Unethical Insurance Adjusters

I recently had an Insurance adjuster who brought another roofer (normal) as the ladder assist. However the Traveler’s adjuster told me he was going to tell the homeowner to use the other roofer. He went so far as to let the other roofer copy his quote and make sure it was lower. The homeowner called me and said the adjuster is putting a lot of pressure on me to use the other roofer, and he said my price would be lower than yours. Since I was meeting the Insurance quote how could it be lower?
Then it got worse, I signed two of the neighbors who were also with Traveler’s and these two tried to steal my customers right in front of me. The saddest part was the homeowners were appaulled at them, and all three suck with me.
I did tell the adjuster he was giving the impression he was unethical because he was pushing so hard for the other roofer. Obviously getting money from the other roofer.
Now he is doing everything possible to deny my supplementals, and wont pay for basic items.
I normally don’t ask for profit and overhead, but I deserve it after what this guy has put me through. My point for all of us is, we hire roofers, can those same guys, file claims, do adjuster appts, do quotes, order materials, dumpsters, go back and fourth, meet with clients, etc… NO, that is what the overhead and profit is for.
Would you turn this guy into the Insurance commissioner?

:badgrin:

:shock: ,

We are a preferred vendor for several insurers.They can tell the insured that we are a preferred vendor BUT they also have to say that they (adjuster)cannot personally verbally back us.

They are also required to say that they are free to choose us or choose a contractor on their own since overall it is THEIR choice.

It HAS to be the insured choice and it HAS to be made known by the adjuster.The only reason I could think of this happening (Possibly) is if the vendor and adjuster are local and you are an out of area contractor.

Free enterprise buddy does not matter if you are local or not,first come,first serve IMO. I feel that what they were doing was unethical.

If it were me, I would report him to the Insurance Commissioner. I would also report him to his boss. If that doesn’t work, report both of them to his boss’ boss. In my experience, you will eventually encounter a very pissed department head who appreciates you bringing his subordinates’ tacky business practices to his attention.

Another matter to note: Do you have a signed contingency agreement beforehand with the homeowner? If so, and please don’t take this as “legal advise” of any kind (funny how we always have to say that!), you may have caught that adjuster and the other contractor in the act of tortious interference. Google it.

Fact: A third party cannot knowledgeably and intentionally interfere with a valid contractual relationship. In addition, if you are using a proper contract with the homeowner, then I assume you have already had the homeowner contractually acknowledge you as their GC (in addition to reserving your right to supplement for additional work that is incurred). By acknowledging you as GC (in a situation that warrants it; industry standards is 3 trades or more), the homeowner has agreed to pay you an additional 10/10 per industry and state standards. Failure to pay this means that the adjuster has arbitrarily raised the policyholder’s deductible, which is illegal.

Bring all of that to the adjuster’s attention, and let him know that you reserve your right to valid contractual relationships that are free from outside interference. If that doesn’t work, contact your attorney. That is one area that I do not play around with insurance adjusters. Keep your ducks in a row, and you don’t have to take it.

All of what ReroofGA said. Plus, don’t mess with the insurance commissioner, in all likelihood, a waste of time. If you can get your Customers, the HO’s to do it, have them call their Agents and attempt to get in contact with this guy’s manager. Or his manager’s manager. Assuming you had a contract with these Customers, you could consider having your attorney send this prick a letter, copying his manager, providing him with a very stern warning about tortuous contractual interference.

Somewhere, you have to draw the line in the sand. I’ve learned to let some stuff go and I’ve learned to let some occasional stuff go but IMHO, there reaches a point where enough is enough and you have to take steps to protect your interests. Too many people are worried about getting on the bad side of an Adjuster, the insurance company, etc… That’s BS. If you act professionally, if you show proper respect, you deserve the same in return. You should assume the Adjuster is there and will provide your Customer with an unbiased judgment regardless of their feelings towards you. I tell my guys we’re not running a popularity contest and it is a heckuva lot more important to be respected than it is to be liked.

No!, Really? Are the “other” contractors initials RRA?

Tortious Interference; Causing harm by intentionally 1) disrupting a contractual relationship, for example by preventing one party from delivering goods on time, or 2) harming a business relationship or activity, for example, by spreading lies about a competitor to one of its clients.

Adjusters doing this more and more in an effort to cause the HO’s to breach their legitimate contracts with their chosen contractor.

Normally you don’t ask for O&P? You should always ask for O&P. O&P is calculated into the insured’s premiums and therefore ins needs to pay it - on 100% of the claim, not on the mythical 2 to 3 or more trades minus roofing, but that’s an argument for another time.

Contacting ins commissioners is most likely a waste of time since most (not all) are in bed with the NAIC who is in bed with the P&C ins industry.

[quote=“Authentic_Dad”]All of what ReroofGA said. Plus, don’t mess with the insurance commissioner. If you can get your Customers, the HO’s to do it, have them call their Agents and attempt to get in contact with this guy’s manager. Or his manager. Assuming you had a contract with these Customers, you could consider having your attorney send this prick a letter, copying his manager, providing him with a very stern warning about tortious contractual interference.

Somewhere, you have to draw the line in the sand. I’ve learned to let some stuff go and I’ve learned to let some occasional stuff go but IMHO, there reaches a point where enough is enough and you have to take steps to protect your interests. Too many people are worried about getting on the bad side of an Adjuster, the insurance company, etc… That’s BS. If you act professionally, if you show proper respect, you deserve the same in return. You should assume the Adjuster is there and will provide your Customer with an unbiased judgment regardless of their feelings towards me. I tell me guys we’re not running a popularity contest and it is a heckuva lot more important to be respected than it is to be liked.[/quote]

DITTO and…

Contractors (pro business owners) and their sales staff are not subserviant to insurance adjusters who are either ee’s of a P&C ins co (staff) or independent contractor’s (IA’s). The contractors job is to see that the ins co pays for all legitimate damage at pro contractor rates (not MOR per my “friends” over at XM8). Staff and IA adjusters often operate under the assumption that all contractors are ill-informed and easily intimidated (unfortunately, many are) and the fact that they (adjusters) are representing multi-billion dollar insurance companies means that they have the power. To some degree, mostly because of the mis perception on the part of many contractors, they do - the contractors give it to them.

How much longer are contractors going to allow themselves to be viewed by adjusters as subserviant?

Line in the sand…as soon as any adjuster opens his or her mouth and starts talking about other contractors who can do the work for less (tortiously interferring, assuming you have a legitimate contract with the insured), “business friendly” is over and the adjuster needs to be given a paper TI notice that he or she has in fact committed the act and will likely be held accountable for any damages, that the notice will also be provided to the adjusters superiors (not just the claims office manager) and that the adjuster provide the contractor with his or her E&O insurance policy information. If the adjuster then wisely “adjusts” their thinking and stops playing games, potential action need not be taken. On the other hand, if the adjuster keeps it up, you proceed to follow through on your “threat.” The adjuster chose their occupation and therefore must deal with the consequences of following the protocols laid out to them - their choice, not my problem.

The same thing applies to O&P refusals. Whenever an adjuster brings up the ole’ “gotta have 2, 3, or whatever trades but no roofing paid”, you give them a “Unjust Enrichment” notice that follows the same path as the TI notice that also asks for the adjusters E&O policy information. The insured paid for O&P, Code upgrades, etc. when they paid their premium, therefore, it is owed to them when they make a legitimate claim.

This and the other usual nonsense continues because most contractors fear they’ll get on the “bad” side of adjusters when they confront them with reality. Most adjusters attempt to underpay and a pro contractor who knows what he/she is doing is going to “fight” for their customer to get the adjuster to pay as promised. Therefore, from the get-go, contractors are already on the “bad” side of adjusters and every adjuster meeting is inherently adverserial. That’s just the way it is.

Adjusters, acting on behalf of P&C insurance companies do indeed owe a fiduciary duty to each and every policy holder they meet with. The usual games adjusters play regularly violate that duty.

Draw the above “line in the sand” in every case as necessary by following the above and when enough contractors start doing the same thing, the word will quickly spread and alot of the nonsense will stop - and your claims will get paid better and faster, on average.

I’m working on a TI and O&P “paper” to hand to troublesome adjusters and will post it on iccoa.com when done.

On second thought, I’ll only be sending it out to 3RS Profit MAX contractors.

Thank you all so much for the information and courage to move forward. Yes I did have a contingency agreement with each homeowner. In the end he was so mad that I brought his unethical practices to his attention, he is not paying a penny of my supplemental. Even for items he agreed initially that were missing, or incorrect. He also gave me his manager’s phone number and said he was aware of the claims and feel free to give him a call.
So I understand that the adjuster has told his manager his side.
My lesson record all conversations with adjusters!!
I am going to bring up the TI, and thank you!
Of course I am concerned that this Ins Co will blackball me so to speak. So I am going to document all events, and write letters to his bosses boss. Should I go as far as filing a complaint with the Insurance commissioner? I will threaten it.
I have great relationships with my home owners, I hate having to involve them. I don’t want it to come off petty, or lose the respect or business of the other neighbors. Its a small NICE street of homes, that I hope to get all the homes in.
FYI the adjuster gave the home owner the other roofers quote along with the claim! Not only that he told the home owners that my quotes were higher, when in fact he did not know what my quotes were. This is going to get messy, I will let you know how it goes! I agree we have got to stick together against these type of adjusters. Normally I get along great with them, In my opinion we are all working together for the same goal. If I did not sign up the customers they would have not had adjuster appts that day.
Finally he did say I’ll pay OP send me your Contractors license. In the state of GA, re-roofers are exempt and not required to hold a GC License. I sent him a copy of the GA Code. He said then he could not pay. So I say, are you telling me your company has never paid OP without a license number? I know that to be a lie, because I have gotten it before. He is a pc of work! Oh, I am in town, not a traveler, and was in the Insurance business for 5 yrs and remodeling for 13yrs. I owned 3 Ins agencies, so I know how they work. deny, deny, deny!

[quote=“LMB”]No!, Really? Are the “other” contractors initials RRA?

Tortious Interference; Causing harm by intentionally 1) disrupting a contractual relationship, for example by preventing one party from delivering goods on time, or 2) harming a business relationship or activity, for example, by spreading lies about a competitor to one of its clients.

Adjusters doing this more and more in an effort to cause the HO’s to breach their legitimate contracts with their chosen contractor.

Normally you don’t ask for O&P? You should always ask for O&P. O&P is calculated into the insured’s premiums and therefore ins needs to pay it - on 100% of the claim, not on the mythical 2 to 3 or more trades minus roofing, but that’s an argument for another time.

Contacting ins commissioners is most likely a waste of time since most (not all) are in bed with the NAIC who is in bed with the P&C ins industry.[/quote]

So share how you get O&P on every claim? Just by saying it’s calculated in the premium? His argument was its a simple roof job that a roofer can do. I pointed out my installer cannot…
Write quotes, meet with adjusters, pull eagleviews, meet with customers, go over the process with clients, order materials, sch deliveries, I went on and on. Thats when he said ok send me your license number. In GA you do not need to be licensed to be a re-roofer, the law state, too coordinate, or do the work. So he must be stating he nor his company has ever paid OP with a license, bull!!!

they are not allowed to refer or discourage the customers choice in contractor. hell yeah turn him in.

well… ive never dealt with the insurance commission and everyone else says no… dont do it… so you might want to listen to them but i say turn his ass in! (im pretty shameless and i am not afraid to make a big deal out of something when people do shady bs like that) he is not following the rules, he almost cost you 3 jobs and now he is discriminating because of it. and the homeowner is caught in the middle.

no matter whos fault it is, its drama. …its traumatic enuf for the homeowner just getting the roof done, having to deal with ins co and a million roofers atop being completely ignorant about whats going on. its very overwhelming and does not leave the HO with a very nice memory…

the last thing i would do is ask the homeowner to file a complaint because its just added stress on them and they dont know what the hell is ethical anyway (regarding the process of claims handling) YOU are the one with the problem, i think YOU should report him. record the convos you have with him. if you file a complaint be able to back up your claims with solid evidence. but even then, none of the HO’s canceled your contract, and the adjuster will use that to his advantage. youll prob still have to ask the homeowner to step forward and say something…

its happened to me before and it made the HO so frazzled he didnt use either one of us… i was pissed. but i chose to turn the other cheek. (and wrote down the license plate number of the roofer) :twisted: im immature, what can i say? i still laugh about that tho and somehow it has kept me from needing to find the address associated w that license plate number.
ah hell REALLY i dont know what the hell u should do so im gonna shut up now.

well said lmb. that is def the way to go. u hit the nail on the head … dont be afraid to get on their bad side.

sometimes my professionalism takes a dive in the company of fellow tradesmen … i refer to situations like this as “showing your b@lls” and many people have heard me say it. sometimes the adjuster needs to see them. sometimes everyone needs to see them. it doesnt hurt to remind people from time to time how big they are and that you will show them in public. :stuck_out_tongue:

im not trying to make light of a serious situation but it does usually make everyone lighten up and at least shake it off for the day. its just a common thing we say went we are pissed off and in a bad position… it gets your point across and makes you feel better to threaten to show em.

i say that adjuster needs to see all of ours. lol… group photo opp. jk that was gay.

Just talked to my attorney and yes he agrees what the adjuster did was torturous interference. I’m going to write a letter to his boss, and if they continue to play games, I will hire my attorney to fight this. This is a large amount as it is two claims, so the attorney’s fees would be worth it.

roofsmith, one last thing. id question the “supervisor” number he gave you and the fact that he relayed any of this to his superior. maybe its just me, but i find the higher up in the chain the more ethical and fair the rep tends to be. id call the company and find out who the sup is and get a number yourself.

it will give you more of a leg to stand on if you try to resolve the issue at the appropriate level first. when you are not satisfied you can move to the next person. if it reaches the top in this manner, i guarantee you will see some changes, because someone is going to foresee the potential damage to their companies reputation something like this could do if it is not corrected.

if we all have to start documenting every adjuster injustice we suffer and compile them … you already have the support of roofers across the state, and i think i speak for everyone when i say we will stand behind you on this.

They dont want a big investigation or for stuff like this to go public.
hopefully…someone will have enough sense to foresee that. if not… well… show em your…!!!

[quote=“madrina”]roofsmith, one last thing. id question the “supervisor” number he gave you and the fact that he relayed any of this to his superior. maybe its just me, but i find the higher up in the chain the more ethical and fair the rep tends to be. id call the company and find out who the sup is and get a number yourself.

Call to claims office asking to speak with supervisor; "Hey, we got some contractor on the line who wants to speak to a supervisor, who wants to be a supervisor on this one? :badgrin: "

it will give you more of a leg to stand on if you try to resolve the issue at the appropriate level first. when you are not satisfied you can move to the next person. if it reaches the top in this manner, i guarantee you will see some changes, because someone is going to foresee the potential damage to their companies reputation something like this could do if it is not corrected.

if we all have to start documenting every adjuster injustice we suffer and compile them … you already have the support of roofers across the state, and i think i speak for everyone when i say we will stand behind you on this.

They dont want a big investigation or for stuff like this to go public.
hopefully…someone will have enough sense to foresee that. if not… well… show em your…!!![/quote]

If you think you’re changing from insurance restoration and/or roofing into an attorney, you should take this route. Otherwise, I’d strongly disagree. If you feel like making every single transaction you have a battle or act of war, go ahead and take this route. Let me know how that works for you.

Look at a couple of facts then decide. First, I’m assuming at least a major part of your work is insurance restoration. With that being the case, where does a major portion of your revenue originate from?

Second, let’s say you’re company is a reasonable size for our industry, even bigger, $10M. Now you’re going to spend your time and money taking on someone like State Farm who I believe posted profits of $1.8 billion last year. Dude, we’re not talking David and Goliath here and you’d be delusional to make anywhere near that comparison.

Larry, why don’t you post here where there is any law written in the books about the insurance company being obliged to pay O&P? Show me a policy where it says that? I don’t really care about “case law” where nimrod vs State Farm in Louisiana in 2003 where the case law really was about including the pro rated O&P portion of the claim as part of the ACV payment. I mean seriously, if people start taking this ultra hard line with insurance adjusters when they can’t back it up, the adjusters are going to laugh their a$$e$ off at them. For the majority of people, that crap simply won’t work.

I do agree with this specific case of this adjuster crossing way over the line, you need to take a stand and respond accordingly. To be clear, assuming you can get the HO to support you in this, I’d do the following:

  1. Ask the HO’s to call both their Agent and the Customer Service Group for their Insurance Carrier to complain specifically about this contractor’s actions.

  2. You should do your Homework and determine who this Adjuster’s Supervisor is. Speak to this person about your concerns.

  3. Speak to your attorney and ask for his recommendations. I seriously doubt at this point your attorney would recommend filing a lawsuit. If he does, ask him if he is willing to do so on a contingency basis with him picking up all the litigation costs such as filing fees, court recorders, etc… I’m guessing he would recommend drafting a letter to send to the Adjuster, his Manager with Copies to higher level people within the insurance company as well as the insurance Agent involved with these HO’s.

It is my belief that in General, you have to conduct yourself professionally, politely, friendly but firmly. Four words that are often very difficult to pull together and make work. If you think you’re going to be successful in insurance restoration by waging war daily with billion dollar companies, please let me know. I have some water front property in FL I want to sell to you. By no means am I advocating that you lay down and kiss every Adjuster’s behind in order to get whatever meager scraps their willing to throw you. Just don’t go at it as if you’re the Avenging Roof Angel with a staff of Attorneys ready to swoop in and make some Adjuster’s life miserable. On the occasions you have issues that “cross the line”, consider your reaction, determine when it is worth it, pick your battles carefully and proceed cautiously. Just remember, it is acceptable to lose a battle now and then if you win the war in a big way.

[quote=“Authentic_Dad”]If you think you’re changing from insurance restoration and/or roofing into an attorney, you should take this route. Otherwise, I’d strongly disagree. If you feel like making every single transaction you have a battle or act of war, go ahead and take this route. Let me know how that works for you.

*It’s not about making every single transaction or any transaction into a battle, it’s simply about leveling the playing field. Construction contractors are an independent lot and are therefore, as a whole, also a disorganized lot. It is that disorganization that allows organizations like the EPA, OSHA, P&C insurance companies, adjusters, WC ins providers, union members who are also legislators, PA lobbyists, etc. to push their weight around.

On the other hand, each of the above named organizations are an organized lot that adheres to certain systems and processes in order to achieve their goals - goals that, more often than not, have a detrimental effect on the construction industry whether commercial or residential, retail or ins work.

I am not, by any means, recommending “unionizing” or anything of the sort. That would be against everything I believe in - “free enterprise”. What I am suggesting is that independent construction contractors of all stripes need to at least get on the same general page by organizing to the degree that we/they can have a fighting chance. “Organized”, regarding specific situations, simply means that all contractors use the same approach nationwide so there is some consistency.*

Look at a couple of facts then decide. First, I’m assuming at least a major part of your work is insurance restoration. With that being the case, where does a major portion of your revenue originate from?

*Dad, if you’re referring to me, I called MN DOLI and told them to cancel my GC license some time ago - 40 years in and out but mostly in was enough. My focus now is on doing whatever I can with what I have learned from both the construction and ins industry to assist, educate, inform and fight back against the bureaucrats and the P&C ins industries nonsense - I enjoy it and I’m good at it!. I have the time and experience to do that while most contractors generally do not or wouldn’t even know where to start. *

Larry, why don’t you post here where there is any law written in the books about the insurance company being obliged to pay O&P? I mean seriously, if people start taking this ultra hard line with insurance adjusters when they can’t back it up, the adjusters are going to laugh their a$$e$ off at them. For the majority of people, that crap simply won’t work.

*You are right, without precedence, that “crap” won’t work, if contractors can’t back it up and as long as contractors remain uninformed. Many contractors are afraid that if they do take a hard line with ins adjusters and P&C ins companies, their business will be negatively affected. That’s called fear and it is unnecessary. Why not take a hard line with them? Who the hell are they, anyway? P&C ins co’s and their adjusters are never reluctant to take a hard line with contractors and their customers.

SF, Allstate, AmFam, Nationwide, Farmers, etc. have all paid, each at least on several of my good size jobs over time, full O&P after I had contacted the CEO’s of each company. Although the majority of court opinions/rulings I have read suggest that O&P should be paid on 100% of ACV and RCV ins work, that doesn’t support that there is any law requiring it. What I stand on is the fact that, without alot of effort, the above companies did in fact pay that 100% O&P with no roofing deduction after the CEO’s were contacted. The actions of those CEO’s set the precedent and it was their direction that their claims departments pay O&P on those claims that became the “law”. Let them prove otherwise. Not likely they’ll be willing to open their books!

Mr. Adjuster says; “We don’t pay O&P on those items, need 2 to 3 or more trades, already included, we don’t pay on roofing - already included” and all the other b.s. I refute their phony unethical and fraudulent claims with the “law” that says they do and I expect them to adhere to that “law”, regardless of what any adjuster or in house claims rep says. *

I do agree with this specific case of this adjuster crossing way over the line, you need to take a stand and respond accordingly.

*As you know, it is quite rare for an adjuster to properly and fully pay any claim. Is this a result of following company protocols (“don’t be too attentive when adjusting your claims” - job security and all) or rank incompetence, or both? Since underpaying claims is standard procedure, anything less than full and proper payment is crossing over the line. Whether an adjuster has crossed the line by just a little bit or a lot is not the issue. The fact that they have crossed the line at all is, and that’s when the contractor needs to have a logical organized process with which to “fight” back and get their customers claims paid.

That’s why I proposed a TI and/or O&P warning notice with request for the adjusters E&O provider info to be handed to any adjuster who puts job security ahead of customer satisfaction. As soon as they breach their fiduciary and ethical duty to their insured’s (cross the line), they get the notice that lets them know the contractor is not interested in dealing with their usual nonsense. Initially, some will laugh, at least outwardly but I guaranty that none of them wants to deal with the potential problems they themselves have created.

The contractor includes the TI and O&P forms with their other paperwork. If an adjuster crosses the line, they immediately receive their notice or notices. If they quit playing games, no action is necessary. If they don’t, they’ll know that the contractor is going to spend the five minutes it will take to notify P&C ins. corporate and the adjusters E&O provider of the infraction then let the chips fall where they may. The adjusters and in house claim reps won’t be laughing long after the notices are received. Once the corporate offices of numerous P&C ins co’s and E&O offices receive enough TI and/or O&P “violation” notices from contractors from around the country, things will indeed start changing for the better.

The fact that P&C ins companies become aware that contractors have become informed and are taking proper action will be a wake up call. I’m not suggesting that every or any contractor get into a battle with every ins company on every low pay claim. All that is needed is for the word to spread. No need to do anything further than hand out the notices then spend that five minutes informing the adjusters real superiors and their E&O people - done. Let them clean up the mess and explain their actions to their superiors. Won’t be long before adjusters and in house claims reps get tired of dealing with it.

Many older adjusters complain about the overabundance of younger adjusters out their these days who have no idea what they are doing. All they really knew is how to spout the company line - “We don’t pay O&P on those items, need 2 to 3 or more trades, already included, we don’t pay O&P on roofing - already included”. Then, most contractors are at a loss regarding what they should do next to get the claim properly paid.

The notices are a good step in leveling the playing field without spending any real time or money going from court battle to court battle since that is not the point. And no need to get the customer and/or their attorney involved.

The other option is to take the Rodney King, “can’t we all just get along” approach. That approach has proven to be futile. We’ll all get along just fine when P&C insurance starts doing the right thing and troublesome adjusters get in line with ethical reality. Only then will the playing field be truly leveled.*

It is my belief that in General, you have to conduct yourself professionally, politely, friendly but firmly.

Agreed, but when P&C ins thumbs their nose at us, we have to be able to offer up something substantive with which to support out position.

By no means am I advocating that you lay down and kiss every Adjuster’s behind in order to get whatever meager scraps their willing to throw you. Just don’t go at it as if you’re the Avenging Roof Angel with a staff of Attorneys ready to swoop in and make some Adjuster’s life miserable.[/quote]

No avenging “Roof Angels” here and no attorneys needed. Just some action to level things out.

[quote]SF, Allstate, AmFam, Nationwide, Farmers, etc. have all paid, each at least on several of my good size jobs over time, full O&P after I had contacted the CEO’s of each company. Although the majority of court opinions/rulings I have read suggest that O&P should be paid on 100% of ACV and RCV ins work, that doesn’t support that there is any law requiring it. What I stand on is the fact that, without alot of effort, the above companies did in fact pay that 100% O&P with no roofing deduction after the CEO’s were contacted. The actions of those CEO’s set the precedent and it was their direction that their claims departments pay O&P on those claims that became the “law”. Let them prove otherwise. Not likely they’ll be willing to open their books!

Mr. Adjuster says; “We don’t pay O&P on those items, need 2 to 3 or more trades, already included, we don’t pay on roofing - already included” and all the other b.s. I refute their phony unethical and fraudulent claims with the “law” that says they do and I expect them to adhere to that “law”, regardless of what any adjuster or in house claims rep says. [/quote]

“At least on several of my good size jobs” Okay, that’s nice. We’re going to do around 500 or more jobs this year. Several good sized jobs hardly makes any difference to me. I am interested in something that works 90% of the time without substantial additional effort. I’ve mentioned the E & O thingie to multiple adjusters, I’ve never even had one flinch. Well a couple did, they smirked like I was a complete fool.

Larry, I don’t disagree with most of the causes you are preaching about. Insurance companies do underpay their claims. Insurance Adjusters do leave off many items from their scopes. Insurance companies should pay O&P. Okay, we agree on all that. I simply don’t find your approach practical for the majority of the people who post here or the majority of contractors period for that matter. You are discussing the solution to a problem being experienced at step 5 or 6 in the process. I have maintained and will still maintain the root cause problem is most of the contractors utterly fail at step 1 and 2 of the process thereby never having a chance as they proceed. They build no reasonable foundation for working effectively with the insurance companies by performing a detailed, professional inspection, gather pictures and data and subsequently presenting a professional, complete, high quality estimate/report to the Adjuster. You’re trying ot make chicken salad out of chicken$hit and that simply won’t work. At least that is my humble opinion.

[quote=“Authentic_Dad”]

[quote]SF, Allstate, AmFam, Nationwide, Farmers, etc. have all paid, each at least on several of my good size jobs over time, full O&P after I had contacted the CEO’s of each company. Although the majority of court opinions/rulings I have read suggest that O&P should be paid on 100% of ACV and RCV ins work, that doesn’t support that there is any law requiring it. What I stand on is the fact that, without alot of effort, the above companies did in fact pay that 100% O&P with no roofing deduction after the CEO’s were contacted. The actions of those CEO’s set the precedent and it was their direction that their claims departments pay O&P on those claims that became the “law”. Let them prove otherwise. Not likely they’ll be willing to open their books!

Mr. Adjuster says; “We don’t pay O&P on those items, need 2 to 3 or more trades, already included, we don’t pay on roofing - already included” and all the other b.s. I refute their phony unethical and fraudulent claims with the “law” that says they do and I expect them to adhere to that “law”, regardless of what any adjuster or in house claims rep says. [/quote]

“At least on several of my good size jobs” Okay, that’s nice. We’re going to do around 500 or more jobs this year. Several good sized jobs hardly makes any difference to me. I am interested in something that works 90% of the time without substantial additional effort. I’ve mentioned the E & O thingie to multiple adjusters, I’ve never even had one flinch. Well a couple did, they smirked like I was a complete fool.

*“At least several” was used merely to get the point across that the precedent has been set. How do they back away from that? They can’t! (but we know they will still make the attempt). Adjusters used to smirk when I mentioned that I would be contacting the CEO’s of the companies they were repesenting. They were no longer smirking however when they got the word from up top that they needed to pay the claims. Instead, they were usually apologizing to me and the customers and making sure that the checks would be forthcoming in a matter of days.

Sure, most adjusters will initially smirk at the E&O and/or O&P notice - mostly because they’ve never been confronted with such a thing before and they don’t understand the ramifications of a contractor actually following through. *

Larry, I don’t disagree with most of the causes you are preaching about. Insurance companies do underpay their claims. Insurance Adjusters do leave off many items from their scopes. Insurance companies should pay O&P. Okay, we agree on all that. I simply don’t find your approach practical for the majority of the people who post here or the majority of contractors period for that matter. You are discussing the solution to a problem being experienced at step 5 or 6 in the process. I have maintained and will still maintain the root cause problem is most of the contractors utterly fail at step 1 and 2 of the process thereby never having a chance as they proceed. They build no reasonable foundation for working effectively with the insurance companies by performing a detailed, professional inspection, gather pictures and data and subsequently presenting a professional, complete, high quality estimate/report to the Adjuster. You’re trying ot make chicken salad out of chicken$hit and that simply won’t work. At least that is my humble opinion.[/quote]

*Mark, we are in complete agreement that my “solutions” are 5 or 6 in the process and that in order for a contractor to reach that level, they need to first become proficient in all of the lower # levels. We both know that 80% of contractors across the country are not likely to invest the time or money to become proficient. It’s the 20% who are the real pros that I focus my energies on. They are the ones who purchase my program. And when that 20% becomes proficient in all the levels then add’s more “muscle” with TI and O&P notices (“cut the crap” notices) given to reluctant adjusters, the insurance industry will stop smirking and start paying attention. Worked exceedingly well for me over the years so there’s no reason it wouldn’t work for other pro contractors.

I only went to court once and that was on on Allstate claim where the Judge told the Allstate reps to pay the claim in full. Less than an hour on the phone and 1/2 hour max in the court room. Most adjusters I worked with knew or learned that I knew what I was doing and knew they would have to pay their claims in full - always at higher than XM8 prices, and they did. Some would even compliment me by saying they appreciated working with a contractor who knew what they were doing, unlike many of the contractors they regularly had to deal with who just pissed them off.

Regardless of the level of success contractors achieve, all contractors have a common goal which is to build an independent free enterprise business. The pros commit their blood, sweat and tears to making that happen. When they do achieve some level of success through their sacrifice, commitment and investment, the last thing they need is some damn adjuster who may not have ever even lifted a hammer mucking up the process by doing what adjusters do (attempt to screw the insured’s) - there simply is no place for any of their nonsense.

Life is simply to short…Today, around noon, a local TV chopper was hovering around the neighborhood. After leaving my office to run several errands I learned why the chopper was in the area. At around 12:30 pm, some 21 year old moron who was driving at excessive speeds down 35W lost control of his vehicle and ran over two construction workers who had been working on a highway project not far away. One was killed and the other is in intensive care. Whether that or falling off a roof and breaking ones neck or simply losing everything one has worked for through no fault of their own as a result of a bad economy, anything that some damn ins adjuster does to throw a wrench into the process so he/she can look good to some ins co is unacceptable.

That’s all I’m saying. And the only way to get the message across is by becoming informed and taking the actions that will eventually turn things around and, indeed, level the playing field. It’s in the book!

As Billy Joel once said, “Don’t take any crap from anyone” I agree.*

Guys,
I learned a long time ago the you should “Know your place.” Many of us have put in the time and effort to “Know our place”, but there are countless others that havn’t got a clue. The adjusters have been selling their line of b.s. for so long that many of the contractors have bought it. “its not worth the time or the extra effort”, those are some of the things I have heard from various contractors. I don’t know if I can really blame them for that. There are really very few hurdles to “starting” a roofing company. If you think about it “chuck in a truck” can go out and take what the insurance company is offering and make $500.00 to $1500.00 a day. You may ask “How can he do that?” No overhead, no insurance etc. That is more money than he has ever been able to make in his entire life. It is really hard to blame “chuck in a truck” for wanting to make that kind of money.

I am still a licensed insurance adjuster. I started my company when I got tired of cheating homeowners. My fight is a little different than others. Part of our mission is to make sure that homeowners are not being taken advantage of by their insurance companies. That being said, it is really hard for me to let these sellout adjusters tote the company line and screw the homeowners and contractors out of thousands of dollars on each claim.

Could you imagine a situation if you estimated a job 50% less that you should have? It wouldnt take many jobs to put you out of business. If I hired you to estimate a job and you missed it by 50% you might not have a job after a screw up like that. The adjusters have nothing to worry about and noone to check up on them. Could you imagine a situation where the department of insurance set up a regional office to monitor “fair claim settlement” The insurance companies would have to change their ways fast. (that will not happen any time soon)

I have chosen to fight for my homeowners and myself. Its the only way I know how to do it. Sometimes the homeowners get a little frustrated because it takes the insurance companies so long to process the supplement. The homeowners are amazed when a claim goes from 8k to 14k or 12k to 35k. My sell is the fact that I am not willing to cut corners. Most homeowners appreciate that and are willing to allow me to do what i need to in order to assist them with their claim. Photo documentation is my best friend. It is hard to argue with a picture of damage or a picture that shows an indirect loss.

With all that being said, I “know my place” and it is to help homeowners and myself. I can grasp many of the ideas thrown around by LMB and utilize many of those to assist me with the claims I have the opportunity to work. I am not a “roofer” I am just a man that wants to live a comfortable life and have meaning. I use roofing and general contracting to allow me to help homeowners. Every time I help a homeowner its as if it gives my life a little more meaning. It is really hard to describe. I have been fortunate to have learned the lessons I have learned and to have made the money I have made.

Many in our industry know their place as well and their place is a little different than mine. Very few are like Roofmaster, Agape, Authenticdad, LMB, Dstew to name a few, have the ability to see a job and work a job from a to z with all the mazes and hurdles. The insurance companys take advantage of ignorance both contractors and homeowners, each and every time they are allowed to. If we sit back and let it continue to happen then we are to blame as much as anyone else.

None of us alone are big enough to fight big insurance, but maybe with a concerted effort we can make a difference. I am definately willing to help all I can. PM me with any questions and I will assure you if I dont know the answer I will definately do my best to find one.

P.S. Small claims court is not too costly to mess with an unethical insurance adjuster. Never know, ya might just win.

[quote=“ALLTEX Roofing”]

If we sit back and let it continue to happen then we are to blame as much as anyone else.

None of us alone are big enough to fight big insurance, but maybe with a concerted effort we can make a difference. I am definately willing to help all I can. PM me with any questions and I will assure you if I dont know the answer I will definately do my best to find one.

P.S. Small claims court is not too costly to mess with an unethical insurance adjuster. Never know, ya might just win.[/quote]

Well said ALLTEX

You are correct in saying that none of us (contractors) alone are big enough to fight big ins. But, together, positive change can be effected. Just think of how, throughout history, most change has come about as a result of just a small %age of very large groups taking action.

As it concerns us there is the construction industry (us) and there are millions of premium paying insured’s. “Big” ins can thumb their noses at contractors all day long but as more and more ins consumers become educated on the process (not rocket science) and learn how big ins’s ‘made up rule book’ cheats them out of many millions of dollars annually (while making Warren Buffet even richer), big ins will be forced to listen.

As more and more contractors learn how to stand up to big ins, they will do better as well - more money in less time with less stress - and ins adjusters and in house claim reps will stop thumbing their noses, at least at the contractors who have made the investment in themselves to learn how to fight back and win - for themselves and their customers. That is my goal and that is why I put together my program and ICCOA.

As more and more despicable self serving politicians like the ins industry employeed knuckle head legislators in GA who voted for the “no negotiating” bill that their Gov signed into law start to feel the heat from the fire that insurance premium paying voters light under their and their cronies asses, you can bet that big ins will start paying attention. I’ve been doing everything I can to help the process along by sending out emails to all state Gov’s and legislative leaders with the expectation that once they understand the ramifications of voting for such nonsense or signing such legislation into law, they’ll run the other way.

Again, my goal is not to fight tooth and nail on every claim and sue CEO’s and adjusters or whatever. My goal is to teach pro contractors how to get the most legitmate money possible on each job which is the right thing to do for any customer. If a job RTA price is $25,000 and some adjusters quote it at $20,000 and the contractor ends up with $23,500, for instance, I can live with that and so can any contractor.

It’s the usual BS arguments that adjusters pull from their behinds that I enjoy combating and defeating. That is why I’ve been advocating TI/O&P/E&O notices to be given to wayward adjusters as soon as they start talking the usual nonsense. The ins co they represent may not take the notices seriously but the adjusters will individually, once they think through the possiblilities. I’m calling those notices ‘cut the crap’ notices that are meant to cause adjusters and in house claim reps to disregard their made up rules and deal in the realm of reality - or suffer the consequences.

We can choose to be reactive or proactive. I choose to be proactive and so should every other contractor (and ins premium paying voter) out there. When that happens, positive change will accrue to the benefit of all parties.