Type of policy | Business owner policy
City | Compton, CA
Description of loss | Description of loss: Intrusion of sooth and ashes resulted from commercial building fire adjacent insured’s location.
Insurance Adjustment Summary |
– Initial insurance company’s settlement amount at $0.00. Insurance carrier did not offer any settlement to insured for four months since receiving the claim from insured.
– Total insurance settlement after Jae Park & Associates, Inc., involvement of adjustment of claim $45,595.15(Before deductible). Differences in settlement amount of $45,595.15, and insured kept all of the damaged products
In early August 2012, a general merchandise store located near the working-class neighborhood near South East of Los Angeles had an unexpected incident. A fire broke out in the building next door, and the ashes and smoke covered Mr. B’s store. Consequently, all the products for sale including displayed clothes, shoes, accessories, etc., and all the furniture, including the display cases inside the store, suffered severe damage. The insurance broker, upon hearing the news, told Mr. B that he would help Mr. B to receive sufficient claim settlement and won’t need to retain a PA. He said that Mr. B should leave everything in the hands of the insurance company. Immediately, the independent claim adjuster appointed by the insurance company visited the site according to the claim filed by Mr. B, followed by an additional detailed inspection by insurance company’s retained hygienist, an environmental expert in mid-November. However, Mr. B, who operated the small store, would suffer serious financial damage if the store lost even a day of operation. So, immediately after the claim was filed he asked the insurance company when he could reopen the business in the damaged site. He asked several times but was given no reply.
As a result, Mr. B decided to resume the business in order to save himself. He cleaned the store as much as possible, trying to maintain the damaged site, and he exhausted the smoke by turning on a fan. Mr. B lacked operating funds, so he borrowed money from acquaintances and purchased new products. How could he sell products that had been damaged by the fire?
Because of the intrusion of the ash and sooth it made walked in customer at unease to breath inside the store, and sales went downward. Thus the revenue loss of monthly sales began to accumulate. Mr. B endured this difficult situation for nearly four months before he finally contacted this PA in mid-December. He told me that he had made several requests for the payment of claim to the insurance company, but those requests were ignored. Immediately after the acceptance of this case, this PA investigated the insurance company’s previous issued mail correspondence to Mr. B including attached expert reports. The results were surprising:
- The insurance policy holder, Mr. B, operated the fan for the purpose of ventilation and cleaning after the fire damage, but in doing so Mr. B spread the damage to undamaged goods. Additionally, after the fire he displayed the newly purchased products mixed with damaged products, so he increased the extent of the damage. (This was pointed out by insurance company’s hygienist during telephone conference with PA.)
- Initially the ashes accumulated near the entrance of the store, and the amount of ashes that traveled back into the store was insignificant. So, apparently the actual fire-related product damage was about $3,000. (In other words, they had no intention of compensating Mr. B. After excluding the $1,000 deductible, the compensation would be just $2,000.)
The PA identified the position of the insurance company as shown above, immediately calculate the size of the damage correctly. The total damage cost, including the loss of products and the cost of store cleaning, was about $63,000.00. According to this, the PA strictly warned the insurance company and demanded the immediate payment of claim settlement.
- The unfair treatment of the insurance company to Mr. B was clear, and for this the insurance policy holder’s rights and interests were significantly impeded. The insurance company refused issue any un-disputed settlement over past three months. So, unless settlement was paid as soon as possible, the insurance company may face serious problems later such as unfair claim adjustment practice by delaying the claim process without merit.
- this PA(Jae Park Public Insurance Adjuster) demand the insurance company issue settlement to Mr. B $10,000.00 for the disaster emergency operating funds. (This was processed immediately.)
- The immediate adjustment for the remaining damaged goods was requested. (It was processed and concluded satisfactorily to Mr. B on March 4, 2013.)
In this case, the insurance company, with its poor claim department system, mainly depended on outside contractors and adjuster. Eventually, this causes many difficulties for the insured. If the readers are in the same situation as Mr. B, you would not want to watch your business go bankrupt as you wait for the insurance company to address your problem.
I would like to finish this column, expressing deep respect to my client who, despite the difficult situation, responded to the disaster wisely and decisively.