Court Implies That Policyholders Are Better Off With Professional Claims Help

Property insurance coverage cases provide lessons for others to follow. A recent Oklahoma federal court decision1 following a fire loss reflects why my book, PayUP!, suggests that public adjusters should be considered for retention shortly after any significant loss. The language from the opinion that caught my attention was the following:

Rather than using a professional company to pack and determine what items were and were not salvageable, plaintiff decided to handle that process herself, and then cleaned most of the salvageable content herself. State Farm then reviewed the information provided by plaintiff about the items that were not salvageable and consistently questioned its validity and accuracy compared to its understanding of the damage caused by the fire. Thus, there is a legitimate dispute as to the extent and valuation of damage to plaintiff’s contents.

Most policyholders have never handled a significant property loss. They are truly learning for the first time what policy terms mean and how they are applied. They have never done an adjustment of real or personal property. For most, they are going to miss many policy benefits and not do all the adjustment steps correctly. As a result, they will often ruin their own claim and miss out on otherwise covered benefits.

So why not interview and retain a competent and passionate loss professional to help?

Fire, smoke, and ash cases are a lot more complex today than 25 years ago. Today, we understand that the smoke residue is often dangerous and requires much more extensive remediation than in the past. I have discussed this repeatedly and encourage readers to study The Importance of Demonstrating that Damages Exist in Smoke Damage Insurance Claims, and Wildfire Insurance Claims—Considerations From An Expert.

The trial court ruled against the policyholder finding that there was no bad faith. I wonder how the case would have turned out—and even if there would have been a need for litigation—had the policyholder hired a claims professional to help from the beginning of the adjustment.

Thought For The Day

Amateurs hope, professionals work.
—Garson Kanin
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1 Coleman v. State Farm Fire & Cas. Co., No. 21-cv-0430 (N.D. Okla. Nov. 21, 2022).