Have you ever read an advertisement from an insurance company that says it will potentially process their own customer's insurance claim with an insurance protocol or technical claims directive like the one I published yesterday, Marring Protocol and Other Unfair Methods to Pay Too Much for policyholders in Florida ? Obviously not. Most insurance companies promise fast, quick, easy and fast payments with the best damages services in the industry.
So, let's use the example of the company that made the "marring protocol" claims directive to see what it promises for claims service compared to when the rubber meets the road at the adjustment point. If you read St. The John Insurance Company website states:
Choose a homeowner's policy that gives you peace of mind.
Choosing a company to protect such a large asset is an important decision. Here are some important factors to keep in mind.
Is the insurer financially stable? Check out their Financial Stability Rating® from Demotech, Inc. Johns Insurance Company has been awarded the Financial Stability Rating® on A, Exceptional, by Demotech, Inc.
Does the insurance company focus on homeowners' insurance, or is it just a sideline? St. Johns offers exclusive homeowners insurance coverage.
A homeowner buys insurance if they ever have damages. So, a good reputation for fair claims rules and superior customer service is as important as competitive pricing. The State Insurance Department can be an excellent source of information about companies that are under investigation for unfair practice or claims for dispute resolution.
Another part of the website says:
St. Johns Insurance is determined to provide customers with the best compensation service, and we have done a great deal to do so.
Claims representatives and adjusters have a fee: do everything to pay covered claims quickly and fairly. Therefore, it is in St. Johns mandatory to contact our customers the same day.
Why should insurance authorities not require insurance companies to provide indemnity bulletins and guidelines for claims for damages on how damages are handled at the point of sale and during the claims process? If the insurer is acting in good faith, why would it be afraid to turn around and publish these directives? This can lead to much better and fairer treatment that is promised in the first place.
Instead, the same insurance company with "marring protocol" also has claims directives that the management approves that affect thousands of property insurance claims. One such directive states:
Meeting to recalibrate on roof repair and replacement issues
See the following notes from our discussion on roofing. Please calibrate with your employees on these expectations.
• In general, we consider slope change as a dwelling for our customer when the damage meets / exceeds 30% of the slope area
• Wear is exempt from the policy. Any claim for replacement of a slope / roof due to repairability in connection with worn / brittle shingles would therefore be excluded.
• Examination of any ceiling claims for damages that exceed the direct / physical loss means that one questions WHY behind this request;
o Matching ̵1; Does the customer require matching as a reason for roof replacement? In that case, the state has matching rules. If so, this would be considered within regulations and legal limits and repairs would have to be completed and paid for.
o Ordinance and law – Considers the customer that they can not get permission to replace the roof (ie 25% rule in FL). In that case, the customer would need to provide a copy of the repair permit and a copy of the permit refusal stating the reason why the permit was rejected. If it is rejected due to regulations requiring replacement, the O&L limit would apply and the repair would have to be completed and the cost incurred.
o Wear – Is the customer claiming that the roof can not be repaired due to surrounding materials (brittle, worn, etc.). Surrounding shingles if they were not damaged by direct / physical loss would not be covered. This allegation would be examined for denial if appropriate.
o Obsolete / interrupted – Makes the customer the roof can not be repaired because the material is obsolete or interrupted (t-lock, atlas, tile, etc.). Slope / height yield can be considered for this reason, although the harvest can be considered as an alternative if appropriate. (ie replacing a small slope / height and using undamaged existing tiles to repair tiles in other slopes / heights)
• Roof requirements can often require additional investigation steps; weather reports, google earth, Zillow or other image measurement, home inspection reports, review of policy history, etc.
I can foresee roofers and property damage sealers who criticize a lot of this directive as faulty for several reasons. Most policyholders would wonder where the directives are that require the investigation and payment to be made within a certain number of days of the loss notification.
My point is that none of this should be kept from the policyholders. Internal guidelines show how the insurance company thinks that peace of mind is created during the claims process. it should be published and easily provided for all to see.
Citizens Property Insurance Company used to publish its claims. The National Floods Program published its guidelines for claims. Why do not all insurance companies do this if they have nothing to hide about how they handle their property insurance claims?
It's easy to make promises. But even the most reliable person knows to look under the hood to see if the promised engine is really there. The insurance claims industry does not want us to look at what it really does when it is time for damages, and the latest examples I have published explain why.
Thought For The Day
I believe that the currency of leadership is openness. You have to be truthful. I do not think you should be vulnerable every day, but there are times when you need to share your soul and conscience with people and show them who you are and not be afraid of it.
—Howard Schultz