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Author: Barry Zalma
Publisher:
ISBN: 9781976782213
Category :
Languages : en
Pages : 243
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Book Description
This Compact Book of Adjusting Liability Claims is designed to provide the new adjuster with a basic grounding in what is needed to become a competent and effective insurance adjuster. It is also available as a refresher for the experienced adjuster.The liability claims adjuster quickly learns that there is little difficulty with a claimant (the person alleging bodily injury or property damage against a person insured) if the claim is paid as demanded. The insured may be unhappy if the claimant's claim is paid as presented since most do not believe they did anything wrong or fear an increase in premiums charged for subsequent policies.The adjuster must be prepared to salve the insured's emotions, explain why in the law and the policy it was appropriate to pay the claimant and that the settlement is in the best interest of both the insured and the insurer the adjuster represents.The adjuster knows, and must be prepared to explain to an insured, that if a claim is resisted or denied the claimant will be unhappy, will probably file suit. If not promptly settled the claimant's lawyers will rake the insured over the coals to prove that the insured is liable for the claimant's injuries. The litigation will take time, effort, and money to establish the extent of the injuries and who is responsible for the injuries. Failure to settle promptly can cost the insured his or her reputation and will certainly cost the insurer much more than the claim could have been resolved for had it been resolved before the claimant retained a lawyer.
Author: Barry Zalma
Publisher:
ISBN: 9781976782213
Category :
Languages : en
Pages : 243
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Book Description
This Compact Book of Adjusting Liability Claims is designed to provide the new adjuster with a basic grounding in what is needed to become a competent and effective insurance adjuster. It is also available as a refresher for the experienced adjuster.The liability claims adjuster quickly learns that there is little difficulty with a claimant (the person alleging bodily injury or property damage against a person insured) if the claim is paid as demanded. The insured may be unhappy if the claimant's claim is paid as presented since most do not believe they did anything wrong or fear an increase in premiums charged for subsequent policies.The adjuster must be prepared to salve the insured's emotions, explain why in the law and the policy it was appropriate to pay the claimant and that the settlement is in the best interest of both the insured and the insurer the adjuster represents.The adjuster knows, and must be prepared to explain to an insured, that if a claim is resisted or denied the claimant will be unhappy, will probably file suit. If not promptly settled the claimant's lawyers will rake the insured over the coals to prove that the insured is liable for the claimant's injuries. The litigation will take time, effort, and money to establish the extent of the injuries and who is responsible for the injuries. Failure to settle promptly can cost the insured his or her reputation and will certainly cost the insurer much more than the claim could have been resolved for had it been resolved before the claimant retained a lawyer.
Author: Barry Zalma
Publisher: Independently Published
ISBN: 9781092475327
Category : Law
Languages : en
Pages : 364
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Book Description
Adjusting liability insurance claims requires skill, patience, knowledge of insurance, basic knowledge of tort and contract law, and knowledge and experience as an investigator. The liability claims adjuster is faced with the following basic obligations:1.To understand the law of torts as applied in the state where the adjuster works.2.To understand the law of contracts as applied in the state where the adjuster works.3.To understand sufficient medical terminology to be able to evaluate claims of injury.4.To understand the costs to repair or replace damaged real or personal property.5.To understand how to read and apply the terms and conditions of a liability insurance policy.6.To understand how to thoroughly investigate all claims assigned.7.To conduct an investigation of every claim assigned fairly and in good faith with an intent to find coverage for the loss presented by the insured.8.To understand how to analyze the insurance coverage and apply the facts established by the adjuster's thorough investigation to the policy wording.9.To be able to negotiate with claimants and lawyers to resolve bodily injury or property damage claims.10.To pay promptly all claims the insurer owes under the contract.11.To resist, and not pay, all claims the insurer does not owe under the contract of insurance. In the United States, the average adjuster is a 22-year-old female graduate of a liberal arts college who has little or no training sufficient to allow her to fulfill the obligations imposed on her as a representative of an insurer. Much to the chagrin of insurance claims professionals, some modern insurance companies simply hire a person to be an adjuster, provide no training, and send them out to deal with the public with only the assistance of a claims supervisor who may only have two years-experience.This Compact Book of Adjusting Liability Claims- Second Edition is designed to provide the new adjuster with a basic grounding in what is needed to become a competent and effective insurance adjuster. It also works as a refresher for the experienced adjuster.
Author: Barry Zalma
Publisher:
ISBN:
Category :
Languages : en
Pages : 340
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Book Description
What Is an Adjuster?An "adjuster" or "insurance adjuster" is, by statutory definition, a person, co-partnership or corporation who undertakes to ascertain and report the actual loss to the subject-matter of insurance due to the hazard insured against. Insurance companies create, by issuing an insurance policy, a contractual obligation to pay valid claims from those insured. To do so insurers understand that the person insured is not able to prove the cause and extent of loss without assistance. Therefore, insurers dispatch a person with special knowledge - the adjuster - to separate fact from fiction, to establish cause and origin of the claimed loss, and determine sufficient information to enable the insurance company to determine the amounts necessary to indemnify the insured as the policy promised. The adjuster is also present to distinguish the valid claim from a claim for which the insurance company is not liable under its policy, whether due to the terms and conditions of the policy or because of attempted fraud. Some policies, like those issued under the National Flood Insurance Program Act (NFPA) specifically state that the claimant must use his own judgment in estimating the amount of loss and that the assistance of an insurance adjuster is a "courtesy only." The insured must still send a proof of loss within 60 days after the loss even if the adjuster does not furnish the form or help the insured complete it. Most insurance policies issued by commercial - non government supported - insurers accept substantial compliance with the policy conditions and require their adjusters to assist the insureds to fulfill the conditions.The insurance adjuster is seldom, if ever, mentioned in a policy of insurance. The strict wording of the first party property policy sets the obligation to investigate and prove a claim on the insured. In order to fulfill the covenant of good faith and fair dealing insurers created the insurance adjuster to fulfill its obligation to deal fairly and in good faith with the insured. The adjuster was created to assist the insured to comply with the material conditions of the policy, to thoroughly investigate the policy and the claim, and to protect the interest of the insurer and protect against claims that were not due to a peril insured against or were false and fraudulent.
Author: Barry Zalma Esq
Publisher: Independently Published
ISBN: 9781091812079
Category : Law
Languages : en
Pages : 342
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Book Description
An "adjuster" or "insurance adjuster" is by statutory definition, a person, co-partnership or corporation who undertakes to ascertain and report the actual loss to the subject-matter of insurance due to the hazard insured against. Insurance companies create, by issuing an insurance policy, a contractual obligation to pay its insureds' valid claim. To do so insurers understand that the person insured is not able to prove the cause and extent of loss without assistance. Therefore, insurers dispatch a person with special knowledge - the adjuster - to separate fact from fiction, to establish cause and origin of the claimed loss, and determine sufficient information to enable the insurance company determine the amounts necessary to indemnify the insured as the policy promised. The adjuster is also present to distinguish the valid claim from a claim for which the insurance company is not liable under its policy. The insurance adjuster is not mentioned in a policy of insurance. The obligation to investigate and prove a claim falls on the insured. Standard first party property insurance policies, based upon the New York Standard Fire Insurance policy, contain conditions that require the insured to, within sixty days of the loss, submit a sworn proof of loss to prove to the insurer the facts and amount of loss. The policy allows the insurer to then, and only then, respond to the insured's proof of loss. The insurer can then either accept or reject the proof submitted by the insured.
Author: Corydon T. Johns
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 680
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Book Description
Author: Barry Zalma
Publisher:
ISBN: 9781976928420
Category :
Languages : en
Pages : 163
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Book Description
The insurance adjuster is not mentioned in a policy of insurance. The obligation to investigate and prove a claim falls on the insured. Standard first party property insurance policies, based upon the New York Standard Fire Insurance policy, contain conditions that require the insured to, within sixty days of the loss, submit a sworn proof of loss to prove to the insurer the facts and amount of loss. The policy allows the insurer to then, and only then, respond to the insured's proof of loss. The insurer can then either accept or reject the proof submitted by the insured. Technically, if the wording of the policy was followed literally the insurer could sit back, do nothing, and wait for the proof. If the insured was late in submitting the proof the insurer could reject the claim. If the insured submits a timely proof of loss the insurer could either accept or reject the proof of loss. If the insurer rejected the proof of loss the insured could either send a new one or give up and gain nothing from the claim. Suit on the policy would be difficult because the policy contract limited the right to sue to times when the proof of loss condition had been met.Insureds and insurers were not happy with that system. It made it too difficult for a lay person to successfully present a claim. The system, as written into the standard fire policy seemed to run counter to the covenant of good faith and fair dealing that had been the basis of the insurance contract for centuries. Most insurers understood that their insureds were mostly incapable of complying with the strict enforcement of the policy conditions. To fulfill the covenant of good faith and fair dealing insurers created the insurance adjuster to fulfill its obligation to deal fairly and in good faith with the insured.
Author: Barry Zalma Esq
Publisher: Independently Published
ISBN:
Category : Business & Economics
Languages : en
Pages : 0
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Book Description
A Primer for the First Party Property AdjusterThe insurance adjuster is seldom, if ever, mentioned in a policy of insurance. The strict wording of the first party property policy sets the obligation to investigate and prove a claim on the insured. Standard first party property insurance policies, based upon the more than a century old New York Standard Fire Insurance policy, contain conditions that require the insured to, within sixty days of the loss, submit a sworn proof of loss to prove to the insurer the facts and amount of loss. In general, failure to file the proof within the time limited by the policy is fatal to an action upon it (White v. Home Mutual Ins. Co., 128 Cal. 131, 60 P. 666 (1900); Beasley v. Pacific Indem. Co., 200 Cal.App.2d 207, 19 Cal.Rptr. 299 (Cal. App. 1962). The California Supreme Court in 1900, when it decided White v. Home Mutual concluded that the requirement of proof of loss by the insured within the 60-day limit provided by the standard form of policy is a condition precedent to the right of the insured to maintain suit.
Author: Jonathan L. Scott
Publisher: iUniverse
ISBN: 1491713259
Category : Biography & Autobiography
Languages : en
Pages : 265
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Book Description
Insurance adjusters meet clients on the worst days of their lives, and they must be diplomatic, tactful, and ethical. The job is not only about returning phone calls and doing paperwork. Whether the case involves cargo damage, residential and business property damage, fire, fraud, burglary, or arson, it's the job of the adjuster to get to the bottom of things. Author Jonathan L. Scott has spent more than thirty years as an adjuster. In a series of short stories, loosely based on actual insurance claims, he recalls navigating the human dimension of balancing a client's circumstances with policy requirements and the law-and it's never easy. All adjusters investigate, evaluate, and settle claims, but the best ones are worth their weight in gold several times over. The bad ones, however, can cause huge problems for the public and their employers. If you've ever been curious about the work of an insurance adjuster, read on and find out how each claim becomes its own little adventure.
Author: Shubham Gupta
Publisher:
ISBN: 9781525550706
Category : Business & Economics
Languages : en
Pages : 132
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Book Description
Legal Precedence at the time when I was adjusting claims in India was not a common consideration. It took me almost six years to get to a stage where I could understand and appreciate the basic concepts underlying legal terms since immigrating to Canada in 2012. It has been a roller coaster ride for me, both scary and enthralling at the same time. Luckily, I had great company all through my journey. That's what inspired me to write this book. It is my attempt to provide a basic understanding of the legal concepts used in handling insurance claims, from an insurance adjuster's perspective. I have tried to tone down these concepts to simple terms, that could be easily followed by anyone not pertaining to the profession of law. I have discussed the day to day concepts, such as Final Release, Reservation of Rights Letter and similar other terms encountered by a claims professional while adjusting insurance claims....
Author: Danny L. Lee
Publisher: Lulu.com
ISBN: 1483479757
Category : Business & Economics
Languages : en
Pages : 134
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Book Description
His common sense approach to sharing techniques on how to make you a great adjuster and providing easy to apply techniques is not seen in most books. After reading this book you will find yourself with many techniques on how to be efficient at what you do, producing great claim files while amazing your customers. His promise to just give key facts will allow anyone to use this book as a reference for years to come. What a refreshing presentation that is geared to truly helping adjusters be great, without having to sift through needless information. Danny lays out a tried and true formula for becoming a great, well rounded adjuster with a fantastic approach to adjusting claims. And Danny does it all in an excellent way that will stay with you long after you finish his book. I highly recommend that all adjusters, from the newest adjuster just entering the property insurance industry to the most experienced adjusters at the tail end of their career, take the time to read and study this outstanding book.