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Category: Legal

When the Insurer Isn’t Who It Seems: The Hidden Challenge of “Group” Policies and review of effect of group risk insurance carrier coverages

When the Insurer Isn’t Who It Seems: The Hidden Challenge of “Group” Policies

November 24, 2025 No Comments

A local Ohio hotel’s storm claim exposed a complex issue in insurance litigation — discovering that the insurer, was actually a group of about 20 underwriting companies. The discovery reveals that each entity might need to be named as a defendant, creating a costly and difficult case to manage. This article examines whether public adjusters have a duty to research an insurer’s business structure, or if that responsibility lies with the Policyholder/Agent. It also explores the practical implications of continuing litigation when recovery is limited and costs are high. The takeaway: understanding who truly stands behind the policy is essential before a claim ever reaches court.

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When a Claim Fails Before It Begins: What Leonard v. State Farm Teaches About the Value of a Public Adjuster

November 21, 2025 No Comments

The outcome of Leonard v. State Farm illustrates how insurance claims can fail when they are not properly documented, framed, or supported. The homeowner’s attorney attempted to argue for full roof replacement based on building code requirements, but the argument was misapplied and unsupported by the factual record. Critical evidence—such as detailed repairability analysis, code-based justification, and even the insurance policy itself—was missing from the case. As a result, the court found no basis to compel appraisal, no factual dispute over the scope of damage, and no grounds for breach of contract or bad faith.

The case highlights the important role a public adjuster can play in developing a strong claim foundation. A public adjuster would have documented repair feasibility, created a code-compliant narrative, established causation, and ensured the policy and supporting materials were properly presented. With the correct framing and a well-developed record, the homeowner’s position could have been significantly stronger.

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Trust Accounting practices

When Settlement Funds Fall Through the Cracks: Protecting Clients and Your Business

November 13, 2025 No Comments

Settlement funds can become compromised when law firms dispute control, delay distribution, or mishandle trust account obligations. Returned checks, uncashed payments, or prolonged disputes place clients at risk—especially when those funds are needed for urgent repairs or recovery work.

To protect client interests, professionals should maintain thorough documentation, verify when and how settlement funds were issued, and communicate proactively with insurers and counsel. Depending on the circumstances, it may be appropriate to request reissued payments, clarify fiduciary responsibilities, or seek guidance from regulatory bodies.

Above all, the focus should remain on ensuring the client receives their funds promptly and safely so they can move forward with necessary repairs and claim resolution.

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Part II: Navigating the Grey Areas — What Public Adjusters Need to Know About Fee Caps, Solicitations, and Legislative Ambiguity

September 26, 2025 No Comments

The regulatory environment for public adjusters is rapidly evolving. Part II of our series explores the growing confusion caused by vague legislative language and new fee caps inspired by the 2024 NCOIL Public Adjuster Professional Standards Reform Model Act. As states reinterpret key terms like “solicitation” and “advertising,” public adjusters must adapt—balancing compliance, profitability, and ethical advocacy. Learn how to navigate these grey areas and strengthen your practice through clear onboarding, sound documentation, and strategic business adjustments.

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The Changing Landscape: NCOIL’s 2024 Public Adjuster Model & Emerging Fee Cap Pressures

September 24, 2025 No Comments

As states begin adopting the 2024 NCOIL Public Adjuster Model Act, fee caps and new compliance burdens are reshaping how public adjusters serve policyholders. This article explores the growing trend of legislative restrictions, including the impact of 15% fee limits, and how they’re affecting access to representation, especially for small claims. It also highlights the unintended consequences of reform and sets the stage for adaptation strategies in Part II of the series.

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Satellite office in KY

Green Public

Insurance Adjusting

Is now in Kentucky serving clients affected by the tornados. Stop by our satellite location at 3205 US Highway 641 N in Benton, KY. We’re just down the road from the Kentucky Opry.