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Last Post 11/19/2007 4:31 PM by  Ray Hall
O&P Question
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Author Messages
rbryanhines
Member
Member
Posts:119


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11/15/2007 8:40 PM

"The suit I hear claims that the insured is entitled to the overhead and profit regardless if they use a general contractor or supervise repairs themselves." If I remember right this is the position some courts have alreay upheld. I think their position was that the cost of a GC's o&p went into the calculations used to arrive at a premium rate therefoer the insured was entitled no matter if they used a GC or not.

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rbryanhines
Member
Member
Posts:119


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11/16/2007 8:30 PM
This is a bulletin from Texas Dept of Insurance http://www.tdi.state.tx.us/bulletin...045-8.html
Summary of Bulletin:

The Department has concluded that an insurer providing property coverage under replacement cost residential policies that allow for the adjustment of covered losses to structures on an actual cash value basis may not calculate actual cash value on the basis of replacement cost with proper deduction for depreciation, less contractor´s overhead and profit, nor may the insurer deduct sales tax on building materials. Any insurer that determines actual cash value on this basis may be subject to disciplinary action for violations of the Texas Insurance Code, including unfair claims practices pursuant to Article 21.21 § 4(10)(a) and Article 21.21-2.

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okclarryd
Veteran Member
Veteran Member
Posts:954


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11/19/2007 8:33 AM


Texas is, in many ways, like a foreign country as far as insurance is concerned. And, Florida is their neighbor.

The bean-counters have taken away the 10&10 up front as they feel that the insured has not incurred this cost and may not. If there is $100 worth of OH&P paid on each claim and there's 100,000 claims paid during any given period, the OH&P that may not be incurred is a very large amount of money.

All companies will pay the contractor's overhead and profit when presented with documentation that a general contractor was utilized on the repairs. At least, all the companies I have worked for will. But they all feel that they don't owe the OH&P until it is incurred.

Once again, it comes down to communication with the insured (and his contractor). If they understand the procedures and how easy it is to collect the OH&P, they are usually good with it. And, the adjuster has to be timely with his forwarding the documentation to the carrier.

This discussion is kinda like shingle quality. There's so many opinions that there will never be a consensus.

That's why we are "adjusters".
Larry D Hardin
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jlombardo
Member
Member
Posts:145


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11/19/2007 9:00 AM
Bryan & Larry,
Here in Florida we pay the RCV up front if the risk is ITV and hold back OH&P until we get proof of completion and repairs are done by a GC..... or we get a copy of a contract with a GC.

Joe
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Ray Hall
Senior Member
Senior Member
Posts:2443


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11/19/2007 4:31 PM

Larry hit a nail on the head. This is a hypo discussion that could be started by just one claim examiner and one contractor out of all the thousands of both. Losses have to be adjusted (settled) and thats our duty. When you get a difficult loss work through all the road blocks to get to your destination. A fair settlement that both can live with usally has some give and take.The adjuster's who can work these type files work a long long time.

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