We will be teaching a Superstorm Sandy seminar for Public Insurance Adjusters next Monday at the East Side Marriott in Manhattan. Here is the agenda we outlined for the New York Department of Insurance:

Title: What We Have Learned And Are Seeing In The Field From Hurricane Sandy
Date: June 10, 2013
Time: 9:30 am – 3:15 pm

9:30am-10:00am: Registration

10:00am-11:00am: Issues, Status of Claims and Litigation Update

This 60-minute presentation will address the status of Hurricane Sandy claims, and how insurers are responding to claimants. It will also address how various courts throughout the affected areas are dealing with the number of lawsuits that have been and will be filed. The discussion will include a summary of any general orders entered by the courts, as well as updated information concerning coverage and litigation matters.

Litigation in New Jersey and New York

  • Mediation programs
  • New Jersey: Order # A13-106; Bulletin 13-08
  • New York: 15th Amendment to Ins. Reg. 64 (11 NYCRR 216)
  • Jakubowski v. Federal Emergency Management Agency, 2:12-cv-02202 (D. N.J. March 27, 2013)
  • American Building Supply Corp. v. Petrocelli Group Inc,, 19 N.Y.3d 730 (Nov. 19, 2012)

Common problems arising during the adjustment of Sandy claims

  • Insurers’ treatment of policyholders and adjusters since Hurricane Sandy
  • Partial payments of claims
  • Impact on public adjusting
  • Standard Flood Insurance Policies
  • Public adjuster not on check
  • Insurer refusing demand for appraisal

Common coverage issues

  • Impact of flood payments, extension of filing deadline
  • How overhead and profit is or is not paid
  • Application of depreciation to a payment
  • Cooperation between the insurer and insured

11:00am-12:00pm: Valuation – Holding up in Appraisal and in Court

This 60 minute long presentation with address various techniques and factors that affect valuation and estimates of damage with hurricane claims in New York and New Jersey. The different types of software programs will be considered, as well as the factors involved in determining whether such estimates and values will hold up for purposes of an appraisal or in litigation.

Appraisal versus litigation

  • Scrutiny applied in each type of proceeding
  • Submission and timing of estimates
  • Differences in the impact the estimates provide
  • Supplemental estimates

The nuts and bolts of estimating programs

  • Exactimate and Simsol
  • Sales tax
  • Matching
  • ACV and RCV
  • Applying building codes

Other related issues

  • Homeowners versus commercial claims
  • Applying deductibles and coinsurance
  • Law and ordinance issues

12:00pm-1:00pm: Lunch

1:00pm-2:00pm: Expert, Legal, and Practical Analysis of Adjustment Issues – How Insurers are Reacting

This 60-minute presentation will discuss the expert, legal and practical adjustment issues arising from windstorm claims to walls, windows and roofs detailing the adjustment steps and practical issues that pertain to the subtle damages that are not readily apparent following a windstorm. It will aid public adjusters in their need to understand construction, restoration and building repair to be effective for their clients, and will assist them in understanding how insurers are reacting to expert analysis of claims. It will include discussion on what public adjusters have found to work over the course of insureds filing Hurricane Sandy claims and on how to understand and respond to any pushback the insurance carriers are giving.

Expert analysis and updated issues being raised by insurers

  • How structures are affected by wind events
  • What to look for when adjusting roofs, windows and sliding glass doors, and walls
  • Push back by insurers in litigation
  • Slab claims

Legal issues and updates on issues being raised by insurers

  • Issues relating to “direct physical loss”
  • Pushback from insurance carriers
  • Exclusions for wear and tear
  • Exclusions for pre-existing conditions
  • Flood vs. Wind damage
  • Overhead and Profit

Public Adjusting issues

  • Slab claims
  • Pushback from the insurance carriers
  • Retaining experts

2:00pm-3:00pm: Causation and Sufficient Proof, New York & New Jersey-style

This 60-minute long presentation will address the causation issues that arise in property insurance claims, particularly those arising from hurricane losses. These events, combined with difficult-sounding insurance contract language lead to much litigation in New York and New Jersey between policyholders and insurers. The discussion will focus on coverage rules regarding causation of losses, proving up the loss and burdens of proof, and how New York and New Jersey courts interpret “concurrent causation” policy language. The discussion will also address how New York and New Jersey laws on these subjects are different from those in other states.

Causation of the loss

  • Burden of proof to determine whether the loss is covered under the policy
  • Issues that arise when causation is disputed
  • All-risk policies versus named peril policies

Proving up the loss

  • Factors to be aware of
  • Experts needed
  • Insurance company mindsets

Concurrent causation issues

  • Ensuing/Resulting Loss provisions
  • Wind versus flood
  • The burden of proof with coverage defenses
  • Wear and tear versus wind damage
  • Multiple causes of loss to the same property

A comparison of laws in other states versus New Jersey and New York

  • Texas
  • Florida
  • Mississippi and Louisiana
  • Others

3:00pm-3:15pm: Questions and Evaluations

Call Kate Finkenstadt at 813-229-1000 to RSVP. Please do not show up at the door without an RSVP because we will have to turn you away. I look forward to seeing you there.