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November 21, 2011

Public adjusters offer alternative on insurance claims | As storm losses mount, some policy holders seek their own adjuster

Jon Biller, attorney, Biller, Sachs, Raio & Zito
Tom Gilmore, independent insurance agent
POOL PHOTO COURTESY HARTFORD COURANT When a freak Halloween snowstorm slammed Connecticut, many businesses were forced to close while those that remained open — like this gas station photographed during Governor Malloy’s helicopter reconnaissance flight — did a brisk business. Adjusters — independent, company and public — flooded the area assessing the damages.

State residents, many still reeling from Tropical Storm Irene, are picking up the pieces from the latest lashing dished out by Mother Nature.

Last month’s historic nor’easter left a long trail of destruction — to the tune of $500-$750 million according to initial reports — and an equally long line of anxious policy holders calling upon their insurance companies to file claims.

The average homeowner claim runs about $1,000, and even for minor damages, navigating the claims process can be a daunting and time-consuming task for a policy holder. But, when damages reach into the tens of thousands of dollars — as is the case for many in the wake of these powerful storms — the process can become overwhelming.

Making a claim on a commercial property or for business interruption can be even trickier.

Was the estimate correct? Am I entitled to more? Am I being treated fairly?

Enter public adjusters.

There are three kinds of adjusters: staff adjusters who work directly for insurance companies; independent adjusters who work for insurers through a third-party; and public adjusters, who are licensed by the state insurance department to work directly for the insured party. They typically require no retainer for their services nor do they collect any fees unless the policy holder receives payment on a claim.

Each brings a different perspective and experience to evaluating claims. And the difference can be significant.

Public adjusters primarily handle claims of more than $25,000, which brings them into play in the case of the larger-scale damages many have recently experienced.

John Apicella of Apicella Adjusters in Orange has been a licensed public adjuster since 1976. Prior to that, he served as an insurance company agent for nearly 15 years.

“We professionally detail, appraise and document every part of the claim and submit it to the insurance company adjuster,” Apicella said. “We negotiate a settlement subject to your approval. We take over the entire burden of preparing and adjusting your claim.”

Apicella said public adjusters can be beneficial not only to the insured, but to the insurance company as well.

“In my years as a company adjuster, whenever I arrived on the scene of a major claim, I was pleased and relieved to find that the insured was represented by a competent public adjuster,” said Apicella. “I knew immediately I would be dealing with someone who knew and understood the policy and what needed to be done to present the claim to me for discussion and negotiation to settlement.”

“It’s a big part of what a good public adjuster does and good company adjusters appreciate it.”

As the stakes get higher, some policyholders — most of who have never even read their policy — that having a public adjuster involved brings some much-needed peace of mind. The public adjuster is working for the policy holder, not the insurance company. And for many, that’s well worth paying 10 percent of the amount recovered to the public adjuster. For larger claims, the fee can be negotiated.

The key said Apicella is to try to make the process as stress-free as possible. In fact, he said clients seldom complain about the fee.

“In the course of the adjustment, they see all the time and effort we put into preparing, documenting, and negotiating the claim,” Apicella said. “Clients are often surprised and impressed with the result; the bottom line; we know what the client is entitled to and working within the framework of the policy we get it.”

Hamden attorney Jon Biller, licensed by the state as a public adjuster since 1978, has recovered millions of dollars for policy holders in cases involving insurance payments.

His Biller Adjusting by Jon is a member of United Adjusters, a public adjuster firm which also includes Tancreti, Phipps, Hoffman & Biller; Robert Megna & Associates; and P.A. Inc.

“Public adjusters provide an invaluable asset to the consumer,” Biller said. “Public adjusters review insurance policy provisions to make sure all coverages are being provided; they inspect and evaluate building, contents and business interruption losses, and they negotiate with the insurance company adjuster or representative to make sure the insured consumer receives proper compensation for their damages.”

Some of Biller’s substantial settlements include:

• A $2 million-plus settlement of a homeowner claim in Eastern Connecticut in 2010;

• A $2 million-plus settlement for a commercial plaza in East Hartford in 2010;

• A $2 million-plus settlement of a homeowner claim in Stamford in 2009;

• A $1 million-plus settlement of a homeowner claim in Westport in 2008;

• A multi-million dollar plus settlement for a commercial plaza in Orange in 2006;

• and, a $1 million plus settlement of a homeowner claim in New Haven County in 2006.

He said the need for public adjusters will continue to grow.

“Each year, more public adjusters become licensed because there is a need for them, and in these difficult economic times public adjusters can be the check valve to be sure consumers are properly paid for their insurance losses.”

For some, using a public adjuster instead of their insurance agent elicits some fear of treading on an already-established relationship with their insurance company.

There is also a notion that public adjusters are trying to undermine insurance agents.

Tom Gilmore, an independent agent in Simsbury, says any animosity that may exist comes from the perception of some insurance agents that the adjuster is out to convince the insured that they are not going to get a fair settlement.

“I think if the person’s house just burned down and he’s standing on the sidewalk when a public adjuster arrives, he is most vulnerable,” Gilmore said. “I personally know of cases where insured’s have hired a public adjuster and then regretted it afterward.”

But, Gilmore is quick to add that there are no hard and fast rules and that each case — and each agent — is different.

“The answer is not black or white, but somewhere in between. I think there are cases where an adjuster provides a valuable service and I think there are cases where it is totally unnecessary and only costs the policyholder money,” Gilmore said. 

Whether choosing to use an insurance agent or to hire a public adjuster, Gilmore says the important thing is to practice common sense and understand your needs before jumping into any agreement.

“The vast majority of claims adjusters do a fair and conscientious job. I think the best course to follow is not jump into a business relationship that is going to cost you a significant amount of money unless you’re sure you’re going to benefit.”



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