There is no right or wrong answer here!

ANOTHER SIMPLE CALCULATION....

OK. Let's say you're ok with a loss threshold of $1000 or less. Now you can choose between a $1000 deductible or a $500 deductible. Here's all you have to do.

1. Find the premium difference between the two.
2. Let's say you save $80 a year in premium to take the $1000 deductible.
   
3. Now look at the DIFFERENCE between the 2 deductibles which is $500. It would take you over 6 years ($80/yr x 6 years = $480 ) to save the DIFFERENCE between the deductibles.
   
4. Now you simply ask yourself, "Do I think I'll have more than 1 claim in the next 6 years?"
   
5. If the answer is yes, you should probably take the lower ($500) deductible.
   
6. If the answer is no, then the higher deductible ($1000) probably makes more sense.

If you're still confused by this, just give me a call and I'll walk you through it....

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

The Paint on my Fender Isn't Going To Match the Rest of the Car

Face it. Paint fades over time. Your car sits out in he sun and gets weather-beaten by rain, snow, etc. After a few years, the paint looks OK, but you can tell that it isn't like it was when the car was brand new.

Then.... you have a little fender bender and your left front fender is crunched. Damage isn't all that bad, but you need a new headlight and some paint when it's all done.
Doesn't matter how good the body shop is at matching the color. Actually most of it is completely computer driven and there's specific formulas for a given year and make of the car. The body shop can match the paint spot-on PERFECT. That's NOT your problem though.


The new paint is new and the rest of the paint is not. While it will match perfectly to the color it won't look the same and you want to paint the rest of the car. You think the insurance company should pay for that.

THEY WON'T. (usually)

Matching paint is not their concern. It's been round and round in the courts and it's just not a case you're going win. There could be an exception if you're dealing with the insurance company of the AT-FAULT driver who hit your car. I'll talk abou that next.

Sadly the case is that the insurance company is NOT obgligated to match the paint on the rest of the car. You might get an adjoining door painted or a little "blending" of some kind, but if you want the paint matched by painting the whole car, you'll have to pay for the DIFFERENCE yourself.
Take heart though! This is an OPPORTUNITY!

You might be able to strike some kind of deal with the body shop to paint the whole car. Remember most of the cost of painting is to set up the job -- Masking; mixing the paint, booth time, drying time, etc. That's all the same if they paint a fender or the whole car.

Make a deal with the body shop OUTSIDE of the insurance deal to paint the rest of the car. You'll get a better price and you can ethically let the insurance pay for all that set up on THEIR nickle.

If you were hit by someone else and are dealing with THEIR insurance company, you might be able to get some consideration for the non-matching paint. NOT MUCH, mind you, but something. This won't work if the accident was your fault because your car is being repaired under the collision portion of your policy and there's no provision for a liability-type payment (which this is) in that portion of the policy and the adjuster (even if they want to) CAN'T pay for that for you.

Before you go after this, be sure you get into the head of the adjuster and know WHAT THEY NEED to write you that check by reading (at least the Purple Section of: They're NOT offering me enough for my vehicle.

You'll need to document the reduced value of your car because of the non-matching paint. It may only be worth a few hundred dollars, but it might be worth your time. Talk to some used car lots or people who sell cars a lot and you'll get some ideas. You'll need to get something in writing so you might want to be willing to type something up on their stationery and return to get their signature. Ask them what to say and you'll be on your way.

Remember the claim settlement gig is a process. Take your time and help the adjuster document their file and you'll get a better settlement.

GOOD LUCK!

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

Options When You Have Damage from a Prior Accident

A client called me yesterday with an interesting dilemma. Said that recently, when his car was parked on the street, it was hit by a Fire Truck on a call. Kind of unusual as Fire Truck Drivers are usually pretty good at what they do.

Nevertheless, he was concerned because on the same side of the car there was some damage from a prior accident and wanted to see if he could get that fixed at the same time. He also wanted to make sure the paint matched the rest of the car. So here's the advice I offered to Steve.

The insurance company is only going to pay for the damage that was a direct result of the accident caused by the Fire Truck. Nothing more, nothing less.

Your best bet is to make a deal with the body shop OUTSIDE of the parameters of the insurance company settlement. Here's why.

Anytime you repair a car there are some fixed expenses that are there regardless of the size of the job. The car has floor time, rack time, parts to order, paint booth time, drying time, set up the paint sprayer time, set up the sander time, on and on and on. The body shop will appropriately include most of that in the estimate for the insurance portion of the repair. Then the body shop might to ahead and fix your "other fender" for less because they have to go through all that set up stuff anyway.

Talk to your estimator at the shop see if you can't make a bettter deal. I bet you can.

GOOD LUCK!

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

They're NOT offering me enough for my vehicle.

Whenever your vehicle has been declared a total loss, the insurance company will offer you a settlement based on the fair market value of your vehicle. (this works for cars, motorcycles, RV's, boats, etc.)

In the realm of United States tax law, the definition of "fair market value" is found in the United States Supreme Court decision in the Cartwright case:

The fair market value is the price at which the property would change hands between a willing buyer and a willing seller, neither being under any compulsion to buy or to sell and both having reasonable knowledge of relevant facts. United States v. Cartwright, 411 U. S. 546.

So you get offered some money for your vehicle. They give you a number. Sometimes you'll like the number... sometimes you won't.

Here's what to do when you don't.

First of all, you should always have a number in mind when you begin to enter the final phase of the claim.. That requires that you do a little research on your own. Please keep this important truth in mind as you do.

MOST PEOPLE OVERESTIMATE THE REAL VALUE OF THEIR VEHICLE.

I know that YOU wouldn't do that, but some do. Just think about if for a second: Most people list their vehicles at a given price either in the paper or Auto Trader and then end up settling for less than that when they actually sell.

Remember: The price that the vehicle actually sells for is the FAIR MARKET VALUE of the vehicle.

Ok, so with that in mind, let's get about finding the FAIR MARKET VALUE of your vehicle. Here's your BEST sources.

1. Call ads in the newspaper for vehicles that are as close to yours as possible. Hope to find people who have already sold the vehicles. WHY? Well because you quickly explain your situation and ask them if they would mind telling you the price for which the vehicle ACTUALLY sold. Might be more or less than the advertised price. Make a record of the ad, the phone number and the ACTUAL PRICE. Get as many of these as you can.
2. Call a local used car dealership and explain your situation and ask for their help. Be willing to go see them. REMEMBER, you're in the market for a new car if yours has been totaled. Ask them help you determine the value of you car by looking in their records to see what similar models of theirs had sold for.
3. BE SURE the insurance company has the right specifications on your car. If you had leather seats and power EVERYTHING, make sure they have that noted in the file. (more on this later.)
   

So once you have a number in mind, you're ready to begin discussions with your insurance company. We'll get to that in a minute.... (and let me remind you here that I'm an agent not an adjuster, but I've worked with adjusters for over 30 years and I know how they think and what they need to write you that check...)

Here's a couple of things that are IMPORTANT to keep in mind as you proceed.

1. The claim adjuster is a hard workin' person just like you are. They're given MANY files a week to work through. I've seen it as high as 75!
   
2. They want to get this file off their desk as much as you want to get your money.
   
3. Most likely they DON'T REALLY CARE HOW MUCH THEY GIVE YOU FOR YOUR CAR! Yes, that's probably true. It's not their money. BUT... They have to justify in the file the amount they give you. If you can give them good justification for the value that you want, they are happy to write the check and get on the the next file.
4. If you become their ally in this effort, you'll get a much easier and (likely) more profitable settlement.
5. Insurance companies usually use an outside vendor to determine the value of the vehicle. (remember we talked about having your car accurately described to the insurance company....Leather Seats, etc???) The insurance company simply forwards that information to this vendor who researches SOLD VEHICLES in your area to determine the FAIR MARKET VALUE. It's usually NOT the adjuster who crunches the numbers..... he's just the messenger.
   

OK, now...back to the settlement.

ALWAYS have your acceptable number in mind before you call and ALWAYS let them make the first offer. You might be thinking $5,500 and they offer you $5,800. If that happens, simply say, "That sounds reasonable to me, can you mail the check today or would tomorrow be easier for you."

Have your documentation at the ready. You've done your research so you're ready. If the number is too low DON'T come unhinged. Ask them how they got the number and let them explain. Listen calmy and patiently without interrupting. Remember.....he wants settle and get rid of this file as much as you do.

Offer your documentation to help him justify paying a higher amount to you. Use phrases like, "Can I get a copy of this to you to help you with the file?" or "Would it help if I gave you some documented sales that were several hundred dollars above your offer?"

Calm... Collected and in control because you are. You don't have to settle until you're completely satisfied that you're getting fair market value.

If you don't have enough documentation, you'll have to go out and get some more. The more examples you can find, the better settlement you'll get for your vehicle.

Remember it's a process, not necessarily a one-time phone call. Take your time and win a friend along the way.

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

One Picture is Worth a THOU$AND DOLLAR$

Yes, I know a picture is worth a thousand words, but it could also be worth a thousand (or THOUSANDS OF) dollars!

I can't tell you the number of times in my 30+ year career in the insurance business that I've listened to a distraught policyholder after a loss struggle to remember everything that was stolen or lost in a fire. Many times I'll get a call many months after the loss because the client just discovered that, "They got my Grandma's silver too. We didn't realize it until we were setting the table for Thanksgiving dinner."

The whole process wouldn't probably take you more than an hour. Just walk around your house and take pictures of everything you own. Well, you don't need to document your underwear drawer, but take pictures of almost everything else. Here's a short list to get you started...

(remember the purpose of the pictures is twofold:
a. To help you remember every thing you have.
b. To document (i.e. prove) to the insurance company) that you really did own all this stuff!)

So here we go...

1. Take a panoramic shot of every room in the house. Some rooms may need pictures from several different angles to get it all in.
2. Then open your cabinets in your kitchen and get pictures of all your dishes, cookware, etc.
3. Take a look in all the drawers and take pictures of any unique items you may have.
4. Get a black cloth or towel and spread it out on your floor or bed. Lay out any special or expensive items such as Jewelry, Silver, furs, CD collections, collectables, baseball cards, plates, dolls, etc for better close ups.
5. While you're at it, take pictures in the garage: Tools, cars, contents of your cars, file cabinets, lawn mowers, etc.
6. Take a picture of your back yard patio furniture, tool shed, etc.
7. Open your closets and take pictures of your clothing. Reminds you of the amount and some of the pieces.
8. Take close-ups of all the pictures, art and decorative items hanging on your walls.
9. Take pictures of your cars: Inside and Out. All the way around

I think you get the idea.

Now.... here's the important part..... ! ! ! !

If these are digital pictures, put them onto your computer and make a couple copies onto some CD's. Take one to your office and give one to a friend or mail one to your Uncle in Toledo, but GET IT OUT OF YOUR HOUSE. Last thing you want is to remember that all your "pictures" burned up in the fire... :)

Make a reminder to at least consider updating the pictures once a year AND whenever you make a major purchase like stove, refrigerator, art pieces, jewelry, etc.

This will make your life SO MUCH EASIER if you ever have a loss.

It's a Good Life !

Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California