Hurricane Season Adjuster To-Do List

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While it’s nothing new for those of us in the claims world,
the official start of the Atlantic Hurricane Season is
June 1st
 
That Means: It’s 5 Days Away! 

At Provencher & Company, we trust our adjusters are as prepared for the upcoming storm season as the insured is advised to be. However, we often get so wrapped up in our daily claim work that we neglect to prepare ourselves personally for a storm deployment.

As such, we have compiled a quick “to-do” list for our adjusters to ensure each of you are ready to go when you get the call to deploy:

1. Prepare your home in advance. Do you live in a “potential threat zone”? Don’t be caught in Florida working a storm and have your home unprepared back in Texas with a CAT 3 headed that way.

2. Prepare your vehicle. Tires good for travel? Routine maintenance done?

3. Using a RV during deployment? Prepare it for the trip too. Routine maintenance, stock supplies, etc.

4. Prepare your computer. It happens every year….. at least one computer crashes in the field and the adjuster panics. Don’t be the person that loses all your work. Make sure you are up-to-date on anti-virus software and have an external hard drive.

5. W5 Claim Management. Learn it, use it, love it! Provencher & Company has a comprehensive claims management system that we have worked hard over many years to develop into all that we want & need. Use it – its to your benefit. Don’t worry about losing your photos or estimates. Once you create them, save them to the claim file and there is no fear of the documents being lost.

6. Estimating Software. The middle of a CAT is not the time to learn a new estimating software. If you are contemplating make a change, please do so NOW! Learn the software prior to having to handle 200 claims in a 2 week period! While Provencher & Company does not currently require one estimating software over another, some of our clients do require Xactimate only. We strongly encourage those adjusters who will be deploying for CAT duty to use Xactimate as it will increase our ability to place you during deployment.

7. Photo Required. We need a photo for every field or desk adjuster on file. These might be used to produce a CAT ID if you work for us in the field. There are also occasions where our clients want to learn more about a file reviewer. We will be sending out a reminder notice in a few days to those still missing photos. Please supply an unprotected Jpeg file so we can resize it to fit if needed. Send any new photo (or if you want to replace your old photo) to info@provencherclaims.com.

8. Updated Personnel File. Please make sure you have completed a 2015 Adjuster File Update Form. If not, we need this! It includes your emergency contact information, state licenses, etc. Heaven Forbid, but if you fall off a roof, we need to know who to contact in case of an emergency! Unfortunately, it happens, even to the most experienced of adjusters! Just ask Jerry!

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Number of Occurrences Determination

3b495-legalscalesimageNumber of occurrence can be a knotty issue for courts and coverage counsel. In interpreting the standard policy language, the vast majority of courts count the causes rather than the effects of the harm to determine the number of occurrences. To determine the number of occurrences, courts must look at the specific act of the insured that immediately precedes the harm and directly led to liability.

Multiple plaintiffs sue a petting zoo for exposing them to E. coli bacteria. The petting zoo’s liability insurer maintains that the applicable policy’s per occurrence limit of $1 million must be spread among all the claims. A federal district court agrees, holding that all of the exposures to E. coli constitute a single occurrence and trigger only a single $1 million limit.

A defective plumbing system damages 19 buildings in an apartment complex. The apartment complex’s insurer maintains that 19-per occurrence deductibles apply. A federal court agrees, holding that the damage to each building constitutes a separate occurrence implicating separate deductibles.

Defective paneling damages 1,400 houseboats, house trailers, motor homes and campers. The paneling manufacturer’s insurer maintains that 1,400 per-occurrence deductibles apply. A federal appeals court disagrees, hold that the damage to all the vehicles constitutes a single occurrence implicating a single deductible. (source)

2015 CLM Webinar

Keais

Number of Occurrences Determination

Identifying the number of “occurrences” as defined in a liability policy is critical to determining whether the per “occurrence” or aggregate policy limit applies. This is often a million dollar difference. The importance of this issue is illustrated in cases involving lawsuits arising out of food-borne illnesses with numerous plaintiffs suffering from serious injuries. The claimants/plaintiffs’ goal in those cases is to maximize the policy limits available.

One such case is Republic Underwriter Ins.,et, al. v. Moore, et al, 493 Fed. Appx. 907 (10th Cir. 2012), in which both Pete Duncan (as the claims professional) and Linda Szuhy Ressetar (as counsel for the insurer) were involved. They will discuss the legal and practical lessons learned during the life of that case and recent litigation on the issue.

Date: Wednesday, June 10, 2015
Time: 12:00 PM – 12:30 PM EDT

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*This posting is for informational purposes only, as a courtesy to our reading audience. Provencher & Company has in no way been compensated for the sharing of this information. The use of or enrollment in any classes, seminars, training, etc. in no way constitutes or implies any endorsement of the provider of said programs. Provencher & Company shares no financial obligation to attendee or organizer.

Reptile 101: What Claims Handlers Need to Know

reptile behavior (1)Reptile strategy has taken the plaintiffs’ bar by storm. The Reptile theory asserts that you can prevail at trial by speaking to, and scaring, the primitive part of jurors’ brains, the part of the brain they share with reptiles. The Reptile strategy purports to provide a blueprint to succeeding at trial by applying advanced neuroscientific techniques to pretrial discovery and trial.

The fundamental concept is that the reptile brain is conditioned to favor safety and survival. Therefore, if plaintiff’s’ counsel can reach the reptilian portion of the jurors’ brains, they can influence their decisions; the jurors will instinctively choose to protect their families and community from danger through their verdict. Thus, the focus of the plaintiff’s case is on the conduct of the defendant, not the injuries of the plaintiff. The jurors are not interested in plaintiff’s injury, even when severe, according to the theory. Rather, the only truly effective way to engage jurors is to demonstrate how the defendant’s conduct endangers the jurors and their families. (source)

 

2015 CLM Webinar

Keais

Reptile 101: What Claims Handlers Need to Know

Plaintiff attorneys are using Reptile strategy to unreasonably increase claims value. Attend this webinar to learn the basics of the Reptile program, and what claims handlers can do to identify use of Reptile strategy, as well as defense strategies which can defeat the Reptile strategy.

Date: Wednesday, May 27, 2015
Time: 12:00 PM – 12:30 PM EDT

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*This posting is for informational purposes only, as a courtesy to our reading audience. Provencher & Company has in no way been compensated for the sharing of this information. The use of or enrollment in any classes, seminars, training, etc. in no way constitutes or implies any endorsement of the provider of said programs. Provencher & Company shares no financial obligation to attendee or organizer.