The ferocious storms that continue to pummel California and much of the nation have resulted in massive insurance claims by thousands of business and property owners.

Often, this is the first time they have ever been faced with filing such claims, says Los Angeles-based Karl Susman, an insurance broker for over 30 years, expert witness in lawsuits involving coverage and agent malpractice issues, and a friend of this column.

He phoned my office, concerned that a great deal of false and misleading advice on how to deal with claims will result in substantial delays, and asked if we can list steps to take from the moment it’s clear you have suffered a loss.

I could not say yes quickly enough.

The do and don’t of it

(1) Start with the assumption that your insurance company is going to do right by you. Do not rush out and retain a lawyer!

But if turns out that they don’t, then ask for a claims manager or supervisor, and if that is still not satisfactory, then consider retaining a public adjuster if you feel they are not being reasonable, and if that still is not satisfactory, then and only then do you want to hire an attorney.

(2) Hiring an attorney prematurely or unnecessarily for the typical loss slows down the process of resolving your claim and can add considerable expense as lawyers will typically be paid a percentage of the settlement.

For the typical storm-related loss, hiring an attorney is the absolute last thing you want to do, as it takes your claim to a completely different insurance company department. As there are fewer adjusters who are trained to deal with attorneys, this will cause delay sometimes lasting months and even years with no benefit.

(3) If I file a complaint against my insurance company with the insurance commissioner’s office over valuation or handling of my claim, will this help me?

Generally it is a zero-sum game. They will send a letter to the insurance company that says, “Please justify your actions with this customer’s complaint.” Your carrier answers the complaint with the same documents they gave to their customer. It seldom accomplishes a thing, but again, we are talking about the average claim. The exceptional bad-faith case is a different story.

(4) Public adjusters — is it worthwhile hiring one? I hear they have a bad rap.

The typical cartoon character public adjuster shows up at your business or home after it has been destroyed and quickly signs you up, and takes a piece of the insurance settlement, leaving you with much less than your own insurance company would have offered you.

“Propaganda,” says Susman, adding, “just as all lawyers aren’t crooks, there are good and some very poor public adjusters. In my experience, the main reason people are often dissatisfied with having retained a pubic adjuster is that the expectations of what a PA can do are not often met and the settlement process can be slowed down considerably. I have seen instances where it took years to resolve a claim and the insured got nothing different than what the company first offered.”

(5) Insurance companies need the justification to pay claims, so put on your claims adjuster hat and ask yourself, “If I was the adjuster, what would I need to see in order to pay this additional money?”

“The public often thinks that hiring a public adjuster will in some way force the insurance company to do more. But that is not how insurance functions.

(6) On national television, we saw RVs at an RV park swept into California’s Santa Clara River. “One was my home business and I have insurance, so what should I do?” a reader emailed.

Susman replies: “If you have a total loss like that, I would ask for policy limits. What often happens is that when people have a total loss and they realize they didn’t have enough coverage, instead of taking policy limits, they want to fight and get more.

“It is a zero-sum game, the worst thing to do. The message is simple: If you have a total loss, don’t try to collect more than your policy limits. It is a waste of time, money and will reward you with heartache.”

(7) One of the people whose RV was shown falling into the river said, “I want to sue the RV park instead of claiming under my insurance because 15 years ago something similar happened and they should have warned me to move my vehicle. That is why I want to hire an attorney and pay on a contingency.”

Susman: “15 years ago? Give me a break! Unless you can prove the park ownership was on notice that the river was about to suddenly flood again, you can’t blame them. That is why you have insurance.

“It is a matter of how far into the future we think we can peer. As these storms have shown, the answer is, not very.”

Some final, important recommendations

(1) Please, don’t forget that claims adjusters are just people. Their job is to hear from folks who are always at their worst! Something bad has happened. Try to have a little sympathy, a little empathy. Be polite!

(2) Don’t threaten with attorneys or public adjusters. Explain and justify your position. The adjuster would love to give you what you want if you can support your position.

(3) Don’t exaggerate. Don’t lie! This can nuke your entire claim.

(4) Don’t forget that adjusters are paid to settle your claims, not reject them. Help them help you.

(5) Think of technology as your friend when claims people are pulling their hair with so much to do. By providing good photos and videos of your loss to your adjuster this will help speed the process.

(6) Yearly, review your insurance needs with your agent or broker.

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

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If you are shopping for homeowners insurance–or about to renew your policy with Farmers–you may wish to reconsider after reading our story.

With 138 million dollars spent on television advertising in 2016, who hasn’t seen actor J.K. Simmons, playing the role of Professor Nathaniel Burke at Farmers University, telling his students, “We know a thing or two because we’ve seen a thing or two. Seen it. Covered it.”

Their entertaining commercials give the impression that Farmers cares about its customers and goes out of its way to pay their claims. Reality can be quite another matter.

Sept. 3, storm

On Sept. 3 a storm accompanied by high winds fed by monsoonal moisture– typical for late summer–caused flooding and wind-related property damage in much of Southern and Central California.

For readers “Sharon and Bill” it was of special interest for two reasons:

1. They operate a tree trimming business. “Our phones rang constantly, with many calls from people who sustained damage, earlier rejecting our advice to get their trees trimmed,” Bill stated.

2. Ironically, their next-door neighbors, “Pete and Cindy” had a monster, 75-foot tall Eucalyptus tree which split apart and came crashing down onto our readers’ corral which housed 10-year-old horse “Charlie Boy” causing serious injuries and high vet bills.

“Giant Eucalyptus drop heavy branches, with or without high winds, and are known as Widow Makers. My husband and I advised them two years earlier of the risk, explaining that when, not if it happens, there will be significant property damage or someone could get killed.

We offered to do it for a discounted price, but we were waved off.”

After the tree fell, Pete and Cindy hired our readers to cart away the massive branches and trim the tree, paying $600 with a balance of $300 which, now they refuse to pay.

Would not reveal homeowners insurance information

Insurance companies require cooperation, starting with providing policy information to someone who may have a claim. Pete and Cindy asked for and were given our reader’s homeowners information, and when “Now, please tell us who you are insured with,” they hung up the phone.

Yes, ignore the problem and it goes away?

Later the same day, a letter was hand served on them–and a copy mailed — asking to be put in touch with their insurance company. Cindy yelled at the process server, “We don’t own the house anymore,” which was a lie. They denied ever receiving the letters.

This couple were the king and queen of ignorance and dishonesty.

The law

“When you are on notice of a dangerous condition on your property and do not remedy it, that’s negligence,” Salt Lake City attorney and author, Randall K. Edwards observes, adding, “Insurance typically pays covered claims due to negligence, and when you know that you were negligent, the most idiotic thing you can do is to tell your insurance company that you were unaware of the problem.

“Even when adjusters think their insured is lying, in order to avoid paying for the damage caused – saving the company money — they might say, ‘We believe our insured,’ and deny the claim. You then wind up getting sued. 

So, by telling the truth you will be protected by the coverage you’ve paid for.”

A nice claims adjuster working for an ethically challenged company

Farmers’ claims adjuster Lindsay McCarty of Grand Rapids, Michigan, was assigned to the claim. She is one of the nicest claims people I’ve ever spoken with and needs to find a job at an ethical company. She interviewed our readers, and the process server who was told, “We don’t own the house any longer.”

In depth, she went into the advice provided two years earlier to have the tree trimmed, and was shocked – you could hear it in her voice —to learn that her insured refused to pay the balance of the bill for removing the fallen tree, telling our readers that she – Lindsay – told them to ask for a refund of the $600 paid!

Richard Osbun is her supervisor and is equally nice but with an agenda. Despite the trail of lies, Osbun stated, “We have to believe our insured. They deny ever being told that their tree was dangerous and needed trimming. Claim rejected.”

“Nonsense!” insists attorney Edwards. “Adjusters routinely disbelieve their own insured when given evidence of mistake or deceit. Here, with a stack of lies and evasive behavior, no experienced adjuster would ever believe the couple.”

Does Farmers Insurance have a culture of unjustified denials? You decide but remember that if sued, your good name will be at risk.

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

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If you have more than a passing interest in the weather and are thinking of starting your own business, then “Treading on Thin Air” by Dr. Elizabeth Austin will be a great read.

Published by Pegasus Books in April of 2016, every chapter kept me anxious to discover what was coming next, and a fly on the wall to her fascinating descriptions of how the weather impacts our daily lives in ways we do not usually think of.

While Austin is an atmospheric physicist and forensic meteorologist, she has the ability of taking highly complex concepts and putting them into terms that aren’t just understandable, but instead, brings the reader into her world of passion for the weather.

“How did you make it? What led to your success?” are questions that most of us who have opened our own shop have asked, with frequent “Hide the ball” responses. But Austin reveals a rare honesty, beginning with her Author’s Note, which I paraphrase:

“I wrote this book from my memories, notes, articles and research. As some events go back many decades, and my memories have faded, still, all events are true to my recollection. This book is not intended to be purely scientific nor a standard memoir, but a unique combination to give the reader a journey through the world of weather through my eyes.”

And does she indeed, in a conversational tone — feeling very much as if you were having dinner with Elizabeth and her husband, Alan — you find a person who deeply appreciates the great teachers she has had. It is obvious that key to her success is someone who isn’t a user, instead is eager to help colleagues and clients accomplish their goals.

In chapter six, “It’s Super Cool to Supercool,” as a graduate student in 1988, she takes you to Storm Peak Laboratory, 10,500 feet elevation, atop Mount Werner in Steamboat Springs, Colorado. Readers can feel the bitter cold, the warmth and excitement of this future business owner, delighted to help scientists conduct weather experiments in miserable conditions.

This quality — a sincere desire to be available, to help — along with exceptional competence, has earned both herself and her company worldwide respect.

“It was 1994 and I had known for years that my ultimate goal was to start my own weather company,” she writes, which is the year WeatherExtreme, Ltd. opened its doors.

Based at Incline Village, Nevada, she and her staff provide national and international consulting and research in, not just global weather forecasting, but areas where the weather had and will have a profound effect. If you ask, “What role did weather play in this automobile or aviation accident?” Austin’s “Treading on Thin Air” shows you the answers with respect for the power of weather and deep compassion for its victims.

If the name Steve Fossett rings a bell, then you recall that he was a record-setting sailor, adventurer, aviator and close friend of Virgin Group founder Sir Richard Branson. Fossett also worked closely with Austin on the Perlan glider project, which she describes in captivating detail.

But you likely remember his name because of the way he died in September of 2007, his small aircraft crashing into mountains near Mammoth Lakes, California. And why did he crash? “Treading on Thin Air” allows readers to visualize how terrified her friend must have been, facing a power greater than anything he could cope with, a downdraft which overpowered his plane. We must wonder if those powerful winds were predicted — and if he knew — before taking off?

Austin helps the reader to see what, for most of us, is hiding in plain view, and that is the relationship of weather forecasting to consumer behavior. “By obtaining accurate predictions in a timely manner,” she writes, “merchants can take full advantage of meteorologists’ intimate knowledge of weather,” and be prepared to have what customers will need to buy before their competition.

The business of weather finds its way into courtrooms every day. Just ask any DA or defense attorney about the importance of eyewitness identifications. If the timing of the crime placed it as the sun was setting, could the witness see those events clearly? Austin introduces us to astronomical and nautical twilight in a murder case where she was the expert witness and the jury convicted, finding that the witness could indeed see what took place.

Not once does the reader get the idea that Austin has been motivated by money. Passion and her desire to be of service led to success. And that’s a lesson for anyone going out on their own.

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

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