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The
objective of the insured consumer is to have their property returned to a
pre-damaged condition.
The objective of the insurance adjuster is to minimize the claim payout.
WE HAVE, THEREFORE, AN ADVERSARIAL SITUATION. The quicker the consumer understands and accepts this fact, the better. Begin by examining the entire claim process exclusively in terms of MONEY. It is your MONEY, and your insurance company wants to keep as much of it as possible. Of course you have lost irreplaceable belongings -- family photographs, letters, and heirlooms. You have no place to live, no food, no medicine, and little clothing. You are emotionally devastated. You can't sleep, and fail to think in terms of the tragedy equating to nothing more then MONEY. Yet, MONEY is the focus of the adjuster; nothing more. OBVIOUS FACTS: The professional adjuster already knows the true damages and the total exposure of the company. Her objective is to minimize what is ultimately paid. The adjuster is required by State law to set "Reserves" (the amount they believe the claim will ultimately cost their company) immediately after inspection of the loss. The insurance adjuster wants the consumer to accept her recommendations on who establishes the building and contents claims. Why? Because the insurance company has control over what their "experts" determine the damages to be. The adjuster wants Contents Restoration firms she controls to immediately take possession of your personal property. Why? They now have "experts" on their side to establish what is and what is not "totaled," and the condition of this property before they removed it from the loss site
HOW THE ADJUSTER SUCCEEDS The adjuster must access the knowledge of the insured and play the game most appropriate to their end. The adjuster's moves are dependent upon company "Guidelines" or "Claims Manuals." Their objective is to keep the consumer off balance by creating confusion while appearing cooperative. (We describe it as: "smile a lot, utter nothingness, and place as little as possible in writing.") To do so she will put as little as possible in writing thereby not committing to anything. This allows the adjuster to retain all options. The consumer is always in a defensive posture and usually does not know it. String the claim out as long as possible hoping the insureds will miss important time limits found in the policy which can invalidate all or part of the claim. Even when time limits do not pass, the consumer will be left with little time to properly establish damages when the adjuster finally discloses these limitations. The longer the claim goes on, with no commitments from the insurance company, the more options the company retains and hence, the better their negotiating position.
WHAT CAN THE CONSUMER DO? 1. The consumer must become the offensive player. They do so by:
(A). Establishing their own damages and presenting them timely and in a form required by the insurance contract, State Law, and current Case Law.
(B). Without properly presenting and itemizing your claim, the insurance company will never pay what the policy promises. 2. All communications are in writing; with verbal discussions documented in writing.
(A). The consumer needs to develop a documented "paper trail.
(B). Correspondence needs to be couched in verbiage found in the insurance policy, State Law and regulations, and be consistent with current Court decisions.
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