What do you do when Insurance adjusters...

[Sticky]

What do you do when an insurance adjuster tells you that your bill is way too high? I am working on a large Cat 3 loss, 1400 sq ft. basement. Total gut and wash/disinfect. I am finishing the mitigation part of the job and submitted my bill. The adjuster said that exactimate is crap and that insurance companies don't recognize it as being legit. He said you can build your bill up to whatever you want. The adjuster is an independent adjuster and I've talked to many people that have delt with him and everyone says he is a stickler. He told me exactimate was a bunch of crap and that Serv Pro doesn't charge them that much. I had a public adjuster look at the job and he wanted to add 15 to 20 grand to my invoice. The home owner wants to get the house put back together and wants the basement rebuilt ASAP. I went back and forth with the adjuster. I had 36 pieces of equipment that needed to be cleaned, disinfected and it was heavy Cat 3(sewage). Exactimate $1500 he wanted to pay me $250. I argued and he said the most he would pay is $50. He only wanted to pay me .30 a sq ft for powerwashing and cleaning the slab. Exactimate charged .80 a sq ft. Many other things as well. He will not pay me any hours for Supervising Water Restoration Tech. I just don't understand how I can create an invoice in exactimate and he can tell me that I charged too much. He kept saying well Serv Pro doesn't charge for all these things and they are way cheaper. He had me look at another job for him. I looked at it and quoted him $3800 to soda blast graffite off of a car wash. He told me Serve Pro only charged $1000. He then later said how it looked like crap and they had to figure out what to do over there. He kept saying Serv Pro doesn't charge this much. After like the 7th or 8th time I started getting pissed. I was like so since when did Serv Pro come the standard of the industry? You just told me that they did a shitty job at the car wash? I told him that I am a specialist and that I do everything in more power to get the job done right and getting it to pre loss condition for the home owner. I talk to him on a daily basis and got his permission to tear out everything. (cause everyone told me he was a stickler) There was a second small back up and he told me that the home owner would have to file a second claim. (second deductible)
I cleaned it up for no-charge. (so my client wouldn't have to deal with anymore BS) Then there was a 3rd back up, it was so big and the adjuster made the home owner file a second claim.
He thought that I did a good job and that everything was done by the standard. I just dont understand how these adjusters can just come in and tell me what they are and what they wont pay for.
What can I do to prevent this in the future? Should I stick to my guns and my invoice or should I meet him in the middle.
Do you think I should have a public adjuster come in? How long will that prolong the rebuild?
He has no problem with my $27000 rebuild invoice. He only wants to pay $15000 for $24000 worth of work. My bill is high becuase I had 2-200ht's and 12 airmovers on the job for 9 days before I could open up the walls and really clean and dry the structure. I had equipment on job for 3 days after I opened the walls. I have had and air scrubber on the job for 32 days and will probably be in the 40 day range before I'm done. (per proto-cal environmental hygenist) I really did everything by the books and just don't understand how this guy can tell me what he is gonna pay. Also, he is holding up the claim now becuase he is subrogating with the town. I don't think that my customer should have to wait for insurance company to make right to my client. Why should they have to wait with there basement all torn apart?
Thanks for any help and sorry for it being so fricken long.

 

[Kevin. McCreary]

Independent adjusters usually shut up for 20%
That's how they work where I'm from.
That's why you will see less and less of them in the future.
I cant stand those MAFIA bastards.

Oh and BTW- stick with your guns if you can afford to
because he wont be sending you any work. If the custy
signed a work authorization you can threaten to bill the
difference to the home owner, but dont actually do it.

I dont think exactamate is fair either I charge more.
I tell them this is my price I could care less what
serv pro gets paid or what you think I should be paid

 

[Sticky]

thanks...I too could care less what Serv Pro charges too. The home owner also told me that the adjuster asked them to switch to Serv Pro but they didn't want too. I'm willing to work with someone but this guy thinks he can tell me what to charge. I did not like that at ALL.

 

[Jerry McMahon]

I agree, stick to your guns!

Independant adjusters are self employed just like us. There are no formal education requirements for any of these occupations.

 

[Hoody]

Oh and BTW- stick with your guns if you can afford to
because he wont be sending you any work. If the custy
signed a work authorization you can threaten to bill the
difference to the home owner, but dont actually do it.

Bingo! Keep the homeowner in the know of whats going on. Don't down talk their insurance company to them, but let them know you're experience some resistance, and you're wanting to serve them and get their life back to normal asap. Ask them to help you, explain briefly why the insurance is resisting(they normally work with companies that will discount for them to get volumes of work) but your prices are normal.

Have you figured out why the problem keeps occurring ?

 

[Guest]

All it takes is 1 time for the Lawyer to drag the adjuster into court for the bill; the insurance company will fire his tail. Stick to your guns. Or if you can't afford a lawyer I know these guys that do collections; the adjuster will see it your way. Let the homeowner be your advocate with the insurance company. Tell them to complain to insurance company that the adjuster is stalling their home being finished; also tell them to file a claim with the state insurance commision. Also; have the county inspector call the adjuster, insurance company, and home owners agent to find out what the hold up is on the permit being completed. DRAG HIS TAIL INTO COURT!!!

 

[Sticky]

There was a problem with the sewer main. Thats why it kept backing up.
I do have a lawyer that works with me that specializes in WTR and collections. I could also call in the public adjuster but don't want to drag the claim out much longer for the home owner. Thanks for all the advice I'll let you know what happens today when I talk to this prick.
thanks again!

 

[Desk Jockey]

The reality is Exactimate is just a guide, a starting point, not the bible. It's not often I've heard of it being high, usually more complaints of it being low.

He maybe right, some of your charges could be a little high, but more than likely they are low.

Servpro is probably lower, but you don't have national agreements for volume work, so you can't be as low as them.

The guy is a jerk, it's his job to be a jerk, he has to show the carrier he saved them money to validate the reason why they choose his company to do the adjusting.

You can play it hard and fight it or you can give a little and get it over with.

We sometimes give in and other times dig in and fight. Depends on what he is questioning. If it's our integrity, it's a fight, price we may give a little.

As long as that job was, we would probably give them an extended use discount of 10%, much like a rental yard that gives you weekly rate cheaper than a daily rate.

But we would do so not because he is pressuring you for one, but because the equipment was on site for that long of time.

Then we would stand our ground. If he is smart he will take it and use it to show the carrier he saved them money.

If he doesn't tell him you can provide him with proof that you have charged other carriers the same rates and you have the proof they paid it.

Guys like this are going to pop up every so often, don't let them get you down, it goes with the business.

 

[Mike Hogan]

This is a copy of a letter I sent out 2 weeks ago. Please excuse the run on sentences,I copied this from my notes on Wordpad. I also x out the names of the guilty,lol. I got paid full price on this loss,no discounts to the adjuster.


Dear XXXX

I just wanted to give you proper info regarding the XXXXX claim. As defined by the IICRC/ANSI S500-520 Standard of Care,this loss was
at the minimum a Category 2,Class 4 water intrusion. I will fax the definitions to you. These are the ONLY standards accepted in a court of law in NY.

I do not allow an insurance company to write my protocols unless they are willing to sign a hold harmless agreement,absolving First Call Emergency
Water Removal of all liabilities associated with violating the industry Standard of Care. Take off the dumpster rental and tax and my invoice is under $13,000,
a BARGAIN for what needed to be done at the XXXX home. btw,it is the fault of the insurance company that this loss got larger than it should have.
Their delay in responding caused microbial growth to get out of hand.I attempted on numerous occasions to get an adjuster involved asap,with no response from Cxxx After sending documentation and photos,I was finally told by Jxxxx Buxxxxx to start mitigation and "do what was neccessary to restore the property".This conversation took place on 2/09.I also recorded the conversation as I got a bad feeling regarding this company. The estimate prepared by xxxxx Adjusting Services was given to me by Jeff Cxxxxxx,a public adjuster,on 4/16/2009. After reviewing the said estimate I can honestly say I don't know where to begin. All IICRC/ANSI S500&S520 protocols were followed. These protocols were line itemed in our estimate. We use Xactimate,an estimating program ownd by ISO,an arm of the insurance industry. Besides the fact that xxxxx Adjusting totally underscoped the loss,their pricing structure was laughable,to say the least. My price reflected our following all measures to get the insured back to pre loss condition. As you know,all estimating software only reflects average industry prices,They are a guide only. To suggest otherwise is price fixing and violates the Anti Trust laws of the
United States.

I am a Certified Mold Inspector as well as a Certified Mold Remediator. I am also Certified by the IICRC in Microbial Remediation,Sewage Remediation,
Water Damage Restoration and Applied Structural Drying. I am also an expert witness,having been employed by my families law firm on environmental
issues regarding indoor air quality. I am FULLY PREPARED to defend our procedures with an arbitrator.

I am going to send out my invoice one last time.I expect to hear from xxxx adjusting in a timely manner. So far all I have gotten are stall tactics and am noting that here.
I expect a line by line response on what xxxx Adjusting finds to be unwarranted
protocols. My attorney also wants to see all industry certifications as well as how many damaged homes were successfully remediated by xxxxx Adjusting.

I am also noting that further secondary damage has been caused by delays .
While at the property on 04/15/2009,we observed mold in the soffits as well as mold
on the siding at the rear of the home. This was also observed by the cause and effect engineer who toured the property.




Yours truly,
Mike Hogan
First Call Emergency Water Removal
845-XXXXXXXX
P.S. Please look at the Moisture Mapping journal that was sent to you. If you don't understand it please call me for clarification.