Catastrophe Insurance (C) Working Group Meeting … Insurance (C) Working Group Meeting ... particularly programs announced several months following a catastrophe, can add ... Earthquake

Catastrophe Insurance (C) Working Group

Meeting Materials

Call 11/6/17

Handout Page 1© 2017 National Association of Insurance Commissioners


Industry Responses to Survey



PCI NAIC Disaster Survey Response

1. From an insurer's perspective, what have historically been the most common non-insurance obstacles that impair a policyholder's ability to recover from a disaster? For example, federal restrictions, local or municipal ordinances, contractor or supply shortages, debris removal, logistic needs, etc.

• A shortage of available, licensed and well qualified contractors to be the most common non-insurance obstacle that impairs a policyholder’s ability to recover from a disaster.

• Local Ordinances - The permit process can be lengthy due to the number of other individuals filing for permits following a catastrophic event.

• Following a catastrophe, the high demand for labor and materials can impact costs, which in turn may result in supplemental estimates so that insurance carriers can reach an agreed repair figure with the policyholder’s chosen contractor.

• Access to affected areas- Road closures and gas shortages can make it challenging for adjusters to quickly inspect the damaged property

• Housing shortages for temporary living while insured is rebuilding.

• “Storm Chasers” – Contractors that arrive in affected areas pursuing homeowners to file what are in many cases questionable claims for damages

• Supply shortages of building materials and replacement items, at times can be another hurdle for insureds but, this is more so for Hurricane losses where there is extensive widespread damage vs a more isolated event like a hail storm or localized tornado.

• Housing issues for Adjusters - For example in Hurricane Ike adjusters had to commute almost an hour each way to the Houston area because so many residents/commercial enterprises/businesses booked large blocks of hotels for their employees so they could live near work and not have to deal with commutes, lack of electricity, etc. and could keep the business working. It wasn’t for almost 3-4 days’ post storm that these rooms got released and we could move our adjusters into the area.

• We are seeing more and more Public Adjusters being involved in large CAT event type losses. The come into the devastated area and make a lot of unsubstantiated promises to both commercial and homeowners.

2. From an insurer's perspective, what have historically been the most common regulatory obstacles that slow an insurance company's claims response to a disaster? For example, federal restrictions, local or municipal ordinances, claim adjuster registration or licensure requirements, etc.

• Adjuster licensing is a common regulatory obstacle we face following a catastrophic event. The requirements for the emergency license vary by state as does the availability of the emergency licenses. Not all states follow the PCS catastrophe declaration. Instead they develop their own assessment as to what constitutes a catastrophe which in turn triggers the availability of emergency licenses. Delays in securing emergency adjuster licenses can cause delays in insurance carriers’ claims handling.

• Although our policy may state a hurricane deductible which is the basis of the policy premium, occasionally state governments may ‘ask’ insurance companies to waive such deductibles. These regulatory changes can cause confusion and impact our claims handling by requiring supplemental policyholder communication.


• State mandated arbitration programs, particularly programs announced several months following a catastrophe, can add complexity to our claims handling. These programs are typically created after an event occurred and claims have been handled. The programs require the insurance carrier to review a significant number of claims to determine if policyholders qualify for the program and issue the appropriate communications. This is during the same time the carrier is responding to newly reported catastrophe claims.

• Ambiguous and numerous data call requests that may require a manual review of numerous files in order to provide requested responses.

3. As to Questions 1 & 2, please share any comments regarding potential solutions that regulators should contemplate in developing best practices or regulatory guidance?

• Streamline and provide consistency in how carriers can secure emergency adjuster licenses for their personnel. Or, automatically grant emergency licenses to insurance carrier personnel who adjust claims in other states. If this is not feasible, automatically grant emergency licenses for carrier personnel property licensed in another state.

• Consider the costs and time involved in responding to data calls and be selective in the information requested and the time frames for those requests.

• Enacting guidelines designed to prevent unscrupulous contractors (“storm chasers”) from taking advantage of consumers by using aggressive marketing campaigns and performing substandard repairs.

• Imposing stricter guidelines on what a Public Adjuster can and cannot do when it comes to being involved in the claims process and what they must disclose to the policyholder before getting them to sign.

4. What, if any, time limitations have the insurer's standard residential property coverage forms imposed on claim submission or payments under the following coverages:

a. Dwelling;

• 180 days to advise of intent to make claims for full replacement cost benefits.

b. Personal Property;

• To submit a claim for personal property, the policyholder must notify the carrier of their intent to replace their damaged personal property within 180 days to be eligible for replacement cost holdback

c. Loss of Use.

• Coverage for Loss of Use is for a reasonable amount of time to complete the repairs. Carriers understand that the lack of available contractors may impact what is deemed reasonable

d. Other

• Timeframe to respond to a request for a proof of loss (60 days)

• Suit Limitations Clause


5. In past disaster or catastrophe situations, have insurers used or permitted any general exceptions to normal claims practices as to certain policy provisions? If yes, please generally explain as to when and how such requirements were waived. Examples of some claims practices or contract provisions that might be waived include:

a. Personal property inventory requirements;

b. Timeframes extended for submitting claims for additional living expenses;

c. Timeframes extended to obtain full replacement cost benefits for personal property claims;

d. Timeframes extended to obtain full replacement cost benefits for dwelling/structure;

• We have extended the time periods for work to be completed on a building. Reason for this is the amount of work in a specific area and the lack of the availability of contractors to complete the work.

e. Requirements to rebuild property on same location to receive full replacement cost value following a disaster or pursuant to any governmental restrictions;

• Most want to rebuild at the same location. If they don’t and they have another we work with them to assure it works out.

f. Contractual requirements about when repairs must be commenced and when those repairs must be completed; or

• We have been flexible with this based on the availability of contractors and when the work can be completed. • Repairing or replacing a roof on a commercial building takes much longer than a residential roof which might

take 2 to 4 days max. A commercial roof may take a month or more to finish so only being able to do one commercial roof a month vs. 8 to 12 residential roofs a month it is not always reasonable to think it will commence or be completed within 180 days.

• The location of the loss will play a key role in when it will get done. If it is Texas, no problem as you can work most anytime year-round vs. a loss in MN where we have a 4 to 6-month window to get it done depending on the timing of the disaster.

g. Any other policy provisions as to other coverages/benefits not identified.

• Unless required by the governing state, practices for catastrophe handling remain consistent with normal claims handling.

• We use good claims judgement in determining timeframes required to obtain full replacement cost benefits and additional living expenses.

6. This question is seeking estimates of the average time it has taken to close claims following disasters. We are asking for the estimated percentage of claims closed within the specified periods, separated by type of claim. We are seeking this information for five (5) different types of natural disasters. (Please use Exhibit A of the attachment)

This information will allow the Subgroup to make recommendations in terms of "the appropriate duration" for additional living expense coverage or to recovery full replacement cost benefits following a disaster. These recommendations are a part of the 2017 Charges for this Subgroup. SEE ATTACHED RESPONSES FROM TWO COMPANIES


7. Are there any additional policyholder obstacles to post-disaster recovery not identified within this survey that insurers can identify? Examples would include, but not be limited to: prescription drug refills and other health coverage issues, dealing with significant injury or death of family members or more basic issues like lost identification or licenses, etc.

• We agree with the examples provided in the question.


Company A

Claims Group Day Range Dwelling Personal Property Loss of Use

Non-CAT Claims

0-30 days 65.17% 69.48% 20.18% 31-60 days 15.24% 13.38% 19.82% 61-90 days 7.06% 5.93% 16.49% 91-180 days 7.94% 6.61% 25.61% 181-365 days 3.46% 3.31% 13.08% Beyond 365 days 1.13% 1.30% 4.82%

Hurricane/Tropical Storm (Wind only)


Large Tornadic Event


Hailstorm


Wildfires


Earthquake



© 2016 National Association of Insurance Commissioners Draft: 8/5/16

Exhibit A

Non-CAT Claims

Dwelling Personal Property Loss of Use

0-30 days 62% 40% 20% 31-60 days 15% 20% 20% 61-90 days 10% 15% 15%

91-180 days 7% 10% 15% 181-365 days 4% 10% 15%

Beyond 365 days 2% 5% 15%

Hurricane/Tropical Storm (Wind only)


0-30 days 50% 30% 20% 31-60 days 15% 20% 20% 61-90 days 10% 20% 15%

91-180 days 10% 15% 15% 181-365 days 10% 10% 15%


Large Tornadic Event


0-30 days 25%

30%

20% 31-60 days 25% 20% 20% 61-90 days 15% 20% 15%

91-180 days 15% 15% 15% 181-365 days 10% 10% 15%

Beyond 365 days 10% 5% 15%

Hailstorm


0-30 days 70% 60% 40% 31-60 days 10% 20% 40% 61-90 days 7% 5% 10%

91-180 days 7% 5% 10% 181-365 days 4% 5% 0%


Wildfires


0-30 days 25% 30% 20% 31-60 days 25% 20% 20% 61-90 days 15% 20% 15%

91-180 days 15% 15% 15% 181-365 days 10% 10% 15%

Beyond 365 days 10% 5% 15%

Earthquake


0-30 days 25% 30% 20% 31-60 days 25% 20% 20%

61-90 days 15% 20% 15% 91-180 days 15% 15% 15%

181-365 days 10% 10% 15% Beyond 365 days 10% 5% 15%


555 12th Street NW

Suite 550

Washington, DC 20004

202-828-7100

Fax 202-293-1219

www.aiadc.org

September 1, 2017 Angela Nelson, Chair Consumer Outreach and Assistance Post‐Disaster (C) Subgroup NAIC Central Office 1100 Walnut, Suite 1500 Kansas City, MO 64106‐2197 Attn: Sara Robben, VIA Electronic Mail: [email protected]

RE: Consumer Outreach and Assistance Post‐Disaster (C) Subgroup Industry Survey Dear Ms. Nelson: The American Insurance Association (AIA)1 is writing to provide member feedback on the Consumer Outreach and Assistance Post‐Disaster (C) Subgroup industry survey. Founded in 1866 as the National Board of Fire Underwriters, AIA is a leading national trade association representing more than 325 major property and casualty insurance companies. AIA members collectively underwrite more than $127 billion in direct property and casualty premiums nationwide annually, and range in size from small companies to the largest insurers with global operations. AIA’s members include leading personal and commercial insurers and prominent reinsurers. As requested, AIA distributed the survey to our members and solicited feedback, explaining that we would aggregate responses and provide information to the Subgroup. AIA member feedback follows:

1. From an insurer’s perspective, what have historically been the most common non‐insurance obstacles that impair a policyholder’s ability to recover from a disaster?

1 AIA compromises approximately 325 major U.S. and non‐U.S. insurance companies that write more than $127 billion in premium each year and provide all lines of property‐casualty insurance to U.S. consumers and businesses.


AIA members have seen delays caused by a shortage of building contractors and contractors that provide debris removal services. In addition, debris removal decisions at the municipality level often take too long and there is ambiguity about the process, responsibility and ownership. In some cases, the market for contractors is thin and then unqualified contractors/storm chasers come to the area and begin to solicit insureds. They are known to request a down payment for services and then, often, vanish without completing any of the work. State‐by‐state inconsistencies in process for non‐insurance relief efforts, such as grant programs, have caused delays. There have also been delays caused by access restrictions – the inability to access insureds’ property. Delays are also caused by lack of timeliness of decisions relative to code upgrades, ordinances, logistics, etc. For large events, such as hurricanes, material price increases present obstacles, especially when insurers’ price software is not able to make the updates timely to reflect the increase in price due to demand.

2. From an insurer’s perspective, what have historically been the most common regulatory obstacles that slow an insurance company’s claims response to a disaster? Catastrophe adjuster licensing and credentialing has historically been an obstacle. As have issues related to access to disaster areas. The emergency adjuster license term of 90 days is too short in some cases. Recently, some states have announced they will only issue temporary adjuster licenses to out‐of‐state adjusters who are already licensed somewhere else. Staff adjusters do not need as many licenses as independent adjusters to this diminishes the available pool of emergency adjusters who actually work for carriers. Onerous complex claim data calls also slow down company claim response. Most states now issue data call requests on the day of the event, or very shortly thereafter, that require daily or weekly updates. Often, insurers must take resources away from the claims handling function to respond to these data calls. There have been events where a state or states changed their reporting requirements several times for the same event.


Often, there is a lack of clarity and consistency regarding lines of business included in a data call request. Similarly, when States require that data calls be responded to via an on‐line portal, it is more time consuming and resource‐draining when a State requires insurers with multiple underwriting companies to go into the portal and input each underwriting company’s data separately.

3. As to Questions 1 & 2, please share any comments regarding potential solutions that regulators should contemplate in developing best practices or regulatory guidance? AIA members suggest that the first required reporting of data be requested no sooner than 72 after an event, and that updates initially be monthly until an insurer reaches a 75% close rate. The data call should then be transitioned to quarterly submissions and deemed complete when an insurer reaches 95%. We also suggest at least 5 days for companies to submit their first data, if a state is using the NAIC template, and 10 days for states that diverge from that template. Further, insurers should be permitted to report at a holding company level. If an adjuster is a regular salaried employee of an insurance carrier and is employed in the capacity of an adjuster, they should be permitted to obtain a temporary license in the case of a catastrophe. For access purposes, perhaps regulators could allow scheduled “drive byes” for insurance companies so they can access known exposures to confirm if damages is present or not. Government officials could lead the “tours”.

4. What, if any, time limitations have the insurer’s standard residential property coverage forms imposed on claim submission under the following coverages:

a. Dwelling: For one member, the policy language indicates prompt notice is required unless the reporting bars the insurer from a proper investigation. The company generally requires a statement of loss within 60 days, but is fairly flexible.

b. Personal Property: Similar flexibility was reported. c. Loss of Use: Similar flexibility was reported.

5. In past disaster or catastrophic situations, have insurers used or permitted any general

exceptions to normal claims practices as to certain policy provisions? AIA members change communication time frame requirements during a catastrophe, as insureds may not be readily available or able to make such communications. Time frames may be adjusted for receipt of a Sworn Proof of Loss.


Time frame requirements pertaining to the claim handler may be adjusted so the claim adjuster is able to obtain all relevant documentation/information prior to developing a resolution plan. A company may choose to exempt certain types of claims from approval requirements relating to coverage disclaimers. Exceptions to water mitigation plans have been granted during catastrophe events.

****

AIA appreciates the opportunity to provide feedback and looks forward to continuing to work with the Subgroup. Thank you again, and please let us know if you have any questions or if we can offer any additional assistance.

Respectfully submitted,

Lisa Brown Assistant General Counsel & Director, Compliance Resources



Consumer Information

Following a Disaster



1

DraftClaimsGuide

Table of Contents

1. Introduction.......................................................................................................................................................................2

2. Adisasterhasoccurred–wheredoIstart?..........................................................................................................2

2.1EmergencyRepairLog.........................................................................................................................................3

5phasesofahomeowners’claim:..........................................................................................................................3

3.TheInsuranceClaimsProcess......................................................................................................................................3

3.1ReportingaClaim...................................................................................................................................................4

3.2WhomaybeinvolvedintheClaimsProcess?............................................................................................5

3.3WorkingThroughtheClaimsProcess...........................................................................................................6

3.4Understandingyourinsuranceclaim(depreciation,estimate,replacementcost)...................7

3.5Repairing/RebuildingPhase.............................................................................................................................7

ShouldIHireaPublicAdjustertoHelpMeSettleMyClaim.......................................................................8

BewareofContractorFraud.....................................................................................................................................9

InsuranceClaims............................................................................................................................................................9

4.Thingstodobeforeadisasteroccurs(thepreparationphase).....................................................................9

Comment [RS1]: FAQatthebackwithsomeofthegeneralclaiminformationturnedintoFAQs??Angie


2

1. Introduction A major disaster has hit your area and your home and/or your property is damaged. What should you do? Disasters happen any time and any place. Property Policyholders who own homes and/or property owners may sustain a significant amount of damage to their homes and personal property as a result of tornadoes, floods, hurricanes, wildfires, etc. This brochure is designed to help you understand what to do after a natural disaster has occurred and what to expect in the insurance process to help you in order to recover from your loss.

2. A disaster has occurred– where do I start? After you have ensured that you and your family are safe and unharmed, your first thought will be of your home and/or your property. How much damage has your home and/or your property sustained? Is my house still livable? What do I do? Here are a few things to start with: Before you enter your property, make sure it is safe. Check for hazards, for example, broken glass;

downed power lines; ruptured gas lines; sharp objects. Once it has been deemed safe, secure your property and take steps to prevent further damage to your

property. You should make emergency repairs to prevent any further damage to your home and/or your property. This includes covering roofs, walls or windows with plywood, canvas or other waterproof material. Do not make permanent repairs without consulting your agent or company. Unauthorized repairs may not be reimbursed.

Do not use electrical appliances that have been exposed to water unless they have been tested by an electrician or other technician.

Take photographs and/or video of the damaged areas. Also, make a list of all damaged or destroyed personal property. This will help you with your claim and will assist the insurance company in its investigation of your claim.

As you are reviewing your property,make a list of all the damage youwant to show yourinsuranceadjuster.

Ifyoucannotliveinyourhome,takeyourimportantpaperswithyou,includingyourinsurancepolicies.

If you cannot stay in your home, save any hotel receipts as the cost of the hotel may be reimbursed by your insurance company.

Before you remove any damaged property from the premises, be sure an insurance adjuster or your agent has seen the damage so a damage-and-loss assessment can be prepared.

Keep all receipts for emergency repairs so you can be reimbursed. If your prescription medications are lost or destroyed, contact your doctor’s office, pharmacy, or

your health plan for information on replacing your prescriptions. Add bullet point regarding medical equipment

Comment [RS2]: AddsomethingthatremindspropertyownerstologsofallinformationregardingtheirlossNote–statingtouselogsattheendofguide?

Comment [RS3]: Addbulletpointregardingmedicalequipment


3

2.1 Emergency Repair Log

Youshouldkeeptrackofanyemergencyrepairsyoumaketoyourhomeand/oryourproperty.Tohelpyoukeeptrackofanyemergencyrepairs.EmergencyRepairLogscanbefoundintheappendixofthisdocument.

5 phases of a homeowners’ claim:

1) Assessingthelossordamagetohome/property;2) Claimreporting;3) Adjusting/estimatingofclaim;4) Rebuildingandrepairing;and5) Finalizingandsettlingclaim.

3. The Insurance Claims Process Onceyouhavesecuredyourfamily,yourhomeand/oryourproperty,andyouhavedeterminedthereisdamagetoyourhomeand/oryourproperty,thenextstepistostarttheinsuranceclaimsprocess.Most insurance policies have a requirement that you immediately report property damage to your home or your property so make sure you do this as soon as you and your family are safe. The easiest way to make a claim is to call your insurance company or agent directly and report the claim by phone. Depending on the amount of property damage your home has sustained, this may be easier said than done. If you don’t have your company or agent’s number handy, but have cell service, try an internet search to find their claims office’s phone number. If you can access social media like Twitter, search for your company or your state department of insurance for more information on how to contact your insurance company. If your cell service is limited because of service, power or signal, know that insurance companies may set up mobile claims centers in your city or town, particularly if it is a large event. Watch and listen to local news broadcasts and check social media like Twitter for announcements of where these claims centers may be located. Here are some tips to remember as you start the claims process:

You will need to generally or briefly explain what happened to your home and/or your property – for example, what is the type and extent of the property damage;

If you are calling a company’s claims hotline, it will help them find your policy and coverage if you have your policy number. If not, don’t worry. They should be able to help you if you give them your name, address and phone number and the name of your agent;

If you have already relocated temporarily, make sure the insurance company or agent knows how to get ahold of you – give them a cell phone number and location/address of where you are staying;

If possible for you to do safely, document the damage to your home and/or your property with photographs, videos, etc.;

Remember, your insurance policy requires that you protect your home and your property from further damage. This means that you should take whatever steps are necessary to prevent further

Comment [RS4]: SuggestedtoaddsomethinghereregardingwhetherahomeownerorpropertyownerwantstoactuallymakeaclaimSupplementalinformationaddedtolastphase

Comment [RS5]: Angie’ssuggestion–toblendintodocument


4

damage and loss to your property until your insurance company has a chance to inspect and assess the damages. Use tarps and plywood to protect the structure and clear away nearby hazards, etc., as is safe to do. If you have questions, contact your insurance carrier or insurance agent.

Here are a few things to ask the insurance company or agent when you make your claim:

Ask them if they can give you a general idea of what is covered under your policy; Get a claim or reference number from them, get the name of the person you are talking to and a

phone number in case you need to call back; Ask them when you should expect a return call from your adjuster; Ask them what additional information they need to process your claim; Ask if your policy will reimburse you for additional living expenses if you have to stay at a

hotel; Finally, ask them if there are any special processes or procedures you need to be aware of or

follow;

3.1 Reporting a Claim Contact your insurance company or agent immediately if you sustained damage to your home and/or your property as a result of a disaster. If the disaster has occurred in a large area, insurancecompaniesmaysetupmobileclaimscentersinyourcityortown.InsurancecompaniesmayalsouseTwitterandFaceBooktocommunicatewiththeirpolicyholders.Yourinsurancecompanymayalsohaveamobileclaimsappyoucanaccessviayoursmartphone.

Ask your agent or company representative: What they need to process your claim. What is covered under your policy. How long you have to file a claim.When you should expect a call from your adjuster. Whether your claim exceeds your deductible. How long it will take to process the claim. Whether you will need estimates for repairs. What is my deductible, including hurricane or wind deductible? If your policy will reimburse you for additional living expenses if you have to stay at a hotel. Are there any special processes or procedures you need to follow. If you have to relocate temporarily, make sure the insurance company or agent knows your

temporary address and telephone number. Document your conversation

Prepare for the adjuster's visits: Your insurance company may send you a proof of loss form to complete or an adjuster may visit your home and/or your property first. (An adjuster is a person professionally trained to assess the damage.) In either case, the more information you have about your damaged possessions -- a description of the item, approximate date of purchase and what it would cost to replace or repair -- the faster your claim generally can be settled.

Comment [RS6]: Duplicative–Isaddingrememberenough?Shouldweshorten?

Comment [RS7]: Addsomethingthatsays“withinreasonorwhatyoucanmitigate”Possiblyaddinformationthatcautioninghomeownersandpropertyownerstoengageinthehelpofacontractortomitigatethedamagepriortotheinsurancecompanyassessingtheloss.Addtothesectionintheclaimsguideregarding“contractors”Addacrossreferencethatsays,“beforeyouhireorcontractwithsomeonetodoanyworkonyourhomeorproperty,seethesectionwithtipsregardinghiringacontractor.”

Comment [RS8]: Rework–Angie–wemayneedtoeliminateand/orblendsomeoftheinformationbelow.

Comment [RS9]: Socialmedia–Ihonestlythinktherecouldbeasubsectiononjustsocialmedia.

Comment [RS10]: Movetoprevioussection?

Comment [RS11]: Movetoprevioussection?

Comment [RS12]: AddedperGeorgeBradner’ssuggestion

Comment [RS13]: GeorgeBradnersuggestsaddingthisbulletpoint

Comment [RS14]: MorelanguagefromRIregardingsuggestionthatconsumerscontactthecontractors’registrationboardtobesureacontractorisproperlyregistered??


5

To substantiate your loss, prepare an inventory of damaged or destroyed items and give a copy to the adjuster along with copies of any receipts. Don’t throw out damaged items until the adjuster has visited. You should also consider photographing or videotaping the damage. If your property was destroyed or you no longer have any records, work from memory.

Identify structural damage to your home and/or your property and other structures such as a garage, tool shed or in-ground swimming pool. Make a list of everything you want to show the adjuster, for example, cracks in the walls and missing roof tiles. You should also get the electrical system checked. Most insurance companies pay for these inspections.

Get written bids from licensed contractors. The bids should include details of the materials to be used and prices on a line-by-line basis. This makes adjusting the claim faster and simpler.

Keep copies of the lists and other documents you submit to your insurance company. Also keep copies of whatever paperwork your insurance company gives you and record the names and phone numbers of everyone you speak to.

Flood damage is excluded under the standard homeowners and renters insurance policies, but there are types of policies that may offer this type of coverage. For more information about damage resulting from floods, you need to look at the information found at https://www.fema.gov/national-flood-insurance-program. (Include link to Transparency WG flood information once available)

3.2 Who may be involved in the Claims Process? During the claims process youmaymeet orworkwith one ormore types of claims adjusters.There are Company Adjusters, Independent Adjusters, and Public Adjusters. It is important toknowthedifferencebetweenthemandwhatthosedifferencesmeantoyou.

CompanyAdjuster. This is an individual employed by an insurance company toreview your claim, decide on the amount of damage to your home and/or yourpropertyandthensettletheclaimbasedonwhatinsurancecoverageisavailabletopay the claim. Policyholders do not have to pay Company Adjusters. CompanyAdjustersarepaidbytheinsurancecompany.

IndependentAdjuster.AnIndependentAdjusterissimilartoaCompanyAdjusterexcept this individualworks for several different insurance companies, instead ofjustone.IndependentAdjustersareusedwhenaninsurancecompanydoesnothaveits own adjuster staff or insurance companies will use independent adjustersfollowingalargedisastertohelptheinsurancecompanyhandlealargernumberofclaims. Policyholders do not have to pay Independent Adjusters. IndependentAdjustersarepaidbytheinsurancecompany.

Bothcompanyadjustersand independentadjusters legallyrepresent therightsof the insurancecompanyduringtheclaimsprocesswhileinvestigatingandresolvingclaims.Theseadjusterstrytoremainasneutralaspossiblewhileworkingonaclaim.

PublicAdjuster.APublicAdjusterisanindividualwhoyou,atyouroptionandatyourexpense, canengage tohandleyour insuranceclaimonyourbehalf.APublicAdjuster does not have any relationship with the insurance company. They willappraise the amountof damage to yourhomeand/oryourproperty, reviewyourinsurancepolicyandnegotiateasettlementof the insuranceclaimonyourbehalf.

Comment [RS15]: WarrenByrd–languagechange


6

Policyholdershave topay for theservicesofaPublicAdjuster.The fees forPublicAdjusterscanvaryandmaybelimitedbystatelaw.

Statelawsvaryonwhocannegotiateaninsuranceclaimonyourbehalf.Forexample,somestatesprohibit contractors from negotiating on insurance claims and some states prohibit publicadjusters,insteadonlyallowinglegalrepresentationthroughalicensedattorney.Ifyouhavequestionsaboutyourclaimandwhatyourstatepermitsintermsofrepresentationonaninsuranceclaim,contact<stateinsurancedepartment>.

3.3 Working Through the Claims Process Prepare a detailed inventory of all damaged or destroyed property. Give one copy to the

insuranceadjusterandkeeponecopyforyourfiles.Yourlistshouldincludeadescriptionandquantityoftheitem(s),dateofpurchaseorapproximateage,costatthetimeofpurchase,andestimatedreplacementcosttoday.Includeasmuchinformationaspossible.

Be present when your insurance adjuster inspects your property. This will enable you to point out all areas that you believe have been damaged.

If a disaster occurs, adjusters will handle the largest losses first, but will work to handle all claims as quickly as possible.

If you do not hear from your adjuster within a reasonable length of time following a disaster, contact your agent or company again, and make sure you leave them with a way to contact you.

If you think the insurance company’s estimate is too low, you may wish to obtain an estimate from your own contractor. A contractor may charge a fee for this service; if he or she does the repair work, the fee usually will be credited toward the cost of the repairs.

Even if your property is condemned by governmental authorities, it may not be a total loss. Your insurance company may decide the property can be repaired. To fully protect your ability to make a claim and be paid, you must be sure your insurance company’s adjuster has fully inspected the damage.

If your insurance company denies any part of your claim, be sure they put the denial in writing and that you keep all the paperwork they send you. You will need it if your area is declared a disaster by the federal government. If the federal government declares your area to be a disaster, you may be eligible for federal relief.

If your home and/or your property was destroyed beyond repair and you decide to rebuild on another lot or you choose to purchase another home and/or property instead, check your insurance policy and discuss your plans with your insurance carrier. There may be limitations on what your insurer will pay if you do not rebuild on the same property.

The amount of your settlement won’t necessarily be the same as your neighbor’s. Your coverages, deductibles, limits and/or level of damage you sustained may be different.

Your insurance policy provides coverage for the repair or replacement of the property with “like kind and quality” that you had prior to the storm. It does not provide for expensive improvements or upgrades, such as installing a slate roof if, prior to the loss, your roof was a standard 3-tab shingle.

Do not accept an unfair settlement offer. If you cannot reach an agreement, call the insurance company and be prepared to explain why the offer is insufficient or unfair. If you are still not satisfied, <contact your state department of insurance>.

TheNAIChas somehelpful links regardingdisasterpreparedness. These links canbe found at:http://www.insureuonline.org/insureu_special_disaster.htm. Comment [RS16]: PaulaPallozzi’s

Comment


7

Asareminder,you have responsibilities as an insured. These include: Report all claims to your insurance carrier immediately. Document your entire loss with photographs, videos, etc.

o Keep a log of your personal property loss and gather all receipts (proofs of payment) for those items damaged or destroyed. If you do not have proofs of purchase, photographs and videos may be substituted. If you do not have either, discuss suitable replacement of those pieces of property with your insurance carrier before you replace them. http://www.insureuonline.org/insureu_type_home.htm; https://www.thebalance.com/top-home-inventory-apps-for-android-1294002 https://www.thebalance.com/best-home-inventory-apps-ios-1294003

Mitigate your damages. This means that you should take whatever steps are necessary to prevent further damage and loss to your property until your insurance company has a chance to inspect and assess the damages. Use tarps and plywood to protect the structure and clear away nearby hazards, etc., as is safe to do. If you have questions, contact your insurance carrier or insurance agent for advice.

o http://homeownersinsuranceguide.flash.org/reducepotentialdamages.htm

In addition to your regular deductible, your policy also may include a deductible that is specific for wind, hail or hurricane damage. Please refer to your policy to determine the amount of your deductible.

o http://www.naic.org/cipr_topics/topic_hurricane_deductibles.htm

3.4 Understanding your insurance claim (depreciation, estimate, replacement cost)

3.5 Repairing/Rebuilding Phase

Avoid shoddy repairs and workmanship by using licensed, reputable contractors. Be sure they secure the appropriate building permits. Beware of contractors requiring a large payment upfront or whose bids are amazingly low. Check with the appropriate licensing agency to make certain the contractor you are planning to use for the repairs has a valid license.

Check the declarations page of your insurance policy to see if you have Ordinance and Law Coverage. A structure or building is required to meet current building codes at the time it is built. This means a building that was previously built to code may not be in compliance today if it is being rebuilt following a disaster. If your home was not built to the current local building code standards, you may be required to rebuild the damaged sections according to current codes. In some cases, this may cost more. A standard homeowners insurance policy generally does not cover such additional expenses. If you do not have Ordinance and Law coverage you may want to consider purchasing an endorsement to your policy that provides coverage for the costs associated with bringing the property into compliance with current codes and ordinances when making required repairs.

You should contact your insurance company and claims adjuster any time you find additional damage not previously reported and inspected, or if you have additional information concerning your claim.

Comment [RS17]: PaulaPallozzisuggestedaddinglinkstoNAICapsthatcanbeused

Comment [RS18]: Wordingchange–WarrenByrd

Comment [RS19]: Changecontexttosuggestthissaysomethinglike,“LookonthedeclarationspageofyourinsurancepolicytoseeifyouhaveOrdinanceandLawcoverage.


8

Should I Hire a Public Adjuster to Help Me Settle My Claim Dealing with the loss or damage to your home, contents or other property following a majorstorm,hurricane,fire,ortheftcanbeoverwhelming.Itisimportantthatconsumerstakestepstoprotectthemselvesandtheirpropertysothattheyareabletorecoverfromthatloss.Whilemanyconsumersareabletoresolvetheirpropertyclaimsbydealingwiththeirinsurancecompanyandtheassignedadjusterontheirown,sometimesconsumersorbusinesseswilldecidetheywouldpreferthatsomeoneelsehandletheinsuranceclaimontheirbehalf.Thesepeoplewhorepresentan insuredwithregardtoaclaimagainstan insurancecompanyareknownasPublicAdjusters.YoucanhireaPublicAdjustertoactonyourbehalftoprocessandnegotiateyourclaimwiththeinsurancecompany.Dependinguponthelawsofyourstate,publicadjusterscanchargeaflatfeeorchargeafeethatisbaseduponapercentageofthesettlementreceivedfromyourinsurer.Thefeeispaidbyyou,thepolicyholder,andnotyour insurer.Foranyquestionspertaining to feearrangements forpublicadjusters,contactyourstateinsurancedepartmentoryourinsuranceagent.

YourPublicAdjustershouldgiveyouacontractspecifyingtheservicestobeprovidedandthefeetobepaidbyyou.

ThePublicAdjuster’smaximumfeemayormaynotbesetbylaw,dependingonyourstate,andmayvarydependingonwhetheryourlosswascausedbyawide‐spreadcatastrophe.

If you hire your Public Adjuster after your insurer hasmade an initial claim settlementoffer,yourcontractshouldspecifywhetherthisamount isthe leastyouwillreceiveafterhisfeeisdeductedfromthefinalsettlement.

YoushouldaskyourPublicAdjustertoroutinelyupdateyouontheprogressofyourclaim.IfyouhireaPublicAdjuster,youshouldunderstandthatyourinsurancecompanymayormaynotagreewith that person’s estimate of your damage. Your insurance company is not obligated toacceptthedamagesthatareclaimedbyapublicadjuster.Theinsurancecompanyisobligatedtosettleyourclaiminaccordancewiththetermsandconditionsofthepolicyitissuedtoyou.Thepublicadjuster'smainresponsibilitiesareto:

Evaluateaninsurancepolicyinordertodeterminewhatcoverage(s)maybe applicable; Research,detail,andsubstantiatedamagetobuildingsandcontentsandany additionalexpensesincurredbytheinsured; Evaluatebusinessinterruptionlossesandextraexpenseclaimsforbusinesses; Determinevaluesforsettlingcovereddamageclaims; Prepare,documentandsupporttheclaim(s)onbehalfoftheinsured; Negotiateasettlementwiththeinsurancecompanyonbehalfofaninsured.

Beforeretainingtheservicesofapublicadjuster,youshouldmakecertainthepersonislicensedwithyourstateinsurancedepartmentoranyotherregulatoryentityinyourstate.

Comment [RS20]: CharlesAngellsuggestions:1.Your Public Adjuster should give you a contract specifying the services to be provided and the fee to be paid by you. 2.The Public Adjuster’s maximum fee may or may not be set by law, depending on your state, and may vary depending on whether your loss was caused by a wide‐spread catastrophe. 3.If you hire your Public Adjuster after your insurer has made an initial claim settlement offer, your contract should specify whether this amount is the least you will receive after his fee is deducted from the final settlement. 4.You should ask your Public Adjuster to routinely update you on the progress of your claim.

(use bullet points)


9

Beware of Contractor Fraud Unfortunately, after a catastrophic event there is usually an increase in scams regardingcontractors. It is important tomakesure thatyouhavechosena legitimatecontractor to repairyourhomeand/oryourproperty.Beforehiringacontractorobtainthefollowinginformation:

Contractor’sName BusinessName LicenseNumber&ExpirationDate Aphotocopyofthecontractor’sbusinesslicense Aphotocopyofthecontractorsidentification

Makesurethecontractorhas: Workers’CompensationInsurance

Getacopyofthedocumentation ProofofInsurance(i.e.Acertificateofinsuranceissuedbyalicensedagentor

insurancecompany) Insurancecarriersname Policynumber Insurancecompany’sphonenumber Getacopyoftheproofofinsurance Calltheinsurerlistedontheproofofinsurancetoverifycoverageandtheauthenticityofallinsurancedocumentspresentedtoyou.

Insurance Claims If youneed to file an insurance claim, keepa logof all interactionswith your agenti, insurancecompany,independentadjuster,and/orpublicadjuster.Alsokeeptrackofanyemergencydamagerepair you undertake by keeping any receipts associated with repairs, taking pictures of thedamagedareabeforeandaftertherepair,andfillingoutthelogprovidedhere.Formstorecordadjusterinformation,claiminformation,andinteractionscanbefoundintheappendix.

4. Things to do before a disaster occurs (the preparation phase) Createaninventoryoftheitemsyouown

Takingan inventoryof everythingyouown isa timeconsuming,butnecessary task.Even ifyoudonottaketimetowritetheseitemsdownonpaper,orrecordtheminaspreadsheet,youcandocumentyourbelongingsbycreatingamoviethatrecordsyourhouseholditems.Asyouaremakingthemovieoftheitemsyoushouldalsostateimportantfacts,suchaswhentheitemwaspurchased,theconditionoftheitem,etc.

Makesureyouhaveacopyoronlineaccesstoyourinsurancepolicies

Your insurance policy is an important document. It is a good idea to store a copy of yourinsurancecopyinasafeplacewhereitcannotbedestroyed,suchasasafetydepositbox.Some

Comment [RS21]: Rewording–WarrenByrd

Comment [RS22]: IncludealinkheretotheCoalitionAgainstInsuranceFraud?Formoreinformation,pleaseusethefollowinglink.

Comment [RS23]: Addafootnoteregardingwhyweareusingthetermagent–seefootnote–needadditionalinformation.

Comment [RS24]: AddlanguageregardingLawandOrdinancecoveragehere?Typesofcoverageapropertyownershouldbelookingfor?ACV/RCV(CharlesAngell)–Warrenagrees–languageneeded.Depreciation?(CharlesAngell)

Comment [RS25]: NAICHomeInventoryAp


10

insurancecompaniesgivetheircustomersaccesstotheirinsurancepoliciesonline.Itisagoodidea to check with your insurance company to see if you have access to your policyelectronically.Yourinsurancepolicyalsohasapolicynumber,whichisimportantintheeventofaloss.Makesureyouhaveyourpolicynumberandyour insurancecompany’scontact informationat theveryleast.

Maintainalistofimportanttelephonenumbers

You should keep the telephone number of your insurance company’s or insurance agent’sphonenumbers.Intheeventofaclaim,youwillneedtocontactoneorbothoftheseparties.

Reviewyourinsurancepolicywithyourinsuranceagentonayearlybasistodetermineifyourneedshavechanged.

Mitigation

Mitigation involves measures that should be undertaken to increase the likelihood thatpropertycansurviveanaturalorhuman‐inducedcatastrophe.Mitigationincludes:

o Strengtheningnewconstructionthroughbuildingcodeso Usingvoluntary“code‐plus”constructiontechniquesandguidelineso Properlyretrofittingexistinghomesandcommercialstructurestoimproveresiliencyo Purchasingafloodinsurancepolicy–formoreinformationpleasevisit

https://www.fema.gov/national‐flood‐insurance‐programTofindoutwhatthebuildingcodesareinyourstateyoucanvisit:https://www.disastersafety.org/building‐codes/Toviewdisastersafetyvideosyoucanvisit:https://www.disastersafety.org/video/

Waystosecureyourhomeand/oryourpropertyforatornado,hurricane,orhighwind Secureentrydoors

o Ensure thatentrydoorshavea two‐inchdeadbolt lockand threehinges,withscrewslong enough to secure the door and frame to wall framing. The frame should beanchoredwell.

Bracegaragedoorso Yourgaragedoor—thelargestpotentialopeninginyourhome—isanothervulnerable

point.Youcanbuybracingproductsthatcanbeinstalledbeforeatornadohits,whichwillmakethedoorstrongerandmorewindresistant.Ifyou'reexpectingbadweather,andyourdoorisn'tbracedalready,installaverticalbraceintotheframingofthewallandthefloor,similartothewayyouwouldboardupwindowsinahurricane.

Installimpact‐resistantwindows

Comment [RS26]: Expandtoincludehurricaneandhighwind


11

o Thismayberequiredbylocalbuildingcode.o People think they should open windows to normalize pressure between inside and

outside, but that is thewrong thing to do.What can happen is that the inside of thehousebecomespressurized, likeblowingupaballoonuntil itpops.Theairpushesofftherooforawallandcausesthehousetocollapseinonitself.

Installwind‐resistantroofstructureso Roof sheathing and covering should be rated to resist high winds. Generally, a home's roof is

attached with roofing nails, which are inserted at an angle, but this kind of roof can come right off. Attach roofs with hurricane clips, which create a stronger connection between the roof and the house. The clips come in a range of protections, depending on the clip you buy and the weight of your roof.

o Clips are required by the building code in hurricane prone areas, but they also help maintain roof integrity in tornado prone areas. When replacing your roof, she advises that you make sure all roof and wall framings are secured with hurricane framing clips. All materials should be wind-rated and impact resistant.

Protectimportantdocumentsandvaluableso Store your important papers and valuable possessions in a fire-proof safe or safety deposit

box to ensure that you'll be able to access them after a tornado. If you have to evacuate, take the documents with you to a shelter.

Comment [RS27]: GeorgeBradnersuggestedmovingthistothe“Thingstodobeforeadisaster”section.


12

WhatisdepreciationWhenitistimetosettleyourclaimwithaninsurancecompanyitisimportanttounderstandthatitems you have owned for several yearsmay not beworth asmuch as theywere the day youpurchasedtheitems.Thislossofvalueiscalleddepreciation.Depreciation is generally calculated by evaluating the cost to repair or replace an itemwith asimilaritemaswellastakingtheitem’saverageexpectedlifespanintoconsideration.Forexample,let’s say your home computer that you purchased two years agowas destroyed in a fire. Yourhomecomputerwasingoodconditionbeforethefire.Asimilarhomecomputerissoldinstorestodayfor$750.Thishomecomputerhasalifeexpectancyoffouryears,meaningitloses25%ofitsvalue each year. Because your home computerwas two years old, it had lost 50% of its valuebeforebeingdestroyedinafire.Therefore,thevalueofyourhomecomputeratthetimeoflossis$375.ConsumerCautionshttp://www.pbs.org/pov/carolynparker/consumer‐tips‐natural‐disaster.php

Comment [RS28]: Wemayormaynotwanttomovethistopictoanothersectionofthedocument–eitherthe“ClaimsProcess”orthe“Resources”portion


13

APPENDIXEmergencyRepairLog

Repair:CostofRepair:DateofRepair:






Comment [RS29]: Suggestedlogsbemovedtoendofdocument


14

InsuranceAdjusterInformation

AdjusterName: AdjusterCompany:PhoneNumber:AdjusterLicenseNumber:Website:

ClaimInformation

InteractionLog

Name of Company: Name of Representative: Date: Time: Interaction Details:

Outcome:

Name of Company: Name of Representative: Date: Time: Interaction Details:

Outcome:

Name of Company: Name of Representative: Date: Time: Interaction Details: Outcome:

iAgentisbeingusedinlieuofproducer.

Name of Company Claim Number Phone Number:


Documents

Catastrophe Insurance (C) Working Group Meeting … Insurance (C) Working Group Meeting ... particularly programs announced several months following a catastrophe, can add ... Earthquake