Insurance Supplements


#21

Larry, in general, we choose option 2 and option 1. We generally don’t start work until the “base claim” pricing has been settled on. It is beyond stupid to go ahead and do the work expecting to get paid several thousands of dollars extra for line items left off, O&P, etc… That needs to be covered, per your option 2, before work begins. You lose pretty much all your leverage once the work is complete. Since the permit fee often isn’t known until the job amount is finalized (permit fee is variable calculated based upon the job $ amount), we most often include this fee in our final invoice. We may have had a slight over run (couple of bundles) of shingles which we will include. If our field people are doing their jobs right, if the over run is more than a couple of bundles, they are to halt work until formal approval has been gained from the Desk Adjuster. It is always possible there were some other minor items that were discovered during the build process that require pictures to have been taken in order to get the supplement approved. If it is more than a few hundred dollars, again, our operating procedure is to halt work until the additional work has been approved formerly by the Field or Desk Adjuster.

I don’t really have a problem with this process to a certain extent. There is no doubt in my mind the Insurance Companies have been swindled out of hundreds of millions of dollars by Contractors submitting fraudulent charges. I’m not going to accept the logic of “well, they’re screwing HO’s and Contractors out of billions of dollars”. Two wrongs don’t make a right. Contractors need to be business men and understand there is a process. Follow the process and things generally work out as they’re supposed to. You may not like or agree with the process but until that process changes, it needs to be followed. When you consider the P&C Insurance Companies, they’re Fortune 500 multi-billion dollar bureaucracies that can’t operate their businesses the same way a $2 million dollar per year Contractor does. The $2 million dollar per yer contractor needs to understand how to successfully work with these large entities. The tail isn’t going to wag the dog, it is what it is.


#22

[quote=“Authentic_Dad”]Larry, in general, we choose option 2 and option 1. We generally don’t start work until the “base claim” pricing has been settled on. It is beyond stupid to go ahead and do the work expecting to get paid several thousands of dollars extra for line items left off, O&P, etc… That needs to be covered, per your option 2, before work begins. You lose pretty much all your leverage once the work is complete. Since the permit fee often isn’t known until the job amount is finalized (permit fee is variable calculated based upon the job $ amount), we most often include this fee in our final invoice. We may have had a slight over run (couple of bundles) of shingles which we will include. If our field people are doing their jobs right, if the over run is more than a couple of bundles, they are to halt work until formal approval has been gained from the Desk Adjuster. It is always possible there were some other minor items that were discovered during the build process that require pictures to have been taken in order to get the supplement approved. If it is more than a few hundred dollars, again, our operating procedure is to halt work until the additional work has been approved formerly by the Field or Desk Adjuster.

I don’t really have a problem with this process to a certain extent. There is no doubt in my mind the Insurance Companies have been swindled out of hundreds of millions of dollars by Contractors submitting fraudulent charges. I’m not going to accept the logic of “well, they’re screwing HO’s and Contractors out of billions of dollars”. Two wrongs don’t make a right. Contractors need to be business men and understand there is a process. Follow the process and things generally work out as they’re supposed to. You may not like or agree with the process but until that process changes, it needs to be followed. When you consider the P&C Insurance Companies, they’re Fortune 500 multi-billion dollar bureaucracies that can’t operate their businesses the same way a $2 million dollar per year Contractor does. The $2 million dollar per yer contractor needs to understand how to successfully work with these large entities. The tail isn’t going to wag the dog, it is what it is.[/quote]

I agree!


#23

In this post you stated that drip edge is often overlooked or intentionally not added to the scope of work. Recently, I submitted a supplement for drip edge on two jobs to state farm but was told they won’t replace it since it wasn’t damaged due to the storm. How do I overcome this? Also, when is it acceptable to ask for overhead and profit as a general contractor?


#24

Show some pictures of the drip edge nailed down on top of the felt. It is then necessary to remove the drip edge to demo the roof. Then take pictures of a pile on drip edge on the ground that has been removed and obviously can’t be reinstalled. It is always appropriate to ask for O&P, they won’t shoot you for asking. Doesn’t mean you’ll get it unless you stick to your guns and have the HO behind you. Certainly helps if you’re a licensed GC in the state you are doing business in.


#25

Topping this to help some people with the supplementing process.


#26

You do not need your client’s permission to expose Insurers/Adjusters fraudulent market conduct.

To expose price-fixing schemes, or other “unfair claim settlement practices” - You present the appropriate documentation to the Department of Insurance, as a concerned citizen, and/or business owner.

Then follow-up on their investigation, until it is finalized.

Too - Please keep up with this site, and with posting your experiences. The names of insurers that financially defraud the public needs to be public domain record.


#27

CatContractor, I’ve honored your request to leave you alone. Now why don’t you leave me alone, stay off my threads and infest the site with your crap on your own threads. Obviously, there is very little if any discussion on your threads, but that’s your problem/fault. Start a thread with some value and interest, perhaps some people will respond.


#28

All good reading here :slight_smile:
I was wondering… I know this is mostly related to insurance in this post and I see its not in the insurance section of the forum…
I posted a summary of an insurance problem Im having and questions in the insurance forum:
http://www.roofing.com/forum/weight-of-snow-vs-ice-damming-t14831.html
Which would be the more appropriate place to ask insurance related questions generally?
I dont want to double post :slight_smile:


#29

If you want an answer from one person, you can post in the Insurance Forum. If you want one from other people, post here.

You have a difficult situation. He said/she said. Let the insurance company send out their hand picked Engineer. Not much you can do to prevent it. Demand a copy of the Engineer’s report. I would be shocked if the finding is anything other than in favor of the insurance company.

If you live in a State where they allow and have Public Adjusters available, I would recommend that you consider contracting one to represent your interests, including having them attend the inspection with the Engineer. That is probably the most economic approach. You could obviously hire an attorney who would then likely require you hire your own Engineer to provide a report that refutes the Insurance’s pet Engineer. You can see where that starts to get expensive.

I am struggling to see how the world’s greatest Engineer would be able to unequivocally prove with 100% certainty the damage was from an ice damn and not from the weight of snow. Therefore, it is unknown which caused the damage which means the insurance technically would have to pay the claim. All case law I’ve seen shows the benefit of the doubt ALWAYS goes to the policy holder. Sadly, the insurance company realizes it is unlikely you’re going to invest 10’s of thousands in legal fees trying to recover thousands so they will often ignore their obligation and put the screws to you.

I wish you were somewhere reasonably local, I’d love to meet the Engineer at your property.

Best of luck, take a serious look at hiring a Public Adjuster. Most roofing contractors aren’t really equipped to argue this particular issue with an Engineer.


#30

[quote=“Authentic_Dad”]If you want an answer from one person, you can post in the Insurance Forum. If you want one from other people, post here.

You have a difficult situation. He said/she said. Let the insurance company send out their hand picked Engineer. Not much you can do to prevent it. Demand a copy of the Engineer’s report. I would be shocked if the finding is anything other than in favor of the insurance company.

If you live in a State where they allow and have Public Adjusters available, I would recommend that you consider contracting one to represent your interests, including having them attend the inspection with the Engineer. That is probably the most economic approach. You could obviously hire an attorney who would then likely require you hire your own Engineer to provide a report that refutes the Insurance’s pet Engineer. You can see where that starts to get expensive.

I am struggling to see how the world’s greatest Engineer would be able to unequivocally prove with 100% certainty the damage was from an ice damn and not from the weight of snow. Therefore, it is unknown which caused the damage which means the insurance technically would have to pay the claim. All case law I’ve seen shows the benefit of the doubt ALWAYS goes to the policy holder. Sadly, the insurance company realizes it is unlikely you’re going to invest 10’s of thousands in legal fees trying to recover thousands so they will often ignore their obligation and put the screws to you.

I wish you were somewhere reasonably local, I’d love to meet the Engineer at your property.

Best of luck, take a serious look at hiring a Public Adjuster. Most roofing contractors aren’t really equipped to argue this particular issue with an Engineer.[/quote]

Maybe I shouldnt have asked where to post, sorry you guys aren’t getting along!

I can demand the engineer’s report? I cant even seems to get my hands on the original insurance estimate :frowning: Im not sure how relevant it will be at this point, since the claims manager said they are going to scratch it due to the engineer coming back out.
Thank you for your wishes, the roofer who is coming when the engineer comes back is rated the #1 roofer in my area. I too find the insurance’s company declaration of ice damming to be presumptuous without actual proof. I wanted so badly to believe that the insurance company wouldnt try to screw me but my gut said otherwise. Im hoping the roofer’s expertise will be sufficient because as you said
to acquire other supports requires the funds to do so.


#31

I would question that your “best” local roofer is really qualified to debate this issue with an Engineer. Perhaps you’ll be fortunate. If you could find a Public Adjuster that would work on a smaller claim, they work on a % of the claim or a % of how much they’re able to increase the claim.

Most State’s have insurance related laws that require the Insurer to provide you with documentation for why you were denied. If there was an original scope of loss provided to you, you should be able to get a written statement of why you were denied the coverage you requested. You need to firmly request this. Of course your Insurance Company would prefer to document nothing that could potentially be used against them should this claim ever go to court.


#32

Hi again I did send a fax last week requesting status. Didnt hear back, had to then call, found out claims manager was on vacation! Claims manager then called from his cell giving me all the info I mentioned earlier verbally. I told him I would like to see the original estimate, his response is we are scrapping it and starting over… Prior to all that, after the original insurance adjuster came but before the insurance engineer came several weeks ago, I asked for the estimate and was told to wait until the engineer came. Then another 2 weeks I waited and thats when I sent the fax. Its about 5 weeks since the claim was initiated.
The insurance company during all that time only sent 1 communication which was a letter noting whom the adjuster was. When I spoke to the claims manager I said I felt the communication was poor, and he said we are within nys parameters, and that he was calling me now (after of course I had to fax & call lol)…
From some preliminary research it doesnt seem there are many public adjusters in my area.
What I was wondering mostly is if you happen to know if public adjusters require payment regardless of the outcome of the insurance claim?
I hear what you are saying about the roofer…
I dont have much time left between now and when the insurance is coming back out this week to try and assemble more assistance if at all possible. The only other thing in the works so far is an electrician whom may come then too.
I feel to some extent I lucked out with this roofer, but who knows I could be coming back and saying that the roofer could not keep up with the engineer. Roofers do roofing for a living and the engineer does not. I would imagine the roofers hands on experience is unmatchable in some respects. This roofer had lots of awards, ratings, media ads, etc He is not cheap either, and its seems that he can ask for top dollar because of his accolades.
If it wasnt effecting me directly I would say it would be interesting how it all turns out, but I need
it to turn out as it should, so we will see… until then Im holding my breath.
There’s been so much displacement in my home Im trying to get things on the right track every which way I can including research etc, but it is hard to work on this all when things arent normal for now.
Thanks again for taking the time to read my post :slight_smile:


#33

Authentic_Dad - “Space” had a legitimate concern. It was addressed accordingly, and appropriately.

And Obviously - Posted Topic “Discussion” volume is hardly the only measure of successful education and discovery impact. Our own feed-back proves plenty of others are benefiting from the varied and critically needed information in the Insurance Forum.

You are more than welcome to comment and/or post in the Insurance Forum. If you have not learned anything there, then good for you. It is not designed for those that already know everything. It is for those that actually need the information, education, professional support, (and market misconduct evidence), that are being reached out to.

As you aptly stated in an earlier posting - the R.C site is ‘an open forum’. However - Not controlling obvious harassing and nonsensical insults - that clash with the Terms of Use here - is your problem/fault. “Infest the site with your crap” type rhetoric is hardly ‘honoring the request to leave others alone’ here.

You too have real legal and ethical obligations to ‘leave others alone’ here.
Please respect that, as all others here are obligated to.

Less than that irrationally disrupts even your own Topic threads.


#34

[quote=“Annietoo”]Hi again This roofer had lots of awards, ratings, media ads, etc He is not cheap either, and its seems that he can ask for top dollar because of his accolades.
Thanks again for taking the time to read my post :)[/quote]

Annie - Thankfully - It does not take an engineering degree to understand what engineers understand. To one degree or another - Many self-educated contractors know what engineers know, and maybe the roofing contractor has a degree of success by such experience.

Knowing what engineers know can help greatly when viable supplemental information is needed by insurers. Backing that working knowledge and experience up with a formally educated engineer that is truly objective, coupled with your own tenacity for justice - can help insurers/adjusters adjust their perspective about your given supplemental issues.

catcontractor@gmail.com


#35

Very interesting read… To bad it kinda faded out… i would have hoped that you guys would keep it going… Not everything was discussed and new ins. co.'s practices have changed some of this info in the past year…


#36

Does anyone know of a good place to get training on supplementing? I have been in the roofing business for a little over a year and have pretty much self taught myself how to supplement, but I want to be a master. I am averaging about 30% on my supplements, a lot in part to documenting and explaining logically why a specific item needs to be replaced although it may not have been damaged in the storm (ie step flashing is interlaced and damage is unavoidable during tear off). I have been getting O&P approved a lot, but it is the one item that I want to always have a great argument for. Bottom line, these blogs have been a great way for me to learn more, but I am interested in some formal training, face to face collaboration, whatever it takes to understand the art of supplementing.

Thanks in advance!


#37

Hi Authentic_Dad, Are you possibly open to doing some type of training regarding insurance & supplements more specifically for a family business in FL? We would obviously compensate you for your time and wisdom. We’re finding this is the hardest part to figure out and eating costs left & right. Thank you either way for your great thread you’ve started!!


#38

I’m not a consultant by trade, I have my own construction/restoration company with permanent offices in 3 states. However, I have helped select people before in this business and would be happy to speak with you. Just understand I have a limited amount of time available and would rather coach/teach you how to become competent on your own versus providing some kind of ongoing service.


#39

Thank you, I understand completely. It would be a one time thing, we’re just having difficulty getting answers and finding information (I thankfully came across this thread of the 4th page of my Google search). Can I give you my email or vice versa to set up a time/date or set up whatever is best for you?


#40

This site apparently has some notification deal that sends an email when a post is replied to. I responded to you directly via email today.