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Last Post 11/13/2008 1:58 AM by  swink_d
Help!!! Contents/Damage questions urgent!!!!
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11/12/2008 11:08 PM
    I have been assigned a bunch of TWIA claims that belonged to another adjuster these claims are old he just didn't finish them or follow up with the people so they pulled them and gave them to me to handle.  I have spoken with all of them and many of them were inspected 4 to 5 weeks ago or more and when the other adjuster took his pictures and there photos they started work on the property, now he is gone and they have no, photos, ect. or they are very limited in what they have.  What is the proper way to handle this I have contacted the other adjuster and he says he gave me everything that he has which was NOTHING.  I want to take care of these folks.  How would you handle this situation.  I have one that I am typing up right now and he had a riding lawnmower that was rolled over a few times that the other adjuster said he could dispose of which he did.  NO PICTURES.  HELP!!!!
    As always thank you for all of your help.
    Jason Wells

    11/12/2008 11:57 PM
    Well, you are in a classic problem with clean-up.  The Insured acted on the advice of the original adjuster whose responsibility it was to correctly document the claim.  From the carrier's point of view (in general here, not necessarily TWIA), the original adjuster's vendor is on the hook for producing that documentation/photos from the original adjuster.  If they can't produce that and the Insured doesn't have documentation because he/she acted in good faith and began repairs, the Insured is owed his loss and the original adjuster and/or the vendor is on the hook through subrogation to pay those now undocumented portions of the claim.  This is the exact reason why everyone needs Errors and Ommissions coverage individually -- rather than relaying on the vendor's E&O.  The vendor's E&O carrier could deny this claim leaving the original adjuster to pay the bills out of his own pocket.
    If you are working for the same vendor as the old adjuster you better take this problem up with senior management because they may well have a financial interest in these claims.  Get their response in writing, work the file as they direct and put a copy of that response in each of your personal files for future reference if any of these blow up in your face.  If they won't give it to you in writing, document the conversation word for word, mark the date and time and person who told you, sign it and fax it to yourself so there is a date stamp on the sheet.
    If you aren't working for the same vendor as the original adjuster, take it up as high as your vendor can with TWIA and get their response in writing and attach it to every file you upload and work the files as they direct.
    I had one in Florida as an examiner where the adjusting firm was on the hook for over $50,000 of contents because of this same issue.
    They may want you to take a Non-Waiver on these files, if so, have them tell you exactly what they want the Non-Waiver to say -- don't guess at it and write it up yourself, there's too much at stake here.

    11/13/2008 1:58 AM

    In discussing the lawnmower thing on chat , besides my points about a 20hp mower being blown over and over several times and no other adjacent damage

    Read your TWIA policy

    PROPERTY NOT COVERED We do not cover:
    1. Animals.
    2. Money, currency or bullion.
    3. Securities, deeds, or evidences of debt.
    4. Records, books of records or manuscripts.
    5. Motor or engine propelled vehicles or machines designed for movement on land, including attached machinery or equipment. However, we do cover such vehicles, while located in a fully enclosed building, which are not subject to motor vehicle registration and are:
    a. Devices and equipment for assisting the handicapped.
    b. Power mowers and other lawn and garden equipment not exceeding 18 horsepower.
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