Proving an Insured Loss: Policyholders Need Experts Too

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...to a covered building or structure in the course of construction or repair. Soft Costs mean only the following necessary and reasonable additional expenses: … C) additional architect, engineering and consultant fees which become necessary as a result of an insured loss. …”

Comment:

This clause is taken from a policy issued by United Insurance Consultants, Inc. Coverage for consulting fees includes part of an extension for “soft costs.”

A Recommendation

Once the potential for the loss adjustment expense exposure is evaluated, it is wise to explore the options offered by a number of carriers. In the absence of a more acceptable endorsement, the insured should suggest the addition of this simple yet comprehensive wording to their policy:

Cost of Recovery — SES Insurance (your insurance carrier) will pay your reasonable expenses to recover a claim covered by this policy. This payment is limited to 10 percent of the amount of the insured claim. Legal fees for litigation and court costs are not included by this endorsement.

Summary

More and more, insurance companies are using experts to support their side of a claim settlement, so it behooves today’s policyholder to take advantage of similar professional resources to help prepare, support and settle their claims. Understanding and utilizing the coverages available for this purpose can help protect the insured not only against financial loss, but for the cost of recovering it.

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1 In some states such as Virginia, if an insurance carrier requests an “appraisal” under the terms of the policy, the state statute requires the carrier to pay for both appraisers as well as the umpire.

Harvey Goodman, SPPA Adjusters International

Once the potential for the loss adjustment expense is evaluated, it is wise to explore the options offered by a number of carriers.

Adjusting Today Basis for Institutes CE Courses The Institutes, the leader in providing knowledge solutions for risk management and the property/casualty insurance industry, offers continuing education courses based on technical information compiled from issues of Adjusting Today . The courses — “Valuing a Property Insurance Claim” and “Natural Disasters: Coverage Issues”— include seven modules each and are approved for credit by insurance departments in most states. They are offered to property insurance producers, adjusters or both, depending on the state, for up to three continuing education credit hours per course. More information is available at CEU.com.

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PUBLISHER

Ronald A. Cuccaro, SPPA

EDITOR

Sheila E. Salvatore

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ADJUSTING TODAY is published as a public service by Adjusters International, Inc. It is provided for general information and is not intended to replace professional insurance, legal or financial advice for specific cases.


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