Introduction

We don’t physically do your job, we help you develop, manage and guide the process you need.

  • Who better to deal with a contractor than another contractor?
  • Who better to deal with an adjuster than another adjuster?
  • Who better to try and resolve problems than a person who provided AAA Judicial Services as a Mediator and Arbitrator?


For Discussion:

  • Purpose
  • Scope of Service
  • Neutrality Issue
  • Qualifications
  • Contingent Fees
  • Fee Schedule Assignments
  • Time Block & Availability
  • Nature of Dispute
  • Facts and Circumstances
  • Alleged Damages
  • Documentation; Available & Needed
  • Status of Loss, Progress & Payments
  • Procedures; Construction & Insurance
  • Suggestions, Desires and Hopes
  • Presentation(s); Form & Contents
  • Industry Standards
  • Supporting Information
  • Supporting References
  • Forms and Database Work
  • Pricing and Summary
  • Coordination and Correspondence
  • Graphics & Photography
  • Findings, Facts and Conclusions

              Attorney Support Services:

  • Solicitation, Research & Reviews
  • Specific Memo’s &  Briefs
  • Task Oriented Assignments
  • Investigative Work & Reporting
  • Compound Question Data (Used in discovery and examinations)


Insurance Matter Services are either provided:

  1. In the capacity of a Public Insurance Adjuster using the Standard Form Contingent Fee Agreement ;
  2. As the Party Appointed Appraiser under a Fee Schedule where insured’s have already submitted claims and/or been in communications with an Insurance Company and its' adjusters or staff.


Appraisal & Appraisers

Once an insured has taken control, submitted claims and had communications with an insurance company, right or wrong, they have failed to do certain things and may have exhausted some alternatives. It may be the insured has also made some number of mistakes. In these instances, insured's are usually best served by appraisal where they have coverage and it is permitted in the policy. The insured and insurer both pick a competent and disinterested appraise to evaluate the costs called actual cash value and replacement cost. The party appraisers then appoint an "Umpire" and where there is any disagreement as to costs, those portions are submitted to the umpire. A decision by two is then final. Where this happens, each party pays their own appraiser and shares equally in the costs of the umpire and any associated expenses equally. It is worthy of noting that in some instances the party appraisers can come to an agreement thus eliminating the need to call upon the umpire and absorb those expenses (i.e. Fees & Costs like Conferencing or Room Rentals)

It is important to recognize that appraisal prohibits any form of coverage review and is only focused upon the costs; units prices and totals comprising the final calculation of actual cash value ("ACV") and Replacement Cost ("RC"). It is also worthy of noting that many disagreements can arise in this process. For example, the first task is to make sure the appraisers have no conflict and are in fact neutral and "Disinterested". They should not have been employed previously or be in a position to accept concurrent and/or future assignments. An insured may be deemed to have achieved compliance and file suit against a Carrier if they refused to appoint a disinterested person. 


Appraisal Process

This process is designed to help circumvent litigation but it must be noted various areas and types of disagreement are not subject to appraisal. People cannot claim damages in appraisal, it is ONLY to review the reasonableness of various costs. Your attorney will also find you can exercise your rights under Rule 202 that provides for a petition and discovery in a "Pre-Suit Examination Process".

Once you hire your party appraiser they should receive a Retainer Payment against which fees and costs are taken; payment in advance insures neutrality. This means an appraiser need not say and do what either party wants to get paid,  but instead, must rely upon their knowledge and expertise to make determinations without undue influence. This design intends a fairness of process for both parties.

Next, the demanding party must then issue a proper appraisal request as the other only has 20 days within which to appoint its’ disinterested representative. The party appraisers then routinely have up to 15 Days to appoint the Umpire. A showing of neutrality can be as simple as documenting a retainer since most insurance companies will not pay their appraiser a retainer.

Next the appraiser must receive and review pertinent records. An award form must be designed, submitted and approved for use by the party appraisers. The form is also provided to the Umpire. This form lays out exactly how the award will be presented upon conclusion.


The Public Insurance Adjuster

This service can rise to the level of an art form where you have a personable individual with vast experience in both construction and insurance. Many problems arise where Insurance Company personnel have little experience in building and repairs; especially where you find a representative that has built a hundred million in work. Why? One can go to school to become a doctor but in fact, really knowing construction, takes many years of experience to develop expertise in so many different areas. All contractors are not experts.

The first step in the process is entering into a standard form contract that cannot be modified as licensed public adjusters are required to have these agreements on file at the Texas Department of Insurance. Should you change your mind, cancel the agreement within 72 hours as there is no pressure. A most important factor is honesty, it is critical you are forthcoming and provide all the information and records needed to present the best possible claim Often your public adjuster will submit a sworn proof of loss as well. Your Public Adjuster will certify the claim and you may be asked to do an Examination Under Oath where you [informally] testify to the facts.

The next step is managing the loss, the documentation, the sworn proof of loss submittal; and providing the meetings and back up services to fully account for the loss in the Carriers file. Your Public Adjuster will also coordinate the distribution of funds.

By State Law, the Public Adjuster operates under a Power of Attorney to speak and act in the insured's behalf, and only represents insured’s not insurer’s.


Consulting, General, Construction , Risk Loss Management and Advisory Services


We provide an hourly service under a simple fee schedule agreement that was first employed in 1982. Contracts are only as good as the people who make them so we decided many years ago not to demand lengthy notarized agreements with our private and commercial clientele; nor do we intend to become involved in disputes with our own clients where we would need such lengthy agreements. You do not even have to sign our agreement, it becomes operative when you first order services and pay the retainer. Buy what you can afford and do not spend money on things you don't need. Spectrum can be turned on and off like a light switch with each account retainer. If your assignment is accepted, you pay an agreed upon retainer, often in relation to a specific time period or assignment. Hourly services are provided and when the retainer runs out you, you can replenish the account. In this way your commitment is limited and you remain in control of the purse strings. We do not bill by the tenth of an hour like attorneys we are more flexible. The hourly service is also simple, it is broken down into three (3) fundamental categories. You pay for Office Work (Class I), Outside Work (Class II) and Legal Related Work (Class III). You pay basic out of pocket type expenses directly related to your assignment and you essentially get the use of our high-tech equipment. When you approve the use of any other team-vendor if necessary, you only pay the direct amount without any other overhead and fees charged by Spectrum. Since Spectrum does not do your job we can also provide our Clients referrals.   Another way you can control costs is using a common sense approach to your assignment. For example, if your assignment requires photographs, you can have them printed, but we often find Client's prefer receiving photographs via email, on Disc or using a Thumb-Drive on larger assignments. We therefore developed a process by which the .JPEG File Format is converted into a .PDF Document. The pictures are consolidated into one document, optimized and the file sizes are reduced in the program. Now you essentially have the exact record, it can be printed in book form, multiple views on each page or single enlarged views by you or any local printing service. 


Conclusions

This presentation is superficial and designed to merely bring out some basic information to give you a flavor of the issues at hand. You should ask questions, learn about the process and be supportive of your representative while remembering, Public Adjusters only get paid when you get paid. The best thing an insured can do is contact their Public Adjuster before calling an insurance company. Did you know if an insurance company pays you within 3 days or you are to receive the total limits of liability you don't need a Public Adjuster?
Many people may not disclose these important facts. You can also call TDI with questions you may have.


Insurance claims can be difficult and more so depending upon the company and the representatives they assign. Some have bad reputations and it is important to stress the lowest policy price is not usually the best coverage; you get what you pay for! 

Good Advice: Always take pictures and  keep an accurate diary starting at inception.


Routine Report Attachments and References


  • Contracts/Agreements (Your PA Contract is a Privileged Agreement, the Part 1 Designation is the Notice Insured's send) 
  • Fee Schedule
  • Key Documents
  • Qualifications
  • Key References
  • Photographs & Sketches
  • Time Line
  • Other

Professional Services

PARTNERING FOR SUCCESS