Important Lessons from Adjusting Hurricane Claims

Butler Weihmuller Katz Craig LLP
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The number of claims arising from a significant wind event such as Hurricane Irma can create intense time pressure on insurers and their adjusters.  The insurer must promptly acknowledge each claim and make prompt inspection.  Given the anticipated number of claims, the adjusters need to make that inspection as thorough as possible.  Our experience has taught us that the following steps increase the effectiveness of the inspection and make it more likely that the insurer’s decision on the claim will be fully informed.  This is not an exhaustive list.  Each loss and claim is unique and must be evaluated on its own facts and merits. 

The initial inspection.

  • The initial inspection should be done as quickly as possible.  If subsequent inspections, including those by experts, are called for, consult closely with the insured to make sure he or she knows when and why they are needed.   
  • Take high-resolution photographs of the entire property as well as adjacent landscaping and property to document consistency with the claim.   (save all photos, whether they make it into your photo sheets or not, and back them up).  
  • Request a recorded statement if time permits and it seems appropriate in a particular claim.   
  • Ensure the electronic file contains all communications to and from the insured or his or her agents (the insured).
  • Make sure any requests to the insured for information or documentation are specific and clear.

Following the Initial Contact

  • Send the insured a prompt and clear response to any statement or inquiry from the insured.
  • When the insured asks for information or documentation respond promptly with the information or with the date or time you expect to have it to them. 
  • When communication with the insured is made by phone or in person, send a quick letter or email to the insured confirming what was said.
  • Provide the insured a clear, written explanation for payments, and the coverage under which each payment is made, partial denials, and denials of coverage.
  • Communicate with the insured as quickly as possible once a decision has been made on the claim.
  • Policies can be different.  Review the policy issued to each insured before quoting policy language in any letter or email to an insured.
  • Any denial letter should advise the insured of the information that was relied upon to make the decision and solicit any additional information the insured might have that could bear on the claim.  
  • When the failure of the insured to provide requested information or documentation has prevented the carrier from confirming coverage, the denial letter should make that clear and note any violation of the insured’s duties after loss.
  • Payments should reflect all payees.   Depending on the coverage, this can include all named insureds, assignees such as vendors and public adjusters attorneys and mortgagees.
  • When providing a coverage decision, convey the information that was relied upon in making the decision, i.e. inspection, expert report (expert identified by name), documentation provided by the insured, the policy provisions, etc. and request that your insured provide any additional information or documentation they believe should be considered, or may have a bearing on the claim.

Important Factors to Remember

  • Back up your files.  If you’re working in the field on a laptop or tablet, back it up every day so your efforts are not lost.
  • Save all correspondence with the insured, no matter the source.  (telephone, e-mail, fax, wearable smart devices, fax, U.S. Mail).
  • Make sure the time line of your file (i.e. the physical documents in the file) matches your notes.
  • Document weather conditions (rain, wind, storm surge) at the property on the asserted date of loss.

Given Hurricane Irma’s projected path, insurers will likely receive a host of claims in many jurisdictions.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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