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Important Notice From the California Department of Insurance

Let us know what your carrier is doing. For help with your insurance claim call us today!

STATE OF CALIFORNIA                                                                                        Dave Jones, Insurance Commissioner




S ACRAMENTO, CA 95814 (916) 492-3500

(916) 445-5280 (FAX)

www.insuran ce.ca.gov


TO: All Property/Casualty Insurance Companies and Other Interested Parties SUBJECT: Personal Property Coverage for Wildfire Claims

DATE:     December 21, 2017

In an effort to assist survivors of the October wildfires in Northern California and now more recent wildfires in Southern California, Insurance Commissioner Dave Jones is calling on all property insurance companies to follow the lead of other insurers who are providing up to 100% of Contents (Personal Property) coverage limits without requiring the insured to undertake the onerous task of completing a detailed inventory.

The Insurance Commissioner recognizes and appreciates that many property insurers have already agreed to the Voluntary Expedited Claims Handling Procedures. These included an initial advance payment for personal property of at least 25% of policy limits when there is a total loss of the primary residence in a wildfire disaster as well as reduced itemization of contents.

However, due to the large scale of these wildfires, many insureds are overwhelmed with the tasks of dealing with housing issues and family issues and construction issues and other major adverse changes in their daily lives. These fires, taken together, are the largest and most destructive fires in California history. The fires have destroyed whole neighborhoods and devastated communities. The Department has received numerous complaints from insureds about the monumental task of attempting to identify every item of personal property they may have amassed over years or decades in order to collect replacement cost.

The Department is aware that some insurers are going above and beyond the Voluntary Expedited Claims Handling Procedures and have made significant efforts to accommodate their insureds by offering 75%, 80% or in some cases 100% of Contents limits without an inventory, with the ability to recover additional benefits if the insured subsequently completes a full inventory.

Insurance Commissioner Jones applauds these insurance companies for putting their customers first and requests that all other insurers follow suit by providing a similar accommodation. The Commissioner requests that insurers advise the Department by January 8, 2018 as to whether or not they will comply with this request.”

Denying Claims is Bad Business.

businessman with umbrella and thumb down rain

Is your claims adjuster trying to find coverage for your loss or are they trying to find exclusions of coverage.

This subject is at the center of every relationship between an Insurance Carrier and their Insured. What duties does the insurance company truly owe their insured when reviewing or analyzing coverage?

One of my favorite texts that describes the relationship between an insured and their claims representatives was written in 1993 in the claims adjusting training text for AIC 33 by Markham, James J. The Claims Environment. Malvern: Insurance Institute of America, 1993 print which says on page 13 paragraph 3:

“The primary duty of the claim representative is to deliver the promise to pay. Therefore, the claim representative’s chief task is to seek and find coverage, not to seek and find coverage controversies or to deny or dispute claims. Because of the personal relationship formed in an insurance transaction, the insurance company should not place its interests above the insured’s. The claims professional handling claims should honor the company’s obligations under the implied covenant of good faith and fair dealings.”

This is one of the most powerful descriptions of what the relationship between and insured and their Insurance carrier is supposed to be. The consumer is at a disadvantage when negotiating an insurance claim as they don’t have a say in what is written in the policy and most-often do not understand much of the policy. More importantly, they are relying on the insurance company to stand by their promise of coverage in the event of a loss. There are several reasons why there is an implied covenant of good faith, but that is a topic for another post.

With the goal of Good Faith claims handling in mind, searching high and low through the policy to find coverage should be the number one goal of a claims agent in every case. Unfortunately, over the past several years, our experience has been that the claims agents are moving farther and farther away from looking for coverage and more toward trying to find ways to deny coverage. Good Luck on your claims.

If you have a claims question, feel free to contact justin@skiptoninc.com or call us at 877.992.7577.

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