HELP! AmFam O&P issue


Alright, here is the issue. I have a homeowner who we did 4 trades: roof, gutters, siding, interior. We requested O&P and provided redacted invoices to AmFam. The adj came back stating that he wanted the un-redacted invoices. Uh no! Got the homeowner involved (she’s satisfied with our work and believes we deserve O&P) and she asked if O&P was within her policy and asked that it be paid out accordingly if so. The adj told her that the contractor (me) did not provide proper documentation, with no mention to her actual question (Is O&P within her policy?)
What do I do?! My colleague informed me that she has NEVER gotten O&P approved with AmFam :frowning:
Any advice or tips are appreciated! Sorry if there are a ton of grammatical errors or if my question is unclear. I’m rushing as I write this!


I would exercise the appraisal clause and go to appraisal. Most appraisers would award O&P. The 3 trade and complexity issues that AM Fam and for that matter most carriers likes to use are BS.


Sorry like, not likes…


Send the unredacted invoices if that is what they want, if they approve o&p it is a win! You have the homeowner on your side, which is a huge plus! I have been doing roofing supplements for 15 years, if there is interior work o&p is a given. A GC is also allowed to make profit on each sub they hire so there is no issue there…


I’m late to the party haha but I did get O&P approved on this one - just a friendly update :slight_smile:
My concern is why…why do they need to see un-redacted invoices? It seems as though they have something devious up their sleeve. It truly is none of their business what my company pays our subs & warehouses. Is that not concerning to you? Do you use Xactimate Suppqueen? I’d like to pick your brain, if I may :smiley:


I do use Xactimate for all my invoicing. I have a company and do supplements for multiple companies…the name of my company is called ClaimGame because that is exactly what it is! It’s a game and unfortunately the insurance companies make the rules and we have to play by them. But unlike the casino, you can win at tgis game! I don’t like it either and it’s not fair, but most of life isn’t. I am an open book…you can pick my brain anytime!


I appreciate that! Have you tried the DMO to RFG change in the unit price? Thoughts??


Actually just did my first one today. Will let you know how it turns out!
What state are you in?


How much would the overhead & profit be in this situation?


They don’t make the rules queen. You’re already losing if you think that.


I still received 10/10. What AmFam is doing is comparing the material/labor invoices with Xactimate pricing to see if O&P is less or more (this info was told to me from the adjuster).


We’re all over the place haha based out of Florida


Do not show the adjuster anything or provide him any ammo. Just submit your


What shingle manufacturer do you mostly use?


Really? Do you get Liberty Mutual to pay the tear off on a steep roof?


Of course they Make the rules and sometimes they change them in the middle of the game but that doesn’t mean that you can’t win the game. I’ve been doing this a long time and my results are outstanding.


Yes, I have many times before. I don’t think I’ve ever really had a problem getting that approved unless the adjuster was a stickler and wanted pics of the crew using harnesses. What are they saying to you? I’m curious to know what rebuttal they have against that.


Yes, you have to send pics but last year they decided even with pics they would only pay for 10 pitch or over on the tear off…So there is a prime example of them changing the rules in the middle of the game. So, the only way to win is to supplement other items that they have no rebuttal for…


Oh wow. I haven’t come across that problem yet. I’d say that workmans comp doesnt care whether the roofers fall off a 7/12-9/12 pitch roof or higher lol


I REFUSE to give out proprietary information to insurance companies. It is NOT their business what we pay for materials and what we pay our roofing crew, etc. Our profit is not the insurance companies business. I’ve had this problem with an insurance adjuster from Acuity. I told her redacted invoices should suffice because that’s me showing the adjuster multiple trades were completed and sub-contractors were, indeed, utilizing. She basically told me to kick rocks, so I contacted her supervisor and got the homeowner involved…O&P approved. :slight_smile: