Insurance Claims Tips and Red Flags: When to File a Claim [Video]

Insurance claims help you recover large commercial losses in case of damages and incidents with your property. So, what can help you make the most of the insurance policy and ensure good payment from an insurance claim?

PissedConsumer.com has interviewed an expert Public Adjuster, Vince Perri. Vince is the Commercial Claims Advocate with over 14 years of experience in handling complex residential insurance claims. 

...you should not file more than one plan every 10 years, and you really should not file more than three claims in your entire lifetime.

In this video interview, Vince Perri shares his expert tips and tricks on how and when to file an insurance claim, what red flags to watch out for when you’re signing off an insurance policy contract, and how a public adjuster can help you get higher compensation for your losses.

Top Insurance Claim Questions and Expert Tips:

• When do you need a public adjuster?
• How does a public adjuster handle insurance claims?
• When does insurance fraud happen?
• Red flags in insurance contract
• When to file an insurance claim?
• Can an insurance claim end up in court?
• Commercial Claims Advocate services
• Most important about insurance claims

Introduction

Michael: Vince, thank you for joining us. Guys, we have Vince Perri today with Commercial Claims Advocate. Vince will walk us through commercial policy adjusting processes related to insurance claims.

Vince: So my name is Vince Perri. Online, on social media, I'm known as a Commercial Claims Advocate. I'm a licensed certified public adjuster in the state of Florida, Texas, and California. I've been a public adjuster now for about 14 years. Before I was a public adjuster, I worked for almost two years with State Farm Insurance as an auto claims adjuster, working at their Property Damage Department.

That's pretty much it. I've got 14 years of experience. I've been through several hurricanes, several hailstorms, several windstorms, and just also, you're just doing normal day-to-day water damage claims. And I deal with anything from homeowners claims to commercial building claims to association claims.

When Do You Need a Public Adjuster?

Michael: What are the occasions that consumers would need the services of someone like you?

Vince: A public adjuster is usually going to be used mainly by the majority in homeowners claims, commercial building claims, or associations, and also boat claims too. I know some public adjusters that have been trying to get into boats too, because again, now you're talking much larger values of an insurance plan because we are paid contingency.

We are paid a percentage of the insurance claims. So, I guess depending on the size of the loss is when you're going to hire a public adjuster. Frankly, I believe, and I am biased to this, but I obviously believe that a public adjuster should be hired in every homeowner or any kind of property damage claim that occurs outside of the auto. And the reason being is that you have to understand that…

...the insurance policy that is given to a policyholder is a signed contract that you have with the insurance company. And it's a one-way contract…

...which basically means that you're not allowed to change anything in that contract. Once you sign off on it, you have to abide by everything that is in that contract.

And there are lists of duties that the insured, which is the homeowner, the policyholder, has to abide by before even notifying the insurance company. You have to make sure that you mitigate your damages by drying everything up. You have to document the evidence before anything before the claim is filed. You have to get all the necessary repairs done. You have to notify the insurance company within 48 to 72 hours.

These are things that a lot of policyholders, although they have agreed to all of these conditions in a policy contract, they don't know that they have to do that. So I always recommend that it's best to call a public adjuster at first because we know how the policy reads. We know all the duties that you have to comply with before filing the claim.

And if you're able to do all of these duties before the claim is actually filed, or at the time that the claim is filed, you're going to have a much better, and faster resolution on your claim. Because the last thing you want is to have a claim, and then that claim gets denied because you didn't abide by one of those duties on the contract.

So that's why it's a good reason to get a public adjuster out there. On top of that is obviously we know how to negotiate your claim. We estimate your claim. 

99% of the time, I would say we get a much larger value on your insurance claim than if you were to go about it by yourself.

How Does a Public Adjuster Handle Insurance Claims?

Michael: If a consumer hires a public adjuster, signs a contract with you, what are your responsibilities as a public adjuster on that contract? What services would you provide to a consumer under that contract?

Vince: I think it's a lot more than people think. Most of the time people are always just like, "Well, why don't I just let the insurance company handle it?" What we're doing is we're going to walk in and we're going to review your policy. We're going to make sure that it's even covered. You have to understand we're just like the insurance company. We're out there to document, estimate.

We'll document damage, estimate how much it's going to cost, and we're also there to determine whether the damage is covered or not.

If it's a covered peril is what we call it. So we're going to review your policy checkbox, "Okay, this is covered." Whether they decide to deny it or not, we know, okay, this is a covered peril and it should be paid for. We're going to document, we're going to take photo evidence. We're going to look at everything.

We're going to ask you, "Did you call a plumber?" Okay, you did. Let's get that invoice. Let's put that away in the file. Okay. You didn't call a plumber. Okay. Let's get a local plumber. Usually, again, public adjusters are in the industry. We probably know a local plumber that can go out there, do the repair, or roofer do the repair. Have you mitigated your damages? Which means did you stop it from getting worse?

Are the cabinets starting to swell now, because they're wet? What could happen as a result of wet being there for too long? Mold. So we need to call a company out to do a proper dry out. You've got that leak going on in your roof. What are you going to do to stop it? We need to get a tarp up there.

All of these things a good public adjuster is going to already have the connections to get these people out there to get it all done. That's before the claim is even filed. Then we filed a claim for you on your behalf. We send them all that documentation. We go out to any and all inspections. We also do an estimate on what it's going to cost to do the repairs. I forgot to mention that. We basically negotiate our estimate, the insurance company's estimate to try to get you top dollar. And then the last thing is we follow up on a weekly basis.

Our system that we have in our company is we do follow up every seven days. We're aware of all the different statutes. Most people don't know that when you reach out to the insurance company in most states, there is a certain amount of days that they are required by law to respond to your communication. In Florida, it's 14 days. If they do not, you can notify the state. You could file a bad faith complaint against them. People don't know that.

And then the last thing I would say is that we document everything. We document every single conversation that we have with the insurance company. We keep track of everything. We basically prepare our file for the worst-case scenario.

Wherever it happens to end up in a court of law, we've got everything documented to make sure that you're going to have a good result in your insurance plan.

It's a lot. It's a lot more than people think I think.

How Much Does a Public Adjuster Charge?

Michael: You mentioned that you charge a percentage of the result. What is your charge?

Vince: Between 10 and 20%. Depending on the state, there are different limits. And also depending on if there is a state of emergency, like a hurricane in some states, you're limited to a certain amount that you can charge. But it usually varies between 10 and 20%.

Where to Find a Public Adjuster?

Michael: You've mentioned that you're licensed in three states. Our consumers live all across the United States. Where will the consumer in New York go to find the right public adjuster? Are there websites that give out information regarding different states where the good public adjusters are?

Vince: Your best bet honestly is to just go online, go on Google. Look for some Google reviews. See who you could find in your area. Obviously, a look at the reviews is very important. You can go on Facebook. I think asking friends is also a good way. A lot of my things come just from referral-based.

Anyway, they'll come from past clients for whom we did a good job. So that would be the best way to do it. I think it's just local friends, locally online research. And then if you bring anybody in if you suffer a loss and you bring somebody in to dry everything out, or you bring a repairman to do something, you could ask them if they know somebody as well.

How Much Higher Can an Insurance Claim Settlement Be?

Michael: Do you have statistics or estimates? How much higher the settlement can a public adjuster get or how much have you done in the past? Would an average consumer have done it alone?

Vince: Studies show 750% more.

When Does Insurance Fraud Happen?

Michael: Insurance is a regulated industry by the government. Insurance fraud is a criminal offense. Does insurance fraud occur? What's your experience?

Who Can Commit an Insurance Fraud?

Vince: You have to understand as a public adjuster, I'm representing the policyholder. Okay. To give you just a quick, quick breakdown of the kinds of adjustments that there are. There are company adjusters and independent adjusters. There are all licenses to different kinds of adjusters, but they both represent the insurance company.

I'm a public adjuster. I represent the policyholder. I'm hired by the policyholder. I'm hired by you, the homeowner, or the business owner to represent them throughout the insurance claims process. So I find it very, very interesting. I find it very interesting that when anybody ever says the term insurance fraud, it's automatically everybody's brain is already fixed towards, "Well, that's a consumer that's committing the fraud. That's the homeowner that's committing the fraud. That's the policyholder that's committing the fraud."

Well, frankly, it's unfortunate, but I do run into several different occasions where it's actually the insurance company that has also committed the fraud on an insurance claim. So when you tell me insurance fraud, that's sort of the first thing that actually pops into my head. Where wait a minute, let me clarify that…

...insurance fraud doesn't just only mean the actual consumer that is committing the fraud, but it could also mean the insurance company committing fraud as well.

Insurance Claim Fraud Case

Michael: Do you have any examples of insurance fraud that has occurred visiting the companies?

Vince: So there was a big issue. So I'm part of several organizations that fight against that. One is the APA, the American Policyholders Association, and another one is AAA, which is American Adjusters Association. And that's really what the main thing is to watch out for that.

And in regards to the example,the APA started after Hurricane Sally hit the Northeast, hit the New Jersey area. And what was happening was insurance companies were actually fraudulently changing engineering reports, so that it could better suit the policy language, and they would deny the claim. So for example, and this thought was all over 60 Minutes, by the way, which was actually when I first heard about it.

So in New Jersey, they had a really bad storm. Hurricane Sally came through, and what happened along the shore, a lot of these properties, they were blown off of their foundation or the foundation was cracked, which means what total loss. You have to tear it down and you have to build it back up again.

They would send the engineers to take a look at these things. And besides the fact that we have an epidemic when an engineer is sent out to an insurance claim, they're already sort of sent out there on a mission to find a way to not really pay the claim, unfortunately. But on these, they want a step further here, and they were actually changing the reports and basically say that "Yes, there is damage here that we found. Yes, this is no longer on its foundation. Yes, there is damage to the foundation. However, that is a pre-existing issue, and was not as a result of this storm."

That is an issue that is wear and tear and has been happening long term, as opposed to it being a result of the storm. And they interviewed engineers on 60 Minutes, and the engineers were looking at these reports and say, "Yeah, I didn't say that. When I went out there, I knew this was the result of this storm. I just pointed out the damage. What the insurance company did after I submitted that report, I have no idea."

Michael: The insurance company, were they brought to justice?

Vince: Yes, they were. There were a lot of lawsuits. A lot of lawsuits. I can't remember his firm, but an attorney, a big-time attorney out in the New Orleans area, John Houghtaling, he was very involved in some of those, but there's always some big ones. Yeah. There were a lot of lawsuits.

Michael: Do attorneys bring you on during the possible claims, or mostly consumers hire you?

Vince: Consumers are the ones that hire us first and foremost. We had a lot of relationships with attorneys and in conversation, and if we need an attorney because they get past our line of defense, or there's just a reason why we can't get the claim done, which does happen, we will speak to the insured and the insured. A policyholder will find an attorney on their behalf.

Red Flags in a Home Insurance Contract

Michael: Most of the insurance contracts are standardized. However, they differ from one to another. What can, or should consumers consider when choosing the home policy?

What is not important to have on the policy? And what are the red flags that you could recommend to consumers to review before they sign off on a contract?

Vince: That's a good question. I think the first thing would be to, honestly, I tell people all the time is to call the public adjuster if you know one, to go ahead and do a quick review of it. Because we know some of the things that we don't want on there if we walk into a house and there's a claim.

One of the things that you want to make sure that you have a low deductible.

I think it's very important that you have a low deductible. Another one that a lot of people don't think of at all, it is required by law. It's called co-insurance.

It's required by law that you are to have a minimum of 80% of your property values worth, you have to have insurance.

So for example, if your property is worth a million dollars, you need to have that minimum of $800,000 in your insurance premium. If you have anything less than that, you will be penalized when an insurance claim happens. So just make sure that you have at least 80%. There's a lot of limitations that we have to deal with.

In Florida, one of the big ones is water damage. So water damage is a very prevalent claim. I'd say it's probably 90% of our claims. A lot of insurance companies have put $10,000 max limits on those claims. So even if you have a hundred thousand dollars in water damage, the policy states they won't pay more than 10.

They've also got stuff like that with hail and with wind and different things throughout the country. But another bad one is called an MRP program, which is the managed right to repair. That means that they will send their own people out to do the work that has been damaged. So that means they're going to go by the insurance company's estimate. And based on that estimate, which again is usually very minimal. 

They're trying to cut corners here and there, based on that estimate, they're going to send their own contractors out to do the work on your property. As opposed to you going out, interviewing different contractors, finding the right person, getting the right price that you want, and using your own money to do it. Manage the right to repair something you have to be careful about.

So be careful with different kinds of limits that aren't your actual premium limits.

I.e. water damage limit, hail damage limit, and also be careful with men and rights and repair programs. That's pretty prevalent throughout the county.

When Should You File an Insurance Claim?

Michael: Let's say the consumer has a water damage clause. In their contract, the water gets out of the bathroom. There is a little bit of water damage. It's a little bit more than the deductible. Does it make sense sometimes not to report it to the insurance company? What is the logic that consumers shall go with?

Vince: Another great question. Exactly. If it's not going to be worth it, there's no sense in filing an insurance claim. I tell people that…

...you should not follow more than one claim every 10 years, and you really should not file more than three claims in your entire lifetime.

There's no sense because there is an underwriting department. The underwriting department of the insurance company determines risk and the higher risk you are, the more you're going to have to pay on your monthly payments, or your yearly payments, or wherever you pay your insurance. So there's no sense.

And then again, I hate to keep coming back to this, if you're onshore, find a local public adjuster, hopefully, he's a good public adjuster, and he will go out to your house. And I do it all the time. I used to tell people, I walk out of half of the homes that I walk into without signing the claim. And that's because it's me advising the client that it's just not worth filing a claim here.

You might as well just move on. If there is no argument for your entire floor replacement, or a kitchen cabinet replacement, or your complete roof replacement, there's probably no point in you falling a claim.

Michael: So what are the financial limits that you think consumers should be aligning themselves to? How much damage should the consumer estimate before calling for a public adjuster?

Vince: It depends on what's involved. So if you have a kitchen leak and that kitchen, you've got wood flooring and it damages the kitchen cabinets and the wood flooring. And the wood flooring happens to be running continuously throughout your entire home, that's a good claim. You should probably file because you will be entitled to all of the floors in your house.

If you've got roof damage as a result of a storm, in Florida, we've got a 25% clause. This means that if 25% or we'll say 26% or more of the roof is damaged, you're entitled to the new roof. So if you look at the damage and you're just not sure, "I don't know, what's going on?" Call a public adjuster, call a roofer, say, "Hey, look, can I get a new roof here?” Because if not, maybe I could just do a repair, or just get away with not…

If you're not arguing full roof, you're not arguing full flooring and cabinets and stuff like that, then I would say, it's not worth it.

It's not so much the significance of the damage is what's going to be related to the damage when you call a contractor that says, "Hey, you probably should have filed a claim here because if all of this seems very small, none of this is going to match." So like we've got a thing here also that's very prevalent is discontinued roof tiles.

So if you get wind damage to it, just a handful of tiles, first of all, if you do the repair, it's not going to look right. Because if those tiles are discontinued, now you're getting brand new tiles to shift from a completely different country. You're doing the repair. Now, every time you drive up to your roof, it's like a sore thumb.

Every time you go home, it's like a sore thumb that's sticking out. And little did you know that although the damage was small and it only costs you $600 to do the repair, you could've gotten a whole new roof and all of that would have looked the same and it could have all been paid for by your insurance company.

Can an Insurance Claim End up in Court?

Michael: If the insurance company doesn't agree with your estimate, and you have to fight or bargain with them pretty much to make a point that your claim was valid. Do consumers have to go to court against the insurance company? Do you recommend going to court and fight it? How often does this situation occur?

Vince: Not often. I would say we do end up in litigation, but litigation doesn't necessarily mean court. So if we've exhausted there, luckily in the insurance policy, there are several different what we call alternative dispute resolution methods. We could go three different ways that we could try to fight it.

Even if they're fighting us, we could file different things that they have in the insurance policy. For example, appraisal, mediation, arbitration different things. If we exhaust all avenues and we can't get anywhere, yes, we can file a lawsuit. But what usually happens like in most lawsuits, I don't know if you know this, but there's always a settlement, right?

So more often than not there is a settlement, whether that's six months down the road or two years down the road. It is usually in 14 years…

...every single case that I have had that has gone to litigation has ended up settling.

So there's that, but as far as going to court, I'm not saying it's never happened before. I've had colleagues that have had to go to court before, but if you're asking how often does it happen? I'd say almost never. I think it's probably like 97 or 98% of the claims avoided going to court and ended up settling out of court.

Commercial Claims Advocate Services

Michael: You are running your own YouTube show. Who is your YouTube show directed to? Who is a customer of your YouTube programs?

Vince: Right now, it's public adjusters. What we're doing is educating public adjusters throughout the country. I figured after about 10 or 11 years of doing this, I felt like I had enough knowledge in this industry that I can pass that on to a lot of other public adjusters

 I was lucky enough to have a great mentor in the last company I was working for many, many years. And I felt like it wouldn't be only right for me to sort of pass that on and do what I can to other public adjusters around the country. Because there is a need for it. There's a lot of firms out there that, although they're great public adjusting firms, they're just not good at passing that education onto their newbies, and the new people coming on.

And when you look online to try to find resources for new public adjusters, trying to just get a step ahead, get ahead of the game and get some extra knowledge, it's few and far between. And I felt like not only is it a way of giving back, but I did also see that there was a need for it. And hopefully, we're trying to fulfill that need.

Michael: How big is your organization? Are you working alone or you actually have other adjusters working for you?

Vince: So the social media persona that I've got and also the education, that's the Commercial Claims Advocate. With that, we basically educate a lot of public adjusters and policyholders through videos, through courses, through all kinds of stuff. My public adjusting company is Elite Resolutions.

So if anyone from this podcast calls me because they want to file a claim and they want to hire me, they wouldn't be hiring me under Elite Resolutions. That's my public adjusting firm. Yes, we are licensed in three states. We have two adjusters in Miami. We're growing right now. We're in the process of growing, and we do have two public adjusters that are working currently in Miami.

We are looking for somebody in Texas and we're almost pulling the trigger on somebody in California. So we're trying to grow in that way. Our organization in total, I do have two assistants that work on my claims and my administration. I have one person who does all the marketing, and then we've got another one, we've got two other ones actually that work on some of the videos and some of the advertising stuff like that.

What Is the Most Important With Insurance Claims?

Michael: What would be important for consumers to know about your expertise?

Vince: Whenever I see a storm coming, I try to get pretty heavy on social media on telling people how to prepare. I think it's wise. I know everybody never thinks it's going to happen to them, but just keep track of your insurance policy. You never know. A lot of times there are changes made to your insurance policy that you're not made aware of.

I don't completely blame the agent. Obviously, they've got a lot of clients and these usually change that just happen across the board. So just keep track of your insurance policy to make sure there are no sudden changes that you're not sure about. Take photos of your home whenever you can.

Just even if you're just taking a photo of your kid. I don't know. Try to get a photo of your house, because the last thing you want is if you have to file a claim in the future, you don't want the insurance company to say that damage is pre existing.

You want obviously, "Hey, no, it's not. This is the first time it's there." I would try to make friends with the local public adjuster. We're all over the country. And honest to God, we do a lot of public adjuster meetups. We get together. We get public adjusters to come together, because for some reason in the past it's public adjusters sort of battling it out with each other to try to find more clients.

But the fact of the matter is we have a constant battle with the insurance company. And the more public adjusters are getting together, the better. And the reason why I say that is that since we started doing these meetups across the country, our public adjuster meetups are outstanding. The energy, when we bring like-minded people together.

I'm sure you could just see. I'm sure in your industry, it is in the same way. It's cool. Like, I can talk to my wife about my job. I could talk to you about my job, but it's not the same as when I'm talking to another public adjuster. It's like, we've got our war stories. We've got our things. And what I want to get at is that we're really, really nice guys, because you have to understand that as public adjusters, we're not getting paid a salary. We're getting paid strictly commission and our main purpose as a public adjuster, our number one purpose is to take care of the policyholder.

My wife calls me Robin Hood. It's like stealing from the rich and giving to the poor. That's what we're trying to do. We're trying to help the little person who's going up against a multi-billion dollar industry. You see the state farm commercials that they're paying millions of dollars in the super bowl. They've got all the experts, they've got all the money. They've got all the experience, and they're coming at you and you don't even know what's on your insurance policy.

It's just very wise to just call a public adjuster, does not cost you anything to just, "Hey, take a look at my policy. Hey, take a look at this. What's going on in my house? What do you think?"

I could almost guarantee you that nine times out of 10, that public adjuster is going to give you his honest opinion. He's going to tell you what he thinks because he knows that if he does you right, you're going to keep this number. You're going to call him and you're going to refer it to somebody else. 

Because that's what our business is all about. But our number one priority is the policyholder. Although we take a percentage, I'm telling you, it's going to pay for itself.

Michael: Thank you.

The insurance claims process isn’t easy as it may seem. However, knowing these expert tips and understanding how insurance policy works in your area can save you time and money. We thank Vince for sharing his expertise and explaining the role of a public adjuster with insurance claims.

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