Handling Insurance Cases 2 – Taking The Insurance Case

Insurance lawyers need a good process for taking on a case.  This includes a good intake sheet and a thorough discussion about the case.

I.  One issue to discuss is the number or prior claims that the client has had in the past.  What repairs were competed?  An insurance company adjuster will use prior claims or lack of repairs to their advantage if possible.  Adjusters have access to this information and will use it fruitfully for themselves.  Having copies of repair receipts and photos are very helpful for the claimant.  Sometimes an expert is needed.

II.  Inspection tends to be the part of a case that has the most varied, and often polarized account of what exactly happened to cause the claim.  The attorney needs to know if the client was present when the property was inspected.  Too many times, the adjuster acted on his own without the claimant being present.  Knowing what the adjuster did can often times help the claim.  It may increase the value of the claim or lessen it.  The insured needs to be sure and point out all the damage the insured is aware of and know whether or not the adjuster looked for other damage

III.  Public adjusters are sometimes helpful to the claim.  Other times they hinder being able to get the claim settled fairly.  It is important to remember that state law prevent an attorney from offering payment to a public adjuster in exchange for referring the case.  This law is found in the Insurance Code, Section 4102.164.

IV.  Claims must be reported as soon as the insured becomes aware of the claim.  Prompt reporting will help in getting the claim resolved favorably plus, it is a requirement in insurance policies.  This is often times difficult when it comes to roof damage claims for obvious reasons.  Thus, it is important to inspect the roof after every severe weather event.

V.  What is the coverage in the policy?  Just assuming a policy covers a claim is the wrong approach.  The policy needs to be read in full, including endorsements, exclusions, limitations, and amendments to the policy.  The insurance attorney should verify coverage was in place during the relevant time frame.  The insurance attorney must also determine the damage is covered by the policy.  What does the policy say about appraisals and how they are to be conducted and under what circumstances?  Also, what are the limits to coverage and what are the applicable deductibles?