We can provide anything from simple scene photos to large loss settlements:
Our Work Product: We provide a PDF file, by e-mail, that can be down loaded to any computer. The file contains the damage report in line by line detail, a report to the company explaining cause and origin, nuances of the particular claim, and how we arrived at the recommended settlement figure. The file also contains color photos, supporting documentation, proof of loss or release as required, and our invoice. The PDF is standard but we can send our closing papers by US mail instead if requested. When we return a settled claim to the master file, it is a truly settled claim. It is an agreed figure that is supported by area companies that will perform the work for the RCV dollars written. We do not just send back figures of what we think the settlement is worth, and then leave it to the claim rep. to sort it out. We send back a finished product, that once approved can be paid and closed. We will do as little or as much as the master file directs.
Loss Adjustment Expense: Every carrier and self insurer is sensitive to LAE and seeks to limit same as much as possible. LAE vs. Claim severity control is a balancing act. We help you strike that balance. For what good is saving on LAE if you give away multiples of that savings in your claim settlements. We are in this for the long haul and see to it that our customers receive good value for the dollar in both service and overall claim control. Really knowing a claim and controlling it ultimately leads to proper, fair settlements that are cost effective We take ownership of our assigned claims and follow through to completion, always mindful that if our charges are excessive or abusive, we will not likely receive future work.
Scene Photos: If the loss occurred in our area of coverage we will visit the loss location and digitally photograph the scene. We will usually do this with the help of a police report and take photos and make a diagram to demonstrate what happened and how it affects the liability position of everyone involved. If there are damages to be documented they will be clearly explained and their relationship to coverage will be demonstrated.
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1st party Commercial Claims: Everyone can't be expert in everything, especially when it comes to Commercial Claims because businesses and their attributes are so varied. Because we have done so many claims, there is a good chance that we have already settled claims like yours, but if we have not, we do know how to find out more about the claim in short order. We know where to look and with whom to consult to standardize even the most unusual claim into a format that can be quantified and finally indemnified. The first thing that we do is to read your policy or apply the appropriate ISO form & endorsements. We verify that coverage exists and to what limit, then we survey the loss and apply the policy with regard to depreciation, holdbacks, special limits, and exclusions to arrive at a settlement recommendation.
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3rd party Commercial Claims: Maybe you are an auto carrier and not set up to handle commercial property claims but your insured did damage to a commercial structure or some commercial equipment, with his vehicle, or maybe your insured owns a condo that leaked down into the lobby of a building. We are set up to handle claims like this. We have settled claims on most anything that a vehicle can hit. Utility poles & transformers, commercial & residential structures, landscaping & fencing, equipment, commercial auto. Also remember that in a 3rd party situation there is no policy and no limit other than the liability limit that the insured carries for property. Because of this the claim can have several aspects including business interruption. We can get to the loss right away and establish rapport, make a direct 3rd party settlement and thus mitigate cost enhancers like business interruption, and the use of a public adjuster. Getting there first can make all of the difference because many claimants prefer to not use their own insurance, and if we can assure them that they will be dealt with fairly, we can take control of the claim and form a win win situation for the carrier and the claimant.
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Equipment claims: As stated before, no one can be expert on every type of equipment but that does not mean that one just accepts estimates as presented. We know how to source reliable background information to make intelligent and supportable business decisions with respect to complicated claims. In the end all property claims break down to labor and materials. Once you have identified the process needed for indemnification and verified pricing of materials the rest is just simple math. See the photos of some equipment claims that we have already settled.
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1st Party Homeowner claims: The first thing that we do is to verify the cause and origin of the loss, and then we apply the policy, whether it be Renters, Condo, or Home Owners. We survey the damages, separate Structure & Contents and proceed to quantify the claim, again applying any sub limits, exclusions, or overall limits. We can also handle Additional Living Expense and execute a proof of loss. We also settle claims with Public Adjusters but we are best at establishing quick rapport so that an insured does not feel the need to deal with anyone other than the carrier. We have settled thousands of 1st party Home Owners claims from simple fences to complete burnouts.
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3rd Party Liability claims: Many carriers are set up to service their first party claims and third party claims that are similar to their first party claims, such as auto damages and residential homeowner damages, but what happens when an insured vehicle damages something else like a utility pole, or a commercial structure? We can help. We have already settled many claims on just about anything a vehicle can hit. Store fronts, building facades, utility poles & transformers, TELCO distribution equipment, boilers, HVAC, guide rails, bridge work, heavy equipment, commercial vehicles, and on and on. If we haven't done your claim we have done others like it. We are different because we actually go out and see the claims. We visit the new utility pole to make sure that the repairs are concurrent with the demand. We visit the damaged building even if it is already repaired. Much can still be seen and reconstructed to see if the demand fits the loss. There is no substitute for visiting a loss, even if the loss is old, much can still be seen and then negotiated. Also we keep a database of our claims so that we can compare and see trends. Some reps. may only settle 5 utility claims a year. We do that in a day or two. We have a large basis for comparison and when a demand comes in that is out of line we take it to task and settle for the fair amount. Also a claimant can be a future insured if the claim is settled fairly and seamlessly, and the claimant is left with a good impression of how he or she was treated. We keep in touch with the insured as well. Many times the insured has received a very large demand, that they have forwarded to the file, and they are apprehensive as to why the claim is not yet settled. We stay in touch with the insured by mail and phone to let them know how the liability portion of the claim is going.
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Subrogation Demands: Every carrier settles claims differently and has different priorities. We receive and audit subro demands and check to make sure that the demand represents true Actual Cash Value and true indemnification. Demands from commercial carriers can be very different from another PP&C carrier in terms of possible business decisions made to appease a first party customer with a large premium. Many commercial policies have underlying agreements of how a claim will be settled, that may not represent indemnification. We check for this and standardize the demand to normal materials and labor damage reports that can be demonstrated to the subrogee. A PP&C carrier rep. may be unfamiliar with the business interruption portion of a commercial claim. We have a process made by a CPA to quantify actual loss of gross profit for a business. We also handle loss of use of equipment and locations. If a file that we handled ends up in Arbitration we answer the petition and then rep the file in person at no extra charge to the carrier.
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Identifying Subrogation Opportunities: The first thing that we do when handling either a 1st or 3rd party claim is to check that the liability position taken by the claim rep. agrees with what we are seeing and reading first hand. We check for comparative negligence and notify the file if our take on the liability differs from theirs. If it is a first party claim we also look for subrogation possibilities either from a manufactures defect or some other contributing negligence factor and report same back to the file. Cause an origin is always part of our final report.
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Utility Claims: We settle a large amount of utility claims throughout the year. Because they are shared, utility poles can have 4 different claimants making demands at different times. We try to see every utility pole and identify who the different claimants will be and approximately how much their demands will total. This is important when dealing with basic property liability coverages to assure that there will be enough coverage to indemnify all of the claimants. If there is not, we notify the file to send out an excess letter and then contact all of the potential claimants to see if they will accept a pro-rata settlement and release the insured. Knowing the claim potential early-on benefits all and negates extra contractual liability. We have a large data base of already settled claims. We compare recent demands to prior settlements to pick up trends and assure that we are recommending settlements that are fair to both the claimants and the carriers. We have found that large demands can have large errors in both scope and pricing. Also utilities can take a long time to submit their demands. This adds to the clouding of the issue and makes a claim harder to quantify, especially from the desk. That is why we like to inspect as many of these claims as possible. Because we have a large basis for comparison we can isolate errors and demonstrate them to the claimants to obtain a more accurate indemnification settlement. We can more easily spot trends as well.
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Municipality Claims: Municipal claims run the gamut of collection methods. Some have their own collection departments, others use a third party administrator, and others still may use their own legal departments. Each of them has a different understanding of indemnification and therefore different requirements and expectations for getting paid for damages. We have worked with so many municipal organizations that we know what to audit, what to ask, and who to see to align their demands with indemnification principles and properly settle the claim.
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Fast-tracking and Desk Reviews: Sometimes we get a claim to review that is clearly a reasonable demand and we simply fast-track for a minimum fee with an explanation as to why it should be paid as such. Sometimes we can do a desk review and negotiate the settlement without an inspection. When we receive and assignment we determine what is best for the carrier and proceed accordingly. Fast-track, Desk Review, or inspection, we do what is cost effective and will realize the best value for the dollar for the carrier.
Business Interruption: We also settle the business interruption portions of either first or third party claims. We take the demand and audit it using our own formulas to arrive at the actual loss of gross profit, and use. We contact the insured's or claimant's accountant and have him fill out a standardized form that we use for daily loss of gross profit. If there is a dispute we then audit the tax returns but usually the form does the trick because it is derived from information on the tax returns. This saves a lot of time and LAE. Because we visit the loss we can also get a handle on partial interruption or even mitigate interruption altogether. Establishing rapport, and reporting the present condition of a loss, in the beginning of the loss, does a great deal to help mitigate business interruption. We get out there fast. Many times before the first party carrier or a public adjuster. Many claimants and insureds see business interruption as simply lost gross sales. It is not, as there are many non-continuing items that go into that sale. We calculate the difference and demonstrate with the insured's or claimant's own accountants report what the true loss is.
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Claim Advice: Many reps just call us up and ask advice about a certain claim that they have. We are happy to provide any help and advice to our customers, even if it means that we will not be assigned that particular claim. We want to establish long term relationships where our customers rely on us to solve their difficult property claims and we rely on them for steady work. There is very little risk in using us and the potential benefits far outweigh any adjustment fee. Each claim stands on its own and is billed so that the carrier always realizes good value for the dollar.
Self Insureds: Towns, municipalities, and some businesses may self insure, or self insure up to a point and then carry excess. Others may carry very high deductibles. We can help a self insured manage it's claim load. We can act as a third party administrator or simply adjust on a claim by claim basis. It is up to the customer. Smaller self insureds do not maintain a claim department and therefore have limited expertise in quantifying and indemnifying a claimant. We provide the expertise to assist the self insured in settling the claim for a proper figure in a timely manner. We can also help a self insured to manage their risk by auditing their insurance coverage, helping them to set reserves on outstanding claims and making recommendations for future coverage and policy changes.
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Watercraft: We also settle boat and other watercraft claims. We have settled many claims for both hull and power plant damages. We visit the boat yard where the loss exist and review the evidence and the demand. We agree on a scope of repairs as well as pricing for same. We also identify the craft and the actual owner to be certain that we are recommending payment to the correct insured or claimant.
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