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13th Case Report of California Certified PA (Public Insurance Adjuster) Jae Park- Water loss at Fullerton, California. “Do I need to file a claim” & “Do I need help with claim adjustment”

13th Case Report of California Certified PA (Public Insurance Adjuster) Jae Park

At the end of February 2013, a pipeline in Mr. K’s house, located in the Northwest area of the Orange County region, was ruptured. Due to this rupture, the kitchen cabinets, the cooking appliances and the high-quality wooden kitchen floor were all damaged. At that time, the insurance broker told Mr. K that if he filed a claim, it could result in future disadvantages such as none renewal and spike of future premiums. The broker suggested that it would be better to repair the damages through his own expenses. Mr. K called the plumber according to the agent’s advice, but the plumber gave Mr. K the opposite advice.

“Since the facilities including the sink, cabinets, etc are showing some signs of collapsing, the scale of repair is too big to fix through your personal expenses. It would be safer to file claim through the insurance company,” he said. Mr. K thought that the plumber had a point, so he filed a claim through the insurance company, ignoring the advice of the insurance broker. Soon after, the insurance company sent the water restoration contractors, and while they were working on the facilities inside the kitchen, the sink eventually collapsed. The compensation was paid at the beginning of April based on the estimates of the contractors appointed by the insurance company.

The details of compensation payment were as follows:

1) 50% of the collapsed sink is reusable, so only 50% of the damaged cabinet portion should be paid.

2) The total compensation for the wooden floor and paint on the wall, etc. will amount to about $12,000.00.

As soon as Mr. K received the compensation, he called several local contractors and requested for construction to commence, however, the contractors refused to accept the job. The problems they pointed out were as follows:

1) It is impossible to recreate the color or appearance of half the sink to match the other half, so the entire kitchen cabinet should be replaced.

2) The kitchen floor also should be completely replaced.

3) All construction costs including other paint jobs seemed to be over $30,000.00.

In other words, it is not possible to repair the damages solely with the compensation provided by the insurance company. So Mr. K requested for additional compensation to the insurance company and the insurance company denied his request.  Mr. K was confused by his current unexpected situation and asked for solutions from many insurance industry professionals including the first insurance broker who had given him advice, but all their answers were consistent – there were no other measures that could be taken. Now, Mr. K had to repair the damage with a large amount of his own expenses. He was stunned.

Greatly saddened, Mr. K was introduced to me by chance, through the floor contractor who visited the flood site. This occurred after one month of suffering, with only his first compensation paid out. I swiftly handled this case within only 8 days after accepting the job, and Mr. K received the second compensation to the sum of about $22,000, concluding the case. Until this case was complete, Mr. K felt regretful that he did not receive any critical information from insurance agents and brokers.

The position of the PA has been in the public domain for a long time, but majority of general public who do not know about this position. If Mr. K knew about the PA in advance, he could have closed this case stress free. I suggest that readers should advise the people around them to subscribe to our office’s monthly case review column for the purpose of obtaining important information regarding their home and business insurance policy and insurance claim adjustment process.

Additional columns available in English, Korean, Chinese, and Vietnamese at www.JPadjusters.com. 

Jae Park, AIC.

Public Insurance Adjuster, License # 2H67374

Ex-State Farm Insurance, large & complex property loss claim adjuster

IICRC/Clean Trust- WRT, AMRT, FSRT

Member of CAPIA/ California Association of Public Insurance Adjuster

Jae Park & Associates, Inc.

3255 Wilshire Blvd Suite # 1414

Los Angeles, CA 90010

Business Cell # 213-572-7379

Fax# 877-277-9752

E-mail: Jae.Park.Assc@gmail.com

Website: www.JPadjusters.com

Posted by Jae Park  |  0 Comment  |  in English

12th Case Report of California Certified PA (Public Insurance Adjuster) Jae Park: Wind damage & Duties After the Water Loss

12th Case Report of California Certified PA (Public Insurance Adjuster) Jae Park

One night at the beginning of the 2012 winter season, a very strong wind began to blow. Due to this powerful wind, a two-story property located 20 miles northwest of Los Angeles caused a great distress for its next-door neighbor. A huge tree in the backyard could not withstand the strong wind and collapsed, breaking part of homeowner Mr. B’s fence, causing huge damage to the roof as well as inside of Mr.B’s neighboring house.

Right after the accident, Mr. B filed a claim to the insurance company after consulting with the insurance broker. A few days later, he was notified of the compensation and was surprised to hear the result.

1)      Mr. B’s insurance company could not compensate for the damage caused to the neighbor’s house. The reason for denial was that for the last three years the house had been rented to other people and Mr. B had not lived in the house himself. The insurance company pointed out that when leasing the home, the policyholder should notify the insurance company. Furthermore, the policyholder did not have the appropriate insurance contract for leasing the house.

2)     For Mr. B’s collapsed fence, the repair cost of $1000 was agreed to be compensated.

3)     As for the tenant’s luxury car, which the fallen tree had damaged, it was not to be compensated (but was eventually resolved by the tenant’s car insurance company).

Based on the above claim results, the neighbor sorted out the damage with his own home insurance company and in February 2013, the neighbor’s insurance company notified Mr. B that the compensation lawsuit was filed (subrogation). The insurance company asked Mr. B to pay the damage compensation which they had paid for. The amount was almost $100,000.00. Mr. B who was surprised to see the considerable litigation costs, made every effort to find a solution. When he finally found me in mid-May 2013, he considered me to be his final hope. About three months passed after receiving the initial notice. After hearing the distress that Mr. B went through, I had to reject Mr. B’s case. I could not solve his case. In other words, the case was impossible to accept. It was heartbreaking for me. The provision concerning house rental including changes in usage of the house is specified in most of the related insurance policy terms. The policyholder must notify insurance company his house is rented out anytime during the contract period. If the house is intended to be leased, it is the policyholder’s duty to inform the insurance company immediately and the insurance contract should be modified. If the policyholder does not mention this, the relevant insurance contract will automatically become invalid. Recent insurance industry trend is to enforce such regulations in a stricter fashion, so they tend to avoid paying the claim. It is the policyholder’s responsibility to inform the insurance company of any changes made to the insurance contract. The responsibility of any problems that occur without notification is not that of the insurance broker or agent. It is not a matter of complaining that the insurance sales professionals did not take care of everything. In other words, the policyholder should tend to his own affairs so that he can keep his property well.

I would like to conclude this column by providing tips for policyholders dealing with flood damage. The policyholder has various duties to fulfill after the loss under insurance policy, I have mentioned these duties and regulations many times before. Flooding is also one of those sensitive type of the loss that shows a sharp difference between policyholder and the insurance company understanding of its duties and responsibilities. The policyholder should be prudent when dealing with insurance contracts, taking into account the size of the expected damage, where compensation might be large.

“If water damage has occurred; to avoid the situation from worsening the policyholder should

1)     stop the leak, or source of the water

2)     Take all possible actions to remediate the loss from further damage.

The policyholder’s duties after the loss in the case of a water loss claim is a powerful clause in the insurance contract.”

Additional columns available in English, Korean, Chinese, and Vietnamese at www.JPadjusters.com.

Jae Park, AIC.

Public Insurance Adjuster

IICRC/Clean Trust- WRT, AMRT, FSRT

Member of CAPIA/ California Association of Public Insurance Adjuster

 

Jae Park & Associates, Inc.

3255 Wilshire Blvd Suite # 1414

Los Angeles, CA 90010

Business Cell # 213-572-7379

Fax# 877-277-9752

E-mail: Jae.Park.Assc@gmail.com

Website: www.JPadjusters.com

Posted by Jae Park  |  0 Comment  |  in Blog, English

11th Case Report of California Certified PA (Public Insurance Adjuster) Jae Park. Water loss/ Homeowner insurance claim/ with High Deductible

11th Case Report of California Certified PA (Public Insurance Adjuster) Jae Park

At the end of March 2013, I (California Certified PA(Public Insurance Adjuster) Jae Park) was staying abroad due to personal reason, across the Pacific Ocean from the United States. Late one night while I was working on a tight schedule, I was interrupted because of an urgent phone call from Los Angeles. It was the first consultation call from the client, Mr. K, who was extremely frustrated due to result of the home insurance claim he have filed recently.

Such telephone consultations continued several more times until I returned to the U.S. Mr. K’s problem was so urgent and he was so anxious that I could not postpone the consultation until I arrived in the U.S. Due to Mr. K’s urgency, my schedule was even busier than before.

Mr. K’s story is as follows:

In early March 2013, the water pipe inside the bathroom located on the first floor of a two-story house near L.A. was ruptured. This caused most of the living spaces, including the living room (with wood flooring) as well as the bathroom, to be seriously waterlogged due to flooding. Mr. K immediately filed a claim. After the staff from the insurance company’s claim’s unit visited and inspected the site, the compensation was promptly paid out. However, when Mr. K received his compensation, he was astonished by the ridiculous amount. It was a check for only $600.00.

The insurance agent who heard the story explained to Mr. K that it was because the deductibles for his home insurance were $7600 (when Mr. K transferred the insurance from another major insurance company to the current one, the current insurance agent increased the deductibles from $1000 to $7600. The current agent attracted Mr. K by lowering the existing premium and the agent chose to increase the deductibles. Mr. K didn’t look at the relevant documents after changing insurance companies.)

Whatever the circumstances, Mr. K did not have the personal funding to repair the damage caused by the flooding. This put him in a very difficult position. Due to Mr. K’s aggressive complaint, the insurance agent requested that the insurance company to process the deductible as $1000, since the agent himself caused the error in the insurance contract. However, the insurance company stated that it was impossible to change the contract, pointing out that three years had already passed. This is Mr. K’s case.  Mr. K expected me to solve this deductible problem. However, that was impossible. What kind of insurance company would change the insurance contract terms in favor of a policyholder after the damage has occurred?

After returning back to Los Angeles, I visited the site. I compared and reviewed the damage, and found some of the scope of damage was missed by insurance company’s staff adjuster. I found items that even experts could miss if they do not pay close attention. After the review I found a clue to improve Mr. K’s situation. I requested additional compensation to the insurance company for these overlooked items. With the claim unit’s sympathy, as they knew about the policyholder’s distressing circumstances, Mr. K received additional compensation and therefore restored the property to its original state. This case was concluded 16 days after acceptance. The insurance terms were chosen by the policyholder.  The policy that is processed by the insurance agent or broker will not be changed even if the policyholder insists that there is something he does not understand.  Readers, please be aware that.

In fact, this case was too small to handle for me, but as an expert in his field I thought it was my duty to help the policyholder.

Additional columns are available in English, Korean, Chinese, and Vietnamese at www.JPadjusters.com.

Posted by Jae Park  |  0 Comment  |  in Blog, English
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