An adjuster starts to close the file on a roofing claim. The adjuster had worked closely with the roofing contractor and saw the claim through to its resolution, with the contractor getting paid in full. Then the adjuster receives an invoice with a supplement, from a company in another state. Upon calling the insured, they had no awareness of this company. Today Steven Badger from Zelle LLP will address these and other topics as we continue our discussion on "hot topics" in hail claims.

Notable Timestamps

[00:01] - Some in the industry describe the "reclaim game" as when an insured gets paid on a prior roof claim, never fixes the roof, then years later submits a new claim for the same unresolved damage.

[02:52] - On every new claim, adjusters can ask if the insured has ever filed a prior claim for the same damage, as opposed to relying solely on industry claim-history reports.

[03:45] - Early investigation often includes reviewing historical aerial and street-view imagery plus a low-cost hail history report to understand the roof's actual damage timeline.

[05:32] - Establishing coverage for business or goodwill reasons can open the door for supplementation.

[06:29] - Permit records, especially for commercial roofs, can confirm whether a claimed roof replacement really occurred and reveal the value and scope of prior work.

[07:35] - Is a supplement being submitted by the contractor who actually did the work or by a third-party supplement firm?

[13:08] - When contractors waive or absorb deductibles, insurers can request proof the deductible was paid.

[14:48] - Contractors who take over the claim process without a public adjuster license may be committing the unauthorized practice of public adjusting in certain circumstances.

[17:19] - Even in contentious claims, both sides can resolve disputes fairly and professionally.

Your PLRB Resources

Steve Badger's LinkedIn https://www.linkedin.com/in/steven-badger-467b0322/

Recorded Webinar: Resolving High Estimates and Post Work Supplementals https://members.plrb.org/education/courses/resolving-high-estimates-and-post-work-supplementals

Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/ask-plrb/) at no additional charge to you or your company.

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