Latest / The Art of Adjusting® Podcast / Episode #65 - Matching Madness: Why Your Neighbor's New Roof Doesn't Mean You Get One Too

Transcript

Episode #65 - Matching Madness: Why Your Neighbor's New Roof Doesn't Mean You Get One Too · The Art of Adjusting® Podcast

• 0:06
  Speaker 1: Hello, I'm Bill Auten of Auten Claims Management.
• 0:09
  Speaker 2: I'm Chantel Roberts of CMR Consulting and welcome to the Art of Adjusting podcast.
• 0:14
  Speaker 1: Today we're going to talk about life as an insurance adjuster from the perspective of property, auto liability or workers' compensation adjusters.
• 0:22
  Speaker 1: Our goal is to bring interesting topics in the world of claims adjusting to people who are working as an adjuster now and to people who are considering a career as a claims adjuster.
• 0:32
  Speaker 2: Hi, I hope everyone is doing well.
• 0:35
  Speaker 2: It is just me today, just Chantel here today For HIPAA reasons.
• 0:42
  Speaker 2: I can't tell you why Bill is here, but he either got smacked around or his wife got injured, I don't know really which one.
• 0:54
  Speaker 2: I can't say.
• 0:56
  Speaker 2: However, I would say, go ahead and share meds with Bill, because he's a little stressed out, he's a little high strung.
• 1:06
  Speaker 2: That's all I'm going to say for HIPAA purposes.
• 1:09
  Speaker 2: Otherwise, you are going to be stuck with me today and, by the way, everybody is fine, don't worry, everybody is fine.
• 1:16
  Speaker 2: Bill is fine, mrs.
• 1:18
  Speaker 2: Bill is fine, everybody is fine.
• 1:19
  Speaker 2: I don't know if he's going to be back next week or in two weeks for our following episode, but if not, then you'll continue to be with me and it should be fun.
• 1:33
  Speaker 2: Today's topic, however, we are going to be talking about hail damage to structures and roofs, and this is again the continuation from two weeks ago.
• 1:45
  Speaker 2: It was a question by Dave, one of our six listeners, hi Dave and he wanted to know a little bit about matching.
• 1:58
  Speaker 2: What happens when you have siding versus roofing.
• 2:03
  Speaker 2: Is there some kind of like cosmetic versus functional damages?
• 2:07
  Speaker 2: He didn't ask about any kind of recent court cases or DOI complaints or trends or anything like that.
• 2:14
  Speaker 2: However, I just thought I would throw that out there because I don't have anybody to complain with or contradict me or anything like that complain with or contradict me or anything like that.
• 2:31
  Speaker 2: So you know, it could be a very fast and boring episode, who knows.
• 2:33
  Speaker 2: But before we do everything else, let's go ahead and, as you know I like to do, I like to separate the fact from frenzy and make sure that you understand how to handle hail, what it is, and be knowledgeable about these sorts of things.
• 2:56
  Speaker 2: So hail is basically or hail damage is basically impact from frozen participation, hailstones and it wouldn't be the frozen participation like snow.
• 3:08
  Speaker 2: It causes physical damage, naturally or it could cause physical damage to property damage and especially our exterior elements like roofing, siding, windows, fences, gutters.
• 3:26
  Speaker 2: You can see damages in all of those areas Afterwards when you see hail, and this is one of the reasons why I chose this time to do the hail episodes from Dave.
• 3:43
  Speaker 2: We talked about cars last time.
• 3:45
  Speaker 2: We're talking about structures this time is because you know, usually you're going to see hail in the spring and summer during strong thunderstorms.
• 3:55
  Speaker 2: Peak seasons of course range, but being from the South in Arkansas, it was always the spring for us, and in Kansas it tends to be spring as well.
• 4:08
  Speaker 2: I went to school down in Texas, so also spring, and if you're catching a drift there of Texas, arkansas and Kansas, I mean we're kind of known as Tornado Alley.
• 4:21
  Speaker 2: I guess we could also be known as Hail Alley, because these are going to be the regions that see the most hail.
• 4:33
  Speaker 2: Speaking of Tornado Alley totally side note, I don't know what I was looking at but I saw this webpage that listed how many states had tornadoes over like a period of time.
• 4:48
  Speaker 2: I don't know if it was one year or five years or whatever.
• 4:50
  Speaker 2: I just remember seeing Kansas had something like 78 or 84 or whatever some weird number, and I was looking around all the other states and it was, of course, higher than all of the others, even Arkansas, which I find kind of amazing because I am Southern and when I see a tornado I'm like here, hold my beer, I'm going to go outside and look because I ain't seen no tornado anyway.
• 5:18
  Speaker 2: So I was looking around and saw that of course, texas had something like 150 tornadoes in a year or whatever, and I'm like, yeah, that kind of makes sense, but they're big.
• 5:28
  Speaker 2: I mean, you know, they're like they're a huge state.
• 5:32
  Speaker 2: But what was even more interesting is something like Vermont or Maine has had zero tornadoes.
• 5:38
  Speaker 2: I cannot even imagine what that is like.
• 5:42
  Speaker 2: I don't know what that is like.
• 5:43
  Speaker 2: Anyway, totally off topic, but there you go, coming from a Southern woman who goes outside and looks at the sky when there's a tornado around, saying like I don't see nothing.
• 5:56
  Speaker 2: So one of the things that adjusters are looking for when we do get up on your roof and look for damage on the roof is, you know we're looking for like on the shingles, like bruising, cracking, granule loss.
• 6:15
  Speaker 2: Of course you're going to have punctures.
• 6:16
  Speaker 2: If it's a really big hailstone In metal components which you sometimes see with more commercial structures than with homeowners but there are some homeowners that have metal roofs You're going to see dents and dings.
• 6:33
  Speaker 2: You can also see these dents and dings on gutters with a regular homeowner, so that's also an indication of that.
• 6:41
  Speaker 2: And with your softer metals you could see some kind of hail splatter, which is when the hailstone hits the roof and it just kind of go.
• 6:56
  Speaker 2: Yeah, and you'll see that right there, which I can't wait to hear.
• 7:00
  Speaker 2: I hope that like gets picked up on the audio version because I know you can see me on YouTube, but with audio I'm not exactly sure you can hear me go.
• 7:10
  Speaker 2: Anyway, you'll just have to let me know.
• 7:14
  Speaker 2: So, like I said, um, you know, a pro tip here is that our hail damage may not necessarily be visible like right away, as soon as the storm leaves or whatever.
• 7:27
  Speaker 2: Sometimes it takes a minute for the storm to die down, and by a minute I don't mean literally 60 seconds, but it's not immediately visible, or it may not be immediately visible and adjusters know what to look for, especially your field adjusters or your field estimators, who are going out there and looking at this on a daily basis.
• 7:52
  Speaker 2: So Dave had a couple of questions in regards to hail, and one of his questions was when one or two sides of a home is or are damaged, what does the carrier have to replace?
• 8:10
  Speaker 2: Would that be all of the siding, some of the siding?
• 8:14
  Speaker 2: And I think that's an excellent question and we get this all tangled up quite a bit and I believe what Dave is getting towards is this whole matching principle, where we're going to be talking about that quite a bit today and the answer, as every good coverage attorney knows, is quote it depends, end quote.
• 8:42
  Speaker 2: You know, yeah, so there you go.
• 8:47
  Speaker 2: Podcast is over.
• 8:48
  Speaker 2: How about that?
• 8:49
  Speaker 2: So easy to do these sorts of things and it's super easy being an expert, right?
• 8:54
  Speaker 2: I mean that's just your answer.
• 8:56
  Speaker 2: It depends.
• 8:57
  Speaker 2: And then you send a bill to the client.
• 9:00
  Speaker 2: So, yeah, so no, seriously, of course it depends.
• 9:05
  Speaker 2: You're looking at your policy language and even with the standardized policy languages with, for example, the insurance service offices, it may depend if the insured has a deductible, that is, a hail deductible, if they have a cosmetic deductible or a cosmetic enhancement or endorsement that's the word I'm looking for cosmetic endorsement If there is just I don't know some policy language that may limit or even enhance the basic policy coverages.
• 9:48
  Speaker 2: So there is some policy language out there that talks specifically about matching and you will see that endorsement.
• 9:59
  Speaker 2: And the sad thing about this is and I'm going to get up on my high horse as I normally do is I kind of criticize the insurance people, being the industry in and of itself, for nickeling and diming our insurance because you know they want the lowest price.
• 10:24
  Speaker 2: And if we are saying, okay, no problem, you want the lowest price, we can give that to you, but you're going to have a 5% hail, storm or windstorm deductible and you're going to have ACV on your roof until you replace it and you're going to have an endorsement that says we're not going to pay for cosmetic damages.
• 10:46
  Speaker 2: And you're also going to have an endorsement that says that we are going to match, we're not or we're not going to match, we're just going to like, replace the two sides that are damaged and that the non-matching part of it is not damaged.
• 11:02
  Speaker 2: Then we can offer you a lower price.
• 11:06
  Speaker 2: It does, of course, matter and depend on what sides we're going to do, and it depends on where our states are and what our courts are also looking at.
• 11:22
  Speaker 2: Because here is the overarching idea Our National Association of Insurance Commissioners, naic the ones who usually put out our unfair claims standards and settlement practice acts that most of our states I think 48 of our states have adopted as things that adjusters and insurance companies should be doing have said that insurers must replace items in an area to maintain a reasonably uniform appearance if matching isn't possible.
• 12:04
  Speaker 2: The issue, of course, is what is matching?
• 12:08
  Speaker 2: Because a lot of times our homes may have actual cash value, right, and if you have actual cash value, then we can't necessarily find some siding that matches.
• 12:26
  Speaker 2: And because this siding has been on the house for, let's say, 10 years, you know it's got a depreciation for 10 years.
• 12:35
  Speaker 2: If we smack some new siding, even if it's the same kind of siding, then that's obviously a betterment and we would need to, of course, take that depreciation.
• 12:47
  Speaker 2: But then, is it reasonably uniform?
• 12:51
  Speaker 2: And is this something that the insurance company took into consideration when they were taking premiums, which of course is a very sore subject right now because everybody's premiums are going up?
• 13:06
  Speaker 2: And, of course, if you ask my students in RMI I love to have them in my first year because I ask them what do you think about insurance?
• 13:16
  Speaker 2: And every single one of them, up to a T, will sit there and say, oh, it's a crock, it's a way to steal money from us.
• 13:23
  Speaker 2: They never pay anything, you know.
• 13:26
  Speaker 2: They just take our money, blah, blah, blah, and they find ways to try to get out of it.
• 13:31
  Speaker 2: Yada, yada, yada, blah, blah, blah, and it takes me a full 16 weeks or so to show them that.
• 13:39
  Speaker 2: I know that's what you think and I know that's what everybody else thinks.
• 13:42
  Speaker 2: But there are methods to our madness.
• 13:44
  Speaker 2: There are exclusions.
• 13:48
  Speaker 2: There are like six reasons why things can't be covered.
• 13:50
  Speaker 2: There are reasons why things can't be paid.
• 13:55
  Speaker 2: If we give everybody a brand spanking new sighting for a house and we didn't take enough premium for it, then we as the insurance company are going to go bankrupt and of course that doesn't do anybody any good either.
• 14:10
  Speaker 2: So the answer is it depends.
• 14:14
  Speaker 2: It depends on a lot of things and naturally it's complicated, as so many adjusters know and understand, but so many of our consumers don't.
• 14:26
  Speaker 2: And of course that is my big old you know soapbox that I'm always getting up on.
• 14:34
  Speaker 2: Okay, so here's the deal.
• 14:37
  Speaker 2: Almost all of our departments of insurance, you know, are talking about how and the courts are coming back talking about how we have to maintain this reasonably uniformed appearance.
• 14:57
  Speaker 2: There was a time back in the day and this is back when I was a little bitty adjuster, a brand new adjuster, when we could do like a break in the visual aspect, and maybe that still goes on today.
• 15:14
  Speaker 2: I kind of am getting the impression that that is no longer something that is done where there is a line.
• 15:21
  Speaker 2: If you look in my book, the Art of Adjusting, I do actually talk about it and I say, oh well, the book is out of date and everyone's like you know, version two update.
• 15:32
  Speaker 2: Oh God, I'm so busy.
• 15:33
  Speaker 2: Who wants to do that?
• 15:34
  Speaker 2: Right, all right, anyway, but there was the idea that if only one or two sides was damaged on a house, you would, as the insurer, only repair those two sides because you would have a visual break.
• 15:54
  Speaker 2: You wouldn't see the other two sides, like the other two sides would be on the other side of the house.
• 16:08
  Speaker 2: Other two sides that weren't physically damaged, they do have some kind of damage now because they don't match or they're not in uniform appearance.
• 16:21
  Speaker 2: It seems a little strange to me, but it is an argument that is out there.
• 16:26
  Speaker 2: Some of the courts have said that they agree with this argument.
• 16:31
  Speaker 2: So, as an adjuster, you would need to know what your jurisdiction happens to say.
• 16:37
  Speaker 2: This would also be the reason why you're getting these endorsements that say, hey, we're not going to match the entire house, we are only going to pay what is physically damaged.
• 16:52
  Speaker 2: And if there is no physical damage on these other sides of the house or this other slope of the roof, then there's no damage there and we're not going to replace it just because we have to replace the other two.
• 17:05
  Speaker 2: You know there's I mean there's that I don't know, but there's something to think about too when we're talking about repair, matching and all of that, being aware of what your state does and does not.
• 17:20
  Speaker 2: Do you know the jurisdictions and things.
• 17:23
  Speaker 2: Florida has a rule that where you can harvest some tiles because a lot of times they have the Spanish tiles, for example and you get into these apartment complexes where you know, I don't know, let's say, 50% of a roof is damaged on eight out of the 16 apartment complexes out of the 16 apartment complexes, apartment buildings in this apartment complex.
• 17:52
  Speaker 2: Well, you can harvest the, the tiles, the clay tiles that are not damaged and put them on the roofs for the places that are damaged, and then you only really have to maybe repair the roof or replace the clay tiles for one or two buildings.
• 18:15
  Speaker 2: And again, I'm giving you an overview of that.
• 18:19
  Speaker 2: There's like a whole rule, I think there's like a 24% thing and it's like math and oh my gosh, I'm not even going to get into it, you know, but it's just like, eh, and in Texas, if I recall correctly, if you I mean you can, and this is a huge thing too, if you're, if you're, you know, repairing a roof, you can put shingles over other shingles and you don't have to tear off.
• 18:50
  Speaker 2: A lot of contractors will want to tear off.
• 18:52
  Speaker 2: This of course, increases the expenses and the insurers estimate will just say, hey, nope, just slap down some new shingles on top of the ones that were damaged.
• 19:04
  Speaker 2: But Texas I believe it's Texas says, hey, no, look, if there is, or are, if there are, three layers of shingles, then you as the carrier have to rip all of that off and put down.
• 19:22
  Speaker 2: You know new felt, new shingles, all of that.
• 19:26
  Speaker 2: It's just one of the rules.
• 19:27
  Speaker 2: So again, something to know and understand is not only what your policy is saying, but also what our venue or our jurisdiction is saying.
• 19:39
  Speaker 2: So, yeah, dave, the answer is it depends, as always, I am, you know, hey.
• 19:46
  Speaker 2: So one of his second questions is you know, hey.
• 19:47
  Speaker 2: So one of his second questions is okay, so what about roof damage?
• 19:52
  Speaker 2: That's cosmetic, and I mentioned cosmetic damage.
• 19:56
  Speaker 2: People expect a full replacement, and they do, you're absolutely right, especially after the contractors come around.
• 20:08
  Speaker 2: And then what?
• 20:08
  Speaker 2: If only you know that one section is damaged and matching is tough.
• 20:13
  Speaker 2: These are terrific questions.
• 20:14
  Speaker 2: In fact, as I mentioned, kansas is in.
• 20:19
  Speaker 2: You know, tornado Alley, hail, alley, whatever, and back, oh gosh, I guess it was November or so, we had quite a few roofers start coming to our house and they were going all through the neighborhood, in fact, because we had a hailstorm that came through in May 2024.
• 20:44
  Speaker 2: So almost a year from from today.
• 20:47
  Speaker 2: So, you know, all these these contractors were coming around wanting to get up on the roof.
• 20:53
  Speaker 2: And, uh, we got tons of phone calls with these roofers wanting to to come out, look at our roof, and all of this sort of fun jazz.
• 21:03
  Speaker 2: And you know, if I wasn't so busy, I would really like to play with them, quite frankly, but I am, thank goodness, because I, you know, no one really wants to be made fun of and be played with, especially me.
• 21:20
  Speaker 2: Anyway.
• 21:21
  Speaker 2: So they would come in and say, hey, you know, so-and-so, your neighbor is having their roof repaired because they got damaged in this May 2024 hailstorm.
• 21:33
  Speaker 2: Your roof has damage as well.
• 21:36
  Speaker 2: And I would go.
• 21:37
  Speaker 2: Really, daddy, I don't see it.
• 21:39
  Speaker 2: Where are you seeing it from here?
• 21:43
  Speaker 2: Because I don't see it.
• 21:44
  Speaker 2: Anyway, they would try to give me the song and dance and finally, I would go.
• 21:49
  Speaker 2: You know, I and my husband are insurance adjusters and it is amazing how much they would like take us off of their phone list and suddenly never come back and bother us ever again.
• 22:05
  Speaker 2: So if you're wanting to get rid of someone that's, I guess obviously how you would do it is just tell them that you're an insurance adjuster, because who wants to talk to of someone that's, I guess obviously how you would do it is just tell them that you're an insurance adjuster, because who wants to talk to an insurance adjuster, am I right?
• 22:15
  Speaker 2: Anyway, such a lonely job.
• 22:17
  Speaker 2: So we would have these people come out and tell us that there is damage.
• 22:26
  Speaker 2: And there may be damage, but it's cosmetic, and what cosmetic is is just like I talked about is, um, it's kind of where maybe some of the grains granular on the on the shingles are missing, uh, but it doesn't change how the shingle works.
• 22:52
  Speaker 2: The shingle can still do its job.
• 22:56
  Speaker 2: In the event of it being metal, the hailstone will hit the metal, maybe even dent the metal, but it doesn't create an opening where water can get through.
• 23:10
  Speaker 2: In fact, I've attended many an engineer's seminars about metal roofs and hailstones and there is they are talking about a clear coating on these metal roofs now and you can see under a very high powered microscope.
• 23:33
  Speaker 2: It's not anything you can see with your naked eye, but you can see under this microscope where the hail stone came and hit.
• 23:40
  Speaker 2: And these roofing contractors what they will say is oh, but the clear coat would have been broken and therefore it will create and cause the roof to deteriorate more quickly.
• 23:56
  Speaker 2: And these engineers showed us picture after picture after picture, and even these nice little videos where they were basically throwing tennis balls.
• 24:08
  Speaker 2: Well, they weren't throwing, they were shooting tennis balls out of, like a tennis ball gun or whatever, to mimic the impact of a hailstorm.
• 24:17
  Speaker 2: And you could see that the clear coat was still intact.
• 24:22
  Speaker 2: And this is something that a roofing contractor or plaintiff attorney or a public adjuster will fight, and they have the right to absolutely.
• 24:35
  Speaker 2: And I'm not going to say that just because they, this roof has been hit by a hail storm or a hail stone and the clear coating it very well could break.
• 24:52
  Speaker 2: But I think this is something that you would need.
• 24:55
  Speaker 2: An engineer who has these very powerful microscopes can see.
• 25:02
  Speaker 2: So that is cosmetic versus structural, because what you're going to be looking for is the roof membrane, whatever it is, rubber the rock kind of on your commercial structures, clay tiles, heck, you could do thatching, I guess, like they do in England?
• 25:27
  Speaker 2: I have no idea.
• 25:28
  Speaker 2: And how those don't leak?
• 25:29
  Speaker 2: I have no idea.
• 25:30
  Speaker 2: And how those don't leak, I have no idea.
• 25:31
  Speaker 2: Cedar shakes, anyway, any kind of thing.
• 25:36
  Speaker 2: What you're looking for is is this just ugly, but it still works?
• 25:41
  Speaker 2: Or is it actually something that has caused this roofing membrane, this roofing cover, to no longer be effective, and then that would be like the structural aspect of it?
• 25:55
  Speaker 2: So then you would need to replace it.
• 26:00
  Speaker 2: In many policies, as I mentioned earlier, we've got the instance where we have the cosmetic exclusion and if there's cosmetic damage, the insurance company won't pay for it.
• 26:14
  Speaker 2: Of course, like I said, there's a question on what is cosmetic damage.
• 26:19
  Speaker 2: It's not defined in the policy, so therefore it's open and that does create some issues.
• 26:26
  Speaker 2: So there's no coverage, basically.
• 26:30
  Speaker 2: Basically, if our roof is still functioning Again with the matching ideas, it depends on your availability.
• 26:42
  Speaker 2: There are and this is not any kind of endorsement of these people.
• 26:49
  Speaker 2: These are the only people that I happen to know, but this there is a um, insurance availability or what's the word I'm trying to look for.
• 27:02
  Speaker 2: See, this is why I need bills, because, like he helps me out with these words, because words are hard, so I don't understand sometimes the words are hard.
• 27:08
  Speaker 2: There's don't understand Sometimes the words are hard.
• 27:10
  Speaker 2: There's a vendor, insurance vendor.
• 27:11
  Speaker 2: It's called ITEL, i-t-e-l, itel and you can find a lot of the building supplies that are out there and that may be out of stock at Home Depot or Lowe's or whatever.
• 27:32
  Speaker 2: Now here's an interesting thing and this is something that I do as an expert witness is, of course, as you know, I try to read a lot of blogs on both sides of the fence, and I was reading a LinkedIn post by an expert or, excuse me, by a public adjuster, and he was talking about ITIL, and what he was talking about is that ITIL is not as good as insurance companies think they are, and part of the issue is that the contractors, when they go out there to get the roofing materials from, let's say, home Depot or whatever, home Depot should totally sponsor this.
• 28:16
  Speaker 2: Since I'm mentioning them, home Depot call me Anyway.
• 28:20
  Speaker 2: So when these contractors, these roofing contractors, are going to Home Depot to get all their stuff, of course they get the contractor price, they get a discount right, and that's a little bit where they can get their profit and overhead and everything built into that, in addition to charging the 10 and 10, or, if that's the case with the general contractors, okay.
• 28:44
  Speaker 2: All of this being said and done, the issue is that with ITEL, they may be in, let's say, vermont or Maine, where there are no tornadoes, so this product is safe from being injured by weather events, right.
• 29:04
  Speaker 2: But now the contractor has to have this material shipped from Vermont or Maine, or wherever, to Kansas or California or wherever, and that actually increases the cost.
• 29:22
  Speaker 2: And so what this public adjuster was saying and it's a very good point something that I wasn't aware of was that you know, so insurance adjusters, y'all need to be a little bit more amenable to being flexible.
• 29:39
  Speaker 2: Put on a brand new roof, I mean, that seems what to just not.
• 29:53
  Speaker 2: We owe the insured to repair the damage, right, am I right?
• 30:00
  Speaker 2: That's that's what the policy says?
• 30:01
  Speaker 2: We've got to put the insured back to where they were.
• 30:04
  Speaker 2: That means we repair the damage.
• 30:07
  Speaker 2: So if it's cheaper for us to repair the damage with new stuff rather than matching stuff because we've got to, like, ship it clear across the country, it seems, it seems to me, it seems to me that that's what we would want to do.
• 30:21
  Speaker 2: But again, I mean, who's to say?
• 30:24
  Speaker 2: I can tell you this again, what you need to look at and this is going to be the theme throughout everything is you got to look at the policy.
• 30:32
  Speaker 2: You need to know what the carrier does.
• 30:35
  Speaker 2: I mean, cause some carriers are like by goodness, no, we're going to do it this way.
• 30:40
  Speaker 2: This is what we do, absolute.
• 30:42
  Speaker 2: We're not no ifs, ands or buts.
• 30:44
  Speaker 2: This is how we do it.
• 30:46
  Speaker 2: Other, you know, policies have all of these exclusions and endorsements in there that we were talking about.
• 30:53
  Speaker 2: So you know state law.
• 30:56
  Speaker 2: What is our state law set?
• 30:58
  Speaker 2: What is the DOI, our department of insurance?
• 31:01
  Speaker 2: What do they say?
• 31:02
  Speaker 2: What are they mandating?
• 31:05
  Speaker 2: We, as adjusters, of course, always need to know these sorts of things.
• 31:09
  Speaker 2: We've got to be a jack of all trades and a master of none.
• 31:13
  Speaker 2: We have to.
• 31:13
  Speaker 2: It's amazing the amount of crap.
• 31:15
  Speaker 2: Can I say crap?
• 31:16
  Speaker 2: I mean it's crap, isn't it?
• 31:18
  Speaker 2: I don't know if it's crap or not, but I mean it seems like it's crap.
• 31:21
  Speaker 2: There's a lot of stuff we got to know right, anyway, and we've got to set these expectations very early with our homeowners.
• 31:32
  Speaker 2: And, again, what that is going to be one of my topics that I love to talk about is how we need to take a good hour to set up our claim, and that includes calling and speaking to our insured, because ain't nobody got time to read a letter about insurance coverage.
• 31:54
  Speaker 2: It's boring.
• 31:55
  Speaker 2: So sit down and talk with them about what the coverages are, what the steps are, when you're going to know it.
• 32:04
  Speaker 2: This is what I'm seeing.
• 32:06
  Speaker 2: This is what the state says about matching.
• 32:08
  Speaker 2: This is what the state says about blah, blah, blah, whatever.
• 32:11
  Speaker 2: This is what the state says about matching.
• 32:12
  Speaker 2: This is what the state says about blah, blah, blah, whatever.
• 32:14
  Speaker 2: This is what the state says about what actual cash value is, which, by the way, can be coming up to.
• 32:21
  Speaker 2: I mean, like a lot of different things.
• 32:23
  Speaker 2: Bill and I talked about it very, very briefly, I think, two weeks ago when we were trying to figure out what that phrase was with the market value, when we were looking at all of the places this especially comes into play with homes when we're looking at ACV and RCV the valuation of a home and if there's, co-insurance issues.
• 32:50
  Speaker 2: So be sure you also pay attention to these deductibles that we have going on, because in a lot of cases, what these policyholders want is cheap insurance and what the policyholders are going to get is cheap insurance.
• 33:10
  Speaker 2: So if you have a 5% hail or windstorm deductible or hurricane deductible or something like that.
• 33:18
  Speaker 2: That's 5% off of the TIV total insured value.
• 33:21
  Speaker 2: So you add up all the coverages and you take 5% off, which means that you need to have $20,000 in your pocket to repair your roof or your fence, or your roof and fence or whatever.
• 33:35
  Speaker 2: And most insureds don't understand that because they haven't talked that thing through with their agents.
• 33:43
  Speaker 2: There you go.
• 33:44
  Speaker 2: That's all we're going to say.
• 33:53
  Speaker 2: All we're going to say when we're, of course, talking with our insureds and setting these expectations and talking about the ACV payments, how ACV payment is going to come out.
• 33:59
  Speaker 2: First, if you happen to have an RCV policy or replacement cost policy, you will talk about how we're going to pay actual cash value first, acv first.
• 34:09
  Speaker 2: Talk about the deductible.
• 34:11
  Speaker 2: Be clear that they can get recoverable depreciation up to a certain amount.
• 34:20
  Speaker 2: Of course, if they repair the roof for cheaper than what you say, they don't automatically get all of the replacement costs.
• 34:29
  Speaker 2: Explain that they don't get to make a profit off of insurance.
• 34:33
  Speaker 2: Many policies also limit older roofs to ACV payments only until and in fact that coverage is there until the insured replaces the roof, notifies the insurance carrier and then the policy will change to where it's RCV on a roof.
• 34:57
  Speaker 2: Many people do not know that and it's a very rude awakening, but this is how you get cheaper insurance.
• 35:02
  Speaker 2: Is this the problem of a claims adjuster?
• 35:05
  Speaker 2: Not really, but they've made it our problem, haven't they?
• 35:12
  Speaker 2: Because nobody is explaining it to them.
• 35:16
  Speaker 2: And I know that there are many, many, many agents out there who are explaining coverages to the insured and the insurer's like yeah, yeah, yeah, yeah, yeah, just like, here's my cash, take it and give me my policy.
• 35:30
  Speaker 2: And they didn't understand, didn't, didn't listen, whatever.
• 35:34
  Speaker 2: I would recommend that you get something then in writing, because it's amazing when you can go back and you go.
• 35:42
  Speaker 2: Is this your signature where you said you understood that you were getting blah, blah, blah?
• 35:45
  Speaker 2: It's just amazing.
• 35:46
  Speaker 2: I used to love doing that when I was an adjuster, but hey, anyway, it is unfortunately the adjuster's job to hold the insured's hand and when you know, by the way, adjusters, that the insured is particularly upset about something, it is always wise to pick up the phone again.
• 36:09
  Speaker 2: Pick up the phone and call the agent, because guess who is going to get called when they hang up the phone with you?
• 36:16
  Speaker 2: Uh, the, the insurance is going to call the agent and chew them out one side or the other, and the agent is going to call you and chew you out one side or the other.
• 36:23
  Speaker 2: And let's just avoid being chewed out.
• 36:25
  Speaker 2: I mean, that's, you know, kind of um, you know the fun part.
• 36:30
  Speaker 2: Uh, moving on, I guess, moving on some recent court cases, of course, there was a Texas and Alabama case.
• 36:39
  Speaker 2: I want to say 2023, 2024.
• 36:42
  Speaker 2: I'm not exactly sure, but State Farm.
• 36:47
  Speaker 2: Both of these were State Farm, texas and Alabama.
• 36:49
  Speaker 2: In the Texas case, a roof claim was denied due to wear and tear but not hail, and you know there was current causation, blah, blah, blah, and the court upheld State Farm's thing.
• 37:05
  Speaker 2: And in the Alabama case, with the roof again not necessarily a hail claim, but it was talking about investigation and these two are very important.
• 37:50
  Speaker 2: When we're talking about wear and tear damages, I've been seeing some trends in claims where there is roof damage or some kind of water damage and insureds will not repair the damage and even though they have a contractor and what they're doing is they are talking about the need that the insurance company's field appraiser or field adjuster or estimator has not gotten all of the damage and it is tantamount of importance.
• 38:33
  Speaker 2: It is so incredibly important that again you pick up the phone and you talk to the insured.
• 38:39
  Speaker 2: Get the agent on the line, get the contractor on the line, I don't care.
• 38:43
  Speaker 2: Get the insured's mother-in-law on the line, that is what it takes.
• 38:48
  Speaker 2: Get Santa Claus on the line, I don't care.
• 38:52
  Speaker 2: But get all everybody that the insured trust on the line and have a very frank conversation with them.
• 39:01
  Speaker 2: You must repair your property.
• 39:04
  Speaker 2: You know.
• 39:04
  Speaker 2: We've given you a check.
• 39:05
  Speaker 2: We we've paid you what you owe.
• 39:08
  Speaker 2: Also very important as soon as you get that estimate from your field appraiser or your field estimator, whatever you pay what you know you owe.
• 39:16
  Speaker 2: If there's contested damages, don't pay that.
• 39:19
  Speaker 2: Of course you're going to contest it, that's fine.
• 39:22
  Speaker 2: Pay what you know you owe.
• 39:23
  Speaker 2: Give that money to the insured.
• 39:25
  Speaker 2: Tell the insured what you're doing.
• 39:27
  Speaker 2: They don't want to repair the house because they are so afraid that if they start repairing the house they're going to destroy any kind of evidence and that you are not going to pay them.
• 39:42
  Speaker 2: Tell them again.
• 39:45
  Speaker 2: Walk them through it.
• 39:46
  Speaker 2: You need to tell them.
• 39:48
  Speaker 2: Speak to them and then follow it up with a letter.
• 39:52
  Speaker 2: You need to tell them hey, look, you know there's this whole thing.
• 39:56
  Speaker 2: It's called a supplement.
• 39:58
  Speaker 2: We go through it every day, every day, every day.
• 40:04
  Speaker 2: You know, and it's, and it's such a common occurrence.
• 40:09
  Speaker 2: Your, your contractor knows about it, your public adjuster knows about it, everybody knows about it.
• 40:13
  Speaker 2: And I realized that you, mr and Mrs Insured, may not know about it because you don't have to deal with insurance claims, thank goodness, every day, like we do.
• 40:21
  Speaker 2: But you know, I want you to go ahead and start repairing that property.
• 40:27
  Speaker 2: If there is additional damage found, tell your contractor to stop.
• 40:31
  Speaker 2: Your contractor will probably know to stop.
• 40:33
  Speaker 2: Start taking pictures.
• 40:35
  Speaker 2: Call me immediately.
• 40:37
  Speaker 2: I'm going to send someone out there again to go take a look and take pictures and then we're going to, you know, see if that is related.
• 40:43
  Speaker 2: If it's related, great, we will add it on and we'll cut you another check.
• 40:47
  Speaker 2: If it's not related, you're going to have to pay for that yourself.
• 40:52
  Speaker 2: But do that because here's the deal, mr and Mrs Insured if you don't, you may violate your coverage provisions.
• 41:02
  Speaker 2: Y'all all remember the policy conditions that say hey, you got to cooperate with us, you know, you got to show us the damages.
• 41:11
  Speaker 2: You got to protect the property from further damage.
• 41:13
  Speaker 2: Blah, blah, blah.
• 41:14
  Speaker 2: It's that protecting property from further damage aspect, and so if you don't do that, we could end up denying the rest of your claim.
• 41:23
  Speaker 2: Like this is going to be it, like this is the line in the sand kind of deal, and I guarantee you that the insured will feel better about this.
• 41:33
  Speaker 2: They may not like what you're saying to them Get used to that as an adjuster but they will probably respect you a little bit more.
• 41:42
  Speaker 2: I found personally that they did If I went out there and just said this is it probably not what you want to hear, but I want to be honest with you so that you will understand it and know what's going on.
• 41:55
  Speaker 2: Want to be honest with you so that you will understand it and know what's going on.
• 41:59
  Speaker 2: You need to follow it and I'm going to tell you as an adjuster follow it up with a letter.
• 42:02
  Speaker 2: You must because I am seeing these trends where insureds are going we're talking 11 months, 15, 16 months, 15, 16 months not doing any kind of remediation.
• 42:17
  Speaker 2: Roofs leaking molds growing.
• 42:20
  Speaker 2: Things are getting worse and worse and worse and worse and worse.
• 42:29
  Speaker 2: Why are y'all waiting?
• 42:29
  Speaker 2: Y'all need to send a reservation of rights letter, whole nother podcast topic.
• 42:32
  Speaker 2: But you know, keep going.
• 42:35
  Speaker 2: Well, let's talk about.
• 42:36
  Speaker 2: I mean, like, how often does this happen?
• 42:38
  Speaker 2: Right In Kansas?
• 42:39
  Speaker 2: I looked this up, kansas DOI said that in 2023, the last numbers that they had they had 147,000 storm claims and $442 million was paid.
• 42:54
  Speaker 2: Now, I mean, that is massive volume and there's no way that an adjuster can move that quickly, which is something that many of our policyholders don't understand, but it is something that, again, we need to explain to them when we're talking to them.
• 43:10
  Speaker 2: Hey, you know what?
• 43:11
  Speaker 2: We got a lot of claims.
• 43:13
  Speaker 2: We're going to send out an adjuster or a field appraiser or whatever to go out and take a look at it.
• 43:17
  Speaker 2: Usually, they get back with me within a week.
• 43:19
  Speaker 2: I've asked them to get back with me in two weeks.
• 43:22
  Speaker 2: Make sure you get a tarp over your roof.
• 43:24
  Speaker 2: Send me the receipts.
• 43:25
  Speaker 2: I will take a look at that.
• 43:27
  Speaker 2: Your policy does cover for you to protect your property.
• 43:30
  Speaker 2: You need to do that to keep it from getting worse.
• 43:32
  Speaker 2: See how we're already feeding them into this conversation and stuff.
• 43:37
  Speaker 2: Um, you know, maybe you sit there and go.
• 43:41
  Speaker 2: Your policy has a cosmetic damage only endorsement, which means if the damage is found to be only cosmetic there, there, we can't pay you anything.
• 43:49
  Speaker 2: However, I'm going to still send out a guy to take a look at it.
• 43:51
  Speaker 2: I want to make sure that I'm paying you everything that you need to be paid.
• 43:54
  Speaker 2: You know insurance.
• 43:56
  Speaker 2: They want to know this.
• 43:57
  Speaker 2: They want to know that you're trying to help them.
• 44:00
  Speaker 2: Okay, so I think I pretty much talked this thing to death.
• 44:04
  Speaker 2: Basically, it's knowing your policy, knowing your jurisdiction, knowing what damages to look for.
• 44:12
  Speaker 2: Go through thorough inspections to look for.
• 44:13
  Speaker 2: Go through thorough inspections your roof, siding, gutters, vents, fences, everything like that.
• 44:25
  Speaker 2: And just because the neighbor got damaged doesn't mean your insured got damaged.
• 44:27
  Speaker 2: It's weird for the insured to figure that out.
• 44:28
  Speaker 2: But there you go.
• 44:30
  Speaker 2: You might also want to look at I think it's VeriRisk or someone like that.
• 44:34
  Speaker 2: Again, call me to sponsor, because they're not a sponsor right now.
• 44:38
  Speaker 2: You may also want to look at them.
• 44:42
  Speaker 2: I think they have like a hail damage thing and if y'all know of any hail websites that tell you like because usually you can do like a zip code or something like that, or get even down to like an address and they'll say, hey, there was an inch hail in this, you know, within five miles of this area, put those things down.
• 45:05
  Speaker 2: Let's help each other out.
• 45:07
  Speaker 2: Anyway, look at your materiality, availability through ITEL or if it's cheaper just to use someone else.
• 45:14
  Speaker 2: Because, like I said, that public adjuster really opened my eyes.
• 45:17
  Speaker 2: This is something to also think about.
• 45:19
  Speaker 2: Guys, you know, let's talk both sides of the fence, no pun intended, but know that sort of thing, homeowner education so very important, it shouldn't fall to us.
• 45:30
  Speaker 2: It's too late by the time that it gets to the claims department, but unfortunately that's where it is.
• 45:37
  Speaker 2: Also, be aware of contractor pressure on your homeowner, public adjuster pressure on your homeowner.
• 45:45
  Speaker 2: But you know, these guys can be or gals, these people can be some of your best friends.
• 45:50
  Speaker 2: I mean, just because they are representing the homeowner does not mean that they are, you know, quote, unquote bad or wrong or anything like that.
• 46:04
  Speaker 2: They're not the villains.
• 46:05
  Speaker 2: I mean, sometimes we're the villains, which is regrettable because we shouldn't be that way.
• 46:12
  Speaker 2: So anyway, I think next time I'm hoping to have a guest, maybe Bill will be back.
• 46:18
  Speaker 2: Anyway, get well, keep him and his wife in your thoughts and we will see y'all later.
• 46:32
  Speaker 1: Bye.
• 46:32
  Speaker 1: Thanks for joining us on the Art of Adjusting podcast, where we talk about life as an insurance adjuster.
• 46:38
  Speaker 1: Hit that subscribe button real quick and tell all of your adjuster friends to check this out as well.
• 46:43
  Speaker 1: For independent adjusting services, go to wwwautinclaims, and for anyone interested in working as an independent liability adjuster, go to the contact us tab to join our roster.
• 46:56
  Speaker 2: So this wraps up another art of adjusting podcast.
• 46:59
  Speaker 2: If you enjoyed this podcast or this episode, please give us five stars and a review.
• 47:05
  Speaker 2: It does help the algorithm pick us up.
• 47:08
  Speaker 2: In the meantime, you can contact me at theartofadjustingcom for consulting and training purposes.