Let’s use the fire claim case that I am currently working on to remind both the insurer and the agent that there are cases where an insurer may not receive any compensation for damage or loss he/she may have suffered. This should serve as a grave reminder to us all.
A fire broke out in a small retail building. We found out in the midst of the claims process that the building did not have any smoke detector or CCTV. Upon inspection, the insurance company said it will decide whether to compensate for loss or not after the investigation was completed.
Many insurance companies do not have this kind of conditions. We recommended the insurer to check with the insurance agent that sold the policy if he was aware of this type of condition. We advised the insurer that although we were not able to predict whether the claim will be denied. If it did, the case would become very complicated and could even involve legal issues. The insurer asked the insurance agent if he was aware of this condition and the answer from the agent was surprising.
“The public adjuster should have taken care of this; why do you ask me?” How could the agent make such an irresponsible statement? The insurer was furious.
In other words, the agent was implying that the public adjuster should have installed the smoke detector before the investigation. The statement was simply absurd.
While the claim in process, we recommend to the building owner to hire a lawyer that specializes in denied insurance claims. This was to prevent the insurance company from denying the compensation altogether.
Fortunately, the insurer was able to receive full amount of compensation after a lawyer sent couple of reference requests (in preparation of lawsuit) to the insurance company. If the insurance company denied the claim, the insurer would have suffered tremendously in trying to restore the building with his own money.
To prevent financial loss and avoid conflicts, ask your insurance agent to provide details on conditions of denial of compensation before signing the contract.
Jung Park, PA
Excel Public Adjuster