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United States Adjusters, Inc. are currently assisting disaster victims across the country such as, Hurricane victims, Flood victims, Mud slide victims, Fire loss victims and more. Most insured's do not know what a Public Adjuster is or does. They will soon want to find out as did the Katrina victims did after their insurance companies gave less than favorable insurance settlements. You would not go to court without representation by a professional so why would you let an insurance company adjuster be in charge of writing a fair settlement? You wouldn't or shouldn’t let the insurance company adjust your claim based on the conflict of interest that exists between the two.

 

THE OFFICE OF PROGRAM POLICY ANALYSIS AND GOVERNMENT ACCOUNTABILITY STUDIES PUBLIC ADJUSTING INDUSTRY IN FLORIDA AT THE REQUEST OF THE LEGISLATURE.  Their report confirmed that:

"Policyholders with public adjuster representation typically received higher settlements than those without Public Adjusters"

Policyholders that filed catastrophe claims in 2008 and 2009 generally received larger insurance settlements than policyholders that did not hire these persons (Public Adjusters). The typical payment to a policyholder represented by a public adjuster was $22,266 for claims filed in 2008 and 2009 related to the 2004 hurricanes. In contrast, policyholders who did not use a public adjuster received typical payments of $18,659. The difference in payments was larger for claims related to 2005 hurricanes, with public adjuster claims resulting in payments that were 747% higher.

For non-catastrophe claims, policyholders who used Public Adjusters received an estimated $9,379 on their claim, compared to $1,391 for those policyholders that did not use a public adjuster (a difference of 574%).

To read the OPPAGA REPORT (CLICK HERE)

 

Citizens Insurance slow to pay, and lowballs settlements, critics charge
Years after damage from hurricanes, 2,000 households still have unresolved damage claims against state-run Citizens insurance
By Julie Patel | South Florida Sun-Sentinel
September 19, 2008
Although the hurricanes of 2004 and 2005 are but a fading memory, Citizens Property Insurance Corp. still has almost 2,000 unresolved homeowner damage claims in Florida.

And in the past two years, the state-backed property insurer has logged 2,422 complaints about how claims are handled. That's far more than the number filed with the state's two largest private insurers. In the same period, State Farm received 142 and Allstate 218.

Citizens delays paying claims and lowballs storm damage, according to public adjusters, attorneys and former Citizens employees. They blame a loophole that has allowed the state's largest property insurer to argue it's not subject to Florida's negligence and bad-faith laws that help keep other insurers in line.

"What we've seen in hundreds of cases with Citizens is that they're just as bad as all the other insurance companies except worse because ... they claim they're the government and you can't sue the government," said Alan Garfinkel, founding partner of the Fort Lauderdale law firm Katzman Garfinkel.
Citizens spokesman John Kuczwanski noted that fewer than 1 percent of the 311,000 policyholders who filed 2004 and 2005 hurricane claims complained about the process. With 1.2 million policyholders, "a few dozen who have commented negatively could easily be countered by thousands, if not hundreds of thousands, of satisfied policyholders," Kuczwanski wrote in an e-mail.

Citizens policyholders James and Anita Sokolowski, and their daughter, Terrill Friedrich, are reminded of Hurricane Wilma every time they walk into their West Palm Beach home with its leaky roof and the stench of mold so strong they get headaches.

The family is among 1,634 Citizens policyholders who sued the insurer over claims disputes from 2004 and 2005 storms. In numerous cases, Citizens was slow or failed to respond to requests for information or meetings, and as time passed, the damage in many homes worsened, policyholders say in court papers.

"They should be held to a higher standard than the private industry, especially because that's where some of our tax dollars go and some people don't have any other choice," Friedrich, 32, said.

Citizens must strike a delicate balance between paying claims fairly and spending money responsibly because all Florida policyholders pay fees on their homeowner insurance to help offset Citizens' deficits after the 2004 and 2005 hurricanes.

The state formed the insurer as a last resort for homeowners to help cover the higher-risk areas of the state that private insurance companies were reluctant to insure. Those locations tend to suffer greater damage and, therefore, generate more disputes, said Martin Grace, professor of risk management at Georgia State University. Citizens paid $6 billion for 2004 and 2005 hurricane claims, compared with about $5 billion paid by State Farm and more than $2 billion paid by Allstate.

Consumer advocates said Citizens'benefits outweigh its flaws.

"The government is known for bureaucracy, not customer service. But itdoes have a low price," said Bill Newton, executive director of Florida Consumer Action Network. The Legislature has frozen Citizens' rates until 2010.

Policyholder suits over the bad-faith issue have been settled or resolved, so state court judges have yet to make a final ruling on the central question of Citizens' immunity as a government entity. Last year, the Legislature amended one of three state laws dealing with the bad-faith matter, but the company's status remains unclear because the statutes are conflicting.

"Bad-faith laws typically are designed to ensure that for-profit companies do what is right, and Citizens is a governmental, not-for-profit entity without any motive to act in bad faith," Kuczwanski said.

Robert Klein, director of Georgia State's insurance research center, said that belief could affect how Citizens handles claims.

"If Citizens believes it's immune ... that reduces the pressure to pay some claims that private insurers would," he said.

John Novak, a former Citizens contractor hired by the insurer from 2006 to 2007 to defend its estimates of claims, said he often knew the damage estimates wouldn't cover repair costs.

"In almost all the situations, it couldn't be done" for the amount Citizens estimated, said Novak, who now represents policyholders in claims disputes.

Adrian Acosta, a former Citizens claims coordinator who cut checks to policyholders until 2006, said there was an unspoken understanding that policyholders would be paid as little as possible.

"It makes you look better by paying less," Acosta said.

Kuczwanski said Citizens employees aren't evaluated or compensated based on how much they pay out in claims.

Troy Norris, a Citizens policyholder who works as a construction contractor, said he knew his Lighthouse Point home couldn't be repaired for the $39,000 that Citizens offered. Hurricane Wilma tore off parts of the roof, and the ceiling caved in, damaging the bathroom, air conditioning system and walls.

Norris sued in 2006. The insurer settled the claim in August 2007 and paid $359,000, the policy limit.

The cost of construction, legal and storage fees and renting an apartment while his home is being rebuilt has surpassed $480,000. But the settlement "sounded like it was enough to get me through, and I was just tired of fighting at that point," Norris said.

The Sokolowskis, retired cafeteria workers, were told by their insurance agent the damage to their home was not hurricane-related. After Wilma, water began leaking into a wall in their kitchen. They hired an attorney in 2006. By 2007, the home's musty smell was unbearable and they moved to a mobile home park in Leesburg. Their daughter moved in with her boyfriend in West Palm Beach.

The family settled with Citizens in June for $31,000, after attorney's fees. But it might be too late. As relocation expenses mounted, the Sokolowskis fell behind on their mortgage payments last year and now are on the verge of losing their home.

"It screwed up all our plans and split up our family," Friedrich said.

Julie Patel can be reached at 954-356-4667 and jvpatel@sunsentinel.com.


  

 United States Adjusters, Inc. is pleased to announce the insurance settlement of The Christo La Roca Church.   

United States Adjusters, Inc. were contacted by the Christo La Roca Church when all else had failed for Pastor Diaz and the church goers; United States Adjusters was up for the challenge and came to the rescue.  The Public Adjusters at USA were able to reach a settlement with the Churches insurance company for well over three hundred thousand dollars, which was almost policy limits. The church will now begin its final phase of rebuilding the damage church and going on their lives. 

(CBS4) OAKLAND PARK On Wednesday, Broward County building inspectors posted "unsafe structure" stickers on a church damaged by yesterday's storms.

Part of the roof over the gym portion of The Cristo La Roca Church off Prospect Road collapsed Tuesday afternoon. That building was destined to house the church’s growing congregation, but now those plans have been put on hold.

"It's not easy because we put so much effort and all the people in the community helped us," said Pastor Angel Diaz.

There are cracks all over the wall of the gymnasium. There is at least thirty percent roof damage, and the fear is the common wall between the gym and church can give way.

The pastor Diaz, said "We need to get a company to stabilize the wall, otherwise, strong winds may knock it down."

Ralph Gonzalez, a Broward County building inspector said, "We're not going to allow the building to be occupied until we determine that the wall is going to be safe."

A dilemma for the congregation, which has no insurance on the building, and must choose its next step: to rebuild, to repair, and at what cost.


  Attorney General files lawsuit against six large insurance companies alleging price-fixing

 Attorney General Charles Foti filed a lawsuit in Orleans Parish Civil District Court late Wednesday alleging collusion, price-fixing and anti-trust violations by six major insurance companies - including Allstate and State Farm - as well as the firms that manufacture their claims-processing software, and the companies that offer them advice or collect their data.

The suit, filed in conjunction with several outside law firms deep in Katrina litigation, is based on the work of an ongoing investigation by the Louisiana Attorney General, who lost his re-election bid in the October 20 primary.

Charles FotiIt says that these groups conspired to manipulate commerce for their own enrichment "by rigging the value of policyholder claims and raiding the premiums held in trust by their companies" and that companies "coerced their policyholders into settling their claims of damages for less than their value by editing engineering reports, by delaying payment and by forcing policyholders to litigate claims to receive full value."
Bob Hartwig, an economist who is president of the Insurance Information Institute trade group, said that Foti's accusations are baseless.

"To allege that insurers act collusively in the settlement of claims is an accusation that has no merit whatsoever," Hartwig said. "Insurers operate independently from each other in settling claims. They do not consult with one another, and they adjust those claims according to their individual contracts with their customers."

In
Louisiana , insurers paid out $28 billion on 1.2 million claims of all types from Hurricanes Katrina and Rita. "Those are very substantial numbers. Much of the rebuilding that's going on in Louisiana today is being done with insurance money," Hartwig said.

The suit names State Farm Fire and Casualty Co. and Allstate Insurance Co., Louisiana's two largest residential insurers; Farmers Insurance Exchange, the state's fifth largest homeowners insurance company; Standard Fire Insurance Co, better known as Travelers, the state's seventh largest homeowners insurer; military insurer USAA Casualty Insurance Co., the eighth largest homeowners company and tiny Lafayette Insurance Co., a division of United Fire Group.

The suit also names Marshall & Swift/Boeckh LLC and Xactware Inc., companies that manufacture leading claims adjusting software; and Xactware's parent company, insurance data collector Insurance Services Office Inc. It also names McKinsey & Co., an international consulting firm which was the architect of claims handling practices used by many major insurance companies.

Many of the companies named in the suit could not be reached for comment Wednesday. McKinsey officials said the company doesn't comment on anything related to client work. Allstate and Travelers officials said they couldn't comment because they hadn't seen the suit, as did State Farm, which also said it stands by its claims-handling procedures.

"We haven't seen the suit. What I can say is that we handle each claim individually based on the merits of the claims based on our contracts with our policyholders," State Farm spokesman Fraser Engerman said. "We pay what we owe."

USAA spokesman David Snowden said that lawyers are reviewing the suit. "USAA's claims practices are based on a foundation of ethics, fairness and integrity. Since Hurricane Katrina, we've worked with our members to individually resolve more than 20,000 claims in
Louisiana ," Snowden said. USAA is owned by its members, who are military personnel and their families.

The sweeping suit says that many insurance companies used the same consulting firm, McKinsey, to devise a strategy for reducing claims, and the success of those companies created financial pressure for everyone else in the industry to follow.

By using claims processing software manufactured by Marshall & Swift/Boeckh and Xactware, the industry has been able to standardize its tactics for low-balling claims, and create a "tainted" database of claims settlements figures which the industry uses to further depress estimates for what people need to repair their homes, according to the lawsuit.. Meanwhile, all of this data is centralized by Xactware's parent company, Insurance Services Office, better known as ISO, allowing companies to collude.

By using these outside vendors to unify "power and control," insurers systematically reduced the percentage of premium dollars that companies return to policyholders in the form of claims payments "under a shroud of secrecy." While the industry has historically paid 70 cents on every premium dollar collected back to policyholders in claims payments, in Katrina, they paid 50 cents for every premium dollar, the suit says.

Foti's suit was filed in conjunction with
Baton Rouge sole practitioner Joseph McKernan; New Orleans sole practitioner Mark Glago; and the New Orleans law firms of Herman, Herman, Katz & Cotlar and Capitelli & Wicker. Those firms are working with Jane Johnson, Louisiana 's assistant attorney general for anti-trust issues, without any guarantees earning legal fees.

The lawsuit relies heavily on the theories of
New Mexico attorney David Berardinelli, who wrote a book about the McKinsey company's work for Allstate called "From Good Hands to Boxing Gloves." The title of the book is taken from a McKinsey slide advising the company to don boxing gloves and pummel anyone who doesn't accept settlements for pennies on the dollar.

Prior to McKinsey's consulting work for the industry, insurance was viewed as a quasi-public trust in which insurance played a vital role in indemnifying the middle class against financial ruin. But McKinsey, in its quest to increase profits for its clients, ignored this unique function of the industry, and created a devastating strategy that rewards shareholders at the expense of policyholders that has spread throughout the industry, Berardinelli says.

Foti's suit says that insurance companies engaged in horizontal price-fixing "with the explicit approval of insurer management," and strategies to delay and deny claims. In the face of such strategies, homeowners are essentially buying insurance that will never adequately compensate them, meaning that they are overpaying on their premiums.

The suit takes note of the record profits achieved by the industry in 2005 and 2006, despite fielding the most expensive hurricane seasons ever in 2004 and 2005.

In alleging the conspiracy, Foti's suit notes the vast influence that the outside firms named in the suit have on insurance companies. McKinsey, for example, advises two-thirds of the nation's Fortune 1000 companies.

ISO brags in press releases that it has a searchable database of more than 500 million insurance claims, and its Xactware is used by 16 of the nation's top 20 property insurers. The company's software allows insurers to monitor what claims adjusters are doing through its XactAnalysis Quality Review and compare their work to the latest prices reported in the software's Industry Trend Reports, and allows insurers to assign reinspections.

Those trend reports allow insurers "to share the current prices being submitted by competitors, and thus, coordinate the horizontal price-fixing suppression, or attempted suppression, of the overall market in repair services at virtually every geographic level and price component," the suit says.

By December 2005, the cost of repairing a home had doubled since before the storm, and the cost of completely rebuilding a home had gone up by 50 percent, the suit says, yet the price lists of the insurers named in the suit had only increased by 15 percent to 20 percent by December 2005.

Once enough companies are onboard using a certain product others are under pressure to follow. Farmers, according to the suit, visited with a bunch of other leading insurance companies in 1998 and 1999, and when it saw the financial benefits of using the standard claims processing software, it started using Xactimate, too.

The suit cites quotes by Frank Coyne, chairman, chief executive and president of ISO, boasting that computerized claims software and aggregated data are changing how companies do business, while companies that don't follow are going out of business.

"In just a decade and a half, approximately a third of the insurers serving the
United States vanished as escalating competition ate into top-line revenue growth and bottom-line profitability. But it isn't just the intensity of competition that's changing . . .The nature of the competition is changing, too, as advances in predictive modeling and other analytical techniques enable leading insurers of all sizes to target their marketing, underwriting and pricing as never before."

Claims adjusters, the suit says, are pressured or required to accept the pricing database information from the Xactware or Marshall & Swift/Boeckh software in the estimates they write if the adjuster wants to be able to close the claim and get paid for the work.

While these companies purport to be providing an independent and objective benchmark for pricing, the suit says, "they intentionally devalue the market price in order to underpay their policyholders and/or artificially deflate, or attempt to deflate construction and repair costs in the affected market."

Meanwhile, the suit says that State Farm has testified under oath that it can modify Xactimate's price lists before adjusting claims. A pricing specialist conducts surveys building material suppliers for the latest prices and updated its
New Orleans prices several times per quarter between 2005 and 2007. However, the suit says, a State Farm price list containing 10,000 different items was exactly the same as a Travelers price list on Nov. 15, 2005 , something that would be "a statistical impossibility without collusion."

"This continuous arrangement gave insurers an unjust advantage over policyholder, which they took advantage of before, during and after the greatest disaster this country has ever suffered, by reaping huge profits from the misfortunes of persons whom they pledged to protect from risk of loss. They raised insurmountable odds against policyholders' ability to recover," the suit says.

The suit asks for all damages, including but not limited to, treble damages, attorneys fees and costs, injunctive relief and all equitable, declaratory and general relief.
 


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