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Newt
USA
657 Posts |
 Posted - 01/24/2003 : 05:17:37
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This 180 day clause is found in the 91 and I don't see it in the 2000 issue of the ISO.
State Farm has a two year clause and they require they be notified within 30 days after the work is complete.
What this subject tells me is, every policy has to be read regardless of the issue or source, I could get awfully red faced, should a client miss it also.
Items such as this should be on a checklist, on things you inform the client of. I am big on check lists. It takes the pressure off, trying to remember what you told or did not tell the customer. |
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whitstorm
USA
9 Posts |
Posted - 01/24/2003 : 12:20:18
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I've only breifly read some of the comments/replies. But, I ran into this several times in Indiana working for State Farm. I was given the following answers:
Under the HO-3 or RDP policy, "notice must be given within 180 days." I was told that, hypothetically, an Insured can tell the adjuster or claims office that he/she plans on making the repairs within that 180-day time-frame, and then complete them 1 year, 2 years, 5 years, 10 years, etc, etc. and still (hypothetically, again)be paid the RC.
Under the new Homeowners (old HO-5), which is all that State Farm issues on Homeowners policies in Indiana now, RC is paid "up-front" - there is no depreciation taken on Cov.A losses,regardless of the amount of the claim (ACV is still paid on Cov.B - until replaced). However, there is a clause that states, "to make claim for any additional payments, you must do so within two years of the date of loss." This applies to "supplemental" payments only.
I know policies differ in different states, and believe it or not, coverages do too. There is no "law of the land" and no "universal coverage", so always consult your supervisor you are working for.
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Jeff S. Whittington |
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Newt
USA
657 Posts |
Posted - 01/25/2003 : 05:15:46
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Jeff, Good post and proves a point, this subject has more variations than snow flakes. The State Policy I have here is FP7955 which is simular to the ISO HO 3.
It gives two years instead of the 180 day clause, also notify them within thirty days after the work is completed. Thats on coverage A1,A2,B1 and B2. It says you must complete the work within two years period and no mention of an extension.
The HO 3 03 10 00 (ISO) left the subject clause out completely, while the 91 edition has the 180 day clause in it.
For myself, I will need to make up a check list when I get into my apprenticeship so that I don't over look items important to the quality of my work. I also need lots of Macros loaded.
This would be an item of intrest to the software gurus, reminders that tell you at the appropriate time for certain of these items should be considered or mentioned, could be pop-ups.
I know that this is got to be included into the flow of the claim and as yet I don't have that flow ingrained. That is the difference experience makes.
I think I need some training on flow of the claim and JimF brought up this subject before, maybe if enough interest is shown , he and Clayton could get this subject going. If I don't have a system or routine my work would be goofed up as a Chinese fire drill. |
Edited by - Newt on 01/25/2003 05:19:05 |
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CCarr
Canada
1200 Posts |
Posted - 01/25/2003 : 10:15:17
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Newt, it all boils down to knowing the policy that is applicable to the claim at hand, specifically knowing what the policy says in regards to Loss Settlement (relative to this thread); in addition to all the other applicable areas of the policy at hand.
I suggest you are going to suffocate yourself in 'field checklists', that will only choke your productivity in the field; and likely result in you telling the insured 'too much' - and some of that is not your duty to expound upon or attempt to educate the insured in.
Your thoughts are creating the picture that you are turning the claims exercise into a monumental task in the field, that really it is not.
You raise the issue of 'flow of the claim', and the suggestion that I or JimF get that subject going.
Personally, I refer you to the "Qualifications" thread in the "Getting Started" forum, where as you know Joe raised this issue, and my comment was that it had been discussed in the CADO forums in 2002 or 2001. I see no point in detailing my 'flow of the claim'. Mine has been carved in stone from many years doing so directly for a carrier, and was modified as required to deal with 50 or so new claims at once as opposed to daily assignments. |
Edited by - CCarr on 01/25/2003 10:17:05 |
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CatDaddy
USA
310 Posts |
Posted - 01/25/2003 : 11:20:47
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Newt, I will assume we are talking about catastrophe claims so I will respond in context to working those types of claims.
At first, and it sounds like this is where your are, you will feel like there is so much information to absorb, how will I possibly ever become as proficient as those around me. The answer is exactly was Clayton and others have said to you before in so many words....experience. And it will come.
Your desire to be organized and as prepared as possible is a good one. To be fast AND efficient, organization is key. Without it, you'll be very average. ALL of the outstanding reps, staff or IA, have their own system that works for them to remain organized throughout their assignments.
Now you are going to get alot of advice from alot of good people. All who are/were successful adjusters. And they are going to want to be Obi Wan Kanobe and want you to be Luke Skywalker; ie.. do it their way cuz its the best way. I say that to say this. Take in all of this information from all these sources and come up with YOUR way of doing it and what works for YOU. We are all trying to reach the same goal, the resolution of the claim fast and correctly, so alot of the advice will be similar but not exactly the same. Take the pieces and come up with Newt's way of providing superior service to everyone involved.
Here's more good news about cat claims. A high percentage of the work is VERY repetitive. Wind and hail claims. And as someone maybe a little newer on the block, your folks will surely send you to this type of cat location first. I wouldnt worry too much about heading to ground zero of a tornado touchdown and handling total losses right from the start. And all these threads about liability, put them out of your head. You dont see too many, if any, liability claims worked from a cat site. I wont give you any examples of how it could come up because that will bring the clouds back into your mind. Think..wind/hail..wind/hail.
And why is that good you so say. Experience! This "repetition" allows you to exact your craft. Soon, you'll start to realize "man, most of the time, all this is pretty much the same everywhere I go". Your routine when you get to the cat site, regardless of the type of cat, will be the same. (arrive at site, sit through orientation, receive files, make contacts, set appointments, inspect claims, close claims, go home and wait to do it again) There will always be some regional differences is how certain areas of the country handle claims. After you leave a California cat site, you'll feel like you just took Composition 101 because of all the letters you had to write. You go somewhere else, and you'll think "eh...what about the letters?" You'll need to stay objective and flexible to these changes, maybe have to alter your routine alittle from time to time, but all will be well in Whoville.
And you will have to handle alot of policy differences. DON'T TRY TO MEMORIZE THE POLICY. |
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CatDaddy
USA
310 Posts |
Posted - 01/25/2003 : 11:28:59
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Opps....hit enter instead of Caps Lock!
Where was I?....oh yeah...don't try to memorize the policy. Learn how to READ it and find the information you are looking for. You will commit some parts to memory simply because you will refer to them so much but when you're not 100% sure, puts your eyes on the policy book.
As Clayton said, it is not as monumental task as you might be building up in your head. You have alot of good folks around you. Use them. That's what we all did when we started. Dont be afraid to ask questions. Dont be afraid of the answers either.
Good Luck.
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Newt
USA
657 Posts |
Posted - 01/26/2003 : 09:17:32
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First I would like to thank you folks for the response, This is just another eye opener. When I state a mis-conception and get good replies such as the ones I get here it adds to my toolbag.
I do branch out into areas that I have no business in, yet it has been a real learning experience.
Having a broad knowledge and at the same time being efficient is my goal.
When the time comes for me to throw my hat in the ring(as an apprentice), I do want to know what I am reading and saying, know where the information is and above all, not appear to the client that I have no idea of what I'm doing.
I don't want a supervisor to ask me something and I stand there like a hog looking at a wrist watch.
I have dealt with enough clients to know, that is the first thing you size up. And it doesn't take long to do it. No two are the same and what you say to one will be used against you by
another. One will leave you alone to do your job, another will hound you in the ground while you're doing it.
Some state laws require you to explain to the customer contents of the policy when doing a claim.
If we don't understand what we read, know what and when to say it, could mean the difference in an informed client or one that is PO'd. You folks know all this and I would like to.
I am in agreement with every thing you say, so don't take my comments as an argument. These are just statements to instagate a response, thats how I learn. I am just finishing up seven months of study. I probably have a C- on my report card but it has been fun.
As you note by the number of posts I make on here I am an intense old dude, and work hard at what ever I take on to a fault. I enjoy what I do or I don't do it..Thanks once again....
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Edited by - Newt on 01/26/2003 09:24:50 |
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CCarr
Canada
1200 Posts |
Posted - 01/26/2003 : 10:55:07
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Newt, in a number of forums now you keep coming back with the apparent defensive statement that, "some state laws require you to explain to the customer, contents of the policy when doing a claim".
I am not at all familiar with those laws or requirements.
Please advise:
(a) What State(s)?
(b) What law(s)?
(c) The nature of the requirement(s)?
(d) Explain to what extent? |
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ChuckDeaton
USA
373 Posts |
Posted - 01/26/2003 : 13:44:56
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| Interesting thought, Clayton, I have always "thought" that the Arkansas Fair Claims Practices Act requires an explanation of coverage to the policyholder. |
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CCarr
Canada
1200 Posts |
Posted - 01/26/2003 : 13:49:23
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Okay Chuck, lets start with Arkansas - with regards to my four part question, can you give me a sentence or two from their FCPA that addresses those questions, or a web link for review?
Excuse me for being repetitive, but if these last three posts are going to take us down a useful trail, we should have a new thread bearing a title that relates to the posts. |
Edited by - CCarr on 01/26/2003 13:52:37 |
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Newt
USA
657 Posts |
Posted - 01/26/2003 : 14:04:13
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I believe it was Chuck that mentioned this, and the State was Arkansas, I don,t know of any others or else no one has mentioned it. That was four or five months ago. I have no other information as to the extent or nature. I don't mean to sound so defensive, I just repeat and hope it is correct.
There may not be a requirement to the extent I assume, so as soon as I get some experience maybe someone can demonstrate how its done.
What seems like a good idea with your face in a book my be all wrong in the real world. I have no plans to go out with out someone who can give me some pointers. I just hope its someone who has the patience of Job and is a first rate adjuster. One more reason to work around a Claims Center, or doing some menial claims work first. It never has taken me long to catch on how things are done, because I try hard to do my homework.
Most everything you do is kind of like fishing, you fish like the people from the area you are in that catch the big ones. Dang, I brought that subject up again. I can't wait til the trees start getting buds or the dogwoods start to bloom.
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CCarr
Canada
1200 Posts |
Posted - 01/26/2003 : 14:12:42
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| I have started a new thread to capture any and all input regarding the singular issue of, "state laws require you to explain to the insured, contents of their policy when doing a claim". This new thread is also in the "Coverage forum". |
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dbencat
USA
3 Posts |
Posted - 02/02/2003 : 11:02:16
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| One must first read the 180 day requirement in each of the policies. The standard ISO is the basis and many companies have amended the wording. Example the Nationwide Golden Blanket policy reads, "Settlemnt will be based on actual cash value for those items. If you later decide to repair or replace those items of damaged or stolen property, you may make an additional claim within 180 days after the loss for the difference between the items actual cash value and the amount payable if repaired or replaced." Even though wording is slightly different, my take on this provision is that the insured need only make claim or notify of their intent to make claim for the replacement cost. I have not seen any wording requiring the actual replacement of the property within 180 days. |
David P Bennett |
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Does Property Have To Be Replaced In 180 Days?
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