If You Have a "Hall of Claims" Event, You Might Not Have Coverage At All

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by Bryan Holtzman

JK Simmons, we love you – but those TV commercials are going to drive us crazy!

You know the ones: a national insurance carrier depicts an outrageous, catastrophic property loss.  A dog starts a fire by playing with laundry detergent, for example.  Or a mountain lion drags its claws extensively over a homeowner’s property - stuff that basically NEVER happens.  And what does JK have to say?

“We covered it.”

For the TV-viewing public, the idea is that this insurance carrier will cover anything – any remotely imaginable scenario that may befall your property will get reimbursed through your insurance policy.

Why does this drive us crazy?  Because it’s not true!

How is it misleading?  Very simply: exclusions.

If you look at a standard homeowner’s insurance policy, it will contain various exclusions for damage caused by random incidents – whether by animals, Mother Nature or homeowner carelessness.  Typical policy language might stipulate that the insurer will not cover damage caused by:

“birds, rodents, insects, or vermin. Vermin means animals that tend to access, or enter into or under, structures for foraging or shelter, and, as a result, cause loss or damage. Such animals include, but are not limited to, armadillos, bats, beavers, coyotes, lizards, opossums, porcupines, raccoons, skunks, snails, snakes, slugs, or squirrels.”

The above definition of “vermin” is telling – and explains our frustration with JK Simmons and his ads.  It’s true that Farmers Insurance did indeed cover the loss for the events depicted in its “Hall of Claims” ads – but they probably only did so once or twice.  After that, their lawyers no doubt updated all of their policies to ensure that such events were thereafter included in a policy exclusion or limitation so that similar events would then trigger a denial of coverage.

When events occur a few times, insurance companies will clarify wording in policies to exclude such events.  Attorneys crafting this language for insurers will add wording explaining specifics as to what, for example, is included in the definition of “vermin” for coverage purposes.

So, keep right on lovin’ JK and his fine work as the Farmers spokesman.  But recognize that insurance companies don’t just hand out checks every time you have a property loss.  Insurers won’t always tell you that – but a public adjuster will!


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Bryan Holtzman

Bryan is Vice President of Swerling Milton Winnick, and has more than 15 years of experience helping businesses and homeowners navigate complex insurance claims. He specializes in building estimates and policy interpretation.  


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Homeowners Beware: the insurance company’s adjuster might miss the extent of your property damage

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Check out this great feature by Fox43 TV in York County, PA.  Jackie De Tore from their crack investigative team examined a bad faith partial claim denial by the Erie Insurance Group (EIG).  It seems virtually every house in a crowded subdivision of identical houses suffered similar roof damage from a powerful hail storm.  Only ONE homeowner – the one with an insurance policy provided by EIG – had the portion of his claim that would have fixed his roof denied.

Huh?

Turns out EIG sent out a not-so-observant insurance adjuster to examine this homeowner’s roof. The adjuster supposedly scrutinized the damage and insisted it didn’t require extensive repairs. So EIG denied the portion of his claim that sought a new roof – even though the claim was supported by two separate estimates from independent contractors agreeing that the homeowner absolutely needed a new roof.

This adds up to bad faith on the part of EIG – so much so that the homeowner threatened to sue and formally complain to the Pennsylvania Insurance Department.

If you live in Massachusetts and you think an insurance company is acting in bad faith – including, for example, denying your valid claim despite compelling facts being in your favor – you can file a complaint with the Commonwealth of Massachusetts Division of Insurance.  To access the Mass. Division of Insurance web page for complaints, please click here.

Or: you can hire a public adjuster (PA) to manage your claims.  Unlike insurance adjusters, PAs don’t work for the insurance carrier – they work for you.  A good PA can manage every aspect of your claim recovery and push back immediately on any bad faith efforts by the insurance company.

Should you need assistance with submitting a claim, contact us at info@swerling.com.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Homeowners Beware: Protect Yourself from Dryer Fires

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Click here to read @GeorgeGraham413’s MassLive article about an overheated dryer that caused Wednesday morning’s house fire in Springfield.

Are you aware of the danger your dryer could pose to your home and family?  We at Swerling Milton Winnick are currently navigating a similar loss – a fire that originated from a homeowner placing pillows in their dryer.  This caused a huge fire and significant damage to their home.  You can help protect yourself by:

1.      Talking to your insurance agent to make sure you have enough coverage in your homeowner’s policy should you suffer such a loss; and

2.      Helping to prevent a loss by refraining from putting flammable household items in your dryer, such as pillows and rubber-backed floor mats.

Should you need assistance with submitting a claim, contact us at info@swerling.com.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Boston Globe quotes SMW's Bryan Holtzman in article on raccoon damage to Milton home

When we warn our clients about the top reasons insurance companies use to deny claims submitted by homeowners, we rarely include “vermin damage” on the list.  When denying homeowner claims, insurance companies are most likely to point to more conventional reasons than damage caused by raccoons. These would include water seepage, wear and tear, problems happening over a period of time, and failure to maintain heat.

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But raccoon damage is definitely a thing.  And when it happens, homeowners are often denied coverage.  In fact, The Boston Globe recently reported on homeowners who faced an exclusion for damage caused by animals.  Based on that exclusion, the insurance company denied coverage for damage totaling more than $80,000.

To provide expert commentary on the issue, the Globe turned to SMW’s very own Bryan Holtzman.  In his role as vice president and claims manager for SMW, Bryan has seen several instances of insurance companies denying claims based on damage from “vermin” – that is, ‘animals that tend to access, or enter into or under, structures for foraging or shelter, and, as a result, cause loss or damage.  Such animals include, but are not limited to, armadillos, bats, beavers, coyotes, lizards, opossums, porcupines, raccoons, skunks, snails, snakes, slugs, or squirrels.’

Bryan pointed out that damage from wild animals, or vermin, is actually fairly common.  It’s so common, in fact, that over the years insurance companies have clarified wording in policies.

To read the entire Globe article, please click here.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

"I came over the hill and everything was in flames"

We recently had a visit from Christopher A. Hauck D.C., owner of Framingham based Chiropractic Solutions.  Chris is a former client and a really great guy, and we recently sat down with him to get an update about the success of his business after SMW helped him recover from a devastating fire.  The discussion brought back a lot of memories, and it reminded us of how important our work can be for small businesses that experience catastrophic events.

Chris experienced the nightmare scenario of any small business owner: the phone call in the middle of the night, the mad dash to his office, and the view of his entire operation literally going up in flames.

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 For Chris and his wife, it was already an incredibly stressful time.  The IRS was auditing him due to an anomaly from a previous filing, and he was undergoing a routine chiropractic board audit.  Add to that the time spent caring for a rambunctious 2-year-old and the sleeplessness of tending to an 8-week-old baby - life was crazy before the fire!

The fire originated from wiring done by non-permitted electricians in an abutting office.  A ceiling fan caused a spark in an open cavity, and the flames grew once they gained exposure to the windy conditions outside.  At 2:34 a.m., Chris received a voicemail message from a client: “Dude, your whole office plaza just burnt down…I know you just had the baby…So sorry. Love you. Bye.”

 Luckily for Chris, he had up-to-date insurance.  The first thing he did that morning – with his office still smoldering – was call his insurance agent.  He confirmed that Chris had coverage and explained what was covered by his policy.

Chris also had clients to think about.  He met with his employees the following morning and commenced the search for new office space.  Within a week he was again seeing clients in a loaner space using borrowed equipment.

Then he met with the adjuster from his insurance company.  “He wasn’t a good listener,” Chris recalls diplomatically, “which made me think I should get a public adjuster.”  Chris’s insurance agent actually advised against a public adjuster, expressing concern about the contingency fee.  It was Chris’s accountant who had used Paul Winnick and his staff for their own claim, and strongly recommended that he talk to Paul and his staff.

Chris’s #1 focus after the fire was signing a new lease.  He needed a new home for his business, which involved real estate shopping and then negotiating the lease.  SMW convinced the insurance adjuster to approve the temporary relocation expense. “I didn’t even know it was a thing to have the insurance company pay for the temporary relocation,” he says.

Chris was poised to sign a 5-year lease, but SMW convinced him to consider another option: sign a lease for one year instead, and wait to see what would happen with the building reconstruction.   “It was a leap of faith, and a really hard decision,” Chris says. “But I took SMW’s advice and signed a one-year temporary lease”.

SMW then started the arduous task of compiling the list of damaged personal property to ensure Chris didn’t miss any opportunities due to coverage limitations.  X ray machines, computers, chiropractic tables, supplies, even the improvements he made to the space – SMW documented all of it.

SMW commenced the process of getting his Business Interruption claim underway, and submitted multiple interim claims.  In addition to this assistance, Chris emphasized the value of having SMW engage with the contractors who were doing the temporary build out.  When the claim for the temporary space was being put together, it was helpful that SMW and the contractor worked together to document the cost of construction and explain the nuances of the temporary buildout.

SMW also ensured that payments kept coming.  Chris wasn’t earning steady income from clients, and contractors need to get paid if you want them to keep working.  SMW made sure Chris did not have to pay out of pocket and remained at the top of the insurance company’s attention list – despite being one of their smaller portfolio items.

In parting, Chris offered some advice for other small business owners:

  •  Do not go through the claims process without a public adjuster!

  • It’s really up to you to know what to insure.  Things add up fast, so reassess your coverage routinely and make sure you have enough coverage.

  • Insurance companies are hard to deal with. You can’t win a game when you don’t know all the rules.

 SMW is proud to have played a role in helping Chris and his wife return their focus to the demands of a young family and a growing business.  Chris himself calls the support he received from SMW “a life changer”.

 Read a letter from Chris highlighting his experience here:

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If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Diane Swerling Presents on MCLE Panel

Victoria Santoro Mair, Esq., Diane Swerling, SPPA, and Brian Jerome, Esq.

Victoria Santoro Mair, Esq., Diane Swerling, SPPA, and Brian Jerome, Esq.

How do insurance companies settle cases? A room full of practicing attorneys had the same question, and for an answer they turned to Swerling Milton Winnick’s very own Diane Swerling.

Diane participated on a panel on December 6th hosted by Massachusetts Continuing Legal Education (MCLE).  She provided key insurance claims information to attorneys looking to brush up on their skills. Diane gave participating MCLE members an overview of the claims process, the important players involved, and various settlement insights. Based on her 20+ years as a public adjuster managing complex insurance claims for both commercial and residential clients, Diane was able to share her thoughts on how to optimize the claims process and avoid missteps.

 SMW was proud to support MCLE in helping practicing attorneys learn the ins and outs of settlements involving insurance companies – they should be ready for their next case!

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If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

What Community Association Boards and Managers Need to Know When Dealing with a Loss

SMW’s Diane Swerling is the author of this informative article featured in the most recent edition of Condo Media Magazine.

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If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Small Business and Retail Coverage You Should Consider this Holiday Season

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If you’re the owner of a small business, Black Friday is a critical profit-making day that looms on your calendar all year long. You prepare everything in your store to maximize this chance to generate sales and spike your revenue enough to put you “in the black” for the year. You double up on your normal inventory levels, staff up on sales associates, and get ready to move some serious product.

But what if something goes wrong? Are you protected?

Suppose all this inventory – twice the amount you usually carry – gets completely ruined. Maybe a faulty sprinkler goes off after hours and sprays the storeroom all night long, or someone leaves a window open and the season’s first blizzard blows in. Whatever the catastrophic event, you’ve stretched yourself way too thin stocking up, and now the entire storeroom full of holiday inventory is useless.

Seasonal Increase Endorsement

You and your spouse own the building and have a standard business owner’s policy (BOP) on the retail store. This policy covers your typical inventory levels, but not the 2X levels you bumped them up to in anticipation of Black Friday. There is an inflation guard under your Personal Property coverage section - usually 4 percent per year. And there’s also a seasonal increase, but it’s tiny – only about 10 percent.  It’s not nearly enough to cover all the inventory that stands ruined in your storeroom.

The lesson from this scenario: endorse your BOP for additional “seasonal increase” coverage. You can add this endorsement for the one uptick a year at holiday-time. It gives you coverage for catastrophic events like the one described above, and it has an appealing benefit: you don’t have to pay a higher limit all year long to get this one-time increase.

Selling Price Endorsement

Even if you selected the Seasonal Increase endorsement, there is more you should do to protect yourself and your business. If your inventory is ruined, as described above, your standard BOP will require you to provide all kinds of sales data to prove what you would have sold during Black Friday. This data is based on past performance and requires a detailed analysis to put you back in the position you would have enjoyed.

Well, what if you could find a buyer for all that ruined inventory? Guess what: the insurance company can be that buyer.

This can happen only if you endorse your policy to value your inventory at selling price, rather than at cost (which is what you will get under the typical BOP). With this Selling Price Endorsement in your BOP, the insurance company will pay you as if they were the customer for that damaged inventory.

So, not only does the insurance company pay you for the cost of your damaged inventory, it also pays you for the PROFIT you would have earned from successfully selling that inventory.

Pretty good, huh?

The Selling Price Endorsement buys you time – time you would have spent assembling a business interruption claim.  You can now use that time to get your store back open, resume operations, and begin selling again – and you won’t have to sit around worrying about reconstruction and length of time for repairs.

If your small business amps up for the holiday shopping season, think about what kind of coverage you have to protect you against catastrophic events. Call us at SMW to get some advice – we’re happy to help!


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

What is "Civil Authority" Coverage?

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The little known “Civil Authority” provision has received much attention of late – especially in connection with the Sept. 13 gas explosions in Lawrence, Mass. This critically important coverage provision is designed specifically for situations where people are forced out by police, fire or inspection services – or any similar “Authority” – due to a catastrophic emergency.

What exactly is Civil Authority coverage?  It’s a provision within most insurance policies. 

Here is an example of the language you will find in a standard homeowner’s policy:

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Note the language regarding the Civil Authority Prohibits Use section.  Your residence must be one of the neighboring premises and those premises must be damaged by a Peril Insured Against, such as fire or explosion.   Therefore, if you are unable to enter your home because of the recent gas explosions that occurred in Lowell, Andover and Lawrence, this coverage would only apply if one of the damaged properties was a neighbor of yours.  If your residence was not one of the neighboring premises to a home that had a fire or an explosion, then the coverage would not apply.

We have been made aware that a few insurance companies are allowing their policyholders to file for this coverage, even though they are not located next to neighboring premises that were directly damaged due to an explosion or fire.  These insurers are going above and beyond for their clients and providing coverage that really does not exist under the insurance contract.

Commercial Property Coverage Form (CP)

The Business Income (and Extra Expense) Coverage Form CP 00 30

Civil Authority coverage in Commercial and Business policies is completely different from Civil Authority coverage in homeowner’s policies.  The language reads in part, “We will pay for the actual loss of Business Income you sustain and necessary Extra Expense caused by action of civil authority that prohibits access to the described premises due to direct physical loss of or damage to property, other than at the described premises, caused by or resulting from any Covered Cause of Loss.”

You will note that in the Commercial policy (CP 00 30), the qualifying language for coverage is not related to the distance the business is from the direct damage - only that the business cannot be accessed, and that an authority having jurisdiction does not allow the property to be occupied or opened.

The coverage starts 72 hours after the direct damage occurs and the coverage is for a maximum of 3 consecutive weeks. 

An example of this coverage took place during the marathon bombings.  Several businesses near the event were shut down even though they had no direct physical damage to their locations.  The authorities cordoned off streets and did not allow businesses to open for several days, even weeks.  These businesses that were closed solely due to the closing of the streets would have been able to collect their loss of business income for a period of up to 3 weeks.

Businessowners Coverage Form (BOP)

If your business has a Businessowners policy as opposed to a Commercial Package policy, then the Civil Authority coverage has some minor differences.  First, the described premises must be located within one mile of the damaged location.   Secondly, while there is a 72-hour deductible (just like the CPP), the coverage duration is for up to 4 weeks and not 3.   

What is covered?

In the homeowner’s policy, Civil Authority coverage is for loss of rents, fair rental value and additional living expenses (i.e. hotel, food).  For business and commercial policies, it is for business interruption and extra expense.

Please be advised that the policies quoted above are specific policies and the verbiage in several policies can be different.  If you have specific questions about this coverage, SMW will gladly review your individual policy and make recommendations.  We can be reached at 781-416-1000


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Diane Swerling Provides Post-Hurricane Advice for Consumer Reports Readers

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When Hurricane Michael ripped through the Florida panhandle last month, it left a trail of wreckage that carried all the way to the Carolinas and Virginia.  In its wake, homeowners and renters from Miami to Newport News faced the daunting task of picking up the pieces and starting the long process of responding to a natural disaster.

Recognizing the many challenges faced by storm ravaged residents, Consumer Reports recently produced a helpful article outlining the proper steps homeowners and renters should take to get the most out of their insurance coverage.  After all, submitting insurance claims becomes a central focus for anyone impacted by a hurricane or other catastrophe.

According to CR’s article, hiring a public adjuster is one of the critical steps policyholders should consider.  For first-hand expertise on the value and benefits of having a public adjuster, CR turned to none other than Diane Swerling.  As a Vice President and Principal at Swerling Milton Winnick Public Insurance Adjusters, Inc., Diane helps business, home and resort owners, condominium complexes, hotels and others recover after every type of major catastrophic event - including hurricanes.

Diane advised CR readers to check the National Association of Public Insurance Adjusters as a first step in finding a public adjuster.  She explained that, upon making contact, policyholders should insist on getting references from past clients, make sure they have several years of experience as a public adjuster, and verify that they have a state license where required.  In the five states where no licensing is required—Alabama, Alaska, Arkansas, South Dakota, and Wisconsin—insureds should contact an attorney who works with catastrophe victims to help them find a reputable adjuster.  She also provided insights on the ins and outs of standard flood policies.

To read the full text of the Consumer Reports article, please click here.

After major hurricanes like Hurricane Michael, clients with complex losses can rely on Swerling Milton Winnick to support them with decades of post-hurricane experience.  To hear directly from our clients about how Swerling helps after hurricanes and other storms, please visit our testimonials.

 Call Diane Swerling or Paul Winnick– we are ready to work with you on the road to recovery.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

SMW is Proud to Support Save the Children as it hosts its First Boston Event

One of the areas that unites the entire Swerling Milton Winnick team is giving back. That’s why we’re proud to support Save the Children, an international non-governmental organization that promotes children's rights, provides relief, and helps support children in developing countries.

In addition to investing in the promise of education for children of war and conflict, we value the chance to interact with the organization whenever we get the chance. On Nov. 2, we had a great opportunity to do just that.

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Save the Children sponsored a wonderful event at the Downtown Harvard Club. It featured Cokie Roberts and other notable speakers who share the goal of aiding girls and boys fleeing unfathomable horrors around the world. Janet Wu, an Emmy Award winning political journalist and investigative reporter and co-host of WCVB’s “On the Record,” hosted the event while Ms. Roberts, a senior analyst for NPR and ABC News, Emmy Award winning journalist and author of six New York Times bestsellers, moderated a round table discussion on The Promise of Educating Refugee Children. The discussion featured child advocates Mary Mendenhall, associate professor at Teachers College Columbia University, and Dan Stoner, vice president for education and child protection at Save the Children.

We also enjoyed the live music! Thank you, Save the Children, for the wonderful work you do. Thanks for having us – proud to work with you!

 


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

The Top 3 Most Denied Property Loss Claims

As public adjusters, we negotiate with insurance companies every day.  We see firsthand the reasons they cite for denying claims by policyholders – both homeowners and businesses.  To help you position yourself for a successful claim process, we compiled the top reasons insurance companies cite for denying a claim.

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 1.  Water seepage

Seepage of groundwater into your house is NOT a covered event in a standard homeowners policy.  In your homeowners policy, the language is very clear: once rainwater hits the ground, it’s considered surface water or groundwater.  This means that if water seeps through your foundation, you have no coverage AT ALL.  On the other hand, if there’s a heavy rain and water seeps in through walls that are above grade, you will have coverage for that (NOTE: this is only true for an all-risk homeowners policy).  

Both the Business Owners and the Commercial Property policies contain this exclusion for seepage and groundwater.  But there is a key difference – in a commercial application, for any interior water damage to be covered, the roof or the exterior of the building must first be damaged by a covered cause of loss.  So, the roof must first be damaged.  Say there is a windstorm and a fallen tree slices your rubber roof.  If the windstorm lifts a section of that damaged roof and allows water into the envelope, that’s a covered event.  Rainwater seeping into a building around a door or window is not a covered loss in a commercial policy.

2.  Frozen pipe vs. burst pipe

In general, water damage from a burst pipe will always be covered under both a homeowners and commercial insurance policy.  Things can get tricky, however, when frozen pipes are involved.  For the most part, frozen pipes will NOT be covered, unless you can demonstrate that you maintained adequate heat.  Which brings us to…

3. Failure to maintain heat

Most insurance policies -- both homeowners and commercial – require that you take “reasonable care” to maintain heat in the building or house, or that you “shut off the water supply and drain all systems and appliances of water.”

If you are away on vacation and your pipes freeze – but you left your heat at a reasonable temperature and the boiler failed – your loss will be covered.  But if you were late for that flight to Florida and forgot to leave any heat on, your insurer can refuse to cover the loss.

Please note that these tips are based on standard homeowners insurance policies.  It is very important for you to read your individual policy as forms vary drastically.  Should you want SMW to review your policy, please contact us to discuss.

Be sure to check back for valuable tips and information.  And if you need assistance in resolving an insurance claim, call Swerling Milton Winnick. 


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Swerling Milton Winnick Public Insurance Adjusters, Inc. Leadership Members Accept Officer Positions with MAPIA

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Hats off to Swerling Milton Winnick’s very own Diane Swerling and Mindi Labella, who recently had the honor of being appointed to officer positions with the Massachusetts Association of Public Insurance Adjusters (MAPIA), the state organization charged with representing professional public insurance adjusters throughout Massachusetts. Diane will assume the role of MAPIA Vice President, while Mindi will serve as MAPIA’s Treasurer.

Both Diane and Mindi have committed to serving one-year terms in these statewide leadership positions. Diane has previously served as Treasurer of MAPIA, and as President of the National Association of Public Insurance Adjusters (NAPIA), the national organization representing public insurance adjusters. Diane also served as a member of the NAPIA Board of Directors from 2016-2018.

The appointments were announced at MAPIA’s annual meeting and education seminar, held on September 27 at the Boston Marriott.

During the seminar portion of the meeting, MAPIA members had an interactive session led by attorneys Tony Antonellis, Chris Reilly and Brendan Labbe of Sloane and Walsh LLP, one of New England’s leading litigation law firms. Attorneys Antonellis, Reilly, and Labbe provided property insurance law updates such as maintaining heat, examinations under oath, proofs of loss, collapse, reference, BI/EE claims, subrogation, and much more.

The entire Swerling Milton Winnick team congratulates Diane and Mindi on this hard-earned recognition. We’re looking forward to a very productive year for MAPIA!


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Your Business Has $1M in Coverage and a $100K Loss. How Can You Be Underinsured? Coinsurance.

Let’s say your business has a commercial insurance policy with $1 million in coverage, and one of the buildings covered by your policy suffers damage that will cost $100K to repair.  You should be all set, right?  Not always.

How can this be so?  

Coinsurance.

Coinsurance is a clause in commercial policies that allows the insured to save money on the premium, which is of course very appealing to any business owner.  But such savings can affect the payout of a claim, depending on the percentage of coinsurance selected.

This is an issue that can arise depending on the decision you make regarding the coinsurance percentage.  If you elect to insure your property for 100% of its value, the limit of insurance you are paying for must equal 100% of the replacement cost of that building.  Thus, if your commercial property would cost $2M to replace, you should carry a limit of insurance totaling $2M.  If you only carry $1M in coverage, then you are only insuring for 50% of the property’s value and therefore not meeting your 100% requirement.

This exposes you to out-of-pocket costs in the event of a loss.  If you had that $100K loss highlighted above, for example, the insurer would only pay you for 50% of the loss – leaving you responsible for the other $50K.

You don’t have to choose 100% coinsurance – you can choose 80% or 90%.  Why opt for 80?  Let’s look at the following real-world example to get a sense of how coinsurance works.

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A golf club’s main clubhouse, which is valued at $250,000 (the “Property Value” or cost to rebuild with “like kind and quality”), experiences a fire in the kitchen that causes $40,000 in damage (the “Amount of Loss”). The golf club had elected a coinsurance rate (the “Coinsurance %”) of 80 percent, a limit of $100,000 (the “Limit of Insurance”), and a deductible of $500 (the “Deductible”).  After the fire, it was determined that the cost to rebuild the clubhouse was $250,000.

Is this property adequately insured? We can find the answer in 4 easy steps.

 Step 1: Coinsurance requirements

Determine how much insurance you should have carried to meet the coinsurance requirements. To make this determination, multiply the Property Value ($250,000) by the coinsurance requirement (80%). Thus: $250,000 X 80% = $200,000.

Uh oh – looks like you’re underinsured. Let’s keep crunching the numbers to see by how much.

 Step 2: Coinsurance penalty

To calculate the coinsurance penalty, divide the Limit of Insurance ($100,000) by the amount of insurance you should have carried ($200,000 – as calculated in Step 1). Thus: $100,000 ÷ $200,000 = 0.50.

 Step 3: Calculate the amount of loss payable

Multiply the Amount of Loss ($40,000) by the coinsurance penalty (0.50, as calculated in Step 2). Thus: $40,000 X 0.50 = $20,000.

 Step 4: Apply the Deductible

Now subtract the deductible ($500) from the amount of the loss payable ($20,000, as calculated in Step 3). Thus: $20,000 - $500 = $19,500.  This amount is what the insurance company will pay you. The remaining $20,500 is not covered and will come out of your pocket.

The following diagram captures these steps in an easy-to-follow graph:

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Want to see an example of adequate insurance?  Take the same scenario above, only increase the Limit of Insurance from $100,000 to $200,000. Use the same numbers otherwise (Property Value, Coinsurance %, Deductible, and Amount of Loss).

Here it is in graph form:

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Another example of how Coinsurance can affect the amount collected after a loss is the following:

A well-appointed private golf club has 10 buildings on its course grounds, insured by a commercial package policy that includes $2.5 million in “blanket coverage” for the structures. This means that the cost to rebuild all 10 structures listed on the policy in the event of a catastrophic loss would total approximately $2.5 million when added together.

The main clubhouse has a limit of liability of $1M.  The clubhouse experiences a total loss that amounts to $1M.  However, the insurance company realizes that the remaining 9 buildings that are listed on the policy do not have enough coverage on them to meet the $2.5M coverage limit.  If it is determined that the total amount to rebuild all buildings is $3M, the insured will only receive 83% of the insurance settlement.  ($2.5M/$3M=83%). Therefore, if you use blanket coverage for your buildings, you need to be certain that the total amount of coverage is adequate. 

Coinsurance is a complicated topic, so hopefully this helps you grasp its complexity. Be sure to have your agent walk you through all related aspects of coinsurance – and be sure you have enough coverage based on an accurate property value!  Otherwise you run the risk of paying more out-of-pocket should you experience a loss.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Swerling Milton Winnick Offers Free Claims Advice to Victims of Columbia Gas Explosion

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Swerling Milton Winnick principals Diane Swerling and Paul Winnick spoke to Fox News about the Columbia Gas explosion in Lawrence, which displaced thousands of residents from their homes and businesses.

 In the interview broadcast on September 18th on Fox 25, Swerling and Winnick explained the critically important Civil Authority coverage provision, which is designed specifically for situations where people are forced out by a civil authority due to a catastrophic emergency.

 Any of these impacted residents who have a homeowner's, renter's or business policy should have Civil Authority coverage, Diane explained. In a homeowner's policy, for example, there are two weeks of coverage for additional living expenses. Maybe a family has to rent a room in a hotel, or must pay for meals at restaurants due to the displacement. If these expenses were incurred due to the gas explosion, they are covered – there's no deductible or waiting period.

 See the related news article here.

 The entire Swerling Milton Winnick team is providing free advice to anyone impacted by the gas explosions and fires in the Merrimack Valley and can be reached at 781-416-1000.

 


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Think your National Flood Insurance Program (NFIP) policy has you fully covered? Think again.

In my early days as a public adjuster, I worked with a grizzled old pro who was a leading flood adjuster.  He once concisely explained to me the basic purpose of NFIP flood insurance:

 “The point is to get homeowners some relief – it’s not supposed to make you whole.”

 I’ve been thinking about that pithy summary as Hurricane Florence barrels towards the East Coast.  Forecasters are calling Flo a “once in a lifetime” storm that might hit the Carolinas with torrential rain, high winds, and a deadly storm surge that could uproot trees, cripple power lines, and dump more than 3 feet of floodwater in several coastal areas.

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 If you run a business or live anywhere near this area, you’re no doubt asking yourself one key question: Am I covered?

 You may not be fully covered if you only have a flood policy through NFIP.   In residential policies, the coverage limit for a single family residence is $250K for the structure and $100K for personal property.  The maximum coverage limit for businesses is $500K for the building and $500K for your business personal property.

 This is important to understand because, in my experience, people who buy a flood policy through NFIP think they have comprehensive flood insurance.

 This is a myth!

 In fact, these policies are not only limited by dollar values but also limited in what is covered.  NFIP policies are limited when it comes to damage that is below-grade – that is, related to flooding.  These policies mainly cover unfinished drywall, insulation, mechanicals, plumbing, electrical but not paint, wallpaper and flooring. 

 So, if you have a policy through NFIP, read through it very carefully to understand what is covered and what is not.  If you want full flood insurance protection, you will have to purchase a complementary policy through a private insurance provider – it may be costly depending on the location of your property.  It will be worth it, of course, in the event of major flood damage.

 But if you only have a flood policy through NFIP, give it a good read and understand what it actually covers. Remember: it’s only supposed to help you get you back on your feet – not make you entirely whole after a flood loss.

 


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Understanding the Commercial Package Policy

If you’re part of a business or a private ownership group, you might have a “commercial package” policy for your entity’s buildings.  Unlike in a homeowner’s policy – which automatically contains a provision that covers the “replacement cost” of buildings, structures, or other property – your commercial package policy does not automatically include coverage for relevant personal property.

So do your due diligence – and know the values you want to assign to each property item.

The commercial package is just what it sounds like: it lets you choose various coverages and endorsements and package them into a single insurance policy.  Here are a few tips to help you put together a package of coverage that’s tailored to your unique needs:

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Building and Personal Property Coverage Form – This commercial policy can cover:  a. Your Buildings; b. Your Business Personal Property; and c. Personal Property of Others.

a.     Buildings – Under this policy form, you must make certain that all of the buildings that you wish to insure are listed in the policy.  Don’t assume that every building on your property has coverage just because you have listed your main building and carried a limit for that building.  

Know your values – It is up to you, the insured, to make certain that the limits applied to your buildings or personal property are accurate.  This is especially true if your policy has a coinsurance requirement.   If the value assigned to any of these structures is from 20 years ago, you should probably increase your limits to reflect the current cost of construction.  Otherwise, you could face a big hit when coinsurance is applied.

Understand your “blanket” coverage – If you have several structures, you might obtain blanket coverage based on a cumulative tally of the value of all structures added together.  Understand that this limit is NOT a catch-all to ensure broad recovery.  You still have to meet the coinsurance requirement, which means you must have coverage at the appropriate value levels for the structures.

b.     Business Personal Property – This coverage is for your Furniture and Fixtures, Machinery and Equipment, Stock, All other personal property owned by you and used in your business, and leased personal property that you are contractually required to insure (for example, a copy machine that you lease on a monthly basis).  If you are a tenant, there is also coverage for your interest in the betterments and improvements that you make to your leased property.

Know your values – Again, the amount of coverage that you carry for this insurance should be the total of all the above listed items that you own.  We will also point out that if you have multiple buildings listed on your policy, a limit for the Business Personal Property should be listed and covered for each of the buildings.  Just because you have Business Personal Property coverage for your main building does not mean that you have Business Personal Property coverage for all the different buildings on your property. 

c.      Personal Property of Others – This coverage covers personal property of others that is in your care custody and control and is located in or on the building described in the Declarations or in the open within 100 feet of the described premises.

Not all businesses need to obtain this coverage.  Actually, most commercial businesses do not need to carry a limit for this insurance.  A good example of a business that would require this insurance is a fitness facility - a business where several different people may have personal property stored in lockers that could be damaged if the building sustained a loss, such as a fire.

Code Coverage – Be sure you have enough coverage for code-related claims.  When determining the amount of loss to a building, the insurance policy will only pay to replace what existed at the time of the loss.  If your building does not have a fire suppression system or an elevator for ADA accessibility, these amounts will not be part of the initial insurance claim.  After a loss you may be required to install these items, but you will need to have purchased Ordinance or Law Coverage in order to obtain payments from your insurer.  This coverage should be discussed with your agent, and in our experience is one of the areas where policy owners often fail to get enough coverage. 

These tips will help you understand the commercial package policy, and hopefully will inform you in making exactly the right coverage selections.  

Look for more insight on coinsurance and Ordinance or Law in upcoming posts.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Want To Speed Up Your Claim Process? Then Slow It Down!

Are you just beginning the claim process?  If you’ve suffered a loss and you’re making a claim under your homeowner or commercial insurance policy, you’ll want to speed things along.  Want a tip for speeding up the claim process?

Slow it down!

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As public adjusters, we run into situations where the insurance company moves quickly to clean up a damaged house or office after an event such as a fire or a flood.  The insurance company adjuster thinks it's helpful to go in and immediately remove all the damaged furniture and personal belongings – even the fixtures.

This is NOT helpful to your claim.  And in the overall scheme of the claim process, it will slow things down considerably.

First of all, you will want a complete inspection “take-off” of the building damage and inventory of the personal property.  If the insurance company adjuster hires a remediation team to strip out the fixtures “full gut”, you will lose all evidence of those custom countertops, the hand-crafted trim, and the grasscloth wallpaper that was specially ordered by your interior designer.

The same rule applies to your personal property.  Don’t throw away that sofa – it was purchased from a high-end decorator and was made with imported fabric. If you don’t get a scope and price agreement with the insurance company for this unique piece of furniture, you may recover only the value of a department store model.

Think about it this way: after a fender-bender, you don’t take the dents out of your car until you know how much money you’re getting.

Preserve the evidence and get quotes for EVERYTHING.  Only then should you make decisions about what gets tossed in the dumpster.

If you have a public adjuster – and you should – let them prioritize the buckets of coverage you will use.  Do you have enough insurance to pay a restoration company to “gut” the entire house and then rebuild?  They might charge two to three times the amount another contractor will charge.  That payment gets taken out of your coverage, which is a limited pool of funds.  If a huge chunk gets gobbled up by remediation – or worse, to send old and unwanted clothing to the dry cleaners – it can’t be used in other aspects of the process.  After your coverage runs out, you’re personally on the hook for related expenses.  These are issues where you’ll want to get advice from your public adjuster as one wrong decision could be detrimental to the claim.

You’re not properly managing the claim process unless you know – and endorse – everything. Every single activity and cost associated with your policy needs to be understood and signed off on by you.

If you’re not effectively managing your claim, then your claim is managing you.  Don’t let the process run things for you – slow it down.  Halt all activity until you have a moment to get informed about everything that’s happening.  Get bids and make informed decisions.  Once you have pulled in the reins, you can quickly choose the steps you want to take.  

Here are some tips to help you manage the claim process the right way:

Know Your Coverage Limits – Remember: this is a zero-sum game. The coverage limits in your policy may look adequate, but they can add up very quickly. You are personally responsible for all costs in excess of that amount.  And keep in mind that every dollar you spend on one item leaves one dollar less for another, perhaps more helpful, ancillary service.

Do Your Due Diligence – Talk to your entire professional services team for guidance on what you need and how to proceed.  This team includes your personal attorney, your insurance agent, and your accountant – anyone who has a professional interest in your well-being.  Get recommendations on what services you need and who to hire.  This is a good time to get a list of qualified public adjusters, and to start vetting them to determine the right fit for you.

Understand the Costs – Before anyone else starts spending your money, ask questions about the services they’re providing.  Insurance agents and their adjusters often contract with remediation services to clean house very early on in the process.  This expedites the claim for them but can run counter to your own claim interests.  Remediation services can be very expensive – did the insurance adjuster compare multiple bids?  The remediation team isn’t worried about making a list of customized cabinets and high-end furniture, which you will need to optimize your own claim.  They just want to gut the house and move on to their next job.  Before you know it, your entire coverage limit has been gobbled up by an expensive remediation company.  And only after the fact are you realizing that they have undermined your ability to itemize lost personal property.

Itemize and Inventory – We touched on this above.  Don’t let anybody take anything out of your property until you have compiled a comprehensive list of all personal property.  This is where a public adjuster can be invaluable.  If you spent $10K on a designer couch, you want to be able to demonstrate that in your claim.  You can’t do that if it hits the dumpster before you arrive (at which point the insurance company will offer you $2k for it).  Do you have custom cabinets?  You must itemize them or risk losing out on the claim.  Granite countertops are pricier than Formica – that needs to be accounted for before they are hauled to the dump.

Mitigate and Protect as Warranted – As the insured, you do have a responsibility to mitigate and protect your property.  So, don’t let your “slow it down” mantra result in a 6-month work freeze.  We warned you against runaway clean ups, but sometimes it’s appropriate for remediation and other construction specialists to do demolition right away.  If an area won’t dry on its own, that area should receive priority demo attention before it buckles or collapses.  As long as the remediation team runs it past you and your public adjuster, it’s ok to let them proceed with demo that mitigates against further damage.

Recognize a “Dead Loss” – Sometimes a property is a total loss and a full demo is in order.  You still need to protect your interests in this case.  You or your public adjuster can get bids to demo the entire property if this is necessary.

If your house or business has a fire or some other catastrophe befalls it, you will be cast into a claims system that can rapidly spin beyond your control.  Managing your claim the right way means slowing down the process to carefully choose the steps you want to take.  This will allow you and your public adjuster to document and strategically use the insurance funds coming your way.  By understanding the process and all related costs, you are more likely to get the best return for your coverage.

And remember:  If you’re not properly managing your claim, then your claim is managing you.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

The "Full Compensation" Rule - Understanding the Equitable Doctrine of Subrogation

If a third party damages your property, the first thing you do is go to your homeowners or commercial insurance policy and check your coverage. Sometimes you will find that you are underinsured, and don’t have enough insurance to cover all your losses.

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What happens then?

You look for a third party who may have liability – and you go after them for the costs you incurred.  This is the point when you may be introduced to the legal right of “subrogation.”

Subrogation answers the simple question in scenarios like the one described above: if the insured is not fully reimbursed for his/her losses, who gets the first dollar of recovery from the third-party tortfeasor?

To clarify this important but complicated subject, let’s look at an example.  Suppose a utility truck from the electric company backs into your house, which promptly collapses.  Damages are $800K – but your homeowners insurance only has coverage up to $500K.  You don’t have enough insurance to cover all your losses.  What do you do?

You look for a third party who has liability, of course.  The electric company clearly fits the bill here – the company’s driver and truck caused the accident, after all – so you file a 3rd party claim against the electric company.  In this instance, your insurance carrier will have a “subrogation interest” in your third-party lawsuit against the electric company.  This is because the insurer paid the $500K on your claim, but the third party (the electric company) was at fault.

A few important points to keep in mind here:

  • Your insurer does not acquire a subrogation right until after you (as the insured) have been fully compensated for your loss
  • This doctrine is equitable – meaning it’s a principle of law established by precedent – but some states do permit parties to ‘contract around’ this doctrine
  • In Massachusetts, we follow the “Made Whole” doctrine regarding subrogation – meaning the subrogating party doesn’t get paid until the victim does (i.e., the victim is first in line for payments)

So you should review your homeowners or commercial policy with your insurance broker to ensure that you have enough coverage to sustain an unexpected loss.  If you are underinsured when you suffer a loss, see if there’s a third pocket of liability you can use. Your insurance company will probably then move to subrogate.

Subrogation is an important legal principle that is sometimes hard to understand.  If you find yourself in a situation involving this ‘full compensation’ rule, your insurance company may have to stand in your shoes, legally speaking, to get money back if there’s a third party at fault.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.

Replacement Cost Coverage - What Does Your Homeowners Policy Provide?

Do you have “Replacement Cost” coverage in your homeowner policy?  This would cover damage to a building, structure, or other real property that you own.  You probably do, even if you aren’t explicitly aware of it – or don’t know exactly how it works.  Here are some insights to introduce you to this important coverage provision and help you manage expectations in the event you need to use it.

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Claims involving Replacement Cost usually arise in the event of property damage involving a residential homeowner policy.  If a tree falls through the roof of your house, for example, your policy’s Replacement Cost provision speaks to your various settlement options – usually under the Loss Settlement clause of the policy.  Most homeowner claims, as far as building coverage goes, will settle on a Replacement Cost basis.

Homeowner policies these days typically contain Replacement Cost coverage; in fact, it’s automatic if the covered real property (your home or other building/structure) listed in your policy is insured for at least 80 percent of its estimated value (Note: the estimated value of the structure does not include the value of the land on which it is constructed).  So if your home is worth $100,000, and you are insured for $80,000, you will be covered for Replacement Cost within your homeowner’s policy.  For personal property, you need to purchase an endorsement that will provide replacement cost coverage.

What does this mean?  Well, if your home suffers a loss, it means that you’re getting New for Old. That is to say: you’re getting a new roof, even if the roof that was destroyed was 20 years old and already nearing the end of its “useful life.”

This is a crucial element in homeowner policies.  Insurance policies didn’t always allow New for Old – you used to get only what you had at the time of the LOSS. So if your roof was 15 years old, and had a lifespan of 30 years, you would get one half the value of the roof.  This is the depreciated value, or Actual Cash Value.  Insurance companies held fast to this “indemnification” model right up until Replacement Cost entered the scene and all insurance companies had to follow suit.

Even if you understand the concept of Replacement Cost, and you know you have it in your policy, there are additional points you may not know about. Such as:

  •  You don’t get New for Old payments up front – initially you will receive the depreciated value of the claim (i.e., the Actual Cash Value).  Policyholders often expect to receive the Replacement Cost settlement immediately.  Not so!  First you must make the repairs and show the insurance company that you spent the money you’ve already received.  Only then may you receive a check from your insurer for the Replacement Cost.  (NOTE: this check will neither exceed the actual amount necessary to repair/replace the property nor the limit of liability under the policy).
  •  In Massachusetts and several other states, “replacement” can mean more than just a repair – it also means you may elect to purchase an entirely new home.  In lieu of making repairs, one can purchase a new home for the replacement cost settlement.  The land value of the new purchase would have to be subtracted from the sale price, and then the value of the residence could be used as the replacement cost figure.  (NOTE: If you elect this replacement cost option, you (or your public adjuster) should first obtain the insurer’s approval since the replacement property must be amenable to the insurer for purposes of releasing the withheld depreciation.)
  •  If you do decide to purchase a new home (instead of making the repairs), Massachusetts law requires that the new home be within the Commonwealth of Massachusetts and be a residential property only.
  • Replacement Cost does not include the increased cost to comply with codes or ordinances. Say you owned a home built in 1996, and the energy code at that time required insulation specs to be R13.  If you go to rebuild in 2018, insulation must now comply with a code requiring a minimum of R21.  Ceilings, meantime, went from R21 to R48.  Typically, your insurance company only accounts for what you had at the time of the loss (indemnification), and thus you’re only entitled to what you had at the time of building the structure (which has, of course, depreciated).

These tips are limited to residential coverage – there’s more to come on the commercial side in upcoming posts.  Also, the Replacement Cost coverage discussed above is not for personal property. To ensure Replacement Cost coverage for personal items, you should include such an endorsement in your policy.


If you’ve had a fire, flood or other property loss resulting in an insurance claim, and need a public insurance adjuster in Massachusetts, New Hampshire, Rhode Island, New England or anywhere in the U.S. or Caribbean, call Swerling Milton Winnick. We are the oldest and largest public adjusting firm in New England, and our team of experts will give you personalized, 24/7 attention to successfully resolve your residential or business insurance claim.