Public Adjusting Overview: What They Do And How It Works

Jack: Welcome you to KSEV, I’m Jack, one of the producers here at KSEV radio. We certainly appreciate you tuning in, and this segment of Ask the Experts, we’re gonna be talking about claims adjusting. We have a public adjuster here who is quite informative of the subject, and she’s gonna be giving you all the information no doubt that you would need. Let’s welcome Ms. Stephanie Corona, she is going to be with ClaimsMate. Good afternoon to you, Stephanie.

Stephanie: Good afternoon, how are you doing today?

Jack: Fine, fine, fine. Now, you know we’ve got a lot of people out there who of course are still suffering through Hurricane Harvey, and of course it’s hard to believe it’s been almost a year and yet people are still having to deal with that. Of course a lot of them might not have all the information they need when it comes to filing a claim, and public adjusting and stuff like that. So, this is probably still a good time to still talk about those things.

Stephanie: It is still a good time. We’re able to go back and full two years and due to the sheer magnitude of Hurricane Harvey, and then the storms that hit Florida and Puerto Rico after that, it’s been a very unorganized claims process. So, people are still really, really hurting out there, and really searching for answers.

Jack: And that kind of leads me to kind of one of my first questions. A lot of people think, and even though it’s almost been a year, it’s not really too late to get a public adjuster involved. And if somebody has an issue with a flood claims, or anything else regarding tax state floods.

Stephanie: No, it is not too late. Like I said, we have a full two years to work out the details.

Jack: Two years?

Stephanie: Two years from the date of the storm, or the date of their last denial, or acceptance letter.

Jack: Okay, so with that being said, whenever you’re looking for somebody regarding this or any type of other business you want to get involved in, you gotta know what to look for. As far as make sure you’re not … I mean, let’s admit it, there’s people out there looking to rip you off, we hear those stories all the time. Contractors and others, so what are some important things to look for?

Stephanie: There are bad actors in every segment. It’s not like the insurance company is evil, it’s not like every public adjuster out there is brilliant.

Jack: Right, exactly.

Stephanie: But, the first thing you want to do is make sure that you’re dealing with licensed, qualified people. The state of Texas has done a good job of setting up a website that you can log onto at www.tdi.texas.gov and you can log on there and do an agent look up. It’ll let you know if that person is license, how long their license has been in play, if they’ve had any actions taken against them or any complaints or anything of that nature. So, that’s always a good place to start off.
Then, there are local and statewide organizations that kind of govern our industry as public adjusters. TAPIA; Texas Association of Public Insurance Adjusters is a good one to check out and see if the adjuster belongs to it, or has belonged to it. Sat on any boards, and what their business model is. I mean a lot of public adjusters go out and they work really, really hard. And some of them have kind of fallen off the wayside and they deal more with attorney’s in that route. Going the appraisal route than actually doing field leg work out in the field.

Jack: And so, let’s go into a little bit more detail as far as that. What the public adjuster, they come out and they take a look at your property and just kind of give you an idea? Is that how it usually works, or how does that normally work?

Stephanie: It’s definitely not just giving you an idea. A good public adjuster is gonna come out to the property, and they’re gonna look at your home, and your policy, and your claim specifically. Kind of like a crime scene investigation. They take each and everything into account, and I don’t care if the damage is 10 years old, they’re gonna wanna know how it got there, why it got there, has there been a past claim so that we can source every type of damage that’s on that property.
A lot of times whenever people file a claim they try to lump everything into one claim. And that’s not how the insurance process works. Each peril is covered under the policy or it’s not. And each individual peril is a different claim.

Jack: Now, I notice on here that some of the questions we wanted to cover was as far as paying the public adjuster. Now, do they get paid up front, or how is that normally handled? So, that way once again somebody doesn’t pay something that they wind up getting as we said before, ripped off. I mean, how is that normally handled?

Stephanie: Exactly, and once again Texas has done a really good job of protecting the consumer where this is concerned. It is absolutely against the law for any public adjuster that’s licensed by the state to take any up front money.

Jack: Oh, that’s good information to know.

Stephanie: They are only allowed to recover, if they recover a portion of the claim for the client.

Jack: Sort of like a lawyer does, you know you pay them, of course you pay them a little bit up front but you don’t pay them everything.

Stephanie: Attorney’s can work in several different fashions, but PA’s do not have that opportunity unless of course they’re working as an appraiser, or they’re working as a consultant for a law firm that that client has already hired and that does happen.

Jack: Now how about the homeowners policies, does that cover floods as well, too?

Stephanie: Homeowners policies do not cover floods-

Jack: Okay.

Stephanie: And in fact increasingly they’re not even covering water damage a lot of the times from like bust pipes, overflowing toilets, especially wind driven rain is a huge one with Hurricane Harvey right now. We’ve got so many clients that experienced hundreds of thousands of dollars of interior damage, and their insurance companies are calling it wind driven rain, saying there was no storm created opening. So, water in and of itself has become a huge issue on the policies, and knowing that language and knowing how to decipher the 60 plus pages becomes very, very important.

Jack: Especially if you’re not familiar with legal speak so to-

Stephanie: Exactly.

Jack: Because you can see something and you think “oh, gloss over it, oh okay, whatever,” but then that whatever can turn out to be something very big if you take it for granted.

Stephanie: We have to remember that in the state of Texas, this is a contract of adhesion state. The insurance company does write that policy wording, you do not have the right to go back in and change it. So, it’s very important that you understand the wording that is there, but they don’t make it easy for you. They can say you’re covered on one page, and then 30 pages later tell you you’re not.

Jack: Oh no.

Stephanie: So, you really need to speak to somebody who’s well versed in policy language and knows how to find that ambiguous wording, and knows how to pick out coverages that you might not even have known existed for you.
Jack: So, and that is basically what involves the public adjuster? They help you along with that, or how does that process usually work with finding a public adjuster?

Stephanie: Most public adjusters are definitely experts whenever it comes to policy language.

Jack: Okay.

Stephanie: There might be times that we come out to a property, and we can’t actually source a leak because we’re not allowed to put a nail in, take a nail out, cut out sheet rock. So, sometimes we have to pull in experts that are licensed trades, like plumbers or something to get to the bottom of it. But, whenever it comes to policy and the language in it, a good PA is going to know that policy front and back and they won’t even do the inspection without deciphering that first.

Jack: Oh, that’s very good to know. So, with that being said, should the public adjuster in case you do need to have damage checked, should they be called first or should you go about and get your insurance claim filed first? Or should you just do both at the same time, and have them work together? How does that normally work?

Stephanie: I think that it’s very important that either you attempt to decipher your policy, or you call a professional that can for you because a lot of times you’ll say things that may not be correct. You don’t know how long a pipe’s been leaking, or you don’t know how long that water’s been going underneath your slab. You need to call in somebody that can decipher the language of your policy, and then let you know if that peril is covered.

Jack: Okay.

Stephanie: A lot of times water claims, if they’ve been going on for longer than 14 days, if they’re hidden or not they’re no longer covered.

Jack: Yeah, you move something around and then you see “Oh my goodness, where’d that come from?”

Stephanie: So, if you call in a claim and you erroneously say “Well, I’m not sure it could have been there six months.” Well, that call’s being recorded, and that can come back to hurt you in the end. It’s better to find out first how long that water leak has been there, and then call your insurance company. Or don’t call them if you know that it’s not a covered claim.

Jack: Okay, well we’re gonna take our first break. It’s hard to believe it’s already been almost 15 minutes.

Stephanie: Wow.

Jack: That’s what happens.

Stephanie: Thank you.

Jack: When you get all that information in there. That’s Stephanie Corona, she’s joining us from ClaimsMate and we’re gonna be giving you more information. More important information like we said, especially if you’ve had trouble with flooding. Even just not from hurricane Harvey, but something else, a type of damage that might have occurred of course due to water as well, too. We’ll talk about that and much more coming up.

Once again joining us for this segment of ask the experts, Stephanie Corona from ClaimsMate, and we’re talking about damage that you might have suffered due to the floods. Hurricane Harvey, once again hard to believe it’s been almost a year since that occurred, but if you have any other type of water damage or any other damage that you suffered due to anything else that might have happened. You know, if you have a house anything can happen just about, that can cause problems, and of course you definitely want to get the right details, you don’t want to get ripped off. Unfortunately there’s a lot of bad people out there to do it. So, why can’t you use a contractor to handle a claim? Because we’ve heard those stories as well, and those can be some horror stories as well.

Stephanie: That’s an awesome question, and the Texas attorney general has actually gotten involved in deciding this. Your insurance policy is really a legal contract for money for services. And whenever you bring a contractor in, that contractor may be only a roofing company. And whenever he comes out to look at your property, he’s going to fight to get the roof portion of that claim bought, but what about all the chips of paint around the house?

Jack: Right.

Stephanie: What about dented you know furniture, or what about leaks on the inside? So, the attorney general has decided that it is illegal for a contractor to act as a public adjuster to interpret policy, and then try to negotiate a settlement with the insurance company. It should not be a contract to negotiate anything, it should be a reason to go after full indemnity. These are the terms of your policy, this is what your afforded under your coverage, and this is what should be paid for from start to finish, every last single dime.

Jack: So, if somebody is kind of being pressured saying “Oh, no, that’s not right,” or whatever. Of course you know and the person feels a little intimidated say “Well, that’s what I heard on the radio and blah blah blah.” So, I mean they shouldn’t rush into it just because that person is there telling them something. And if they get out of it and eventually leave, what would be the next step as far as I guess they could report that person, or let them know “Hey you know you can’t be doing this, and you can’t be forcing me to do this as well, too.”

Stephanie: Exactly. It’s very important that if you’ve got a contractor that says that they’re an insurance specialist, or that they can interpret your policy or negotiate your claim for you, that you be very wary and that you do report them because it is illegal in the state of Texas. Typically they’re not trying to do anything wrong, they just really want to get the claim bought. But a lot of times they are, and a lot of times they will hurt your cause with the insurance company rather than help it. The insurance company is under no legal obligation to speak with them, to negotiate with them, to hear them out, to buy things that they think are damaged, and they can literally just shut down the whole claim process.
If you hire a licensed public adjuster, that insurance company by law has to speak to us. They have to discuss the terms of the policy, they have to give us reasons of why things are not being covered and give us an opportunity to prove why they should.

Jack: So, a claim has been denied, all right? So, what is the next step? Is that it? I mean is there another resource that home owner can go to to try and get things taken care of?

Stephanie: There are several avenues that home owners can do. One of them is to hire a PA, and that is usually a good place to start because that PA is typically gonna be the most honest person-

Jack: Once again, PA’s a public adjuster.

Stephanie: A public adjuster.

Jack: Right.

Stephanie: Because they don’t get paid unless they actually recover funds for you. Okay, there is some policy wording that states that you have the right to hire an appraiser, but if you’re only dealing with a $15,000 roof replacement, well an appraiser’s gonna cost you $2,500, it’s gonna cost the insurance company $2,500 as they hire their appraiser, and then you have to split the cost of the umpire in the middle. A lot of times these umpires do not have construction, or building or insurance experience, so you have somebody deciding who’s estimate is actually fair that might not be that knowledgeable in the industry. But that is one way.
You definitely have the right to seek an attorney to represent you on … when seeking an attorney I would again suggest seeking the services of a public adjuster first. Because unless the insurance has committed breach of contract, or an actual bad faith act, or they’ve denied your claim unfairly, then the attorney really can’t recover their attorney fees from that insurance company.

Jack: Oh, is that right?

Stephanie: So, give them a chance to build a case. That public adjuster will usually work with you to the bitter end, and if they’re unable to recover, then they’ll definitely tell you to seek legal action. Or if it becomes a matter of law, such as ambiguous wording in a policy and that’s something that can be decided either way. A person of normal intelligence thought that this policy said my water damage is covered, so when you have that ambiguous working a public adjuster is not able to argue it, that becomes a matter of law.

Jack: Once again, we are talking to Stephanie Corona of ClaimsMate, and if you have any questions for her after we forget … forget, after we finish the show you can of course contact her at 281-231-9242. Once again that’s ClaimsMate, 281-231-9242 and you also have a website ClaimsMate.com correct?

Stephanie: Yes sir.

Jack: And you have it set up where they can send you questions as well?

Stephanie: Yes sir.

Jack: Okay, is there gonna be like a Ask a Question link on there?

Stephanie: There are several ways that you can ask a question or you can leave information, and of course our phone lines remain on 24 hours a day.

Jack: Oh, good. That’s very important because you never know when something might happen in the middle of the night as well too, as we’ve seen-

Stephanie: House fires, water pipe leaks, anything like that.

Jack: Well, that’s a good thing.

Stephanie: Again, its best to call a public adjuster or somebody that is well versed in the terms of that policy before you speak to your agent or your insurance company.

Jack: Okay, now you were talking earlier something of course that we said is very important charges and costs and everything like that. And, I know that you covered a couple of things. Is there any other things as far as cost wise that a home owner needs to kind of worry about as far as … and what would they be looking at as far as cost regarding other things that might be involved?

Stephanie: Well, when you’re dealing with a public adjuster, we usually work for a percentage of the claim. If you’ve been really successful today, let’s say you’ve gotten $100,000 and we’re only able to get you an extra $20,000, at that point the state allows a public adjuster to come in and charge 25% of just the new funds, rather than 10% of the whole claim. Because they’ve already pretty much worked for half of their money. So, it gives them some relief a lot of times.
There are also expert witness fees that come into play. A lot of times if we find that the damage is questionable and we need a forensic engineer or structural engineer out there, we will employ them to come in and make those decisions where we can’t. You know that six year degree seems to give them a lot of pull whenever you’re dealing with the insurance companies, so…

Jack: So, you have access to a lot of different people. Not just you, but other people who when you see something that needs to be taken care of by another entity, then you have access to all these other information as far as that goes.

Stephanie: Most public adjusters have huge bases of forensic people, and experts, and consultants that help them do their job. And they tend to stick with you for a long time, I mean our group of contractors, engineers, appraisers, umpires that we deal with, we’ve been in contact for over 10 years.

Jack: And if it’s a good reputable public adjuster, then I think usually you can probably count on these other entities as being good and reputable as well, too. Because you’re not gonna deal with bad people because that makes you look bad, you know?

Stephanie: Exactly.

Jack: Word of mouth so to speak, you know?

Stephanie: Exactly. It’s really hard. We’re under a lot of rules whenever it comes to referring people out, such as an attorney or a contractor. We can’t give one person and say “You have to use this person.”

Jack: Right, right.

Stephanie: We must give them a list of at least three and let them interview them and make their own decision.

Jack: And that makes it very fair because if you just get that one, then you just trust that one person. I mean, like you said having … it’s just like when I call to get an estimate on something I don’t call just one mechanic. Like, say if it’s my car, I call about two or three and that way you can kind of get an idea of what’s fair and what isn’t.

Stephanie: Exactly. Most public adjusters are gonna have a good base of people around them, though. We don’t want to be out knocking on doors and bothering people right after they’ve had something horrible happen.

Jack: Right, it’s a very traumatic time.

Stephanie: We want our clients to be past clients, referral business from those past clients, and you can’t do that without a good group of people around you to support you.

Jack: Because that’s all it takes is just one bad … and even though all the other ones can be, just one bad one and that spreads like wildfire. So, we have a company adjuster, and independent adjuster, and a public adjuster. So, could you please just kind of just a brief overall of what the difference between all of three of those would be.

Stephanie: I can, and it gets really confusing because right after a storm, you’ll see an influx of adjusters come from all over the country and those are known as independent adjusters, or catastrophe adjusters. They are hired by independent firms that are then hired by the insurance company to go out and handle the claims. So, these independent adjusters do not work for the insurance company, but they are most certainly paid by the insurance company. A lot of times they’re overworked. They’re handed 75 claims a week for one person.

Jack: Wow.

Stephanie: Most good PA’s handle 75 claims a year, okay? So, you’ve got an independent adjuster that’s from the East coast that doesn’t know our building codes here, doesn’t really know the lay of the land or how our counties and cities work with their codes. And they come in, and they are so much in a hurry to move through that estimate, and move on to the next one.
And, it’s not a matter of them not doing their job, it’s really a matter of this storm, Hurricane Harvey was 700 miles wide, 200 miles deep, and then there was another storm that hit right after it in Florida. So, all these independent adjusters got up and left and went to Florida where the claims are bigger.

Jack: Right.

Stephanie: So, everybody around here just got kind of got left twiddling their thumbs. So, those independents are very fluid, they move around a lot, they don’t really specialize in anything particular. But once it starts to slow down, then you’ll start seeing your staff adjusters come back. They actually work for the insurance company, and these people are usually highly educated. They’ve been with their companies for a long time. It’s easier to get somebody intelligent to walk through a claim with you and listen to you about why and how things might have happened.
And then there are public adjusters. Most public adjusters have over 10 years experience. Most of them started out working for the insurance companies, and then came over to what is commonly known as the dark side.

Jack: Going back to Star Wars there, huh?

Stephanie: But, a good public adjuster doesn’t fight your insurance company for you. What they do is they go in and they work with that insurance company to meet the terms of the policy. And, a lot of times all it takes is really good paper work, and documentation, and an open ear so that everybody is getting along. The emotion is taken out of it from the home owners side of things, and things get worked out a lot faster like that. So, a good public adjuster is not gonna be fighting the insurance company. They’re going to have the respect of that insurance company, and the respect of the adjusters that come out and meet with them. It should be much more amiable then whenever it first started.

Jack: Right, right. Once again, we’re talking to Stephanie Corona, she is with ClaimsMate, and once again if you’d like to ask more questions, if you think of something we’re not talking about right now or maybe you’d like a little bit more information on what she is talking about, feel free to call her. Or go to- the website ClaimsMate.com, that phone number once again is 281-231-9242. That’s 281-231-9242. Once again the website’s ClaimsMate.com.

We only have a couple of minutes left here. So, going back real quick to touch on something that you were mentioning. So, you said something about out of state people. So, I guess it’s because you may not know what you said, the codes and everything, it’s best to look for somebody here locally then, right? Or at least within the state when you’re looking for somebody?

Stephanie: Public adjusters typically are a little more settled down than an independent adjuster. We don’t have to be somewhere in 72 hours anymore, we typically have a good base network that we work out of. A couple of major cities, a couple of smaller cities. But, if you’re in a smaller city, it may be very hard to find a public adjuster, especially right after big storms. Whenever Hurricane Ike hit about 10 years ago, there were 17,000 public adjusters in the state of Texas. Whenever hurricane Harvey hit, I think there was just under 200 of us left. So, there were 200 people out there that were actually licensed and able to ink a contract. And start on your file and help you compared to 17,000 ten years ago.

Jack: Holy moly, gosh. You know it’s funny because as I drive around the city, I still see places that still have houses, and have trash and garbage from the hurricane still out. And, it’s hard to believe that it still is, but yeah people are still dealing with. So, that’s why it’s still important to talk about these things.

Stephanie: Yeah, I don’t know if anybody’s drove through New Orleans lately, but there are whole parts of the city that are still shut down.

Jack: Oh my goodness.

Stephanie: I mean nobody ever moved back in, and it was because they didn’t have the representation that they needed. There was no such thing as a licensed public adjuster in Louisiana at that time.

Jack: Well Stephanie it’s hard to believe this is it because we have talked a lot about a lot of stuff, but as I said before I’m sure there’s still some things out there that people want to talk about. So once again, let’s one more time, we can’t mention your number too many times. Let’s say it once again.

Stephanie Corona with ClaimsMate, you could reach her at 281-231-9242. 281-231-9242 or of course go to the website, we’re all internet savvy these days. ClaimsMate.com. Well, once again Stephanie thank you for joining us. We certainly do appreciate it.

A lot of good information there, ma’am.

Stephanie: Thank you so much, and I’m looking forward to coming back.

Jack: Oh, well good. Well we like that. All right ladies and gentlemen, thank you for joining us for this addition of Ask the Experts, and we certainly appreciate you tuning in. Call Stephanie if you have any questions regarding your claims, and she’ll definitely provide you with all the information you need. Thank you, this is KSEV, the voice of Texas.