DennisBeaverFebruary 14, 2015 • By Dennis Beaver

“It does not matter what kind of a claim you have. Always remember that an insurance claims adjuster wants to quickly settle with you for as little as possible, using sneaky tricks, all to save the company money.

“Some adjusters will ‘become’ your best friend. Do not be fooled. You are most vulnerable right after an incident, and we take advantage of that every day. We excel at applying pressure, looking for ways of unfairly reducing the value of your claim. Business owners who have suffered an insurable loss need to accept the fact that there’s a lot they don’t know. So, obtain legal and accounting help or risk being greatly short-changed.”

Those comments were from a senior claims adjuster and long-time friend of this column, working for one of the companies whose cute ads we see everywhere. His advice is especially relevant to our reader, Abe, who had the scare of his life last Christmas Eve at 4 p.m., just about to close his small convenience store and come home early.

“We are right across the street from a women’s shelter,” he explained. “Normally on Christmas Eve at that time, lots of moms and their kids would be doing some last minute shopping.”

Call it the hand of Fate, or Providence, he was the only person in the store.

“I was sitting on a stool behind the cash register when, suddenly, there was a loud squealing of tires followed by a scene which has given me repeated nightmares. An out-of-control car smashed into the store, to the precise spot where customers and their kids would have been standing and the car kept on moving, right toward me!”

Confirmed by the security camera video he e-mailed, Abe “Moved like a character in ‘The Matrix,’ flying off the stool, escaping from the car! I hurt my back and have had nightmares about this ever since!”

That day our Central California reader was the luckiest man on Earth, for a number of reasons, significant insurance coverage being one.

Where did my customers go?

Three insurance companies would be involved in the loss:

  • His business policy for business interruption/lost income;
  • The landlord’s insurance, covering repairs to the building;
  • Insurance on the car which smashed into his store.

“We were shut for about a week, everything inside was repaired like new, but it has been over a month and most of my customers have not returned. Some have told me they are afraid, that there’s a hex on my store! If this keeps up, I could go out of business,” our reader told us.

“60 days or you get nothing”

“I’ve been trying to handle this myself but am a bit worried because my own insurance company tells me that I only have 60 days to present them a claim for lost income, or I will get nothing. What should I do? What am I entitled to? And what about my injured back and nightmares? Do you think I need a lawyer?”

In our opinion, when told this 60-day nonsense by his own insurance adjuster, it should have occurred to Abe that he desperately needed to consult a lawyer, and we were glad that he contacted You and the Law.

We ran these facts by Hanford attorney Rissa Stuart, who outlined Abe’s damages which insurance should pay for, at first pointing out something that lawyers see far too often, over-confidence.

“The thinking goes along these lines: ‘I am successful in my business, so, surely I can handle this myself.’ However, insurance claims–especially loss of income–are often complex, and benefit from a team approach – legal, accounting and very likely in Abe’s unique situation, medical, psychological and a business consultant.”

Prepare for a loss before it happens

“The best way of dealing with such a loss is to prepare for it and hope that nothing happens,” Stuart observes, adding, “Especially for small, retail business, you do this by keeping till records which show income generated on a day-to-day basis and the number of sales.

“This information provides a history of all transactions and proof that gross income has decreased. These records serve many purposes and should be retained for many years,” she stressed.

“Next, current profit and loss statements would be extremely important to show a change after an event which temporarily shuts you down. With a good accounting program, it’s easy, but there is nothing wrong in having an accountant professionally maintain this important information for you.

“These records will be requested and should be provided to the insurance adjuster, but I would caution against releasing income tax returns unless advised by your attorney. Don’t surrender your privacy unless absolutely necessary,” cautions Ms. Stuart.


Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.



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