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Admin
547 Posts |
 Posted - 02/27/2004 : 07:23:03
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Forum transfer: Posted bydriftwoodjack on 02/26/2004 : 16:18:20
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[i]Let's face it. Pay Leonard's, get a license. Keep your seat warm for a day for USAA or Farmer's certification (along with a check of course), boom! - you're certified.
[?]Reading your quote on USAA I had a question. Should an adjuster handling mold claims have a thorough understanding of the New York City Guidelines on Assessment and Remediation of Fungi in Indoor Environments?
In addition, I'm asking whether and adjuster with experience adjusting over 100 mold claims should understand what it means when a CIH report states that a NYC Guidelines Level 5 mold problem exists?
On the subject of USAA training, are you saying USAA adjusters training is less than adequate compared to other training regimentations?
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Admin
547 Posts |
Posted - 02/27/2004 : 07:25:41
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Forum Transfer Posted By: R.V. Winkle on 02/26/2004 18:31:48
Driftwood,
I'm not sure what your intent is here in this website, and if you are looking for bullets you are not going to get one from me.
For those that may not know what I'm talking about, the following link is included in Driftwood's profile:
http://usaa-mold.com/
If you have a problem with USAA, I suggest you take it up with them directly through their staff's claims office.
This site is for independent and staff adjusters who perform mostly limited tasks, by way of subcontract of the insurance company through a network of Independent Adjusting Firms.
I did not refer to USAA "training". What I referred to was "certification", which is a term used to described a very short orientation that is usually, but not always required for an independent adjuster to work claims for a carrier. Many companies offer such certifications, but in my experience there is not a lot of policy or estimating specific information to be gleaned from the experience. It is usually limited to format requirements for reporting and customer service expectations.
Coming from the outside, you obviously have or are trying to misconstrue the topics posted here.
I wish you well in your continuing endeavors, but after reading from your website, it is clear that you have an agenda and might be biased against the people here. I have never been pressured, directed, told to do anything by an insurance company that was illegal or unethical. I personally do not wish to subject myself to you or your legal team..
What you will find here is a caring group of individuals that do everything they can to help the policyholders they service within the guidelines set forth by their client.
(Edit: I see that you have a mold claim in litigation after reading your posts from last year. So I apologize as it seems you are in a tight spot, and have been professional in your quest to gain information and insight. I think, however, your questions should be presented by your legal team to USAA directly. How is your lawsuit going?)
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Edited by - R.V. Winkle on 02/26/2004 18:31:48
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Admin
547 Posts |
Posted - 02/27/2004 : 07:30:01
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Forum Transfer Posted by: driftwoodjack on 02/26/2004
quote:
(Edit: I see that you have a mold claim in litigation after reading your posts from last year. So I apologize as it seems you are in a tight spot, and have been professional in your quest to gain information and insight. I think, however, your questions should be presented by your legal team to USAA directly. How is your lawsuit going?)
I have to be careful here. In my opinion the lawsuit is going well for our side. Again, and this is just my opinion, unfortunately for the adjuster, he took a path that has significantly questioned his credibility. He said one thing in the first half of his deposition. In the second half we produced a company training manual with straight forward guidelines that he had said earlier didn't exist and that he did not follow.
One of these guidelines was to have a thorough understanding of the NYC Guidelines from Level I thru Level 5. I was just curious if this was something adjusters handling mold claims use as a basis for their investigation of mold claims.
I apologize for posting my question and certainly meant no discomfort to any member.
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goose
57 Posts |
Posted - 02/27/2004 : 09:08:52
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Mold was not even a covered peril. And it shouldn't have been. See the link below. It is common of many studies I read while working mold. These type of reports are now common in the media, but unfortunately, were not when the hype started. Even though mold kept me employed for awhile, I regret working it. Unlike a storm where you feel empathy for the insured and want to help in every way possible, I kept thinking that most of the claims I was working were for people I would never want over to my home for dinner. The lawsuits that are popping up support that belief. http://www.tcais.org/insurance/mold_study.php
And your adjuster was doing what he was told to do. There has been a lot of "criticism" on this board because adjusters are not given enough independence in determining coverage. When working mold, I definitely wanted all decisions documented as coming from the company, for the reasons that are now obvious. Many of the people that file mold claims are hysterical hypochondriacs and thus are more susceptible to being manipulated by trial lawyers and mold remediation companies. |
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StormTrooper030
USA
1 Posts |
Posted - 02/28/2004 : 10:06:40
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| I recently visited the ussa-mold web site which is monitored by a homeowner, driftwood. It seems to me that he is saying in a lot of his posts in his forums that the adjuster cannot be trusted in handling a mold claim properly, and that we are only there for the Insurance Company, and not for the homeowner. Mold is in our air that we breathe everyday since the start of time. I personnaly handled several hundred mold claims back in 2002 and treated every one of the insureds as they needed to be treated. What this homeowner does not understand, is that we are there for the Insurance Company as well as the homeowner as an independant contractor to handle each claim within the guidelines set foruth in the policy which is a legal and binding contract between the Insured and the Insurance Company. We, the independant adjusters, were not there when the homeowner bought the policies, so the blame should not be on the indepedant adjuster who is just trying to do his/her job to the set guildlines of the policy in which the homeowner purchased from the Insurance Company. I guess the homeowners need to start reading their policies more thouroughly as I do with my own Insuance Policies that I purchase to cover my personal belongings. I'm just so tired of the homeowner trying to blame the indepedant adjuster for all their problems. It's time for the homeowner to realize that they are the ones who purchased the policy and they are the ones responsible for reading the policy to its full context before making any such purchase. And finally, one of the main reasons that the cost of remediation is and was so high was due strictly to the remediation contractors charging such high and ridiculous prices for remediation. In one such claim that I received, I was the third and probably not the last adjuster on a certain un-named party. There had been 3 different remediation pojects which were completed prior to my handling of the file. It was the homeowner who chose the remediation company the first two times and both failed the cleance testing. The Insurance Company picked up the bill for both remediation projects as well as the third which the Insurance Company had a say in the remediation contractor company, because they wanted the job done right. I know that the Insured was trying to get his house paid off just by certain things that were discussed when I completed my first interview, ie, "can we try and get this remediation bill up to $75,000.00 so I can just bull dose the house and then rebuild". WOW. And this was such documented in my diary for all to see what discussions were held during the whole process. There were a few more instances of this happing to some "pre-owned files" in which I handled, but for the most part many of my claims were justifiable under the set policies back then. So, to put things in perspective, watch the remediation companies day in and day out on the projects if possible, make sure the homeowner understands the total process of the claim being handled from the Insurance Company all the way to the remediation contracting company and to the claims closure, and always, ALWAYS, CYOA in documentation in your diary about all discussions through the claim handling process. Doing this and this alone will keep you out of litigation problems from the future. |
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Jportillo
USA
17 Posts |
Posted - 02/29/2004 : 17:16:27
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Storm Trooper I could not agree with you more. The Mold issue has been fueled by greedy homeowners, Attorneys, and contractors that saw an opportunity to make quick money and took it. I would say 50 to 60% of claims that were filed were bogus.
They were simply people who wanted their house remodeled. I can't count the times homeowners would ask me to lie and pad the estimate for them. It made me sick.
I reported about 30 homeowners to the Insurance company and explained what the homeowners had asked me to do. their response was we don't care we want to pay the insured and get their claim closed.
I called the Texas Depatment of Insurance they simply told me the insurance company would have to file a complaint first then they would proceed from there.
It is ridiculous what has went on because there was no attempt to implement any type of regulations. To much money floating around state capitols for anyone to give a hoot. I blame the Insurance company for not utilizing their resources and throw people in jail for committing this fraud.
There are many ways to do a Mold job without packing people out of their house. I have done many. With the right containment and process you can do just about anything no need to try and get that content money.
Some people are just greedy. My insurance cost is outrages and it is all because of other peoples greed. My business insurance has gone up 50% just because we are a restoration company.
I guess the Insurance companies are trying to force the many of the small guys out of business who can't afford $22,000 premium for one year of General Liability coverage.
Does anyone know of a good broker that can beat those rates.
Well take care everyone and GOD Bless. |
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JimF
USA
1014 Posts |
Posted - 02/29/2004 : 18:13:29
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| Do you remember a while back when some of the adjusters were posting on here that "mold is gold"? Wonder what they have to say about it now? I am not aware of any adjusters who got rich and retired handling mold is gold claims. |
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Redeye
2 Posts |
Posted - 03/02/2004 : 16:39:14
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I think all adjusters handeling mold claims should be well versed in NYC guidelines as well as EPA guidelines on remediation of mold. Did the mold thing get blown way out of perportion? yes it did. I am not only an adjuster but also in the environmental field. I have been in the environmental field since the 80's, so I didn't just jump into it when mold came along. I have handled over 6000 mold investigations in 2002 for insurance companies, homeowners, and attornies( although I handled more for the insurance companies because homeowners and attornies didn't realy like the fact that I wouldn't bulldoze the entire place). I think it was around 5000 for 2003.
If you have mold then it does need to be removed. Generally mold is caused by a water loss that is a covered peril. Sometimes it is lack of maintenance or poor house keeping that causes mold as well. If it is a covered peril, then most of the time, the homeowner has allowed it to sit and grow.
You really can't say that all remediation contractors are greedy and have outrageous prices. You can say that alot of them are not trained to handle mold remediation jobs. I have ran into alot of remediation contractors that do not even know the NYC and EPA guidlines. If all you were doing was going in and tearing out structural items then yes they were greedy, but they had to carry the insurance incase homeowners sued them, had to buy all the special personal protection items, and had to use dehumidifiers and negative air machines. All of these items cost big bucks. It was the number one reason I don't do remediation, right there with conflict of interest. The ones that amazed me were the contractors that went in and said "well we have to clean all the items in the house" boom $60,000 dollar bill on personal property alone. If the adjuster knows the EPA guidelines on how personal property is handeled then they would be able to shoot this down. You can find the personal property tables on the EPA website. As far as packing out all the contents of the house, The only reason there would be a need to pack out the entire house is if there weren't enough space to place all the contents within uneffected areas of the home.
Yes we have lived with mold since the beginning of time. Mold is all around us. As long as it remains at a natural level it shouldn't cause a problem. There are extreme levels of mold spore concentrations found within indoor envronments. If you have live plants in your home, these can produce high concentrations of mold spores. Homes these days are set up for growing mold. The construction is tight, and homeowners don't know how to maintain their homes. Things like pooring bleach down the A/C condensation drain line once every six months or have the entire HVAC system cleaned once a year. You would be suprised how many problems I saw because of dirty air filters. Do these things, repair water damages and keep your indoor humidity down and you shouldn't have a problem. Every once in awhile do what people use to do and open up your windows to allow air to flow through your home.
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KileAnderson
USA
875 Posts |
Posted - 03/02/2004 : 16:49:04
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You handled 16.44 mold investigations a day for an entire year and never took a day off. You must be one tired hombre by now.
Why would anyone who isn't from New York City or plan to work there need to know what their guidelines. I know that people from New York think they are the whole world, but there are alot more of us than there are of them. |
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Johnd
USA
110 Posts |
Posted - 03/02/2004 : 17:56:44
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16.44 a day,......... yeah, and I am averaging closing 65 files a day, ....... don't sound like much if you talk fast. PLEASE, now can we all get back to reality!
OK, Ghost, what setting would you use on this one?
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John Durham
sui cuique fingunt fortunam |
Edited by - Johnd on 03/02/2004 17:58:17 |
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gloverb
USA
54 Posts |
Posted - 03/02/2004 : 18:08:07
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JohnJay,
My primary profession is as an adjuster; however, I also own a restoration company In Texas, & boy can I relate to what you are saying! I had a $2M umbrella last year. I dropped that & reduced my GL limits. What has happened is that all of the HO policies in Texas have changed. The old HO-B's basically no longer exist. Policies no longer cover non-weather related water claims, for the most part. This means mold is no longer covered.
Insurance companies have realiized that the lawyers are going to find somebody to sue for mold. Guess what? The restoration contractor is the next one in line.
I worked as a loss control consultant/safety engineer for various insurance companies during the late 70's & 80's. At that time GL & umbrella premiums were cheap. At that time premiums were basically based on experience rating meaning that if you had few or no liability claims over the previous 3 yrs, your premiums stayed low. Mid to late 80's this all changed. The insurance companies shifted their emphasis from an experience rating to a "potential for loss" type rating.
I read an article about that time (late 80's) regarding GL for the Boy Scouts of America. Based on an experience rating they paid about $1M per yr in GL premiums. Some underwriter is sitting there thinking "Oh my gosh!" The Boy Scouts have 100,000 boys swimming up a river somewhere tring to get their swimming merit badge. The very next year, because the emphasis shifted to a "potential for loss" rating system, their GL premium went to $8M dollars.
You think you have problems now! Just wait for the lawsuits to start. Thank you, but my emphasis has also shifted. |
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gloverb
USA
54 Posts |
Posted - 03/02/2004 : 18:18:37
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Does anybody know the status of the mold claim (Farmers) in Dripping Springs, TX that more-or-less got the whole mold thing started? What I have read is that it started as a $98M suit. Court awarded $32M ($4M for house & contents & $28M punitive damages). On appeal was reduced to about $13M. Appealed again & is now down to $4M house & contents with no punitive.
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khromas
USA
103 Posts |
Posted - 03/02/2004 : 21:17:26
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Latest appeal was the $4M. As of now, that is where it stands.
Interesting sidebar, I met with an attorney today on a case and in the course of our discussions, he told me that a Houston Federal magistrate had recently ruled (1) MOLD is not covered and NEVER WAS COVERED under the HO policy (apparently regardless of what policy form) and (2) POLICY LIMITS meant just that during the POLICY TERM and would only be paid once. (You would NOT get the policy limits for each claim set up.) The practice under the old HOB was to set up seperate claims for every little area of MOLD so that you could get enough dollars to cover the exorbitant remediation invoices that were pouring in.
I did not get the case he was referring to and don't have the time to go do the legal research for it, but has anyone else heard anything on this? |
Kevin Hromas |
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Ghostbuster
476 Posts |
Posted - 03/02/2004 : 21:43:48
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Iz this here one of them thar activist judges Kiles Federali El Presidente is yammering about what with the marrige amendment an all? Sounds like in this instance, the good judge is coming down on the side of all them thar Republican Country Club corporated inshonce cumpnees. (How's that for mangled syntax and grammer?)
Johnd, it ain't worth firing up Ol' Dragons Breath for this. Looks to me, he's hanging himself by his own petard. |
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Johnd
USA
110 Posts |
Posted - 03/02/2004 : 21:59:13
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| Awe common Ghost, not even Bic Lighter Setting? |
John Durham
sui cuique fingunt fortunam |
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KileAnderson
USA
875 Posts |
Posted - 03/02/2004 : 23:13:31
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| Ghost, it isn't judicial activism if a judge reads a legal document and says it means exactly what it says. Judicial activism is when a judge tries to devine the "intent and spirit of the law". That's when things that don't exist such as the constitutional seperation of church and state and a right to privacy are created. |
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