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

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Picture yourself running your own little convenience store in a poor section of town with a large, highly superstitious, immigrant population.

It’s Christmas Eve, and normally lots of moms with their kids would be shopping, but now–fortunately — you are all alone.

Suddenly, a car crashes through the front door, headed to where you are sitting behind the cash register. Like a character from The Matrix, you perform back-flips and contortions, avoiding the car, but get one heck of a backache and nightmares.

Fortunately, the out of control car, your landlord, and your business have adequate insurance. Claims adjusters immediately arrange for repairs, so you’re only closed about a week.

But then something very odd becomes clear:

Many of your customers are frightened, some talking about a hex — a spell — on the building, and they have not returned, leading to a substantial reduction in sales.

You also sustained some type of a back injury, and have recurring, horrible nightmares, but have been trying to “tough it out” and not yet been seen by a doctor or psychologist.

To make matters worse, your own insurance company, which should cover lost income, announces that you only have 60 days to make a final claim. But at this time, how could anyone know what the loss will wind up being?

That real fact situation is currently facing Abe, our Central California reader. You and the Law has turned to Hanford attorney, Rissa Stuart for advice on how to deal with claims adjusters, and other steps Abe needs to take to prove his loss of income claim, beginning with good record keeping.

Good financial records +video surveillance evidence = solid proof

“Just as for an individual who may have been off work due to an accident and would prove lost wages with pay stubs from a employer, it’s the same for a business.

“Abe’s situation is unique and could greatly benefit by having more than daily till records and profit and loss statements. His store video surveillance system could play a critical role in proving these substantial losses by showing customers in the store over a period of months prior to the accident,” Stuart points out.

And once again, Abe was a lucky guy, as his video system has an enormous 8 terra bytes of storage, and had been running for almost a year. But what about this 90 day cut off limit?

’90 days to present the claim is unrealistic’

“An insurance company must allow adequate time for you to gather the facts and elements of proof which establishes your claim. Abe’s could easily require help from a forensic accountant, an economist and a cultural anthropologist to establish his present reduction of income and prove what could very well be a permanent loss of customers putting him out of business at that location.

“This 90 day limit to present his claim is unrealistic and sounds like bad faith. Abe is clearly being pushed around by a claims adjuster, likely an attempt to minimize what is paid out.

“That alone is reason to at least have a consultation with an attorney, but as there are three insurance companies involved in the incident, Abe likely cannot handle it by himself,” Stuart believes.

Toughing it our — delaying treatment — weakens the claim

Of course anyone going through something like this would certainly be affected, at least emotionally, and Abe could indeed have experienced some kind of a back injury.

“But if you are hurt, you see a doctor and you do this now. It’s the same thing with emotional injuries, as the longer you wait to be treated, the believability of your injuries can take a nose dive,” Stuart notes.

To superstitious customers the hex or spell is real

Just how serious, how real is the “hex” on Abe’s store and could this be the basis of compensation for lost business?

“It could be very real to his former customers,” anthropologist Dr. Phillips Stevens told us. He is associate professor of anthropology at the Buffalo campus of the State University of New York.

“In many communities all over the United States the belief in magic and the supernatural play a role in everyday life. If a belief in this ‘hex’ can be confirmed through interviews conducted by a cultural anthropologist, it would help to explain his loss of business,” Stevens believes.

Proving the reality of those fears to Abe’s former customers and others to whom the worlds of magic and the supernatural are real then raises one determinative question:

“If Abe cannot somehow convince his customers that it is safe to return, then what?”

In that event, it will be one of the most interesting cases that any lawyer will ever have.

Cross my heart and hope to die!

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

The post Advice for dealing with claims adjusters appeared first on 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.

The post Don’t rush to settle insurance claims appeared first on Dennis Beaver.

Returning home from a day trip in the early hours of the morning to water everywhere set the stage for a rare positive email from Becky, a retired high school English teacher living in Visalia with her husband. Both are 85 years young and received what can only be described as exceptional customer service.

“Your article about the disaster restoration company and its dishonest customer got our attention, in part because we recently had our own horrible experience with a burst water pipe, and were so fortunate with the high degree of service provided both by our homeowners insurance claims adjuster and the damage restoration company.

“Our water pressure regulator failed, causing a section of pipe to explode. Water pipes coming into most properties in our neighborhood are huge — 2-inch diameter — which means that pressure is very high and you must have a regulator. Testing your home’s water pressure is so important and easy. A gauge costs less than $20. Eighty psi or under is what you must have, we learned.

“After shutting the main water valve, we phoned homeowners claims and in less than 90 minutes, two angels arrived: our claims adjuster and the damage restoration supervisor with his crew. It was 3 in the morning!”

An unexpected suggestion

“Our house was inspected, lots of photos were taken and the supervisor was thorough and took plenty of time in explaining how they find water damage by using high-tech cameras which see moisture behind walls, and under the floor, to help avoid mold issues down the road.

“We signed a number of contracts and other documents after our adjuster gave her approval. This was all new to us — you don’t have busted water pipes every day, if ever, and who reads a homeowners insurance policy before a loss?”

“And then, something happened which was completely unexpected and made a reality out the TV commercials which tell you how wonderful it is to have this or that homeowners insurance.

“Our adjuster asked us to sit at the kitchen table, and in such a reassuring tone of voice, told us the following:

“Fortunately, water appears to have run for just a few hours, not days, but it is still going to be a real job in drying your home and preventing mold. The drying process requires using powerful fans, and possibly opening up certain walls, depending upon where the water settled. This means noise, a lot of noise and real inconvenience, with the crew coming in and out, removing furniture, carpets, anything that got wet and needs to be dried.

“Your insurance has a very good additional living expense provision, so you do not have to remain here while work is being done. I will help you pack what you need right now, and book you into a nice hotel downtown. In fact, I’ve already reserved your room. We will cover food and other related expenses during the time your home cannot safely be lived in.

“Mr. Beaver, at that time, I began to cry. Our adjuster truly was the angel we needed right at that moment. It took about three weeks to repair the damage, and we just could not be more satisfied with the way everyone dealt with us. We heard from the restoration company often and always did what they asked of us to help put things back to normal. I know that you hear more complaints than compliments, but I’ll bet our experience is the rule and not the exception.”

Staying involved in the process leads to a better outcome

“Dennis, this is a great story, and your readers had such a positive experience, in part, because they were involved in the restoration process,” commented Tampa-based Pete Consigli, a friend of this column and a national authority in restoration and damage repair.

“The property owner has an obligation to their loss. Never just turn it over to the company and walk away. You must be involved, in the loop. It is your home and you need to stay involved in the process, at whatever level you feel comfortable, to assure that your property is restored back to pre-loss condition,” he observes.

“This story also illustrated something that happens every day, but does not get the attention merited. And that’s the important role of claims adjusters at times like this.

“In the 35 years that I have been in this industry, your reader’s experience truly is the rule, and not the exception.

“The most successful claims adjusters will be good communicators and have compassion for the insured. And the same thing can be said for the restoration crew that comes to your house, just like with Becky, at 3 in the morning.”

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

The post ‘Water everywhere — and then two angels showed up’ appeared first on Dennis Beaver.

“Mr. Beaver, I am the president of a disaster restoration company in Central California where two of your recent columns really got applause from all of us here in management. You zeroed in on something that happens far too often, and that’s customers who received — and kept — insurance checks intended to pay our bill.

“It is important for your readers to understand that insurance proceeds received, and meant to pay the restoration company, are designed to do just that. When customers use that money for other purposes, they may be breaking the law.

“Disaster restoration contractors are ready to help homeowners at their time of need, such as after a burst pipe or smoke damage from a fire. They truly help our communities. Just like sudden illness or death, at these times we are most vulnerable, do not know where to turn, what our rights are or how to select a qualified company. You could do a real public service by explaining damage remediation and what homeowners need to know in order to hire the right company for their type of loss. Thanks again, Eric.”

Know in advance who to call when the pipe breaks

Eric’s suggestion to become aware of who to call before it’s necessary is a message that Tampa, Fla.-based Pete Cosigli firmly advocates.

As an authority in the area of restoration and damage repair, Consigli lectures frequently both in the United States and abroad, holding the position of industry advisor for the Restoration Industry Association of Rockville, Md. Even though he is not an attorney, we find his knowledge of the law and common-sense approach to the prevention of legal disputes admirable.

“The question is not if there is going to be a loss requiring the services of a restoration company. It is when. And, for this reason, I urge your readers to become familiar with companies in their community, and what types of certifications they have — the kinds of losses they are trained and qualified to handle,” he tells You and the Law.

“You want a company that is certified for the kind of work you’ll need, such as fire, water, drying, mold and other related services. Look at the phone book and the Internet to see which trade organizations they are members of and what certifications they hold. Being unprepared — not knowing who to call — could make you vulnerable at the time of loss. So, just like moving into a new town with small children, you would look for a pediatrician before your kids are sick. The same logic applies here. Know in advance who to call when the pipe breaks,” he urges.

“Www.restorationindustry.org. tells you how to find members of the oldest and largest restoration trade association. Www.iicrc.org gives you a list of certified technicians in various cleaning and restorations disciplines. These organizations have stringent codes of ethics and conduct as well as a grievance process which can help consumers in the event there is some problem,” Consigli points out.

Damage restoration is science based — watch out for red flags

We asked, “You just returned home from work and find that a broken pipe has flooded carpet, floors, walls, soaked your furniture and other personal property. You call a restoration company and they arrive promptly. What should the homeowner expect at that time?”

“A competent technician will ask the customer, if it is known, to explain what caused the incident — which pipe burst and where it was located, for example — and will try to determine the sequence of events which led to the damage. It is critical to be sure that the cause was determined and that it was fixed before restoration efforts are begun,” Consigli stressed.

“Today, damage restoration uses scientific principles and begins with a thorough inspection to determine what materials are wet and the degree of saturation.

“The use of appropriate diagnostic instruments is absolutely essential at this stage. A huge red flag would be a technician saying something to the effect, “Gee, that looks and feels wet (or dry) to me, without actually using moisture-testing instruments to verify the accuracy of that statement.

“Sudden, accidental water damage is the most common restoration emergency that homeowners are likely to experience. The more you know — in advance — the better prepared you will be to select a qualified company. Your worst nightmare in a water-damage claim is moisture which should have been discovered and treated, which then leads to mold, odors or structural damage,” Consigli cautions.

Restoring a water-damaged home can be incredibly noisy. Next time, we’ll tell you what questions to ask your adjuster to make life so much more bearable while your home is being dried.

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

The post Want to hire a disaster restoration company? Read this first! appeared first on Dennis Beaver.