Negotiating & Adjusting claims unlicensed!

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Negotiating & Adjusting claims unlicensed!

Adjusting claims or provided contractor claims services by an unlicensed Public Insurance Adjuster, how can I perform without getting into trouble or be reported to the TDI Fraud Unit (1-800-252-3439 – Report Fraud)?

During Mr. Ramirez’s construction career, he worked in Culver City, California gutting out the exterior/interior to the studs walls working directly with local building inspectors on bringing the building back up to code learning how to do it right with California Codes.   Although he had experience custom Home Builder & Professional Remodeling, Mr. Ramirez found his true mentor (City Inspector) failing him and introducing him to International Residential Code Book, which changed his life forever.  Returning to back home to Houston, TX he found himself working with investors with rental properties inspections, Abatement, Supervising Third Party’s,  Demolishing Commercial buildings and more.

In 2008 he accomplished his Graduate Master Builder (GMB) & Certified Green Professional (CGP) destination with the National Association of Home Building . During Hurricane Ike as a General Contractor, it wasn’t uncommon that unpaid supplemental on house were not paid by the insurer leaving the insured to pay the remaining cost.  In 2010 after completing his projects from Hurricane Ike, he took the challenge to diversify his career, studied and became a licensed Texas All-Lines Independent Adjuster.

As a Professional Estimator, a Commercial Construction Company client from San Antonio, TX called Mr. Ramirez to do an estimate for them for a commercial building in Universal City, TX, Mr. Ramirez was explained that the Staff/Independent Adjuster offered approximately $90,ooo and previous Public Insurance Adjuster wrote his estimate for $300-400k, Mr. Ramirez explained that he cannot negotiate or speak to the Staff/Independent Adjuster as it was stated in his contract, but that Mr. Ramirez will give his Professional Estimate with justification to each line item, after reviewing the estimate and going over with the commercial contractor Mr. Ramirez final estimate came out to $700,000+.  Mr. Ramirez do not know the final outcome of each estimate since Mr. Ramirez had an agreement not to interact with the Staff/Insurance Adjusters.

Another experience that Mr. Ramirez had was in a Hail Storm in March of 2012, in Mc Allen, TX.  In June of 2012, Mr. Ramirez had a Commercial Construction Company client call at very late hours asking him that if he was available for an emergency call for 3 Commercial buildings to do a complete evaluation and provide a Professional Estimate.  Within 48 hours of that call Mr. Ramirez was on the first flight to Mc Allen, once again he explained to his client that he cannot negotiate or speak to the Staff/Independent Adjuster as a Professional Estimator and would be a conflict of interest with his licenses.  Once Mr. Ramirez completed his estimate he was able to justified 1.7 million (70,000 Sq.Ft) “only exterior” .  Once again Mr. Ramirez was informed that the insurer only offered $200-300k, how nice it would have been to have a licensed Public Insurance Adjuster on your side right from the beginning.

How many times have you heard this or happen to you?

Don’t be afraid to call us for help, we can assist your clients (policyholder) on their claim and we will review all supporting documents to ensure that our estimates has local code upgrades and any additional coverage that was left out and not leave your clients with the remaining unpaid bills.

 

Violations

Note: Off-Season Independent Adjuster who perform as Contractors, General Contractor, Restoration, Auto, etc should be mindful of not using the Carriers version (Claim Rep, Policy#, Claim#, Date of Loss, etc) on your Estimating Software as most software has the option for Contractors.  Practicing as a Carrier, Agent or Claims Rep or Processing Claims or adjusting claims or business insurance by an unlicensed individuals without a licensed could be in violation (ClickTexas Department Of Insurance Bulletin)
 
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