Thursday, July 3, 2014

Home Emergency Preparedness Kit

As I am typing this, Hurricane Arthur is making an impact on the eastern shore. Are you prepared? Are you evacuating? So you don't live on the east coast and aren't affected by Arthur, are you ready for the next one? Are you prepared to evacuate quickly if the need arises? 

It doesn’t matter where you live, you are susceptible to an earthquake, hurricane, snow storm, power outage, flood, etc. and any of these things could leave you and your family stranded at home for a few days without power or electricity or being forced to leave your home quickly during an evacuate order.

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Before talking about the emergency kit needed for the home, let's discuss the emergency kit everyone should have in their car at all times.  An emergency could happen while you are driving, so it is always a good idea to have a few essentials stored in a tub in your trunk that includes: a blanket, an extra pair of sneakers and socks (just in case you ladies are wearing heels or sandals and need to vacate your car and walk), a flashlight, a power flare, non-perishable snacks (nuts & granola bars maybe) and water.


If you are a pet owner, you should also have one emergency kit prepared for each of your animals containing items such as: a towel, food, water, and extra food dish, a leash, a toy, and medicine.  Keep the kit(s) stored next to your emergency home kit, so if you have to evacuate quickly you won't forget about your pets necessities too.


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For a personal home kit, it is recommended you have supplies stored in air-tight tubs or on shelves in your garage or basement. 


{Photo Credit}


Here are the items that should be in your kit, this list comes directly from FEMA

  • Three-day supply of non-perishable food.
  • Three-day supply of water – one gallon of water per person, per day.
  • Portable, battery-powered radio or television and extra batteries.
  • Flashlight and extra batteries.
  • First aid kit and manual.
  • Sanitation and hygiene items (moist towelettes and toilet paper).
  • Matches and waterproof container
  • Whistle
  • Extra clothing
  • Kitchen accessories and cooking utensils, including a can opener.
  • Photocopies of credit and identification cards.
  • Cash and coins.
  • Special needs items, such as prescription medications, eye glasses, contact lens solutions, and hearing aid batteries.
  • Items for infants, such as formula, diapers, bottles, and pacifiers.
  • Other items to meet your unique family needs.

Depending on your climate, this items might come in handy as well:

  • Jacket or coat.
  • Long pants & long sleeve shirts
  • Sturdy shoes.
  • Hat, mittens, and scarf.
  • Sleeping bag or warm blanket (per person)
  • Mosquito Spray
  • Sunscreen

As important as it is to have an emergency kit, don’t forget to do these things to maintain your kit:

  • Keep canned foods in a cool/dry place.
  • Store boxed food in tightly closed plastic or metal containers to protect from pests and to extend its shelf life.
  • Discard any canned good that becomes swollen, dented, or corroded.
  • Rotate your supplies to always keep the freshest things in the kit.
  • Change stored food and water supplies every six months. Be sure to write the date you store it on all containers.
  • Re-think your needs every year and update your kit as your family needs change.
  • Keep items in airtight plastic bags and put your entire disaster supplies kit in one or two easy-to-carry containers, such as an unused trashcan, camping backpack, or duffel bag.

Maybe you would like to build your family an Emergency Bucket Kit. I personally think this is a brilliant idea!

{Photo Credit}

Whatever you choose to do, don't wait until the last minute to begin preparation. We are already one month into hurricane season. Make sure you are ready to keep your family safe, no matter what sort of natural disaster you are being faced with. 






Contributed by:

Wednesday, July 2, 2014

PLRB - Tender Benders: A Practical Approach to Additional Insureds and Contractual Indemnity Webinar




Tender Benders: A Practical Approach to Additional Insureds and Contractual Indemnity
Join us for a Webinar on July 10, 2014


Space is limited.

Join us for the final installment of our webinar series "Hot Topics from the Claims Conference." We know some of you could not make it to the PLRB Claims Conference this year, so we are bringing you modified versions of some of the best presentations. While there is no CE credit for these webinars, this is a great opportunity to see what you might have missed at the Conference. 


When today's mail brings a request or demand for additional insured and/or trade contract indemnity protection, both novice and seasoned claims professionals have to act both quickly and wisely. If the tender comes from a party claiming to be owed additional insured status under an insurance policy and contractual indemnity under a trade contract, how should those requests be properly and accurately evaluated? Similarly, how do you determine when your insured may be entitled to the protection by a trade partner or another insurer, and what tools should be harnessed to best protect your insured and your company? PLRB is pleased to offer this webinar led by Dan Kohane, a senior member at Hurwitz and Fine, P.C., in Buffalo, NY, as he provides you with a practical approach to unraveling the tender conundrum. 

Learning Objectives

Dan plans to help you:

- Analyze and understand the differences between tenders based upon additional insured provisions found in liability policies and requests for defense and indemnity under hold harmless agreements in trade contracts; 
- Develop a method and approach to identify when to tender and to whom, when to accept a tender and when to refuse; 
- Understand the rights that are associated with additional insured status as compared to contractual indemnity provisions; 
- Respond properly when on the receiving end of a tender and know instinctively when you should be seeking the protection of others.

** Registration is limited to 1000 participants **

Title: Tender Benders: A Practical Approach to Additional Insureds and Contractual Indemnity
Date:  Thursday, July 10, 2014
Time:  11:00 AM - 12:15 PM CST
          (12:00 - 1:15 PM EST / 10:00 - 11:15 AM MST / 9:00 - 10:15 AM PST)
Cost:  Free for PLRB & LIRB Members and PLRB Affiliate Members 

Please register using your Provencher & Company email address. After registering you will receive a confirmation email containing information about joining the Webinar. Please note there are no adjuster CE credits earned with this webinar series.

Reserve your Webinar seat now at: https://www3.gotomeeting.com/register/192307614

System Requirements
PC-based attendees
Required: Windows® 7, Vista, XP or 2003 Server 

Macintosh®-based attendees
Required: Mac OS® X 10.5 or newer

Mobile attendees
Required: iPhone/iPad/Android smartphone or Android tablet



Tuesday, July 1, 2014

Raiders of the Lost Profits Introduction: Introduction to Inspection for BI



Introduction to Inspection for BI
Don’t get caught in front of the rolling stone!


Arriving, on time, at the destination marked with an ‘X’ on the map included in the courier packet for the ‘very special assignment’, Our Hero (that’s you), fedora suavely tilted and measuring tape ready to be un-holstered, surveys the devastation in the marketplace.  

You (Our Hero) hand the head honcho your card (with aplomb, of course), then proceed to inspect the site.

Camera clicks fill the air, making a historical record of the front and the back of the risk.  You grab your trusty ladder and climb onto the roof, camera again clicking away.  Following the head honcho around you (for the last time - Our Hero) take the rubber band off an overstuffed and well-worn notebook, whip out your trusty pencil and start jotting down notes and measurements (okay, so you type it into your phone – go with me on this).  You dig up answers to questions about age of equipment, replacement opportunities, and ordering time for new trinkets and treasures to fill restock the marketplace.  

You, of course, make no commitment for coverage.

All your digging done, with tape measure re-holstered and notebook safely tucked in your belt, you prepare to depart.  But wait!  Something is amiss. This is a commercial loss.  There was nothing in the assignment packet that indicated any loss of commerce.  But what if there is no coverage?

******
DOESN’T MATTER!  Our heroes (that’s YOU’all), should always inspect commercial risks with consideration for BUSINESS INCOME LOSS, whether the risk is covered or not, or whether the insured has made a claim for loss of income or not.

In this series, we will explore some of the simple steps to assuring the successful inspection of commercial risks that will be an invaluable service to Provencher clients and your Provencher Business Interruption Unit.

Our Business Interruption Unit (BIU) will handle all the heavy lifting after your initial inspection, such as:

•BI/LOI interview with insured to assist in document request and adjustment
•Provide insured with educational material about their coverage and instructional material about the process
•Maintain the physical and electronic files
•Maintain consistent contact with the insured and the client
•Request, collect, identify, process and qualify financial documentation from the insured, including qualification of Extra Expense
•Perform the financial analysis
•Adjust and determine the loss
•Report to the client
•Review analyses and determination with the insured, providing basis and instruction on interpretation of schedules
•Negotiate settlement.
•Provide support for appraisal and litigation

But, there are a few items that only our stalwart and heroic adjusters can determine and are responsible for:
•You must assess and document the ‘Covered’ Cause(s) of Loss
•You must establish the Period of Restoration (POR) and provide the basis by elements.  
•You must differentiate between POR and POS (Period of Suspension)  
•You are the first line of defense in the Control of Extra Expense

Attachments:
(you must click to advance after the first slide)


Raiders of the Lost Profit Series:
Introduction: Introduction to Inspection for BI
Part One: The Secrets of Daily Loss Inspection
Part Two: Adventures in CAT Inspections
Part Three: Search for the Grail:Covered Cause of Loss vs. Actual Cause of Loss
Part Four: Pit of Snakes:  Establishing Period of Restoration
Part Five: Reporting to HQ:  Here’s What We Know So Far


Written & Contributed by:




Monday, June 30, 2014

“Hire us and we’ll pay your insurance deductible!”

“Hire us and we’ll pay your insurance deductible!”


Ever seen an advertisement like this as an incentive to hire Contractor A versus Contractor B?  I bet many commercial property adjusters have heard about this incentive and have been asked whether this is legal.

Well, in many states it is legal for contractors to solicit commercial business by making the same or similar offer.  However, Missouri Legislators have taken a step forward to stop this type of advertising and to provide commercial consumers with the upper hand as the article below demonstrates:


Friday, June 27, 2014

Emerging Issues: Marijuana, Fires & Explosions

There is obviously a trend today to legalize the use of marijuana for medical treatments and to assist those undergoing chemotherapy treatments for cancer. These are positive steps for those involved. 


However, in Colorado and Washington, not only has the medical use been decriminalized by these states, but its general use has also been legalized. 

As a result of the legalization of marijuana for general use, users and purveyors are seeking stronger alternatives to smoking or ingesting the flowers, leaves and stems of the plant. One such alternative is the production of “hash oil” or “honey oil”. This alternative has raised great concern because it is produced by pouring butane through the marijuana. Yes, butane. As a result, there are new variety of coverage questions emerging that the article Marijuana, Fires & Explosions by Thomas Mallin, President & CEO of Property Loss Research Bureau, has summarized for all adjusters.

Thursday, June 26, 2014

Coming Next Week: Raiders of the Lost Profits



GET READY TO ENJOY



In this series, we will explore some of the simple steps to assuring the successful inspection of commercial risks that will be an invaluable service to Provencher clients and your Provencher Business Interruption Unit.

BEGINS TUESDAY
JULY 1, 2014

*********

Introduction: Introduction to Inspection for BI
Part One: The Secrets of Daily Loss Inspection
Part Two: Adventures in CAT Inspections
Part Three: Search for the Grail:Covered Cause of Loss vs. Actual Cause of Loss
Part Four: Pit of Snakes:  Establishing Period of Restoration
Part Five: Reporting to HQ:  Here’s What We Know So Far

*********


Report Writing the Provencher Way: Part 4 - Report Captions Continued

In our ongoing effort to maintain and continuously improve our business, we have taken the time to document proper report writing specifics to Provencher & Company.  The intent of this post is to describe a standardized content look for a Provencher & Company captioned report.  Below, you will see that we have defined the purpose/meaning of each caption and provided an example of the report writing style and expected technical writing level of the content.

As this is such an important topic; one that requires great attention and detail, the Report Captions section of this series has been divided into three parts.

Report Captions Continued:


Adjustment:
In this caption, you need to state in a clear concise manner, the facts associated with the loss adjustment. While this caption needs to contain the story of the loss, do not, under any circumstances, write in such a fashion that it appears to be folksy, conversational, repetitive, or opinionated.  Additionally, do not, under any circumstances, attempt to restate anything prepared by an expert you or the client has employed.  Refer the client to the expert’s report, along with a comment regarding the summary finding.

Example of Adjustment Caption Verbiage:
We are enclosing sample photographs of the damage.  We are also attaching our estimate on the remaining repairs.  Our estimate will detail the scope of damage found during our inspection.  Sixteen offices, two baths, a kitchen and a long hallway were damaged by water.

Our damage estimate totals $25,188.14 and is based on normal and reasonable unit prices for this area.  We believe that the cost for repairs and painting will probably not exceed this amount.  Our contact, Mr. McClay, advised that he has an estimate in process for the repairs but has not as yet forwarded it to us.  You should note that our estimate is conservative for painting all surfaces and does not include any allowances for moving and/or protecting furnishings.  We believe that the insured will get the painting done on only the effected walls and may not expend the entire amount in our estimate.

We Clean Systems, Inc. was used for water extraction and drying.  We have a copy of the work authorization but no estimate or invoice has been received to date.  We have requested the information from your insured and hope to get it shortly.

Kittleburger Plumbing made repairs to the plumbing and we have their invoice for the repairs.  The cost for the repairs was $102.50. Lock Technology was contacted to replace a broken lock cylinder on the front door and rekey another cylinder to match the one on the front door that was broken to gain emergency entry in off hours.   The cost was $417.19.

Barclay Electric was used to replace a phone jack and blocked off some floor boxes to prevent additional damage.  No invoice has been provided.

Business Interruption:
At Provencher & Company, we have a separate Business Interruption division, which includes a Forensic Accounting expert that is responsible for managing and reporting on all losses with a BI exposure.  That office will work in concert with you, the field adjuster.   While the BI staff will conduct a comprehensive interview with the insured and request all financial documentation, we need you in the field to determine the Covered Cause(s) of Loss, establish the Period of Restoration (POR), and initial control of Extra Expense (EE).  If there is no suspension of the insured’s business, that should be documented in your report and why.  That can be accomplished all in one caption entitled Business Interruption.

Example of Business Interruption Caption Verbiage (no loss of income claimed): 
While the insured risk did sustain wind damage to the roof, allowing water to enter into the premises damaging walls and floors, the insured is not filing claim for loss of income. They were able to open immediately and resumed operations working around the affected areas.

If you are assigned a claim that has a BI exposure, please insert the following captions into your report template:

(Refer to the Business Interruption – Interface with the Property Adjuster document for details on workflow)

Cause of loss – Business Income:
For all commercial losses that have BI coverage and either a partial or complete suspension of their business operation has occurred, you must identify and document what cause(s) actuates the coverage.   Be brief, clear and factual. Note that most policies require direct physical damage to the insured’s business space, even if not covered property, caused by a Covered Cause of Loss. Even if only the BPP is covered property under the policy, the physical damage to the building will guide both the actuation of the coverage and the period of restoration as long as it was from a covered cause.  Note that even if BI/EE coverage may not be apparent, a claim by the insured may be submitted.  Therefore, we prefer to be proactive in identifying if a covered cause of loss exists should coverage be found.

Examples of Cause of Loss for BI Caption Verbiage:
The roof of the building, occupied by the insured business, was severely damaged by wind.  As a result, the insured’s business suffered extensive water damage to the interior of their space resulting in a complete suspension of their business operations.

Another Example
While the insured did sustain direct physical damage to their space from wind damage to the roof, the physical damage to the insured’s space is not sufficient to shut down operations.   The reason the insured could not operate was due to off-premises power outage which is not covered by this policy.

Another Example
The insured’s operations were suspended due to wind driven rain, a non-covered cause of loss, which entered the building through an open window.

Period of Restoration – Business Income:
The ‘period of restoration’ is the reasonable length of time necessary to restore full business operations due to the covered cause of loss that actuates the BI coverage.  This is very important as you may have an area damaged by a covered cause of loss and other areas damaged by non- covered causes of loss – this needs to be clearly identified as the POR is only established for covered cause(s) of loss.

If the insured is a tenant in the building, we still need to know the extent of damage to the building and length of time anticipated to affect repairs due to the covered cause of loss.  This is critical as that will be the governing factor in determining in the length of time for which a business income claim will be considered for payment – not just the time required to affect repairs to the insured’s covered property. The POR is not simply established based on the amount of time the insured is out of operation.

Examples of Period of Restoration for BI Caption Verbiage:
The period of restoration for repairs is three months.   However, the insured should be able to utilize the undamaged portion of the building to continue operations, in full or in part, while the repairs are being undertaken.

Another Example
The period of restoration is six months.  Due to the nature of the insured’s business, temporary relocation is not feasible.

Another Example
The period of restoration is six months, but the insured may be able to relocate the operation to temporary facilities.

Another Example
While it is anticipated the insured’s operations will be completely suspended for a total of six months, we are only establishing a period of restoration of three months as this is the anticipated length of time necessary to complete repairs resulting from the covered cause of loss.  The flood damage to the building is a non-covered cause of loss which is the contributing factor to the extended period of time the insured’s operations have been suspended.


Extra Expense – Business Income:
With the exception of the CP 0050 (specific to EE coverage), most policies that include this coverage limit the use of Extra Expenses to the amount by which it reduces the BI loss.  As such, your narrative in this caption must clearly demonstrate the need or prudence for using this coverage.

Example of Extra Expense for BI Caption Verbiage:
The insured will be able to expedite the clean-up process through the use of their employees which will require payroll in excess of normal. 

Another Example
Since the period of restoration is six months, the insured will likely opt to move into temporary quarters in order to preserve their customer base.

Another Example
Because of the refitting necessary to accommodate their equipment, it is not feasible for the insured to move to temporary quarters.  However, the use of expediting expenses for the damaged equipment and replacement of inventory should reduce the period of restoration of six months to a period of suspension of four months.

To Be Done:
In this caption, you need to clearly and concisely tell the client what tasks remain outstanding in order to bring the file to a timely and successful conclusion.  If there are multiple items that still remain to be done, this may be best demonstrated in a bulleted format.

Again, you must demonstrate to the client you are in control of the adjustment and have clear direction on how and what needs to be done to bring the case to a timely and successful close. We point this out because this is often where adjusters make a huge leap of faith which can be fatal.  

You feel that because you know what you’re doing and what needs to be done, the client feels the same way.  Generally speaking, that’s not true or more importantly their boss who may be reading your report may not know you at all.  Do not simply state (as we often see) “Please diary your file ahead 30 days for our next report” as that adds no value and more than likely will force the person reviewing the file to write or call you to find out your action plan or even worse, ask for the case be reassigned to expedite closure.

Example of the To Be Done Captioned List Verbiage:
1.   Obtain all outstanding invoices.
2.   Once all invoices are received, compare against amount allowed.
3.   Secure copy of the engineering report.
4.   Secure agreed price with insured.

Recommendations:
In this caption you will make any necessary recommendations for action on the part of the client. If you are requesting an advance payment, correspondence on their part that needs to be issued, etc. would all go under this caption.

Example of Recommendation Caption Verbiage:
After application of the policy deductible, final payment is recommended in the amount of $1,465.83 as follows (see attached Statement of Loss for details):
           Net claim         (Advanced)      Final Payment
           $41,465.83  $40,000.00      $1,465.83

Due  to  the  small  amount  of  existent  claim  payment  due,  I  would  not recommend including mortgagee or the loss payee on final check.  Loss was adjusted with Operations Manager, Mr. McClay.  Check should be issued in the name of your insured, Stevens & Sons, LLC and sent directly to:

          Stevens & Sons, LLC Mr. John Jasper
          Owner & General Manager
          2010 Blue St. Westlake, OH 44145

If your report is a final report, you want to conclude your recommendations with a professional conclusion.  Remember, this is a report, not a letter. Reports are directed to a file, not addressed like a letter, nor signed like a letter.  The pre-filled captions at the top of the report identify the file to which this report is directed.  Your name and title go at the end of the report attesting to this being your work product.

Example of the File Conclusion Caption Verbiage: Recommendations:
This concludes the adjustment of this loss.  We are closing our file. Thank you for the assignment.

_____________________
(Your Name) 
(Your Title)

(Your Provencher Email)
(Your Cell Phone)



Report Writing Tips
Now that you have the report structure guidelines ala Provencher & Company, we would like to close with a mini flashback to your grade school and middle school grammar and writing classes with a few bad habits we adults have picked up in our business writing.  Please don’t let this happen to you!

Basic Rules of Grammar and Structure

•Maximum length of a paragraph is eight lines.  If it is more than eight lines, break into two paragraphs, or re-read it and eliminate extraneous words.

•A paragraph should focus on one subject. A paragraph that is too long is unreadable.

•A paragraph consisting of only one sentence is usually improper and needs to be edited by expanding the thought, eliminating it or adding it somewhere else in the document.

•Use consistent spacing throughout report. Block alignment provides best overall appearance.  Make sure the selected font size is not too big or small; 11 or 12 point font works best for business writing.

•Try not to use the word “and” more than once in the same sentence.

•If you find you have a lot of commas in one sentence, consider breaking it into more than one sentence.

•Sentences that meander endlessly are impossible to follow.

•Single digit numbers are to be spelled out, “two” instead of “2”, while double digit numbers are to be displayed in numeric form, “37” rather than “thirty seven”.   Write “first” instead of 1st.  If you are beginning a sentence with a number, always spell it as a word.

•Don’t type over old reports because you are too lazy to start a new one.   This is how incorrect information gets transferred!

•Read your report aloud to see how it sounds.

•Use Spell Check and the on-line dictionary! Howe embarrassing 2 git to cart wit misspelled words on yur repert!  Also keep in mind Spell Check cannot pick up on misspelled words if the misspelled word is a real word, i.e., two versus too – proofing your work is critical!









Wednesday, June 25, 2014

Webinar Wednesday: Florida CEU - Claims Resolution


Claims Resolution is designed to provide an in-depth analysis and explanation of one of the most important elements of  property and liability claims adjusting: resolution. As this course shows, many factors are involved in resolving a claim—that is, bringing the claim process to a conclusion. Two key factors to which much of this course is devoted involve negotiation and litigation. The course also examines the important topic of ethical claims handling.  

The course includes the following chapters:
  • Duties and Process
  • Negotiation 
  • Litigation
  • Recoveries
  • Ethics




*Please note: This posting is for informational purposes only, as a courtesy to our reading audience. Provencher & Company has in no way been compensated for the sharing of this information. The use of or enrollment in any classes, seminars, training, etc. in no way constitutes or implies any endorsement of the provider of said programs. Provencher & Company shares no financial obligation to attendee or organizer.

Tuesday, June 24, 2014

Impact of Improperly Adjusting a Claim


As human beings, adjusters occasionally make mistakes that go unnoticed by their clients or supervisors.  However, failure to properly adjust a claim can sometimes bite back. Take the subrogation case addressed here. 

Although the Plaintiff Insurance Company and their Insureds won on liability, they ended up paying more in costs then they recovered in damages because they failed to identify the errors in their alleged damages.  This is a cautionary tale for both adjusters, subrogation departments and their attorneys.




Contributed by:
Brian Single
Sr. Claims Examiner



Monday, June 23, 2014

Are You the "Ant" or the "Grasshopper"?

Remember the story of the ant and the grasshopper? The ant worked hard all summer, gathering wheat grains to store for winter. And the grasshopper? He just hopped around, enjoying the sunshine and laughing at that sweaty ant. Well, once winter hit, the grasshopper wasn’t laughing, but was cold and miserable and hungry. And the ant? He had plenty of food and could now toast his toes in front of his warm fire.

The point is, instead of waiting for January 1 to make your next set of New Year’s resolutions, start now working on those you made eight months ago, working on the principle that there is no time like the present. Here are four quick tasks to undertake—one for each week of this coming month—to get your financial life under control and heading in the right direction. (You’re on your own with the diet and exercising!)
1. Start saving now. Have a set amount of money deducted from your paycheck and sent directly to a “don’t touch no matter what” savings account. Self-employed? Do your own auto-deduction from your checking account. (Bonus tip: save your change and once a month, make a coin drop to your account. Or go even further: Don’t spend those one dollar bills but instead save them. When you get 10, deposit them. It’s amazing how quickly your savings balance will grow!)
2. Review your life, business, auto and home policies. Do you have enough coverage—and the right kind? Can you increase your deductibles to save a few dollars? Do you need to add any extra options, riders or increase existing coverage amounts? Schedule a session with your insurance agent for a complete evaluation of your existing policies. 
3. Pull your credit score. Go to Annual Credit Report  —one central site where you can request a free credit file disclosure (also called a credit report) once every 12 months from each of the nationwide consumer credit reporting companies: Equifax, Experian and TransUnion. Look for any errors or unexpected information and then get it corrected—ASAP!
4. Create a workable financial plan. Do you know where your money goes each month? Take a look at your income and outgo. Are there expenses you can reduce or eliminate? If so, use the extra money to either pay down debt or save for a rainy day. Consider the “Latte Factor”: the concept that many small purchases can add up to a significant expenditure over time. For example, a $3 coffee five days a week is an expenditure of $780 a year. Settle for a regular cup of joe at half the price, save the rest and, at minimum without factoring in interest, you’ll have $390. Every little bit helps, whether it’s spending more or adding more to your monthly payments.
Excerpted from Life Happens

Thursday, June 19, 2014

Report Writing the Provencher Way: Part 3 - Report Captions

In our ongoing effort to maintain and continuously improve our business, we have taken the time to document proper report writing specifics to Provencher & Company.  The intent of this post is to describe a standardized content look for a Provencher & Company captioned report.  Below, you will see that we have defined the purpose/meaning of each caption and provided an example of the report writing style and expected technical writing level of the content.

As this is such an important topic; one that requires great attention and detail, the Report Captions section of this series will be divided into three parts.

Let's begin the report:

Begin each First Report with this sentence:

We received this loss on (fill in the date) and contact was made with the insured on (fill in the date). An inspection and meeting with the insured was held on (fill in the date).


Note, this should always come after the report header and before the first caption and not repeated for subsequent reports.

Enclosures:
List all enclosures you are sending with this report.  Photographs, engineering report, letter from an attorney, etc.  Do not list your report as an enclosure!

Example of Itemized List of Enclosures:
1.   Photographs
2.   Conquest Engineering Inc. report
3.   Letter of representation from Public Adjuster, Joe Smith

Reserve Recommendations:
Special Note: Current reserves should be documented on EVERY report.

As you know, insurance company reserves are those estimated sums of money that are set aside by an insurance company to cover known and unknown projected and open claim payouts and expenses. There are few functions more important to an insurance company than maintaining a proper balance between reserves and actual payments made on claims. A key measure of the solvency of an insurance company is their posted calendar and accident year loss ratios, which are calculated from earned premiums compared to claims paid in the current calendar year and those still outstanding to be paid through the reserves. Over and under estimating reserves are both problems. We must strive to get the estimated reserve as close and as accurate the first time and adjust it when needed. 



List each coverage and be as accurate as possible. If there is coverage for Business Interruption and the insured’s business has suffered a loss of income, list that coverage in the reserve but do not list a value as that is the responsibility of the Business Interruption department. In lieu of a dollar value, insert the verbiage “TBD – separate report to follow”.


If you determine there could be a possible higher exposure at a future date, mention it in your narrative under this caption. If for some reason you need to recommend a change to the reserve inform the company immediately via interim report. Don’t wait until the next report! The reserves you submit are probably the only numbers that will be reviewed by upper management of a client. Every time you review a file, you should always ask yourself, are the reserves still adequate?  Has anything materially changed since my last report that may impact my reserves? Is so, this information needs to be communicated to the client.  Remember, recommending to raise or lower the reserves are each important to the client along with why the change is being recommended.

If  there  is  a  huge  swing  in  reserves,  contact  the  Provencher  & Company  claim  manager immediately! At our end of the business, surprises are rarely a good thing!

An improperly reserved loss reflects incompetence in the eyes of the client and that is all that matters.

Example of Reserve Caption Verbiage:
Building: Loc 1, Bldg 2 $100,000
BPP:         Loc 1, Bldg 2 $  25,000
BI:         Loc 1, Bldg 2 TBD – separate report to follow

Our reserves are based on our initial inspection. The building reserve may increase due to possible structural damage to several steel beams. This loss is being inspected by an engineer to determine the condition of the structure. Once the engineer inspects the damage we will adjust the reserves accordingly.

You have now informed the client there may be a large increase in reserves to cover the structural beams that may need replacing. Since you have set the foundation for a potential large reserve increase, the client is not likely to question your adjusting ability.

Abstract of Coverage:
The adjuster is responsible for verifying coverage in place at the time of loss for every claim. All claims will generally require a copy of the Policy Declarations unless otherwise specified. Claim files must demonstrate the adjuster understood the full importance of coverage, including all forms and endorsements, and how the coverage applied to the claim.

Example of Abstract of Coverage Caption Verbiage:
Coverage was verified through the Declarations Page provided by your office. Coverage is afforded under Building and Property coverage form CP 0010 (04/02) insuring Item A, and B Building and Business Personal Property under a blanket building and business personal property at location 001 in the amount of $4,340,750. Coverage subject to Cause of Loss form CP 1030(04/02). Coverage is subject to a coinsurance clause of 90%; Replacement Cost Valuation. The policy is subject to a $10,000 deductible.

Coverage Issues:
This is an example of an optional caption you should insert when there are coverage issues that need to be brought to the attention of the client.

Example of Coverage Issues Caption Verbiage:
At time of our inspection, it was noted the property had been vacant for a period in excess of 60 days.   Your policy specifically excludes loss resulting from vandalism when the property has been vacant for more than 60 days.

Risk:
In this caption, tell the client what they insure. If they insure five buildings on the property, make a sub-caption and briefly describe each.  Loss Location One, and the address. Describe business at Loss Location One - furniture store, multi-family dwelling etc. Type of construction - pier and beam construction with composition shingle roof.  Building use - warehouse, restaurant, age and condition prior to loss.

Example of Risk Description Caption Verbiage:
At risk is a family owned corporation, engaged in the masonry business. Your insured has been in business at this location for more than 30 years and appears to operate a very efficient and well maintained property. Approximately two years ago, the insured engaged the services of a contractor to replace the composition roof.   The building consists of one story masonry block building, in excess of 25 years of age with brick veneer, approved composition roof and has been maintained and was in good condition prior to this loss.

Cause of loss:
What caused the damage? Date, time (if applicable), sequence of events.   Be brief, clear and factual.

Example of Cause of Loss Caption Verbiage:
On the reported date of loss, 4/10/2010, the area was impacted by back to back severe snow storms causing approximately five feet of snow to accumulate on the roof of the insured building. As a result of the weight of ice and snow, the roof system failed, causing the roof to collapse.

Subrogation:
Subrogation refers to the potential of recovery under the subrogation provision of the policy; in this example, a contribution from joint-tort feasors, fidelity bond recovery, and refund of overpayments could be sited as subrogation possibilities.

When claims involve potential subrogation recovery, the adjuster is responsible for: recognizing subrogation opportunities, investigating matters related to subrogation, and advising the carrier/client accordingly.

Example of Subrogation Caption Verbiage:
The damaged insured building is less than two years old.  It is believed the design of the roof did not conform with local building codes, which could have contributed to the collapse of the roof.  It is the recommendation of this adjuster that a structural engineer be hired to determine the actual cause of the roof failure.

Salvage:
Any property covered by an insurance policy that is damaged but escapes total destruction by a covered peril is defined as salvage.  As a verb, salvage refers to the process of recovering all or part of a claim payment through selling the remaining damaged property.

Example of Salvage Caption Verbiage:
The business personal property contained in the building sustained minimal damage to the packaging.  As a result, the undersigned adjuster contacted the file handler at your office and secured the approval to bring in The Salvage Guys, a professional salvor. The salvor is working with the insured to separate damaged from undamaged goods and will submit a complete inventory within the next two weeks. You will be updated on the status of the salvage through our next report.



Report Captions is to be continued next week....

Did you miss the beginning of this series? Find them here:




Wednesday, June 18, 2014

Haag Certificate *Price Break*


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