Fair Contractor Markets - Adjusting Adjusters

[align=center]How Do I Know If My Loss Claim Value Is Fair?
What Do The Adjusters’ Construction Line Items Mean?
[/align]

Labor, Materials, Sales Tax, Overhead, and Profit =
Contractor’s Construction Project Cost Estimation Values.
*

Those Values also Can/Should be found on a “Adjuster Summary” type page as “Line Items”. Claims are Commonly Underpaid when Contractor Costs are missing.

These Individual Line Items are the Constant Pieces of the Financial Foundation needed for the existence of small and large structures placed, or replaced, by Primary-General Construction Business Owners/Investors.

Conversely, constructed structures and Construction Business Costs are to be accounted for by Insurers-Agents to help figure out future Primary-General Contractor Replacement Cost Values, for a given property.

The Texas Department of Insurance by Bulletin B0045-98 has “reminded” insurers to account for and Repay Back to claimants (Primary-General/Sub-Trade) Construction Contractor Costs, including Business Overhead and Profit loss dollar Values whether they use a Primary-General Contractor or not, so that Insurers do not reap “illegal windfall”.

Simply stated, Insurers can anticipate that it is reasonable to assume that in preparing costs (Premium Costs and Loss Payment Costs) for the worst case scenario, Replacement Costs will involve a Prospective Primary-General Building Contractor.

tdi.state.tx.us/bulletins/1998/b-0045-8.html
tdi.texas.gov/bulletins/2008/cc70.html

Generally, when insuring a property, one cannot properly claim to have figured out reasonably anticipated Future Replacement Costs for a structure unless one were to estimate costs like a Primary-General Contractor, who can use both in-house and Sub-Trade Expertise and Labor.
**
Insurance Agents Estimation Programs help them to do just that.**

It appears though that, per the necessary TDI bulletins and basic math, Insurers that disclose Sub-Contractor O&P business costs only in their “Adjuster Summary” are not accounting for and paying FULL Primary-General “Contractor” dollar values woven into the loss value, whether any Contractors are used, or not.

Real World Example: Roof damage/loss has General Contractor using a Roofing Contractor value woven in it. Ask almost any Builder to verify that fact.

Since Home Owners have Pre-Paid for Prospective Primary-General Contractor Expertise, and do not pay Replacement Cost Premiums to act as their own “Contractor”, hiring Primary-General Contractors for Single Trade or Multiple Trade “Insurance Work” is quite reasonable.

Be aware if you hear something from an adjuster like, ‘we don’t pay General Contractor Overhead and Profit on Roofing, Carpeting or Fencing in Texas’, or, "the work is not “Complex” enough for General Contractor Involvement’. Or, 'there needs to be a certain number of trades involved before overhead and profit costs are owed.

The Adjuster may be Interfering with Fair Trade, Fraudulently avoiding fiduciary responsibilities, and (tortuously) may be trying to put a Wedge between you and your Contractor of Choice.


Expertise/Labor Costs- Owners-investors, managers, internal and external general support all provide financial, mental, and physical effort for the business.

Consider some new construction and reconstruction expertise-labor, from the top down, that are accounted for in your insurance premium payments;

  1. Primary-General Investing Contractor
  2. Front Office Support - Secretaries, Assistants, Sales Representatives
  3. Back Office Support - Customer Service, Accounting, Marketing
  4. Field Support - Sub-Trades Craftsmen, Supervisors, Managers
  5. External Support - Legal, Engineers, Architects, Others
    **
    When a new house or business is placed in your area, ALL anticipated labor, materials, sales tax, overhead, and profit costs are typically accounted for by the investing primary-general contractor.**

Again, when a insurance agent, using their own aggregate construction / premium estimating program, adds up ALL anticipated labor, materials, sales tax, overhead, and profit costs to replace a house or business in your area, ALL construction costs are accounted for again, (along with the insurance company’s business and profit costs), and are part of your monthly insurance payment values.

So, when you see the insurance adjuster line item estimate total, look carefully, it may simply account for the visually measured damaged areas, and the different (leveling, roofing, carpentry, painting, sheet-rock, cabinetry, AC, carpeting, etc). general trade work labor needed, and materials, and sales tax, but not primary-general contractor overhead and profit costs.
**
Materials Costs-**

…can be verified over the phone. Delivery costs and labor for accepting the delivery on the project site should be accounted for. Many professional contractors do not sell their materials or equipment at cost to their clients, as they need to make their own labor costs, and a profit, on those investments.

Sales Tax-

Applicable rates for various purchases will apply.

*Business Overhead
Costs Vary & Can Include-

-Office Rent
-Office Mortgage
-Office Supplies
-Maintenance
-Electric Bill
-Water/Sewer
-Gas
-Project Site Office
-Trucks
-Vehicle Rental
-Vehicle Fuel
-Vehicle Maintenance
-In-house Equipment
-Rental Equipment
-Phones
-Copiers
-Fax Machines
-Computers
-Cell phones
-Internet Access
-Business Insurance
-Property Insurance
-Workman’s Comp Insurance
-General Liability Insurance
-Bonds-Insurance
-Vehicle Insurance
-Project Insurance
-Health Insurance
-Dental Insurance
-Hospitalization Insurance
-Life Insurance
-State Licenses
-City Licenses
-Permit Fees
-Other Needs

Profit-

The monetary reward above the total investment risk costs of the primary-general contractor. What is left over after all others are paid.

10% is a common pre-tax profit factor.

How Can I Tell If ALL Contractor O&P Loss Value Has Been Paid?

Some insurers, like Allstate, use the (NCE/IntegriClaim/Xactimate/Simsol/Powerclaim/Symbility) construction estimate line item called “Contractor’s Overhead & Profit” (O&P) to account for Sub-Trade Contractors O&P value only.

This has shown up in hurricane Rita as being 29%, if it is accounted for at all.

However, according to conversations with the IntegriClaim construction estimating program “management”, MS/B (Marshall Swift & Boeckh), regarding their own instruction manual, the “Contractor’s Overhead & Profit” line is for accounting for a single primary-general contractor’s overhead and profit values.

Basic single investing contractor O&P (10+% & 10+%) together with the various sub-trade contractors O&P, (29+%) typically equals a base 49% O&P value per common Allstate post-storm construction estimating methodology.

However, as Allstate representative Mark McGillivary indicates, any basic 20+%, 29+%, 49+%, etc. O&P percentage value may be too low for the individual contractor, and deserves market adjustment, whether storm work is involved, or not;

“There’s no set formula of what we pay,” he says. In some cases, rates are set by state regulations. If there are no laws governing the rates, Allstate uses a basic “10 and 10” formula for overhead and profit. That said, there are many areas where the company pays more depending on what the market rate is, McGillivary says.

zoominfo.com/people/McGilliv … 75907.aspx

The insurance claimant’s “contractor-of-choice” is who determines what their business overhead and profit needs are, not insurers.

Financially responsible insurers/adjusters “adjust” to the various labor, materials, sales tax, overhead, and profit contractor market range values, and fair game/market trade practices. They should do not try to set/fix them, or try to rig them.

Good info Cat. I printed those bulletins regarding O& P. Would it be appropriate to send the adjuster a copy of those if encountering resistance to paying O&P?

Absolutely - As a business courtesy, we send them. And it places it in their electronic file, which cannot be altered due to being locked down upon them hitting the “enter” key. We place it there for evidence.

We do not send them on behalf of the insured, but on behalf of protecting our business, and our clients, and it helps the (wise) adjuster avoid embarrassing disciplinary action from the TDI.

[quote=“CatContractor”]Absolutely - As a business courtesy, we send them. And it places it in their electronic file, which cannot be altered due to being locked down upon them hitting the “enter” key. We place it there for evidence.

We do not send them on behalf of the insured, but on behalf of protecting our business, and our clients, and it helps the (wise) adjuster avoid embarrassing disciplinary action from the TDI.[/quote]

So you send them with your estimate automatically each time? I am glad to know of their existence as this makes it MUCH easier to stand my ground. It seems very clear to me O&P should be paid on every claim as many others on this site have suggested. What gives on why so many contractors who are aware of this would settle for anything less. Am I missing something here? The TDI sets the standards and the P&C companies need to follow them. Seems case closed to me. There is also some other language in those bulletins that was very helpful in clearing up my understanding of how the process should work in determining value for replacement cost. I feel like someone just gave me a license to kick some ass if I’m not treated fairly :stuck_out_tongue: .

Not every base estimation needs the TDI O&P docs. They are faxed/pdf’d to corrupt adjusters, as necessary. If the adjuster, or their corrupt handlers, does not get their mind right, then our file evidence is sent directly to the TDI.

After all - To fraudulently generate “illegal windfall” - That the TDI Bulletin B-0045-98 points to - Requires a financially illegal indemnification act. That in turn creates an illegal fiduciary scenario/scheme. That then creates probable cause - and potential jailable prosecution.

Collecting O&P values from consumers, then keeping those dollars by all kinds of deceptive post-underwriting schemes - delivered by adjusters - is a serious deal. And the illegal windfall/fiduciary responsibility issues are getting more public exposure by real contractors and alert consumers everyday.

Quote - What is Insurance Fraud?

Insurance fraud occurs when companies, agents, adjusters, health care providers, or consumers intentionally deceive others or misrepresent facts for financial gain. It usually happens during the process of buying, using, selling, or underwriting insurance **and is usually motivated by greed.
**
Insurance fraud is a crime in Texas!

What are the Fraud Unit’s responsibilities?

The Fraud Unit enforces laws relating to fraudulent insurance acts. The unit’s responsibilities include receiving and reviewing reports of fraud, initiating inquiries, and conducting investigations when TDI has reason to suspect insurance fraud.

In addition, the unit actively seeks criminal indictments, makes arrests, and assists in prosecutions to deter insurance fraud in Texas.

tdi.texas.gov/fraud/

There are other TDI bulletins that make clear forcing Xactimate type estimation programs (only) onto consumers/the market, and insurers (illegal) threat to use their “preferred contractor”, are also serious no-no’s.

We are more than happy to share that info, and more - catcontractor@gmail.com

P.S. You also asked - “What gives on why so many contractors who are aware of this would settle for anything less. Am I missing something here?”

Some contractors are not dealing with the financial corruption because they think that it is pointless to. Others are just plain lazy, but not too lazy to bash others that are actually doing something about it.

Some are trying to get organized in Texas - but I have seen so much misinformation being passed onto other contractors at some meetings - that it kills me to see newbie, or seasoned, insurance related contractors being taught twisted insurance industry propaganda, and believing it.

Cat,
I will not say that there is not validity to some of the information you are publishing. However, I am saying that pushing the contractors to illegally negotiate an insurance claim on whoevers behalf without a license to do so is only going to further hurt the industry.

TDI has requested that the insurance companies turn in any contractors that are doing this type of act.

Maybe it would be better to educate the contractors on the LEGAL way to handle a claim.

  1. Identify problems with a claim.
  2. Speak to the policyholder about the problems and let them know about their legal options.
  3. Refer them to a competant legal entity that can assist them.
  4. Supply any relevant information to that entity to assist them with proper information.
  5. Maintain contact with the client and wait until claim is properly settled.
  6. Do the work.

After all a roofer or general contractors job is to sell the job, and install the job. NOT TO NEGOTIATE THE JOB OR PAYMENT WITH THE INSURANCE COMPANY.

Know your position in the industry and be the best you can be.

Cat, I ask that you please not intentionally urge people to break laws which will eventually end them up in hot water for breaking the law.

If you want to adjust claims for an insurance company, go get an adjusters license.
If you want to adjust claims for policyholders, go get a Public Adjusters license.
If you want to fight with insurance companies, go get your law degree and pass the bar.
If you want to be a contractor, be a contractor.

You cant be all at the same time on the same project.

I have learned how to be properly paid on claims, as well as, who and how to deal with on these same claims. I would be glad to assist any of you that would like to send me a PM.

Good Luck

Alltex

Thanks for weighing in. Just so I’m clear on your view. In my example I am doing the following.

  1. Sending in my signed contingency agreement with my estimate.

  2. Making the adjuster aware of the mistake of roll roofing where it should have specified modified bitumen in the scope of loss.

  1. Mentioning to the adjuster my estimate includes O&P.

Is there something in that sequence that is not in line with the proper steps a contractor should take?

[quote=“noserider1234”]Alltex

Thanks for weighing in. Just so I’m clear on your view. In my example I am doing the following.

  1. Sending in my signed contingency agreement with my estimate.

  2. Making the adjuster aware of the mistake of roll roofing where it should have specified modified bitumen in the scope of loss.

  1. Mentioning to the adjuster my estimate includes O&P.

Is there something in that sequence that is not in line with the proper steps a contractor should take?[/quote]

You appear to be in line at this point.
If you can get your homeowner on board you would do better to have the homeowner send it in. Then have the homeowner tell the adjuster to contact you to discuss any problems he has with your estimate. As a contractor you have to walk a fine line.

The law is pretty clear. I just don’t want to hear about you getting into some trouble down the line.

[quote=“ALLTEXRoofing”]

[quote=“noserider1234”]Alltex

Thanks for weighing in. Just so I’m clear on your view. In my example I am doing the following.

  1. Sending in my signed contingency agreement with my estimate.

  2. Making the adjuster aware of the mistake of roll roofing where it should have specified modified bitumen in the scope of loss.

  1. Mentioning to the adjuster my estimate includes O&P.

Is there something in that sequence that is not in line with the proper steps a contractor should take?[/quote]

You appear to be in line at this point.
If you can get your homeowner on board you would do better to have the homeowner send it in. Then have the homeowner tell the adjuster to contact you to discuss any problems he has with your estimate. As a contractor you have to walk a fine line.

The law is pretty clear. I just don’t want to hear about you getting into some trouble down the line.[/quote]

Well I dont want to hear that you heard that I got into trouble down the line. I’ll take heed in your words. You had mentioned the bulletins Cat posted were old and the industy has changed since their publication. Is there any reason to believe the TDI has changed their position regarding those bulletins?

[quote=“noserider1234”]

You appear to be in line at this point.
If you can get your homeowner on board you would do better to have the homeowner send it in. Then have the homeowner tell the adjuster to contact you to discuss any problems he has with your estimate. As a contractor you have to walk a fine line.

The law is pretty clear. I just don’t want to hear about you getting into some trouble down the line.

Well I dont want to hear that you heard that I got into trouble down the line. I’ll take heed in your words. You had mentioned the bulletins Cat posted were old and the industy has changed since their publication. Is there any reason to believe the TDI has changed their position regarding those bulletins?[/quote]

As an educated person / construction contractor that understands much of the law, and it’s intent - The “age” of the TDI bulletins has not changed their context, or weight - The command language is clear - Do not “act on behalf of” the insured. Do not try to “effect” the claim.

Of course if one were crazy enough - they could claim that a contractor repairing a insured loss funded structure was “effecting” the claim by their mere presence, and protocols.

And it is fantasy to believe by giving the adjuster your base estimation directly makes you acting in “behalf of the insured”. Or that you are trying to “Effect” the claim. Real insurance general contractors don’t care about “the claim”.

They care about the working budget/project, professionalism, and making a profit. One can accomplish all of those things without any hint of “effecting” the claim “on behalf of the insured”. Period.

It is starting to feel as if ALLTEX thinks that only PA’s and Attorneys can discuss construction business estimated construction costs with adjusters now.

If that is your underlying point ALLTEX - Good luck with that.

One can only imagine the logistical nightmare insurers would deal with by only speaking with construction professionals regarding damage scope, restoration scope, but not cost scope.

That is why B-0060-05 was modified ALLTEX. Because the TDI grown-ups were reasoned with that should a catastrophe hit - and contractors could not have full communication access to adjusters - that the communication circle circus to follow would bog down all restoration efforts.

It would chase contractors out of the market because of the irrational dysfunctional communication hassle factor, and increase costs for both contractors, and carriers, and independent adjusters. And really hurt “consumers” (our neighbors and their families).

We were in on three of those conversations with TDI ALLTEX - where were you?

[quote=“ALLTEXRoofing”]Cat,
I will not say that there is not validity to some of the information you are publishing.

However, I am saying that pushing the contractors to illegally negotiate an insurance claim on whoevers behalf without a license to do so is only going to further hurt the industry.

Actually - again - read with precision - “on behalf of the insured”, not “whoevers behalf”. You can add to the command language to invent the “crime” you imagine, but it is still wrong logic.

TDI has requested that the insurance companies turn in any contractors that are doing this type of act.

They want contractors that are acting like adjusters, not contractors that are acting like insurance work educated contractors. They also want adjusters that commit fraud.

Maybe it would be better to educate the contractors on the LEGAL way to handle a claim. Yes - That is best. The LEGAL way, not the wishful thinking way.

  1. Identify problems with a claim.
    Wouldn’t that “effect” the claim somehow?
  2. Speak to the policyholder about the problems and let them know about their legal options.
    Give them advice for “their behalf”…uh…oh…
  3. Refer them to a competant* legal entity that can assist them.
    *Competent
    Do you mean refer clients to overly zealous Public Adjusters or Attorneys, that can convince contractors they cannot discuss construction costs with the adjuster ?
  4. Supply any relevant information to that entity to assist them with proper information.
    Do all the upfront work the PA or Attorney should do, then hand them over?
  5. Maintain contact with the client and wait until claim is properly settled.
    Properly settled - With 10% or more missing from the construction budget to pay for the PA, and it taking God knows how long to “settle” by the Attorney or PA.
  6. Do the work.
    Thank you for that permission.

After all a roofer or general contractors job is to sell the job, and install the job. NOT TO NEGOTIATE THE JOB OR PAYMENT WITH THE INSURANCE COMPANY.

ROFL - Leave major business decisions in the hands of a PA or Attorney, and then do the work for the leftovers. RIGHT.

Know your position in the industry and be the best you can be.
Our position? Our we still talking about the construction market industry, or the PA/Attorney driven industry?

Cat, I ask that you please not intentionally urge people to break laws which will eventually end them up in hot water for breaking the law.

ALLTEX - I ask that you please not embellish the law, or it’s intent, or pretend law abiding contractors are out to hurt others.

If you want to adjust claims for an insurance company, go get an adjusters license.
If you want to adjust claims for policyholders, go get a Public Adjusters license.
If you want to fight with insurance companies, go get your law degree and pass the bar.
If you want to be a contractor, be a contractor.

You cant be all at the same time on the same project.
Actually - that’s true. But you can know what they know.

I have learned how to be properly paid on claims, as well as, who and how to deal with on these same claims. I would be glad to assist any of you that would like to send me a PM.

Psssst - ALLTEX - Just between us guys - You do not have the only method for insurance based/funded work being conducted legally, ethically, and profitably.

Good Luck[/quote]

ALLTEX - Again - You are misinterpreting and overreaching regarding the law and the TDI directives. Good luck with trying to create synthetic ILLEGAL wrongs to turn into the TDI.

Guys - Don’t “negotiate” with adjusters, do not speak with adjuster “on behalf of the insured” or try to “effect” “the claim”.

Follow the law as it reads - in common English, with common definition.

Adjusters may try to negotiate with you - but do not “negotiate” with them. You are not “negotiating” with an adjuster when you are only necessarily and objectively discussing estimates and other construction business technicalities with them.

Justifying sound working protocols and viable costs is not negotiating. It is educating the adjuster to your business model, or informing them of construction technicalities, or stipulating why something is the way it is.

  1. We do not negotiate with adjusters regarding anything.
    Period. It is illegal to do so.
  2. We are not out to “adjust” any indemnified structures’ loss value after an “event”.
  3. We rationally discuss ALL damage scope - ALL sound and responsible reconstruction work - and ALL actual and necessary construction costs. Nothing in that process has anything to do with the “adjusting” of the financial value of a insured loss. Nothing.

Adjusters are not to act as contractors -
Contractors are not to act as adjusters.

The Texas Department of Insurance knows it. And insurers know it. But - It seems - Some common sense is becoming less common around here. Turn hard won clients over to PA’s or Attorneys just to present the costs to the adjuster - ? Sorry - that is just pure nonsense.

However - It would make a great income stream for PA’s and Attorneys, having ALL claims filter through them. Hmmmmm. Is that your actual agenda ALLTEX?

Embellish the ACTUAL legal command language - scare contractors and the general public - have all property claims filter through the “competent legal entity” machine, and sell the idea to the construction industry in Texas?

Interesting. Bad idea…but interesting.

[quote=“noserider1234”]

You appear to be in line at this point.
If you can get your homeowner on board you would do better to have the homeowner send it in. Then have the homeowner tell the adjuster to contact you to discuss any problems he has with your estimate. As a contractor you have to walk a fine line.

The law is pretty clear. I just don’t want to hear about you getting into some trouble down the line.

Well I dont want to hear that you heard that I got into trouble down the line. I’ll take heed in your words. You had mentioned the bulletins Cat posted were old and the industy has changed since their publication. Is there any reason to believe the TDI has changed their position regarding those bulletins?[/quote]

Would a cease and desist of the actions suggested by cat be reason enough to change. I know of at least 3 other contractors who have landed in some pretty hot water for acting as cat suggests.

Cease and desist of “the actions”? How about a “stand down”!!! order.
What “actions” in particular are you referring to ALLTEX?
Who are you trying to influence? Lol.
Put their TDI cases online here - without their names

The “3 other contractors” probably do not do what we do.
Or many others like us. In short - Again - We don’t negotiate.

Sorry you don’t get it yet. Your PA focus is commendable - but contractors can still conduct their insurance related business fully - without PA and Attorneys.

The law clearly says to not discuss/negotiate things - “on behalf of the insured”.

When the law actually states that ONLY Public Adjusters and Attorneys can discuss construction costs with an adjuster - then I will become a PA - for contractors. Or consumers - or both!

Construction costs are fair contractor market fluid - and have nothing to do with actually “adjusting” the indemnified value of a “loss”.

Adjusting financial loss values based on an insureds contractor of choice own market replacement costs is the adjuster’s job. That process keeps adjusters from illegally price fixing construction markets.

PA’s may want to keep that in mind as they try to insinuate that they should dictate a construction business’ costs. They may find themselves in hot water as deceptive trade and anti-trust practices, and laws, suggest.

[quote=“CatContractor”]

[quote=“ALLTEXRoofing”]Cat,
I will not say that there is not validity to some of the information you are publishing.

However, I am saying that pushing the contractors to illegally negotiate an insurance claim on whoevers behalf[/quote]

without a license to do so is only going to further hurt the industry.

Actually - again - read with precision - “on behalf of the insured”, not “whoevers behalf”. You can add to the command language to invent the “crime” you imagine, but it is still wrong logic.

TDI has requested that the insurance companies turn in any contractors that are doing this type of act.

They want contractors that are acting like adjusters, not contractors that are acting like insurance work educated contractors. They also want adjusters that commit fraud.

Maybe it would be better to educate the contractors on the LEGAL way to handle a claim. Yes - That is best. The LEGAL way, not the wishful thinking way.

  1. Identify problems with a claim.
    Wouldn’t that “effect” the claim somehow?
  2. Speak to the policyholder about the problems and let them know about their legal options.
    Give them advice for “their behalf”…uh…oh…
  3. Refer them to a competant* legal entity that can assist them.
    *Competent
    Do you mean refer clients to overly zealous Public Adjusters or Attorneys, that can convince contractors they cannot discuss construction costs with the adjuster ?
  4. Supply any relevant information to that entity to assist them with proper information.
    Do all the upfront work the PA or Attorney should do, then hand them over?
  5. Maintain contact with the client and wait until claim is properly settled.
    Properly settled - With 10% or more missing from the construction budget to pay for the PA, and it taking God knows how long to “settle” by the Attorney or PA.
  6. Do the work.
    Thank you for that permission.

After all a roofer or general contractors job is to sell the job, and install the job. NOT TO NEGOTIATE THE JOB OR PAYMENT WITH THE INSURANCE COMPANY.

ROFL - Leave major business decisions in the hands of a PA or Attorney, and then do the work for the leftovers. RIGHT.

Know your position in the industry and be the best you can be.
Our position? Our we still talking about the construction market industry, or the PA/Attorney driven industry?

Cat, I ask that you please not intentionally urge people to break laws which will eventually end them up in hot water for breaking the law.

ALLTEX - I ask that you please not embellish the law, or it’s intent, or pretend law abiding contractors are out to hurt others.

If you want to adjust claims for an insurance company, go get an adjusters license.
If you want to adjust claims for policyholders, go get a Public Adjusters license.
If you want to fight with insurance companies, go get your law degree and pass the bar.
If you want to be a contractor, be a contractor.

You cant be all at the same time on the same project.
Actually - that’s true. But you can know what they know.

I have learned how to be properly paid on claims, as well as, who and how to deal with on these same claims. I would be glad to assist any of you that would like to send me a PM.

Psssst - ALLTEX - Just between us guys - You do not have the only method for insurance based/funded work being conducted legally, ethically, and profitably.

Good Luck

ALLTEX - Again - You are misinterpreting and overreaching regarding the law and the TDI directives. Good luck with trying to create synthetic ILLEGAL wrongs to turn into the TDI.

Not trying to create anything. You are creating pleanty for yourself.

Guys - Don’t “negotiate” with adjusters, do not speak with adjuster “on behalf of the insured” or try to “effect” “the claim”.

Guys, write a better estimate and respect yourselves enough to get a fair profit for that work. As business owners you also need to know your rights and how to do it right.
Follow the law as it reads - in common English, with common definition.

Adjusters may try to negotiate with you - but do not “negotiate” with them. You are not “negotiating” with an adjuster when you are only necessarily and objectively discussing estimates and other construction business technicalities with them.

I agree…WOW

Justifying sound working protocols and viable costs is not negotiating. It is educating the adjuster to your business model, or informing them of construction technicalities, or stipulating why something is the way it is.

  1. We do not negotiate with adjusters regarding anything.
    Period. It is illegal to do so.
  2. We are not out to “adjust” any indemnified structures’ loss value after an “event”.
  3. We rationally discuss ALL damage scope - ALL sound and responsible reconstruction work - and ALL actual and necessary construction costs. Nothing in that process has anything to do with the “adjusting” of the financial value of a insured loss. Nothing.

Contractors need to know who to call when they cannot get it done your way.
Adjusters are not to act as contractors -
Contractors are not to act as adjusters.

The Texas Department of Insurance knows it. And insurers know it. But - It seems - Some common sense is becoming less common around here. Turn hard won clients over to PA’s or Attorneys just to present the costs to the adjuster - ? Sorry - that is just pure nonsense.

Again, what should they do when the adjuster tells them to go pound sand. They should know how to accomplish the same task legally and or most likely for more money than they were asking for.
However - It would make a great income stream for PA’s and Attorneys, having ALL claims filter through them. Hmmmmm. Is that your actual agenda ALLTEX?

My agenda is more complex than that Cat. I want to help contractors do a better job on the front end as well as help them on the back end in the event they cannot achieve their goals alone.

Embellish the ACTUAL legal command language - scare contractors and the general public - have all property claims filter through the “competent legal entity” machine, and sell the idea to the construction industry in Texas?

How is it a bad idea to get paid properly on claims?

Interesting. Bad idea…but interesting.[/quote]

Cat, the Public Adjusters and Attorneys that specialize in property damage claims are filling a need in the market. Many contractors would be forced to concentrate considerable efforts toward a plan such as yours and take their eye off the ball losing focus of their entire business. Public adjusters and attorneys can help these contractors stay focused and concentrate on running their businesses while bringing in a third party to handle a great deal of the BS from the insurance companies and make more money at the same time.

COMMISSIONER’S BULLETIN #B-0017-12

tdi.texas.gov/bulletins/2012/cc16.html

June 26, 2012

TO: ALL AGENTS, PUBLIC INSURANCE ADJUSTERS, AND ADJUSTERS, AND TO ALL INSURANCE COMPANIES, CORPORATIONS, EXCHANGES, MUTUALS, COUNTY MUTUALS, RECIPROCALS, ASSOCIATIONS, LLOYDS, AND OTHER INSURERS WRITING PROPERTY AND CASUALTY INSURANCE IN THE STATE OF TEXAS

RE: Adjusting claims by unlicensed individuals and entities

It has come to the attention of the Texas Department of Insurance that a number of contractors, roofing companies, and other individuals and entities not licensed by the department have been advertising or performing acts that would require them to hold a public insurance adjuster license. Additionally, the department has learned that the tactics used by these unlicensed individuals include visiting neighborhoods and areas of the state where languages other than English are commonly spoken. These unlicensed individuals often prey on unknowing consumers by promising to ‘work’ insurance claims to achieve a higher settlement.
All agents, adjusters, and insurers should be mindful that, pursuant to the Insurance Code Chapter 4102:

  1. A person who, for direct, indirect, or any other compensation, acts on behalf of an insured to negotiate or effect the settlement of an insurance claim is performing the acts of a public insurance adjuster.
  2. A person who advertises, solicits business, or holds himself or herself out to the public as an adjuster of claims for loss or damage under any policy of insurance covering real or personal property is also performing the acts of a public insurance adjuster.
    With limited exceptions, a person performing the acts of a public insurance adjuster or holding himself or herself out as a public insurance adjuster in this state must be licensed under the Insurance Code Chapter 4102. Additionally, insurers cannot utilize roofers as de facto public insurance adjusters nor provide commissions to them in the form of direct or indirect payments or rebates that are in excess of amounts owed under the policy.

The department takes seriously the harm unlicensed individuals and entities can cause on the marketplace when they prey on unsuspecting consumers and the industry. I urge insurers, agents, adjusters, and consumers to help call attention to and halt attempts by unlicensed persons to negotiate insurance claims, and I encourage everyone to report these practices to the department and the TDI Fraud Unit (1-800-252-3439 – Report Fraud).
The Insurance Code provides for both civil and criminal penalties for violating this licensing requirement. The department will refer unlicensed persons performing the acts of a public insurance adjuster to the Texas Attorney General, pursue all remedies available under the Insurance Code, and highlight these practices to the Legislature so that it may consider further steps to regulate these persons and activities.

Eleanor Kitzman
Commissioner of Insurance

[quote=“ALLTEXRoofing”]COMMISSIONER’S BULLETIN #B-0017-12

tdi.texas.gov/bulletins/2012/cc16.html

June 26, 2012

TO: ALL AGENTS, PUBLIC INSURANCE ADJUSTERS, AND ADJUSTERS, AND TO ALL INSURANCE COMPANIES, CORPORATIONS, EXCHANGES, MUTUALS, COUNTY MUTUALS, RECIPROCALS, ASSOCIATIONS, LLOYDS, AND OTHER INSURERS WRITING PROPERTY AND CASUALTY INSURANCE IN THE STATE OF TEXAS

RE: Adjusting claims by unlicensed individuals and entities

It has come to the attention of the Texas Department of Insurance that a number of contractors, roofing companies, and other individuals and entities not licensed by the department have been advertising or performing acts that would require them to hold a public insurance adjuster license. Additionally, the department has learned that the tactics used by these unlicensed individuals include visiting neighborhoods and areas of the state where languages other than English are commonly spoken. These unlicensed individuals often prey on unknowing consumers by promising to ‘work’ insurance claims to achieve a higher settlement.
All agents, adjusters, and insurers should be mindful that, pursuant to the Insurance Code Chapter 4102:

  1. A person who, for direct, indirect, or any other compensation, acts on behalf of an insured to negotiate or effect the settlement of an insurance claim is performing the acts of a public insurance adjuster.
  2. A person who advertises, solicits business, or holds himself or herself out to the public as an adjuster of claims for loss or damage under any policy of insurance covering real or personal property is also performing the acts of a public insurance adjuster.
    With limited exceptions, a person performing the acts of a public insurance adjuster or holding himself or herself out as a public insurance adjuster in this state must be licensed under the Insurance Code Chapter 4102. Additionally, insurers cannot utilize roofers as de facto public insurance adjusters nor provide commissions to them in the form of direct or indirect payments or rebates that are in excess of amounts owed under the policy.

The department takes seriously the harm unlicensed individuals and entities can cause on the marketplace when they prey on unsuspecting consumers and the industry. I urge insurers, agents, adjusters, and consumers to help call attention to and halt attempts by unlicensed persons to negotiate insurance claims, and I encourage everyone to report these practices to the department and the TDI Fraud Unit (1-800-252-3439 – Report Fraud).
The Insurance Code provides for both civil and criminal penalties for violating this licensing requirement. The department will refer unlicensed persons performing the acts of a public insurance adjuster to the Texas Attorney General, pursue all remedies available under the Insurance Code, and highlight these practices to the Legislature so that it may consider further steps to regulate these persons and activities.

Eleanor Kitzman
Commissioner of Insurance[/quote]

ALLTEX - YAWWWWNN!

Now Fellow Contractors…The whole (Insurance Code Chapter 4102) truth is quoted next - not just a partial truth.


Archived File - for Reference Use This file is historical in nature. Links and contact information may be outdated and no longer valid.
https://www.tdi.state.tx.us/bulletins/2005/b-0060-05.html

September 30, 2005

COMMISSIONER’S BULLETIN NO. B-0060-05

TO: ALL INSURANCE COMPANIES, CORPORATIONS, EXCHANGES, MUTUALS, RECIPROCALS, ASSOCIATIONS, LLOYDS, OR OTHER INSURERS WRITING PROPERTY AND CASUALTY INSURANCE IN THE STATE OF TEXAS AND TO AGENTS AND REPRESENTATIVES, ADJUSTERS, AND PUBLIC INSURANCE ADJUSTERS, AND THE PUBLIC GENERALLY

RE: Hurricane Rita - An Extraordinary Event

Public Insurance Adjusters

On September 24, 2005 , Hurricane Rita struck Texas causing significant property damage. In the current disaster circumstances, the Texas Department of Insurance (TDI) reminds all persons, including building and repair contractors, that Texas Insurance Code Chapter 4102 (formerly Article 21.07-5) requires all persons acting as public insurance adjusters to be licensed by the department. The Insurance Code provides for both civil and criminal penalties for violating this licensing requirement.

Insurance Code §4102.001(3) (formerly Article 21.07-5 §3(A)) defines a public insurance adjuster as:

(A) a person who, for direct, indirect, or any other compensation:

acts on behalf of an insured in negotiating for or effecting the settlement of a claim or claims for loss or damage under any policy of insurance covering real or personal property;  or
on behalf of any other public insurance adjuster, investigates, settles, or adjusts or advises or assists an insured with a claim or claims for loss or damage under any policy of insurance covering real or personal property;  or

(B) a person who advertises, solicits business, or holds himself or herself out to the public as an adjuster of claims for loss or damage under any policy of insurance covering real or personal property.

Further, Insurance Code §4102.158 (formerly Article 21.07-5 §23(l)) prohibits public insurance adjusters from participating directly or indirectly in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the license holder or engaging in any other activities that may reasonably be construed as presenting a conflict of interest, including soliciting or accepting any remuneration from, or having a financial interest in, any salvage firm, repair firm, or other firm that obtains business in connection with any claim the licensee has a contract or agreement to adjust.

Contractors are not listed among the persons exempt from the licensing requirement in Insurance Code §4102.002 (formerly Article 21.07-5 §3(B)).

Chapter 4102 does not prohibit contractors from providing estimates or discussing those estimates and other technical information with an insurer or its adjuster.

Additional information regarding public insurance adjusters, including fees public insurance adjusters are allowed to charge for services, is available on the department’s website at: tdi.state.tx.us/agent/agpubadj2.html

Questions regarding this bulletin may be directed to the Enforcement Division at (512) 305-7239 or the Fraud Unit at (512) 463-6492.

Now ALLTEX - Take the June 26, 2012 Bulletin - Carefully compare it fully to the B-0060-05 Bulletin. Chapter 4102 DOES NOT prohibit contractors from providing estimates or discussing those estimates and other technical information with an insurer or its adjuster.

The June 26th 2012 Bulletin properly reiterates that ones acting on behalf of the insured, just like in the 2005 Bulletin, better be legally able to do so.

Now put two and two together - The June 26th 2012 Bulletin did not take away the established 2005 mandate that clearly states - Chapter 4102 DOES NOT prohibit contractors from providing estimates or discussing those estimates and other technical information with an insurer or its adjuster.

Partial quotes by Eleanor Kitzman are just that. Adjust your message to contractors accordingly. You use all of Xactimate’s tools - So - Use all of TDI’s.

I wonder why all of the bulletins you are posting about are archived.

Many wonder why you think the word “archived” equals irrelevant.

Just curiously, if you don’t care about the claim, why have you posted so many examples of complaints you have rendered to TDI?

To help develop public awareness -

Because people are getting financially ripped off by insurance industry flim-flam artists. Corrupt carriers are quick to claim “insurance fraud” when someone takes money from them under false pretense - but are ok to take premium money and knowingly not pay claims properly.

After catastrophes - People have heart attacks, and even die, by the stress provoked and perpetuated by corrupt carriers and adjusters heartless business culture.

These are your neighbors. Why aren’t more here as active?