Page 156 - FDCC_InsightsSpecialIssue_Published

Property Law
Case Number
Description
Results: Saving
1
In response to appraisal demand, requested insured produced requested documents and submit to an EUO.
First setting, no response. Sent another demand, and PA advised that PA and insured were “no longer pursuing claim”
Appraisal Withdrawn:
PA’s Estimate: $1,773,695.77 Carrier’s Estimate: $760,332.50 Gross Savings: $1,013.363.27
2
In response to appraisal demand, requested insured produced requested documents and submit to an EUO.
First setting, no response. Sent another demand, and insured advised he was withdrawing appraisal demand
Appraisal Withdrawn:
PA’s Estimate: $52,780.76
Carrier’s Estimate: $798.09, but below $2500.00 deductible
Gross Savings: $50,280.76
3
In response to appraisal demand, requested insured produced requested documents and submit to an EUO. Found insureds had committed fraud; submitted POL that contained claim for damages they admitted did not exist and was just created high “to negotiate”
Result: Claim Denied
4
In response to appraisal demand, requested insured produced requested documents and submit to an EUO. Insured testified she never hired PA,
PA was for roofer; never met or spoke with PA, no idea payments had been made for undisputed ACV to insured and PA; no idea that appraisal had been invoked. Learned PA owns both the roofing company and the adjusting company and did not disclose that to insured.
Result: Referred claim to DOI
5
The insureds and their PA (same PA
for all 3 claims) submitted to EUOs; learned from the insureds that PA had told them that carrier had not paid ACV, when carrier had. PA forged signature on checks. Lead to TBI investigation.
Result: PA plead guilty to numerous counts of fraud; currently in jail.
issues or damages will be part of the appraisal and those issues that will not. Public adjusters generally reject such memoranda and threaten to proceed with a “empty-chair” appraisal in which the insured’s appraiser and the umpire proceed with the appraisal with the carrier’s appraiser and issue an award. To prevent that scenario, carriers could proceed with filing a declaratory judgment action with the court asking the court to
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FDCC ANNUAL INSIGHTS 2023