According to our attorneys, they say ‘Yes’.
Insurance adjusters in Texas can be liable
for independent acts, errors and omissions (E&O) when they violate insurance codes, breach
contracts or negligently handle claims. The primary reason for
this is that insurance adjusters, who are trustees, have specific duties and
obligations to fulfill when investigating and processing a claim. Failing to
honor these duties can open adjusters up to liability and lawsuits. We are not attorneys. We are not adjusters. We are roofing contractors who guide and
navigate the chaos and headache for you.
It’s important to note that this liability is not limited to company adjusters (i.e., adjusters
who are staff of insurance companies). It can also impact independent and
public adjusters.
If you believe an insurance adjuster has
made an error or omission that compromised your claim, contact Roofing Professionals of Texas.
We have decades of experience handling thousands of
insurance claims on behalf of consumers. Perseverant, enthusiastic, diligent
and relentless… we have the skills, knowledge and resources to effectively prevent
bad faith insurance practices and help our clients get what is owed to them. We
are ready to explain your options during your free consultation.
Has an insurer undercut,
compromised or denied your valid hail damage claim?
Adjusters’
errors and omissions can take many forms, some of the most common of which
include:
1. Failing to acknowledge the
claim – Adjusters
are legally required to promptly respond to new claim submissions and
communications regarding the claim. Ignoring claims and failing to communicate
with the claimant can constitute an unfair settlement practice for which an
adjuster can be liable.
2. Making misleading or false
statements – Written
or oral statements an adjuster makes to deceive a contractor or policyholder
can open the adjuster up to liability. These statements are typically made in
an effort to undercut or deny the claim – or to get a policyholder to withdraw
the claim. For example, insurance adjusters may make misleading or deceptive
statements like (but not exclusive to):
·
The policy doesn’t cover the damage associated with the claim, despite the fact that the
damage IS covered.
·
The policy only covers part of the damage and necessary repairs, despite the fact that all of
the repair costs (including O&P) SHOULD BE covered per the policy.
·
You need to accept this settlement offer because it’s the best
you’ll get, despite
the fact that claim IS worth more and that negotiating IS a viable option.
·
You don’t need to or shouldn’t retain a lawyer because a lawyer
can’t help you, despite
the fact that an attorney CAN help you protect your rights, interests and
claim.
3. Failing to provide complete,
accurate claim information to the provider – When a property damage claim is submitted,
the insurance adjuster should collect certain information as part of the claims
process. This information should then be promptly and accurately passed onto
the insurance provider. Failing to collect all of the necessary information or
failing to accurately provide all of the necessary information to the insurance
provider can be the basis of an E&O claim against the adjuster.
4. Failing to meet claim deadlines – Property damage claims
(like many other types of insurance claims) are time sensitive. If the adjuster
misses a filing deadline for a claim (for any reason), that adjuster can be
held accountable for the error.
5. Breaching the contract – The insurance policy is a
contract between the policyholder and the insurance provider. Although the
adjuster is not specifically a party to the contract, (s)he can be personally
liable for mishandling the claim. For example, when an adjuster fails to
reasonably investigate a claim or when (s)he relies on unqualified “experts” to
assist in the claims investigation, (s)he can be liable for breach of contract.
It’s important to point out that these are not the only ways in which insurance adjusters may
open themselves up to E&O liability.
4 Red Flags You May Have an
Errors & Omission Claim against an Insurance Adjuster
Here are
a few common warning signs that an adjuster may have been professionally
negligent in handling your claim:
1. The adjuster is unresponsive to
your claim submission or fails to promptly respond to any of your inquiries
regarding the claim.
2. The adjuster uses ambiguous,
convoluted or conflicting language when explaining your coverage or the claims
process.
3. The adjuster uses high-pressure
tactics to try to coerce you into accepting a low settlement offer.
4. The adjuster denies your claim
without providing any (or a valid reason) for the denial in writing.
If you have experienced any of these (or other)
questionable incidents when dealing with your insurance adjuster, contact Roofing Professionals of Texas to
provide you with a no cost assessment.
It can happen to anyone... Hurricanes, tornados, hail or fires can leave your home and business in ruins. You want to get back on your feet quickly.
