I don’t know what to do next, any help would be appreciated. I have a claim that I had a PA friend of mine rewrite. The scope of loss is the same as the original scope from the insurance appointed adjuster. The only difference is pricing.
O&P was not included in the original scope. I had O&P added to the rewrite plus I updated pricing with a newer price list from Xactimate.
Repairs include:
-roof
-gutters
-ac comb
-paint and seal soffits
-window screens and glazing
I submitted the re-write before any work was performed but the insurance company did not approve it. They reluctantly offer 5% overhead and 5% profit and that’s it. I recorded the conversation and transcribed it so I’ll include it at the bottom.
Here are my questions:
1.) Am I justified in asking for 20% O&P when I’ve farmed all the work out to multiple subs?
2.) Am I justified in adjusting the pricing up based on a newer xactimate price list?
3.) What tactics can I employ to get the rewrite approved?
The original scope: $7450.50
My rewrite: $9894.88
Difference: $2444.38
Phone transcript
Desk adjuster: How can I help you?
me: Ya I’ve got a claim here, I’m a contractor on one of your claims.
Desk adjuster: Alondra XXXXX?
me: Yes, and uh we submitted a supplement, we rewrote it to add a couple of things to it and submitted it to you for your approval. And my estimator Regan XXXXX was called on Friday but it’s really me that you need to talk to. Were there questions about what I submitted?
Desk adjuster: Um, I think our scope is the same so I’m not sure why the pricing is off. And uh you’re wanting overhead and profit. I really don’t think the claim has the complexity to warrant overhead and profit at all but um I did get approval to offer you 5% overhead and 5% profit.
me: 5% where do you get that?
Desk adjuster: Um, that’s just what we offer, I mean…that’s kind of being generous, I don’t think it’s warranted at all.
me: Well it’s pretty industry standard stuff, 10% overhead and 10% profit when there’s multiple services.
Desk adjuster: Well, it’s based on the complexity of the claim, there’s not a whole lot of coordination going on in the claim. So based on the complexity of the claim, you know, no regards to trades just the complexity of the claim it’s not really warranted. However, I did get approval to offer you 5% for overhead and 5% for profit.
me: Ok, and then as far as the pricing, so what did your scope come out to be when you included that?
Desk adjuster: Um, (inaudible) lets see…so our final cost is (inaudible) $7450.50 I can give you 5% for overhead and 5% for profit.
me: Ok, so you didn’t approve the 25 year shingle?
Desk adjuster: No, 20 year shingles are available. They’re no longer manufactured but you can still purchase them.
me: Ok well our suppliers don’t carry…
Desk adjuster: The policy won’t allow for the upgraded shingle
me: Our suppliers don’t use or don’t sell the 20 year shingle, um.
Desk adjuster: There are suppliers that do.
me: K well, then I’m going to submit this to TDI and see what they have to say about it. Um…
Desk adjuster: Go ahead
me: I think what I’ve asked for is pretty fair. 10% overhead and profit, I sent you the bulletin on it, it was back in 1998 that they established that overhead and profit…
Desk adjuster: Right but nowhere does TDI say what that amount should be. So it’s negotiable, I offered 5 and 5.
me: Ok, well I want 10 and 10.
Desk adjuster: Ok, maybe this isn’t the job for you. I don’t know but I’ve already made my offer.
me: Alright well um, I’ll write the complaint then and we will just settle it with TDI.
Desk adjuster: Ok, thank you.