Help Me With Sign Nebraska Banking Claim

Help me with industry sign banking nebraska claim

okay good morning everybody welcome to our webinar on the overview of the insurance claim process my name is Steve Rappaport I'm a partner at SAC Sachs Kaplan as many of you on this call know sex acts Kaplan has been representing community associations for over 35 years and his experts in at the Community Association condo HOA and Country Club practice but one thing we have not always been able to provide our clients is first party insurance coverage representation and we have with us today Larry base from the Merlin Law Group it's very it's an honor for us to be able to announce to our clients that we are now teaming up with the Maryland law group tomorrow to provide the best representation for our condominium homeowners associations and community association clients with their first party insurance claims merlin law group is the largest law firm in the United States focusing solely on first party property cases and has over 35 years experience in this endeavor and so with that you all came here to listen to Larry and not myself so I'm gonna jump off the webinar and turn it over to Larry Larry thank you and thank the Merlyn wall group for being a part of this and for helping to organize this and we look forward to hearing your presentation thanks Thank You Stephen appreciate that introduction good morning everybody my name is Larry beige I do work with the Moreland Law Group and I Steven mentioned we are here to talk about first party property insurance claims so we will go ahead and get started the purpose of today is really to give an overview of the insurance claim process in my experience and handling claims with HOAs and COAS is the terminology is different its unique a lot of people do not realize what a public adjuster is what an assignment and benefits is what is my and who is my insurance adjuster and even who my insurance company is and so the purpose of the day is to give an overview of who the people are and the parties that participate in the claim process so that everybody can feel a little more comfortable with who they're talking to and who they should be talking to as Steven mentioned we have 64 attorneys across the country nationwide that specialize in first party property claims we do nothing else I have personally practiced this area of law my entire legal career and I'm in my 10th year and before that I clerked with chip Merlin while in law school out of our Tampa office our Tampa office is our home office but we have offices throughout the state of Florida as far north as Panama City Florida as far south as Key West another one of our fully staffed offices is in West Palm Beach chip Merlin is the founder and president of the Merlin Law Group chip Merlin has been practicing this area of law exclusively for more than 35 years a chip started off as a defense attorney working for one of the larger defense firms in the country and switched sides in about 1984 1985 and founded the Merlin Law Group a chip his license pretty much all over the country we have lawyers that are licensed in almost every single state those licenses are listed there but for purposes of today it's important that you know that our offices including chip are licensed in every federal court in the state of Florida as well as the state of Florida obviously that's me I'm licensed in multiple jurisdictions I have practice in more than 17 different states over the last 10 years focused only and primarily on first party property insurance that is my email address if you have any questions please let me know if you have any additional questions regarding a claim that you may have please let Steven know with sacs and he will make sure that we have a file review setup for you specifically so we need to start off with what is first party property insurance and what is a first party property insurance claim the best way to explain it is it's if you have a claim under your own insurance policy a lot of people get confused on who exactly is paying for the claim the prime example is a car insurance claim where driver a is driving and hits driver beat if driver B has a claim against driver a is insurance that is a third party claim driver B seeking benefits from driver s insurance if driver B is seeking insurance from his own insurance company that would be a first party claim and the reason that's significant is that there are certain duties and obligations that a first party insurance company owes to its claim it that it does not owe to a third party claim it for everybody that's participating in today's webinar if you have a claim that we're going to talk about it would be a first party claim so what are some examples of first party claims well obviously a hurricane can't hurricane irma hurricane Michael those are claims that would be under the condominium association or your homeowners associations policy another common example is going to be a water loss a fire loss and a hail loss those are types of claims that would be under your insurance policy and that would be as instance where you would need to consult with the first party property insurance attorney another type of loss that we're dealing with right now is business interruption regarding the Cova 19 claims so those policies are triggered and then you have certain duties and obligations that we're going to get into in more detail but the first Duty that I want to discuss today is the timely notice of a loss not a claim so the insurance policies require an obligation of you the policyholder or you the property manager I know we're dealing a lot with property managers they need to be aware of these terms and these obligations and the first obligation is to report the damages and report the loss a very common example that I have seen as a result of Hurricane Emma recently is the property managers and the boards I do not want to report a claim because obviously they're concerned about the implications of the premium implications of reporting of a claim and what they do is they wait and they wait to see what the repair costs are going to be throughout the process you know for example if you have a 50 building so and you have a leak how much is that leak cost to repair and then as time goes on the damages accumulate until the point that exceeds the deductible so the biggest mistake that I see with the timely reporting of a claim is people will have taken that to mean that you don't have to report a claim if it does not exceed your deductible um that's not accurate the policy does not say report a claim the policy is requires timely notice or prompt notice of a loss that can be triggered under the policy so it's also important to remember that when you have a loss like a hurricane loss or a fire loss or a water loss there's additional damages that may not be visible to you that need to be investigated so often times with these hurricane irma claims especially with tile roofing systems you may have underlayment damage that you're not aware of you may have decking damage that you're not aware of you may have tiles that have been displaced or loosened that you're not aware of until somebody actually investigates those roofing systems and actually walks them and physically manipulates them to determine if there's been went up lift we then see a claim is reported a year after the loss two years after the loss and even now I actually received a phone call last week for a claim in Naples and they have a claim that has not been reported now we're gonna have to deal with that issue of timely notice the good news is is that in Florida you can report a claim untimely as long as the insurance company has not been prejudiced now we can do an entire webinar on Florida law on notice and Prejudice but for purposes of today please just know that there's an obligation to report damages not just a claim that you may believe exceeds your deductible or does not exceed your deductible I would also recommend that if you're unsure about whether or not you have sufficient damages that would trigger the policy you can also consult with a contractor or public adjuster that will evaluate those damages for you and provide you with an estimate for your evaluation the point this slide is do not just assume that you do not have to report damages because you're not aware that they exceed your deductible this leads us to the next point regarding timely notice Florida law changed in 2011 where they've restricted the timely notice or defined what a timely notice is under Florida law and that's found in Florida statute six twenty seven seven zero one three two the statute simply requires that all claims whether it's a freshly reported claim or it's a claim that has a supplement that was not identified earlier they must be reported within three years from the time that the storm made landfall so if you're in South Florida and hurricane struck your property on September 9th of 2017 you have until September 9th of 2020 to report any damages that you want to claim under your policy so here we are on June 24th 2020 we have less than 90 days to ensure that all damages are being reported in other words if you're going to evaluate the windows you need to get those evaluated right away I see a very common example where the policyholder or the property manager wants to finish the roof claim before they supplement the claim for windows or supplement for interior damages you cannot wait more than three years after the loss to submit a supplemental claim it's also not best practice to not report or identify all the damages that you can initially so that you don't have to deal with a timely notice or an untimely noticed defense of those claims so in summary you have three years from the time the storm makes landfall to report any portion of your claim if you do not report it within that three year period you lose your right and those claims are barred now this 3-year limitation period is not to be confused with a statute of limitation a statute of limitations is the time period that a claimant has to file a lawsuit against a third party or in our context the insurance carrier in Florida you have five years from the date of the event or the date of loss it's not five years from the date of denial it's five years in the date of loss so a firkin armor made landfall in your area on September 9th or September 10th of 2017 for example you would have until September 9th or September 10th of 2022 to file a lawsuit there's two other important factors that we have to discuss as it relates to statute of limitations the number one question that I have commonly run into from property managers especially with the Lloyds policy or a Zurich policy or any type of excess liability policy is the policy will say you have two years to file a lawsuit in the suit against us provision there are some jurisdictions that insurance carrier can limit the law or the statute of limitations by the contract so there are some jurisdictions where if you have a five-year statute like we have in Florida versus a policy or a contractual limitation period of two years the contract would control and you would only have two years to bring that lawsuit based on the contractual limitation period in other words the contractual limitation period would supersede the statute of limitations for five years in Florida the law does not allow the contract to limit the statute so even if you have a Zurich policy even if you have an I cap policy or Lloyds policy or Lexington is another common one and it says two years you still have five years to bring that lawsuit so your claim is not barred I've had property managers give improper advice on that issue because the agent will mislead the property manager and direct them to the contractual limitation period and say listen there's nothing you can do it's already been two years in Florida that's not true you have five years now Larry how does that play with the 3-year limitation that you just discussed in the prior slide under Florida Statute six to seven seven zero one three two well let's talk about that you have let's use hurricane Irma because I know most of our associations are gonna be in South Florida and I know our managers are as well and Irma was so devastating across the entire state that regardless of where you are you're very likely dealing with an association that has an ER McClane so I'm going to walk you through an example so I'm an example kind of guy some of this stuff is kind of dense to make sure that you understand how the 3-year limitation period and the five years statutory period they go together and how they work together September 9th 2017 hurricane Irma hits the Miami area you have until September 9th 2020 to report any claims that you want to make under that policy assuming that you comply with the statute for timely notice you have five years from September 9th of 2017 to file a lawsuit if the carrier does not properly pay the claim that means you would have till September 9th 2022 to file a lawsuit so if you have any questions about that please let Steven know and you know Merlin and SSC will get together and make sure we provide you with an analysis what are the additional duties for the policyholder now this is important for property managers because a lot of times you're getting fielded with questions and you're getting document requests from these insurance companies I mean they're just ruthless with what they ask for it's it's exhausting most of its not relevant most of it is really just to you know provide for a you know fishing and we can talk about how we narrow those requests on another webinar but there are certain duties and obligations that you must comply with if you want to get the claim paid number one is protect the property from further damage and oftentimes this is best illustrated where the contractor comes in and they tarp the roofing system so if building number seven reports a leak you need to make sure that you take care of that leak property managers please instruct the contractors to document the damages that they're repairing and the remediation that they're doing that will help a lot in getting the claim paid from the very beginning obviously you must provide access to the property we're going to talk about the different people that will be accessing the property in a little bit but make sure that you provide access they have the right to inspect the roofs the next requirement can have an entire separate webinar on it it's called a proof of loss and it's really a term of art in our world the first party world a proof of loss is a specific form document that the insurance company provides to you and it's a it's a sworn statement and proof of loss meaning that a representative for the Association not the property manager I understand that the property manager often will get authority to execute documents on behalf of the Association I have seen property managers legally execute proof of loss forms and I have seen property managers legally and ethically execute assignment of benefit forms I want to caution against this I believe it's best practice to have an association member of the board execute these documents that are being submitted to the insurance company I understand it may not be as easy I understand and working these claims that a lot of these board members live all over the country they do not fold they not live in Florida full time many of these board members are a little bit older than than I am and they're not as familiar with technology scanning else I know it's getting better sometimes it's just easier to get the authority and get it executed because you haven't known at the office there's nothing wrong with that if you have the authority from the board make sure there's a vote make sure it's document in the minutes that you have the authority to do it but our recommendation our law firm is simply this have the association execute these documents so that as a property manager you're not exposing yourself to any liability the next requirement is one that a lot of people get confused that they even have to sit for it it's called an examination under oath and it's a fancy term for really a pre suit deposition it looks like a deposition it acts like a deposition but it's not a deposition okay so you have an exam nation under oath which essentially there's a document request attached to it and I'm sure most of you have dealt with this before then it's an extensive document request which you can obviously ask to narrow down for what's important and you provide these documents in a notebook to the insurance company and then they want a representative of the Association to sit for the examination under oath and they will hire an attorney that will come in whether court reporter who will transcribe the questions and answers provided for the --uo or examination under oath and it looks just like a deposition and then the representative will be asked to sign off on the examination on your transcript this is a investigative tool that is allowed and required to be complied with under Florida law if the insurance company requests it my recommendation our firms recommendation is kind of a common-sense recommendation if the insurance company is hiring an attorney to ask one of your board members questions what do you think the recommendation should be to the Association right they should get an attorney involved as well and that's where you know SSC can step in you know we'll meet with them we'll meet together with your client and we'll make sure that they're prepared for the examination under oath where we have the documents will have a bait stamps we'll have them in a very chronological order fashion or by topic fashion all of our staff all of our paralegals are very familiar with this process we do it for depositions as well do not let it intimidate you a lot of times these notices go out for one reason and it's to intimidate the insured I've had insurance adjusters tell me that these letters go out because a lot of times there's no response and a lot of times the claims will go away because they intimidate the property manager or they intimidate the insured out there is no reason for that 90% of the time on a hurricane claim 99% of the time there is no suspicion of any wrongdoing on behalf of the Association in reality there's really two purposes for this I'm a practical standpoint number one the insurance companies are overwhelmed with claims their adjusters are overwhelmed they need help if it's a large enough loss they can justify having an attorney come in investigate participate in the claims decision request documents and they can trust the attorneys going to do a good job second reason is they want to know facts about the building they want to know how much did you spend to remediate what steps did you take to remediate the damages or mitigate the damages how old are the roofing systems have there any pre whether any repairs before the hurricane hit the property with mismatched tile or outdated product is the underlayment been replaced at any point in time in the past they want to know the age of the windows if windows are part of the claim they want to know the board meeting minutes did people complain of window leaks after the storm they're just trying to piece together the puzzle but there's no doubt about it they're definitely trying to build policy defenses that's why they do any but there is no reason to be intimidated by it if you're prepared in fact most of the time after I do an EEO I'm able to resolve the claim because they're able to check the box off that they spoke to the ensured that they investigated the claim at that point in time we can usually move forward to their coverage decision here's some key terms and really it's a dichotomy that I want to make sure everybody's aware of because I watch television i watch sports a lot of times and I see LeBron James I see Chris Paul I see my beloved Peyton Manning advertising and marketing on behalf of insurance companies and I want to make sure that the policyholders the board members and the proper managers understand the distinction between an agency and the claims department the product that's being sold is what you're seeing on television and ideally it's supposed to be a great product and insurance is important and it is a great product when it works our economy requires insurance and it's a great system however it has nothing to do with the claims department your your agent is going to have one role if you choose to use it in a claim and that is to provide notice of the loss to the carrier at that point the agent has no involvement and how much money is going to be paid and the investigation of the damages or investigation of the losses and I know these brokerages I know these agencies market to property managers just like everybody else does understand they have no involvement in the claims process the claims process is totally different the agents gone and now you're gonna have an insurance adjuster more often than not with the audience that we're speaking with today property managers condominium association numbers HOA members you're going to be dealing with a larger insurance company whether it's American Coastal American Capital Zurich Lexington Lloyd's Ike at the list goes on those insurance companies will outsource the claims process okay that's right they actually do not adjust the claims the biggest surprise when I meet with my clients that day I tell them is there's been nobody on behalf of the insurance company the actual insurance company no employee has been to the property to inspect the loss instead they send what is called an independent insurance adjuster and most states don't even require an independent adjuster to have a license the most common independent gestures that you have probably dealt with will be Vera claim Engel Martin & Associates Crawford & Company I mean those are the big ones and they actually do not work for the insurance company in fact they don't even receive the insurance policy most of the time and most the time they're not even provided the insurance companies claim guidelines their job is to go to the property document the damages and submit those photographs and initial reporting to the desk adjuster so the independent adjuster is the person that you will meet on-site that independent just has no authority to cut a check or provide coverage they will if you ask them they will tell you we have no authority to make a coverage decision overwhelmingly that is where the house of cards falls apart I have cases on my desk our firm deals primarily with cases that the insurance company's professionals that they have out sourced let everybody down they let the insurance company down for doing a poor investigation and most importantly they let you down as a property manager or policyholder and the investigation of the claim especially policyholders that are unrepresented there's a lot of reasons for this but the two biggest reasons that we've identified is number one the independent juster is too busy oftentimes they will be asked to go look at five or six over a two-day period and oftentimes that may be in excess of 200 buildings we've identified many cases where the independent jesters don't even get on the roofs to inspect damages as a result of Hurricane Irma or hurricane Michael instead they drive around the building's they document what they can see on street level missing tiles dislodged tiles or broken tiles and they put together a very quick estimate and that's what they do and they submit that to the desk adjuster the desk adjuster happily issues a letter that says this does not exceed the policy it's deductible and we're not denying the claim but you did not suffer damages where we owe you a payment so that is actually who's involved in the claim not your agent not a representative of the insurance company or an employee of the insurance company as a third party that has very little information and has too many claims to inspect the second most critical failure that I see with an independent adjuster is their lack of experience oftentimes the insurance companies will vet the third party independent adjusting company and they will require certain credentials of the top layer management of the ia or independent adjusting company and those guys are qualified there's no doubt about it um you know there are 30 year employees 20 year employees they've got the licenses they've got the experience unfortunately that's not who investigates your loss instead they'll get 50 assignments a hundred assignments 200 assignments from an insurance company after a hurricane and they hire anybody they can to go out and do these inspections and a most of the time where I see remember I'm involved in claims that did not go well so there's a lot of claims that go perfectly fine that's great but the ones that I'm involved in the independent jester's often we're working at Subway six months before the storm you know I've had Taco Bell I've had no experience at all with adjustment of a and they essentially just write a scope submitted to the desk adjuster and the desk adjuster knows nothing about the qualifications of the person that actually inspected the property so that is what is and what is not an independent adjuster a desk adjuster a desk adjusters are typically going to be employees of the insurance company they're the ones that are going to review the photo report from the independent adjuster to make the coverage decision the desk adjuster is the one that signs the reservation of Rights letter or any correspondence that's from the insurance company directed to you as the property manager and/or your association the desk adjuster will have the guidelines and will apply the guidelines to the photographs provided to the desk adjuster unfortunately the desk adjusters coverage decision will be limited based on the information provided to the desk adjuster by the independent adjuster at that point in time you will receive a coverage decision but that's the desk adjuster is if you are dealing with the carrier's we've discussed what you typically are you're going to be dealing with a TPA which is a third party administrator the most common third party administrator that I deal with is a company called cjw it's a great company they do a good job but unfortunately they're relying on these third-party adjusters and engineers to make their decisions and most of the time that's where the decisions are made that are wrong so if you're dealing with the Lloyd's of London for example you're dealing with a TPA and as a result or an American coastal you're gonna be dealing with a TPA why is that important because we need to know who has the authority to pay the plane who can I after a decision has gone bad or decision was made that was wrong where can I usurp the authority from that desk adjuster or that Claims Manager and get someone that actually has the authority to pay the claim to review the information and make the right decision that's the advantage of hiring people that specialize in a particular area of law is they understand who to talk to and what to provide them this is an example of understanding who you're talking with and who can actually make the decision to pay the claim what is a public insurance adjustor a public insurance adjuster is a insurance adjuster that does not work for the insurance company like an independent adjuster but actually works for you as a policyholder or a property manager they're the ones that will help you the public adjuster field in the state of Florida is a licensed and regulated profession by the Department of Financial Services public adjusters get paid to scope the loss they will inspect the property they will document the damages and I can assure you that in my experience they do a much better job than most of the independent adjusters that I have seen of documenting the full extent of the loss and providing a legitimate estimate to the insurance company to pay the claim public insurance adjusters a great option media immediately following the storm a public adjuster will assist up the property manager or assist the association and documenting the damages a lot of times my law firm we hire public adjusters as consultants so if we're getting hired directly by the policyholder we can hire the public adjuster to assist us in that process with writing an estimate and documenting the damages public adjusters are typically paid on a contingency agreement because a lot of times the insurers do not have the money to pay them on an hourly basis whenever we work with public adjusters we typically would hire them as a consultant pay them hourly um if they're the right person for the job but it's a good option if a public adjuster can step in on a claim help the Association and get what's what's owed by the insurance company now a public adjuster can write an estimate a public adjuster can negotiate your insurance claim a public adjuster cannot file a lawsuit for you so that's a big distinction that I've had people asked me what can my public adjuster file a lawsuit the answer's no but they can negotiate your insurance claim what is reinsurance another common question that I get reinsurance is is kind of self-explanatory but how it works is a whole different story reinsurance is essentially insurance for your insurance company so when you pay a premium that you pay annually to your insurance company they're actually taking a portion of that premium and that goes to their operations and then they're actually purchasing a bigger policy for that property for reinsurance against another insurance company so you may be insured with American coastal and they may have reinsurance with Lloyds of London and so you may not know that but part of your premium is gonna be paying for that reinsurance so again why is that important for you to know well it's important because a lot of times in mediations I may be filing a lawsuit or dealing with an insurance company a like let's call it American coastal for example if they've got reinsurance they may not be the ones that are actually authorized to pay what I need for that claim they may be directly communicating with the reinsurance company so I always want to make sure that I understand who's actually the one responsible for paying the claim so I can ensure that they have the information they need to make the right decision another big issue over the last few years is something called an assignment of benefits or an assignment of claim so what is an assignment of benefits our claim it's essentially a legal contract and in the state of Florida they're legal and they're allowed and it allows a Association to or any policy holder for that matter to assign their rights under the insurance contract to a third party like a contractor the most common example would be a contractor to do work at the property in exchange for the rights to collect those monies from the insurance company right the most common example that I see after Hurricane Emma our roofing contractors now who come out and they will agree to tarp the roofing systems to mitigate the damages without charging the Association upfront and they agree to provide an estimate to the insurance company they agree to negotiate the claim for the insured and they agree to meet the adjusters and engineers at the property and most importantly they agree to document the damages to provide to the insurance carrier for all those services they get an assignment of benefits document in exchange that allows them to recover the money from the insurance company for the work performed you do want to be careful to limit the assignment of benefits to the services being provided by that contractor a lot of times and I speak a lot to contractors and they will do a blanket a OB or AOC and of course the concern with that is there's certain benefits that the Association should maintain if the contractor is not going to do that work most of times the contractors will agree with that they just did not realize the effect of the full assignment of benefits so the question is should you sign one my recommendation is it depends on the facts and circumstances I work with a lot of contractors that do a very good job and a lot of them work with assignment of benefits because it really is a bargain for exchange they want to ensure that if they're going to do work that they're protected on the claim to get paid on the same token I've heard a lot of stories about the benefits from policyholders that did n t go well or have held up the process so a lot of it just depends on the professionals that you're working with my recommendation would be if you're going to deal with an assignment of benefits or an assignment of claim please call Stephen or another partner in sex acts and Kaplan they'll work with us to ensure that we review the agreement that it is exactly what the parties intended to be and then it works out really well the next topic I want to discuss and we have about another 10 to 15 minutes is how do I resolve my claim like what are the options because I'm frustrated the insurance company is telling me that you know I'm owed a certain amount of money I've consulted with contractors and they tell me it's not enough how do I resolve this or I have a denial for my insurance company I did not have any leaks on any of my buildings as a property manager you you gob viously get the complaints before the storm I might have had one or two complaints a year after Hurricane Irma or another storm it went up in propensity and I was getting 10 complaints a month or five a week why are they not paying for my damages and the answer to that is there's there's really three or four different ways that a insurance claim that's under dispute can be resolved number one a claim negotiation a dispute over a contractor's pricing and scope of work should be able to be something that the contractor meets with the adjuster and they can resolve oftentimes that you have a public adjuster a lawyer or a contractor they resolve these claims every single day the insurance companies are financially motivated to pay less contractors are financially motivated to make more so you have this inherent conflict of interest policy holders gonna want more money an insurance company's gonna pay less it's not brain surgery you've got to have disputes you're gonna have conflict in this scenario because the more money the insurance company pays the less money that they get to keep at the end of the year right the more money the policyholder gets for the job maybe they can negotiate upgrades maybe they have money to do the work and then also make sure that it's done 100% the right way and so the frustration is the insurance companies do not have construction experience so a lot of times the adjusters miss scope items miss items within their estimates that the contractor is very frustrated with because they need those items to complete the work this is the most common way claim negotiation that insurance claims are resolved in the country by far most claims get resolved through a claim negotiation the second most common dispute resolution process when it comes to an insurance claim is called appraisal not to be confused I know my property managers and my associations have all heard the term appraisal this is not a real estate appraisal think of it as an insurance claim appraisal essentially it's where both parties would appoints a third party adjuster or consultant to serve as their representative of the claim to a appraisal panel so it's policyholders appraiser insurance companies appraiser and then there's a third party umpire the third party umpire is agreed to by the two appraisers involved in the appraisal panel if they cannot agree then the policy provides that you can file a it's it's an action it's technically a lawsuit but it's really not an adversarial lawsuit it's a petition to a point umpire under the contract where you know an attorney from Saks acts and Kaplan or Merlyn Law Group goes to a simple hearing we provide a list of recommendations for an umpire we attach TVs or resumes of the three or four people we're recommending the defense counsel does the exact same thing and the judge plays pin the tail on the donkey and picks an umpire that's literally how it works I wish I could tell you it's more complicated than that it's really not um of course I've been doing this for 10 years so the first time I did that it was probably much more complicated but the point is is that you get the umpire then here's the important part about the appraisal process whatever decision is made by that panel if any two of the three agree both parties are stuck with that result and I say that again with an example policyholders asking for five million dollars insurance company says it's only two million dollars there's a dispute appraisal is invoked there's an umpire the policyholders appraisal or appraiser submits the five million dollar estimate the insurance company's appraiser submits the two million dollar estimate that umpire comes back at four and a half million dollars that's binding on both the insurance company and the policyholder if one of the appraisers agreed to it period that means if the appraiser for the insurance company wins the day and it's two million dollars in the umpire agrees you the policyholder are stuck with the two million dollar in work it's binding so appraisal is mandatory for participation and the results are binding if any of the if the umpire essentially agrees with either one of the appraisers the other thing to be aware of is that the appraisal process is it cost money it's not something that's a covered benefit under your policy and that means that the Association has to come out of pocket and pay the appraiser fee as well as half of the umpire fee that's important to know which we could talk about a different webinar about the appraisal process in more detail about who can serve as the appraiser and things like that the next option is litigation this is more often than not what I'm involved in I am involved or my firm is involved a lot of times with appraisal processes appointing an umpire appointing an appraiser hiring experts to participate in that appraisal process all those things we do have involvement in but the majority of the claims that I handle are ones that are going to be in litigation at that point if we cannot resolve to the claim negotiation process so they make one point that's clear a lot of my claims are settled in the claim negotiation process so I get involved I hire the experts at my attorney for my firm against the experts we submit the package with the proof of loss and the insurance company will hire someone whether it's a Claims Manager or an attorney that I deal with and we can resolve those claims if that process fails then another option is litigation litigation in a first party property context is it can be you know it can be intimidating to a lot of policyholders so a lot of questions that I get from the property manager is what's expected out of me so if we take this next step what do I have to deal with and what does my board have to deal with and my response is consistently we need your help with getting documents which you've probably already put together for the insurance company and number two just like an EU oh we're going to need someone's participation in deposition and then we're gonna have you know some of my associations I have weekly phone calls my Fridays are usually spent but back to back to back phone calls with associations okay just updating them on the claims we'll send them a document they'll have a question and that's typically how we update the boards so what we need is documents and participation but we're gonna we're gonna carry the heavy lifting my law firm is going to assist with the document production we're gonna assist with the discovery we're going to take the depositions defend the depositions and hire the experts and we front those expenses the biggest question I get when it comes to litigation is how long does it take and how much is it going to cost well the timetables change because of kovat 19 but most of our cases are going to be resolved between 6 & 9 months unless there's a trial that's required furthermore in the state of Florida and this is very very important there is a statute it's 6 to 7 4 to 8 it's an attorney fee statute and this statute is unique there's only about 7 to 9 jurisdictions in the country that have an attorney fee statute there's only two or three that have an attorney fee statute that is like Florida's attorney fee statute I believe I know it's Nebraska and I believe Oregon as well has what I call one party fee statute and this statute per lines that if you if your association has to retain you know SSC and Merlin law group to pursue the claim through litigation and we prevail on that litigation whether it's through summary judgment whether it's through settlement or whether it's through trial the insurance company has to pay and reimburse the Association for attorneys fees and for taxable costs it's very important to understand now I want to be clear then the next question I always get is Larry how does that work in a mediation or settlement the insurance company is fully aware of this statute they're fully aware of the exposure this statute creates so it allows the parties to be what I call equal footing at a mediation because the insurance company is the one that's cutting the check so they're always going to have the upper hand in the litigation in most jurisdictions in Florida this is the true equalizer this means that hey you want to stand by your position you want to stand by your faulty investigation you want to stand by your biased engineers go for it because if you lose you're gonna have to reimburse my client for all my attorneys fees and taxable costs I know that sounded very aggressive the real way it plays out is this if we have a 1 million dollar dispute we go to mediation we don't we're not offering a million dollars to resolve the case we're gonna offer 1.5 million dollars to resolve the case we're gonna add in the attorneys fees and cost that the insurance company knows that they're gonna have to pay if they lose the insurance companies in the state of Florida are very familiar with that they fully understand appreciate that the Association is looking to recover sufficient funds to resolve the claim with her candor me cases that's typically going to be the cost to replace roofs and sometimes there are cost to replace windows but they know that you've had to hire a lawyer and they fully expect when they are assessing these claims those legal fees and costs so the biggest advantage in litigating in Florida versus other jurisdictions George or Missouri is that if we prevail we were able to get our attorneys fees and costs on top the next question I get often about hiring a lawyer for litigation from property managers as well as from associations is what happens if we lose do we have to reimburse you know SSC and Merlin Law Group for those expenses in time the answer is no the marketplace for what we do is typically going to be a contingency agreement between the Association and our law firms that means that if we do not prevail we do not recover our fees and expenses from the Association or our client that's why it is very important that the sooner you can get us involved after these storms the better because we want to fully assess these claims because we're not going to invest in claims that we do not believe more money is not owed or that the insurance company has adjusted properly and frankly I have on many occasions told my clients that the contractor they hired is wrong was at the public adjuster I disagree with or another attorney I disagree with I do not believe that any more money is owed as a result of that I do not take the case of my law firm does not agree to take the case so we definitely want to properly investigate the claim make sure that if we're in it we're in it to win it and that's why we like to do a proper evaluation another topic and then we're about finished is bad faith I hear a lot of lawyers a lot of adjusters a lot of contractors that talk about bad faith and honestly they just have no idea what they're talking about I don't mean that to be rude but as you can imagine after a hurricane one of the biggest reasons why I respect what sex acts and Caplin is doing is they specialize in an area of law that I would not be able to even have a discussion with them on they would just they blow me out of the water they also appreciate that we specialize in an area of law and I believe what they're doing is the best interest of their clients by working with us because this is all that we do but there's a lot of lawyers that our car accident lawyers or no HOA lawyer or you know any type of lawyer criminal defense lawyers all of a sudden throughout billboards all of a sudden they become special specialized in insurance and they mislead clients they settle for claims that a lot of money should have been paid on and the insurance companies love them it's like shark bait they know that if they're dealing with people that they've never heard of they're able to you know throw some money at them and they'll go away or take advantage of them on a summary judgment issue that they should be better prepared for I say all of that because I hear a lot of attorneys or clients will tell me that this attorney says that I can do this and this and I can get bad faith the reality is is that fate damages in Florida are going to be unique to every single case but there's not a statutory penalty or punitive damages unless you can prove a business practice but I digress I want to talk about first what is bad faith that faith is essentially unfair claims handling there is a National Association of Insurance Commissioners that are run by insurance companies these guys that in good faith want to establish rules because good insurance companies don't want to compete with that insurance companies because if that insurance companies are not paying claims they're making more money than the good insurance companies and they can offer lesser premiums and it becomes a race to the bottom instead of having standards at the top so this naic this National Association of Insurance Commissioners they have an association from every stage represented and they come together and they provide these model claim acts these guidelines that these obligations and duties that all insurance adjusters should hope and comply with and they're required to comply with them I mean one of the most basic obligations is to treat the insured you or your client in good faith what does that mean well that means you're not trying to play gotcha you're not trying to hide documents you're not gonna improperly delay the claim because you can if you know you owe money pay what you owe you don't use money that you know is owed to negotiate disputed money I mean that's adjuster ethics 101 right so there's nothing standards it's actually a document that's lays out rules that adjusters have to comply with and when the adjusters or the insurance companies fail to comply with those rules then they are subjected to a statutory action and bad faith that means that after you prevail in your breach of contract you're able to sue them again for a tort for bad faith it's really unfair claims handling but it's we call it bad faith the week we can discuss we can have a whole another seminar all day long about unfair claims handling and practices and remedies and burden of proof stuff like that which we won't talk about today but I say all of that because there's a very important prerequisite in the state of Florida that if you ever want the opportunity to hold the carrier accountable for their unfair claims practices you have to file what's called a civil remedy notice a civil remedy notice is a fancy term for a complaint it is a formal complaint it's a form that you file a long line you definitely want a lawyer to complete this form because it's interpreting statutes it's providing information the good news for my property managers and the associations that we're talking to today this is a service that is something that you know sax acts and Caplin will provide with our law firm immediately on any claim that we feel one is necessary will do a free evaluation and will evaluate if a civil reminisce needs to be filed it's a couple hours of work to verify the proper facts and circumstances that need to be included to make sure that you allege the proper statutes that have been violated so very important to understand that you have to file this document before you ever bring a bad faith action and again a lot of lawyers that are not familiar with this type of law they will never file a civil remedy notice on a claim that one should have been filed on and then after an appraisal award or after a jury verdict they're not allowed to bring a bad faith claim so understand that there are conditions proceed into ever getting there that if you don't know what you're doing you're going to mess it up and so you have to get a CRN or so notice on file again assuming it's valid before you can ever bring a bad faith action here is some condominium hurricane preparedness guides if you click on these this PowerPoint is provided it's a handout so in the little chart for this GoToMeeting there's there's a handout that says Larry six to forty one power PDF and if you click on this link of this PowerPoint this will give you a hurricane preparedness guide that the two law firms got together and we put this information in here some of the information that I'm talking about today is included in this guide but there's also additional information that I believe every property manager and every association should be aware of it's free please review it if you have any questions please let us know and we'll get with you on that okay so the my my biggest red flag when I meet with an association or property manager is they don't ever ask me about results and I don't know if it's if people are uncomfortable with talking about results or whatever the reason is it's always surprising to me that they will hire me without ever asking me for a result or a reference now understand that I'm a trial attorney I like to speak with people I'm good at speaking with people but I shouldn't be that good at speaking with people that no one ever asks me Larry what is your firm done tell me results tell me references every single time I sit down with an association I give them references of local other associations that my firm has worked with or I specifically worked with and we have these success stories that we share with our clients this is a success story for example of an association that we took from below deductible okay this claim went from below deductible to nine and a half million dollars for settlement okay and the Association is thrilled as you can imagine they got all new roofs they very happy with the result of the case and I'm very happy with the results of the case and I'm proud of that result for the case and my law firm is proud of the result for this case and we want you to call our clients we want you to call these different boards and ask them how did mr. bass communicate how did chip Merlin communicate with you how did mr. Austin communicate with you how did miss Kubiak and mr. Delgado communicate with you you know how was the result did they work with you in preparation what was your overall impression of them because we're meeting with them now obviously sack sacks and Kaplan has vetted us quite a bit to get here and so a lot has already been done for a lot of you property managers obviously you know you trust your your associations attorney and you work with them a lot but please anytime that a lawyer is meeting with you or our firm asked us for success stories click on this read about it call our client they'll tell you all about the result and how the process worked this was another example of a case that we resolved this this is all 20/20 this is all hurricane-related you know these weren't this was about I believe [Music] associations about two and a half million dollars a piece that the insurance company said was below deductible again I mean very commonly what I see is the loss is do not exceed the deductible after a hurricane this is another seven figure settlement and this is just recently we have a lot of other success stories and references I walk in every presentation with a list of them that you can call make sure you're comfortable with who you're working with okay lastly chip Merlin who is the founder and president of our law firm that we talked about he wrote a book and it's called pay up and it's a great book about insurance claims and this book is on Amazon and it's $15 on the Kindle or you can buy the audiobook for $14 the one that I'm holding here is 18.6 to nine cents and it's a great book it gives you a 30 year history of chips experiences I'm kind of giving you the why that insurance companies don't pay gives you information on success stories and why insurance companies sometimes need to have a get a little bit of help on what they owe from lawyers and policyholders so it's a great book I recommend read it's an easy read because it's not technical it's very it's it's story based it gives examples there's a large bad-faith case that I discuss in this book or chip discussed for me and discusses a case from State Farm where the insured thought they were owed $25,000 we got them 2.3 million dollars in bad faith that's a that's on page 89 in the book so I'm very proud of that because I was mentioned on a case that was very important to me for my clients so definitely recommend that if you want to get to know chip Erling a little bit read the book and that way you know exactly who you're working with so lastly we've got our website we've got our phone number on here because that's typical of any PowerPoint but you guys obviously know sex acts and Kaplan please reach out to them if you have any claims let them know you saw the webinar with Larry beige that you'd like to meet Larry Bayshore chip Merlin and we'll come down and meet with you and answer any questions that you have with Stephen or another partner over there at the firm so I'm gonna finish up here I don't see any questions posted if you do have any questions let us know at this time I just want to say thank you so much for your time today I look forward to working with anybody that needs our help thank you