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Tag: Claim

Walking the Line: Staying Neutral When Ego Enters the Room

October 30, 2025 No Comments

When two parties clash over ego or personality differences, resolving the issue often becomes less about facts and more about feelings. Professionals caught in the middle must balance empathy with objectivity — listening to both sides without being drawn into personal loyalties or emotional narratives.

Maintaining neutrality requires a focus on documentation, process, and shared objectives rather than assigning fault. Clear communication, factual summaries, and forward-looking language help redirect energy toward productive solutions. Setting healthy boundaries and avoiding private alliances preserve credibility and prevent further escalation.

Ultimately, successful conflict resolution relies on professionalism, transparency, and emotional discipline — guiding all sides toward mutual respect and a common outcome, even when egos are at their loudest.

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Contractors in Ohio: The Wisconsin Warning You Can’t Ignore

October 28, 2025 No Comments

Wisconsin’s recent enforcement action against a contractor for violating Wis. Stat. § 629.10(3) highlights growing regulatory scrutiny over contractors who engage in the Unauthorized Practice of Public Adjusting (UPPA). The contractor was fined for combining repair services with “claim assistance,” a violation of consumer protection laws.

For contractors in Ohio, this serves as a critical warning. The same activities—negotiating insurance settlements, interpreting policy coverage, or marketing claim management services—can expose businesses to significant penalties under Ohio law. The issue is further complicated by the Cinnamon Ridge v. State Farm decision, which adopted the “line of sight” rule for determining material replacement boundaries. That ruling expands repair obligations but also increases the temptation for contractors to discuss claim scope or coverage—conversations reserved for licensed public adjusters.

To remain compliant, contractors should focus strictly on construction and restoration activities, ensure their contracts exclude claim negotiation, train staff to recognize legal boundaries, and refer insurance-related matters to licensed public adjusters. Collaboration and education within the industry are essential to prevent future enforcement actions and to protect both consumers and legitimate contractors from costly missteps.

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Proposed Pennsylvania Legislation Threatens Homeowner Recovery Rights

October 24, 2025 No Comments

Pennsylvania’s proposed House Bill 1972 and its companion Senate Bill could drastically limit the ability of public adjusters to help homeowners and small business owners recover after property losses.

The bills would cap public adjusting fees at 15% on all claims and just 10% on catastrophe claims, impose a 15-business-day right of rescission, and ban adjusters from owning or receiving payment from construction or restoration companies. They also double bonding requirements and forbid any financial relationships or referrals between contractors and adjusters.

Supporters state the bills protect consumers, but in practice they would force many small adjusting firms out of business, leaving some policyholders without independent representation during the claims process. Without public adjusters, many insureds would face underpayment or delays, with little recourse other than costly litigation.

The legislation could represent a significant shift of power toward insurance companies, undermining consumer rights and professional advocacy in claim recovery. Public adjusters, homeowners, and small business owners are encouraged to contact their legislators and oppose these bills to preserve access to fair claim representation in Pennsylvania.

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Balancing fair practices when handling insurance claims

When “Too Late” Isn’t Fair: Allstate’s Holdback Refusals and Ohio’s 60-Day Notice Rule

October 22, 2025 No Comments

Allstate and other insurers are increasingly denying replacement cost benefits by citing a 180-day deadline found in their “How We Pay for a Loss” and “Building Structure Reimbursement” provisions. Policyholders who complete repairs and request payment afterward are sometimes told their claim is “untimely” — even when no prior warning was given. Under Ohio Administrative Code 3901-1-54(G)(5), insurers must provide written notice at least 60 days before any contractual limitation expires if the claimant is not represented by counsel. Failure to do so can invalidate the carrier’s reliance on the 180-day rule. This article explains the legal duty to notify, outlines defenses against untimely denial, and offers best practices for public adjusters and policyholders to protect recovery rights when carriers fail to communicate looming deadlines.

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You!

Who Determines an Appraiser’s Competence?

October 13, 2025 No Comments

As more appraisers transition to independent practice, questions arise about who ensures their ongoing competence beyond reputation and certification. While professional organizations like IAUA, WIND, and P.L.A.N. provide voluntary training, oversight has largely been self-regulated — until now. Iowa recently became one of the first states to require a Certified Appraiser license for insurance appraisal work, signaling a move toward greater accountability. This article explores how that change may reshape expectations of competence, regulation, and professional credibility in the insurance appraisal industry.

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hail spatter

Does Spatter Matter? The Debate Over Hail Verification and Aluminum Siding

October 7, 2025 No Comments

When hail hits, everyone starts looking for proof — and “hail spatter” often becomes the focus of debate. Does the presence or absence of spatter really determine whether damage is recent or covered? This article explores both sides of the argument, from the contractor’s field perspective to the attorney’s view of the carrier’s duty to investigate. Ultimately, while spatter can help tell the story of a storm, it’s only one clue in a much larger picture.

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Zen moments during a busy day

Insurance Claims Fatigue: How to Finish the Year Strong Without Burning Out

September 19, 2025 No Comments

As the year winds down, insurance claims professionals often face an overwhelming surge in workload, deadlines, and client expectations—leading to a condition known as claims fatigue. This end-of-year burnout is driven by high caseloads, slow carrier responses, emotional strain, and the pressure to close files before December 31st. To combat fatigue while maintaining high standards of service, professionals are encouraged to implement time-blocking strategies, communicate clear boundaries with clients, break large tasks into micro-goals, and take intentional breaks to recover. Reconnecting with the purpose behind the work helps restore energy and focus, ensuring a strong, sustainable finish to the year.

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The Insurance Check Whac-A-Mole

January 3, 2022 No Comments

They’d been paying premiums every month for insurance and the adjuster just tried to make them responsible for paying everything upfront.  That’s worse than kicking

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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.