The Anatomy of a Proper Complaint – PublicAdjusterBootCamp.com Session 002-20

 

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Session 002-20 February 3rd – 7th, 2020

 

Below is a redacted complaint that will be delivered this morning. So we are all very, very clear… the Department of Insurance will not normally force a carrier to do much of anything, but respond. The intent is not have the DOI force them to pay what they owe, that will never occur. The intent is to get it on record, where everyone that needs to know what occurred, knows. This would be inclusive of anything that would arise on this claim. From the reports they must turn into the DOI on complaints, to the number they receive, and ultimately, to deter those who would say that carriers are doing “just fine” by insurers…

This could very easily be you as an insured…

If you are reading this, the odds of it happening to one of your clients just shot to about a 99.99% that this is occurring on claims you are working now. While we cannot stop carriers from pulling this, what we can do, is what we have done here, and laid out a road map to the entire process. That would be inclusive of performing the insured’s “Duties after a loss” as well as the “Suit against us clause.” Carrier typical amass a ton of legitimate looking paperwork that makes it appear that they have gone above and beyond, and dad gum it, we just don’t owe anything… Like any #PyramidScheme, there needs to be an illusion that this works. Again, like all “Pyramid Schemes”, once the first layer comes off, what is underneath is impossible to hide.

That is what we teach you to do… #ProtectTheInsured

 

 

December 31, 2019

 

Complaint with regard to the below named company:

“Carrier”

P.O. Box 12345

Oakland, CA 12345

800-Claims

877-Fax

Desk IA-

Field IA –

Field IA –

 

(While we do not normally include the contractor, this one is involved from the carrier’s behest, as part of their “preferred vendor” program. That involvement is a portion of this complaint.)

 

“Preferred Vendor”

12345 Avenue

Oklahoma City, Oklahoma 12345

877-730-1948

 

Re:   

Insured:                     Protected Insured

Property:                12345 Drive

Blanchard, OK 73010

Claim No:              12345

Policy No:             12345_6

Date of Loss:         September 09, 2018

Covered COL:       Fire

 

Oklahoma Department of Insurance:

Consumer Complaints

Anti-Fraud Unit

 

We represent the insured named above in this complaint against the above-listed parties.  Please note that we need to be notified of any actions that may be taken on this complaint.

 

The insured suffered a covered loss on September 09, 2018. She subsequently filed an insurance claim on the above policy and received the above claim number. The insurance carrier notified the insured of their “Preferred Vendor” program and got her in contact with “Preferred Contractor”. She subsequently signed a contract with the “Preferred Contractor”, that is, in essence and appearance, an AOB, authorizing the “Preferred Vendor” to “work” with her insurance carrier to obtain the proper amounts to restore her home to pre-loss condition. (Signed 9/11/2018 Exhibit “C”) This was done because the insured, who is Hispanic, and speaks very little English, was led to believe it was in her best interest. Unfortunately for her, and everyone involved, it has taken over a year, and the involvement of outside help to decipher what occurred, and why in the world the insured is still not “home”, nor is any of her belongings. One year and 3 months after the loss. What we are providing below, are the facts as we know them, and what we have put together as the claim has progressed, once the insured retained us, and we went back to the policy, and followed the provisions therein, more specifically, Duties after a loss and the Suit against us clause that would require the carrier to perform. As we have proven, they have done everything to “appear” to have done a thorough and professional job, however, after a quick review, it should become clear to even a layperson, that never even come close to happening, until we did it.

 

There are so many blatant violations that we are only going to list some of the major ones. We are not attorneys, we are simply laying out the case for the Department, and the attorney who will represent the insured once we are done.

 

We signed with the insured on 10/01/19. She signed on 09/10/19. We completely reviewed everything we could get before accepting her claim. The following all occurred prior to our involvement, and is what we have found to be the facts of the claim:

 

  1. The insured has Jewelry and a Coin Collection stolen during the “pack out”. The insured notified “Carrier Adjuster” Oswald via email on November 1, 2018. (Exhibit “D”) “Carrier Adjuster” Oswald responded in that chain, stating while she felt sorry for her plight, she was free to file a new claim, and that a new claim with a new deductible would apply. There are several issues with this. The first being a misrepresentation of pertinent coverages. The policy, (Exhibit “A”) specifically includes this scenario, and is listed in Section E Additional Coverages, Subsection 5, Property Removed. The date falls well within the 30 days provided by the policy from when she was provided a list of the items by the “Preferred Vendor” According to Exhibit “E” it was the same day. November 1, 2018. There would be no need for “new claim” nor an additional “deductible”, both of which are detrimental to the insured. Which brings us to the next symptom of this problem. The original fire is considered “man-made”, therefore it would go against the insured on a claim filed per policy period, or more specifically, how many can be filed in a 1-year period before an insurer can “legally” cancel an insured. The second claim that “Carrier Adjuster” Oswald encouraged her to file would be just that… a second claim against the insured, thereby allowing a cancellation if it occurred. (While I will never see the inside of “CARRIER”’s claim handling, the Department of Insurance can, and if I were the department, I would certainly want to see, to make certain that none of these aspects were done for that very reason… to eventually remove her based on the 2 claims strikes.) Suffice to say this alone… is bad, and it is in writing.

 

Sec. 551.107.  RENEWAL OF CERTAIN POLICIES;  PREMIUM SURCHARGE AUTHORIZED;  NOTICE.  (a)  This section applies only to a standard fire, homeowners, or farm or ranch owners insurance policy.

(b)  A claim under this section does not include a claim:

(1)  resulting from a loss caused by natural causes;

(2)  that is filed but is not paid or payable under the policy; or

(3)  that an insurer is prohibited from using under Section 544.353.

(c)  An insurer may assess a premium surcharge at the time an insurance policy is renewed if the insured has filed two or more claims in the preceding three policy years.  The amount of the surcharge must be based on sound actuarial principles.

(d)  Subject to Subsection (e), an insurer may refuse to renew an insurance policy if the insured has filed three or more claims under the policy in any three-year period.

(e)  An insurer may notify an insured who has filed two claims in a period of less than three years that the insurer may refuse to renew the policy if the insured files a third claim during the three-year period.  If the insurer does not notify the insured in accordance with this subsection, the insurer may not refuse to renew the policy because of claims. The notice form must:

(1)  list the policyholder’s claims; and

(2)  contain the sentence:  “The filing by you of another claim, except for a claim resulting from a loss caused by natural causes, a claim filed but not paid or payable under the policy under which it was filed, or an appliance-related claim that we are prohibited from using under Section 544.353, Texas Insurance Code, could cause us to refuse to renew your policy.”

(f)  In this section, “premium surcharge” means an additional amount that is added to the base rate.  The term does not include a reduction or elimination of a discount previously received by an insured, reassignment of an insured from one rating tier to another, re-rating an insured, or re-underwriting an insured by using multiple affiliates.

(g)  The commissioner shall adopt rules as necessary to implement this section.

 

  1. We have sent demands for all paperwork involved. We have received a corrupted disk that had a virus on it. We asked them to send paper copies. We received a ream box full of mismatched, duplicated files that were an apparent attempt to be petty. Among the information sent, is a summary of all payments (Exhibit “B”). There is a payment in July of 2019 for $24,756.56 to “Preferred Contractor” that is not listed, yet the paperwork is there for it. We have no idea why it is not in payment summary, or why it is separated. (Exhibit “F”)
  2. “Preferred Contractor” submitted an estimate/invoice for $10,021.89 on 09/21/18. (Exhibit “G”) “CARRIER” paid the full amount on 11/05/18. In this Invoice alone, that was paid in full by “CARRIER”, “Preferred Contractor” billed for plethora of items. All detailed in the exhibit above. The problem arises when you bill an insurer/insured for stuff that was never completed. A few of the simple to check items on this invoice, would be the tub, toilets, cleaning the duct work, just a few. This is called Fraud. (I pointed all this out on the mutual inspection that occurred on 11/18/19. “Mr. Carrier Adjuster” agreed, at that time, that the loss was not where it was billed to be.) This is textbook fraud. “Mr. Carrier Adjuster” and “CARRIER” have had since then to correct, or report. They have done neither.
  3. “CARRIER” revised their estimate on 10/12/2018. A supplement was issued for $13,385.63. (Exhibit “H”) There is no question that there was not enough money paid to complete the project, but there will never be a time where it is ok to double bill for items, or bill for items that do not exist, or were not actually done. Suffice to say, I have poured over every document, and to list the large amount of items that have been double billed, would extend this already lengthy complaint. I also believe that we have gone as far as we can as Public Insurance Adjusters. These exhibits show that. What they also show, is that “Preferred Contractor” never really sent a bill or an invoice after their initial estimates. All of our paperwork, both what has been provided by insured and carrier, sow no invoices or demand for payments until they sent the demand claiming they were going to legal on July 30, 2019. More on that later.
  4. “CARRIER” again revised estimate on 02/16/2019. A supplement was issued for $7,747.59. This follows the same line as the other revisions. “Preferred Contractor” had no clue how to estimate or valuate the loss. Richard Smith stated clearly when we are on the 11/18 inspection, that he was no estimator. What has occurred has been a horrific game of rob Peter to pay Paul. (One very clear indicator would be the price list used. While the loss occurred on 09/18, several major disasters occurred shortly after, like Hurricane Michael. None of the revisions ever included updating the price list to today’s market, which is necessary, because they were paying for work that had not yet been performed…) Some items up to three times. At this point, “Preferred Contractor” and “CARRIER” had been involved in this insured’s home approximately 6 months, and they never really were capable of getting it together. We are awaiting their “revised” estimate from our 11/18/2019 meeting. We were notified they had it today, and it had been sent “management” for review. Meaning that over 1 year and 2 months later, they still aren’t at indemnification. Yet they kicked her off of ALE in May, even after the insured sent her photos showing the condition of the home, and that it was not livable. (Exhibit “I”)
  5. Permits were known to be needed, yet never paid for. Instead, letters were sent saying if the “code was enforced, they would need a letter stating it was enforced. As far as I know, and can find, BULLETIN PC 2016-02 made clear how the Department viewed code. BULLETIN PC 2016-04 clarified. (Exhibit “J”)
  6. On 05/06/2019 “Carrier Adjuster” Oswald again revised the estimate, issued the full payment for the supplement and all the recoverable depreciation. As I stated earlier, I have yet to see an actual invoice or demand from “Preferred Contractor” until the letter dated July 30, 2019. (Exhibit “K”) The insured has these funds. All other funds have already been paid to “Preferred Contractor”.
  7. On 05/30/2019 the insured retained counsel. (Exhibit “L”) Unfortunately, on September 09, 2019, the attorney had to withdraw. (The letter of rep was pretty good indicator to anyone who read it, that the attorney was a little out of his field of practice.) This claim, while typical of many out there, has been made difficult on purpose.
  8. On 07/30/2019 “Preferred Contractor” sent Exhibit “N”, threatening legal action if they were not paid $103,143.38 within 10 days. There are several problems with this. A. They were at “best” 80% complete by “Mr. Carrier Adjuster” own admission. B. They had already been paid approximately $90,000.00. C. Fraud was committed in order to get any of the money after the initial was paid. The demand itself is an instrument of fraud. It states services has been rendered and does not offset any payments. The letter goes on threaten a lawsuit, attorneys fees, liens… the list goes on. Let us remember, this insured suffered the actual loss, these folks have taken advantage of her for over a year, and they are now throwing threats around.

This is the point we became involved and began to represent the insured. After reviewing everything we could get ahold of, and inspecting the actual property, we submitted the most comprehensive valuation of the loss that the carrier had seen to date. We provided them with this on 10/25/2019. In other words, it took us less than 25 days to get the entire claim to a point where we knew exactly what had occurred, and what need to occur to reach indemnification. At that specific time, the carrier and “Preferred Contractor” had been working on it for a year and two months. Below is a breakdown of what has occurred since then.

 

  • We attended a mutual inspection on 11/18/2019. “Mr. Carrier Adjuster”, “Preferred Vendor”, “Preferred Vendor Adjuster”, and I were all in attendance. (We do not work with or for contractors, so it is unusual for one be an inspection. In this case, I am glad they were there. It got both the carrier and the “preferred vendor” in the same room. By the time we make this meeting, I have met and spent time with the insured, I have went through all the files, and suffice to say, I was very upset. During that inspection, I proved that all the items I spoke of above, that were billed for and never completed. I pointed out the remaining insulation in an area that you could just walk into. (Insulation was to be replaced behind the sheetrock in the entire dwelling. If it was not replaced in the areas we could easily access, I find it very hard to believe it was done in the areas we cannot see without destructive testing.) It was at this meeting that “Mr. Carrier Adjuster” agreed, that the very best case scenario, and not accounting for any of the items that had not been done at all, or for the items that were obviously incorrect, like the cabinets, they were at 80% completion. (One must remember, this is “CARRIER”’s “preferred vendor”.)
  • At this meeting, there were several telling conversations. I asked “Preferred Vendor” if his company was able to make money on the 10% overhead and profit? This was asked because “Mr. Carrier Adjuster” commented on it right away… “Mr. Spoon, you have 15% and 15% on yours…” When asked point blank, he said yes. I let it go. We walked to the cabinets, the ones that had been replaced, and I asked them what happened? The original guy that built these beautiful custom cabinets was supposed to have done them. He did not, and what is in the place of what was there, is less than half the cost of the cabinets that were there and are currently in the rest of the home. Everywhere. Laundry, bookshelf… all the same, solid wood, custom cabinets. What they were replaced with was stock Home Depot/Lowes cabinets. “Preferred Vendor Adjuster” tried to say they were custom because he had to “order” them. I disagreed and told him we could prove it real quick. Those are stock cabinets available to pick up. I then asked if the ordered cabinets were off size. Like a 33” cabinet instead of a standard 30” or 36”, to which he finally agreed, those off cabinets were the only one that had to be ordered. I then asked him why the original guy did not do it. His response… “It was not in our budget.” I then turned at looked at “Preferred Vendor” and stated… there is your overhead and profit markup above the 10 and 10. “CARRIER” paid for high grade cabinets, you know, the ones that were in there. “Preferred Contractor” made a conscious decision to prop up profits by using the standard grade. The whole loss was done precisely the same. We are talking about a ½ million-dollar home in Blanchard, Oklahoma. This is also fraud. The correct amount was paid on this item, yet choices were made against that did not benefit the insured, and the insured had no part in. Therefore, the person who adjusts the claim should not work on the claim. They have carnal knowledge that the insured is clueless about. Then throw in a language barrier for good measure.
  • “Mr. Carrier Adjuster” stated that Thanksgiving was here, and that he and “Preferred Vendor Adjuster” would come back the week after Thanksgiving and spend the whole day on property re-writing their estimate. At this time, “Preferred Vendor Adjuster” stated he was not an estimator, to which no one really seemed to care, except us. At this point, I was more angry that we had made the appointment, and they did nothing but inspect, and had no plans to do anything until 2 weeks in the future, before they would even get started, on a project that they already had all this info on, as well as our detailed valuation. “Mr. Carrier Adjuster” was supposed to be a large loss adjuster, meaning none of this should be new to him. I was afraid at the time, and since proven correct, that this would become a pattern.
  • The residence was in such bad shape, “Mr. Carrier Adjuster” agreed on the spot to provide additional housing, provided limits had not been reached.
  • Since the insured had already done all of this, having her credit run for almost every needed item after the fire, then having housing terminated by “Carrier Adjuster”, was afraid to go through all of that again. “Carrier Adjuster” stated that the insured could use ALE Solutions again. Which would require all the same issues. The insured stated they just wanted to stay in the motel, close to their home. At this point, “Carrier Adjuster” became an absolute stickler about an interpretation of the policy, that she just chose to start trying to use. (Exhibit “O”) This is our email chain between “Carrier Adjuster”, me, and “Mr. Carrier Adjuster”. Even after pointing out that she had paid everyone from “Preferred Contractor” to ALE in advance, she would not issue the funds for Mrs. “Insured, Protected” to obtain housing that is safe, free from the soot and smoke, and has working heat and air. (Exhibit “P”) Is the combined invoices and payments made to ALE, before they were ever due. She demanded the insured pay out of her own pocket, knowing full well that insured was due additional amounts, and had legal threats made by “Preferred Contractor” against her. She had also already made a habit out of pre-paying anybody involved in the claim, unless it was the insured, when she desperately needed to get herself and her son out of the home. (Stating she can use any funds other than those from her coverage is outrageous. We pointed out the threats because she has them, and a limited amount of cash on hand. Meaning any reasonable person would have the same hesitation before committing to funds that no one is sure of if, or when they may come. At this very point the insured is sleeping on the floor with no heat or HVAC and no furniture, while all others involved enjoy Thanksgiving in their homes, self included.
  • “Mr. Carrier Adjuster” contacted our office on 12/2/19 stating he would be on-site most of the day on 12/3/19. We made arrangements for the insured to allow access for him and “Preferred Vendor Adjuster” to revise their valuation. He again contacted our office on 12/09/19 stating he had missed a few things, and that he needed to go back on 12/12/2019 to finish up, could we arrange? We contacted the insured and arranged, but somehow, it does not appear it was communicated. “Mr. Carrier Adjuster” stated that was ok, he had everything he needed. 12/17/19 I received an email stating it went to contractor for review. I responded that I was not even sure what that meant, and that Christmas was here, and we were no closer. I received a response back on 12/20/2019 claiming that it would be the 12/31/2019 before he got it back. Today, 12/31/2019, we received a call from “Carrier Adjuster”, just letting us know that she was “doing her job” and letting us know that the revised valuation had been sent to management for approval, but, you know, it is the holidays so we are slower than normal.

After reviewing all of this, along with the exhibits to verify the facts, a couple of things have become clear.

  • The insured had a policy for roughly $500,000.00 in dwelling coverage alone. The fire damaged the entire interior of that same home.
  • “CARRIER”, being the insurer, and the one who should have more tools and knowledge at their disposal than anyone else in the equation, attempted to pay less than 20% of the value of that policy. My valuation, the correct one, puts it closer to 390k when done according to policy, and the facts of the loss. (Exhibit “Q”) According to the patterns, this was no accident.
  • “CARRIER” and their representatives, and their “preferred vendors” put their own wants/needs above those of the insured’s resulting in the current situation. The insured being effectively homeless since May of 2019.
  • “CARRIER” interprets the Oklahoma Insurance Code to allow them unlimited amount of time to complete a claim. And that Holidays allow entire weeks. They do not. They allow they day of. “Mr. Carrier Adjuster” and “Carrier Adjuster” both show a complete lack of respect for the code itself, and ultimately, the insured.
  • The involvement of our firm was forced. Ms. “Insured, Protected” had exhausted all other avenues. The good thing about that, we followed the policy. On October 25, 2019, InsuranceBusters.net submitted, a signed, completed Proof of Loss. The most complete document “CARRIER” has possessed to date. It included everything the “Duties after a loss” section requires. The 45 day, maximum 60 to complete the claim started then. Both timelines have come and gone, and still, against 36-1250.7, no resolution. “CARRIER” has no valid reason to have extended the claim this long, and unfortunately for them, the Holidays are just that, the one day they are observed by the government. In short, did the Oklahoma Department of Insurance get to close the entire department down for a week for Thanksgiving, and a week for Christmas? We all know the answer to that.
  • At the closing of this complaint, and receipt of whatever last response the carrier may have, we will have completed our last portion of this claim and given the carrier every opportunity to perform as intended. We will have checked off the “Suit against us clause” in that same policy as well. Meaning we have ran the distance of what our license allows, and the time for attorneys on the insured’s side who are as well versed as we are in insurance is now. They will not be sending letters of rep screaming no legal action has been filed and to just talk to the insureds without them… No, it will be a very different type of attorney. One who only does this for a living.

There is a lot more. So much more that it is quite scary for any insured who may have to deal with either “CARRIER”, their adjusters, or their “preferred vendors.” It is all in the files we have delivered along with this complaint.

 

Please notify InsuranceBusters.net of any actions taken in regard to this complaint.

 

Cal Spoon

InsuranceBusters.net

 

Exhibits

 

Exhibit                                                              ID                                                                       Found

A                            Declarations Page w/ Policy

B                            Latest Payment Summary                                                                        35 of 43

C                            “Preferred Vendor” Contract                                                                   88 of 168

D                           Email about Jewelry Theft                                                                        142 of 168

E                            “Carrier Adjuster” Email with list                                                            151 of 168

F                            “Preferred Vendor” Payment                                                                  90 of 168

G                           “                            “ 10k Inv/Est                                                                   91 of 168

H                           “CARRIER” Revised Supplement 10/12/18                                           121 of 168

I                             “CARRIER” Revised Supplement 02/06/19                                           127 of 168

J                             “Carrier Adjuster” Letter demanding show of enforcement            25 of 168

K                            Final “CARRIER” revised with Deprec Released 05/06/2019            126 of 168

L                            Attorney Letter of Rep                                                                              136 of 168

M                          Attorney Letter of withdrawal                                                                 38 of 43

N                           Email chain between “Carrier Adjuster” and Us.

O                           Legal Demand by “Preferred Vendor”                                                   29 of 43

P                            ALE prepaid Invoices                                                                                  81-85 of 168

Q                           Our valuation

 

As promised, we will choose one Veteran that meets the criteria posted in this video. Veteran Qualifications for free Class.

 

If CE route is chosen, it will go as follows: (Choice is made by majority vote at beginning of 1st day.) The same items are gone over, the difference is we can pick what areas you are actually having trouble on, and focus on them. Last class left with their most problematic claims at closing points. (Appraisal and PIA)

 

Our Texas State Credentials, found @ hyper-link below.

Registered Provider: Public Adjuster Boot Camp LLC – Melanie Spoon, Shaun Hodge, and Cal Spoon

Texas Registered Provider Number: 160583

Type of Study: Classroom

Location 902 51st Street, Galveston, Texas 77551

Course length: Course will be five consecutive days, beginning Monday. Course will be eight hours per day, for a total of 40 hours. We understand that the minimum requirement for our profession is 24 hours. We are not trying to reach the minimums, we are going to exceed them, thereby assuring that anyone who has attended, and passed, will be more than capable of performing the duties of a Licensed Public Insurance Adjuster. For those who need CE, they will receive the hours credited through Sircon and a certificate of completion for 24 hours as well as a certificate of completion for the full 40-hour course.

Daily Schedule

Time                                       Activity                                              Classroom Hours

08:00 am – 10:00 am             Ethics and Law                                   2.0 hours

10:00 am – 10:15 am              Morning Break

10:15 am – 12:00 pm              Policy and Interpretation                    1.45 hours

12:00 pm – 12:30 pm              Lunch

12:30 pm – 02:45 pm             Policy and Interpretation                    2.15 hours

02:45 pm – 03:00 pm              Afternoon Break

03:00 pm – 05:00 pm              Application of lesson to a claim         2.0 hours

 

The following course topics and discussions will be gone through, thoroughly, beginning to end for the Ethics and Law portion:

  • Texas Prompt Payment of Claims

Timelines

Claim Acknowledgment

Acceptance/Rejection/Additional Information Request

Payment of claim

Court decisions on Texas Prompt Payment of Claims

  • Ethical duties in adjusting a claim and submitting documents on behalf of an insured.

Insurance Fraud

Recoverable Depreciation

Prior loss history

Duty to fully investigate

Sworn Proof of Loss

Examination Under Oath

 

  • Texas Insurance Code Chapters 541 & 542

Duty of Good Faith and Fair Dealing

Unfair Claims Settlement Practices

Deceptive and false information regarding policy coverage.

Statutory Bad Faith

False, misleading information, failure to disclose known facts impacting the claims adjustment

Recent court decisions interpreting Chapters 541 & 542

 

  • Public Adjusting 101

Public Adjuster Rules

Public Adjuster Obligations

Ethical and Legal Requirements of Public Adjusters

Conflicts of Interest and prohibited conduct

Unauthorized Practice of Law

Unauthorized Practice of Public Adjusting

 

  • Recent appellate decisions concerning Public Adjusters and the appraisal process

Public Adjuster liens

Endorsement of claims check (fiduciary duties)

Rights of Public Adjusters

Interpretation of appraisal provisions (competent and independent)

Survival of bad faith and prompt payment of claims post appraisal

Allowed compensation of appraiser’s expert witness

 

The following course topics and discussions will be gone through, thoroughly, beginning to end for the general knowledge portion:

  • Insurance fundamentals – Updated 03/03/2018

Insurance Defined & the Principle of Risk

Elements & Characteristics of Insurance Contracts

Important Terms Pertaining to Insurance Contracts

The State Insurance Department

 

  • Insurance Companies – Updated 01/19/2018

Insurance Companies – Classifications

Insurance companies – Agents, Producers, Brokers

 

  • Property Insurance Concepts – Updated 03/08/2018

Property Insurance Concepts

Loss Valuation & Settlement methods

 

  • Liability Insurance Concepts – Updated 01/05/2018

Liability Insurance Concepts- Updated 01/05/2018

 

  • Unfair Claim Settlement Practice Act – Updated 10/23/2017

Unfair Claim Settlement Practice Act – Updated 10/23/2017

 

  • Standard Fire Policy

Standard Fire Policy- Module A

The Standard Fire Policy – Module B

 

  • Dwelling Insurance

Dwelling Insurance – A

Dwelling Insurance – B

Dwelling Insurance – C
Dwelling Insurance – D

Dwelling Insurance – E

 

  • Homeowners Insurance Texas – Updated 3/28/2018

Eligibility & Definitions

The Homeowner Forms

Exclusions; Section I in Detail

Exclusions; Limits of Liability; Coverage D

Additional Coverages

Section I – Property Conditions

Section II – Liability Coverages and Exclusions

Liability Exclusions and Additional Coverages

Section I and II Conditions

 

  • Personal Inland Marine Insurance

Personal Inland Marine Insurance

 

  • Personal Watercraft & Yacht Policies – Updated 7/27/2017

The Personal Watercraft & Yacht Policies – Updated 7/27/2017

The Yacht Policy – 7/27/2017

 

  • Insurance Claims Adjusting

Introduction to Claims Adjusting – Updated 11/01/2017

Adjusting Insurance Claims — Updated 11/01/2017

 

  • Adjusting Property Loss Claims – Updated 03/02/2017

Adjusting Property Loss Claims – A

Adjusting Property Loss Claims – B

 

  • Texas Public Adjustor Law

Texas Public Adjuster Law – Updated 08/03/2018

 

  • Personal Automobile Insurance

Personal Auto Policy, Eligibility, Rating Factors

Part A Liability Coverage and Exclusions

Part B Medical Payments; Part C Uninsured Motorist; Part D Coverage for Damage to your Auto

Limits of Liability; Parts E and F Conditions; Other Provisions; Endorsements

 

  • Commercial Package Policies & The Business Owners Policy – Updated 11/10/2017

Introduction to Commercial Package Policies and the BOP

BOP Eligibility and Coverages

Additional Coverages; Extensions of Coverage

Liability Coverage; Optional Coverages and Endorsements

 

  • Commercial Property Insurance – Updated 6/1/2017

Introduction to Commercial Property Insurance

Property not covered

Commercial Property Conditions

Cause of Loss Forms

Business Income (Time Element)

Miscellaneous Property Forms and Endorsements

 

  • Equipment Breakdown Coverage

Coverages and Extensions

Deductibles, Endorsements, Exclusions

 

  • Umbrella & Excess Liability Coverage

Personal and Commercial Insurance

 

  • Commercial Inland Marine Insurance

Commercial Inland Marine

Commercial Property Floaters Risks

Bailee Forms and Dealers Policies

Loss Conditions

Conditions (cont.); Exclusions

 

  • Ocean Marine Insurance

Introduction to Ocean Marine Insurance; Implied Warranties

Hull Coverage

Cargo & Freight Insurance; Ocean Marine Forms, Perils & Exclusions

Ocean Marine Claims Handling and Payment of Premium

      • Aviation Insurance

Aircraft Hull Policies, Aircraft Liability Coverages, Definitions

Admitted Aircraft Liability, Hangar keeper’s Liability, Exclusions

  • Bonding & Surety – Updated 06/01/2017

Bonding & Suretyship, Fidelity Bonds and Surety Bonds

Contract Surety Bonding and Financial Institution Bonds

 

All course work will be performed through the online version of Insurance-Schools.com Public Insurance Adjuster course in an open discussion classroom setting. This is being done for many reasons, I will list just a few.

  1. We have administrative rights to all tests and scores taken, and can submit those, as needed by the department, to confirm the effectiveness, participation, and general amount of time spent by time logged in, and tests taken. (Attendance, roll call, and exit.)
  2. The material provided by Insurance-Schools.com has already been approved by the department and will not be changed or deviated from in our classrooms. We will actually discuss them in great detail, with different scenarios.
  3. Insurance-Schools.com incorporates any new legislation affecting the rules that govern us, as you can see, all versions above carry the latest updates.
  4. We used the very same program to obtain our initial Texas license, and have used them whenever necessary to obtain licensure in other states.
  5. Courses will be administered via laptops we provide, specifically and solely for this purpose, and will remain in our possession at all times, save for theft, or any other instance out of our control.

What can you expect from this Session?

Students who have taken and successfully completed our course should be able to read and understand common policy language and conditions. This would include exclusions, endorsements, and claim filing procedures. After each 6-hour class day, there will be an additional 2 hours dedicated to the open discussion, and actual application, based off our collective knowledge in the field. This equivalates to 40 actual classroom hours, more than the required 24. Finally, if the student is not already licensed, that student should be able to schedule, take, and pass the exam provided by Pearson VUE, then be capable of performing their duties once a license is obtained.

We look forward to helping insurance professionals maintain the highest standards possible, by raising those very standards.

CANCELLATION – REFUND POLICY

All cancellations must be received in writing on or before the 14th day prior to the commencement of the course.    Cancellations requests received in writing on or before the 14th day will result in a refund of the registration fee less a 20% administrative charge.   Any cancellations less than 14 days prior to the course will result in the forfeiture of the registration fee.     Cancellation requests must be made in writing to the registrar at Public Adjuster Boot Camp Attention: Melanie Spoon at 902 51st Street, Galveston, TX 77551-4110.

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