Live Like a King

Letter to NJ DOBI Regarding Our Claim

Posted on: March 13, 2009

This letter is from our Public Adjuster to the Dept. of Banking & Insurance regarding our claim with Liberty Mutual. I’ve removed the names of the parties involved except for us in the interest of those person’s privacy.

This letter is a summary of the claim from my involvement to present day. The chronology will touch lightly on items not in dispute and address the more current issues at greater length that still have not been resolved.

1. Date of loss captioned above.

2. Public Adjuster (PA) contacted for services March 21, 2008.

3. Spent March 24th thru the 28th counting over 1800 articles of contents.

4. (LM Contents Adjuster) spent 6 hours over two days accounting for 757 items; the time spent was noted by Chris King who opened the house for (LM Contents Adjuster) to gain access.

5. Kings receive contents scope from (LM Contents Adjuster) on June 27, 2008.

6. Many discrepancies were discovered as the Kings and PA reviewed the June 27th contents scope from (LM Contents Adjuster). Our presentation of Contents Inventory Replacement Cost is enclosed for your review. Please see attachment. Sent August 27, 2008.

7. Complaints about the home provided to the Kings for temporary living was sent to Marriot on July 29, 2008. Some items complained about were resolved on August 2, 2008. There are still outstanding issues to be resolved and to date no resolution has occurred.

8. We had several meetings with (LM Structure Adjuster) and (LM Contractor). In the September meeting, (LM Contractor) admitted to Chris and Dawn King that his scope did not cover the cost to rebuild. All parties, Chris and Dawn King, (LM Structure Adjuster), (LM Contractor), and PA all agreed that the coverage of $208,300.00 was not enough to rebuild and the Kings are underinsured.

9. From this meeting in September (LM Contractor) revised their estimate and the dwelling portion was raised from $157,840.21 to $197,293.91, just under the policy limit of $208,300.00. In response, PA sent a highlighted scope of omissions that when adjusted would place the claim over the policy limit and trigger additional coverage. See attachments.

10. On October 14, 2008, the Kings received a letter from (LM Structure Adjuster) stating that a new policy limit was now in effect of $249,960.00 because of the Home Protector Plus Endorsement.

11. In response to the highlighted scope of omissions, a subsequent revised estimate from (LM Contractor)was generated for $232,622.67 again just under the new policy limit.

12. On November 12, 2008, the PA sent a second letter of rebuttal enumerating the omissions that still exist, which prompted another raise in new policy limit of $253,461.00 in a letter dated November 26, 2008, this time reflecting inflation protection.

13. A third letter of rebuttal was sent December 1, 2008 demonstrating with documentation that the scope of repair exceeded even the newest policy limit.

14. Liberty Mutual claims management has consistently received all the documentation to demonstrate the RCV is far in excess of the newest policy limit change. On three different occasions Liberty Mutual has represented different policy limits in an attempt to circumvent the policy’s additional coverages. The Kings are now being told that even though the newest policy limit has been reached and the additional coverage of debris removal is enacted, that only the dump receipts will apply minus the labor it took to fill the dumpsters.

15. The policy under Additional Coverages

1. Debris Removal – We will pay your reasonable expense for the removal of:

a. Debris of covered property if a Peril Insured Against that applies to the damaged property causes the loss; or
b. Ash, dust or particles from a volcanic eruption that has caused direct loss to a building or property contained in a building.

This expense is included in the limit of liability that applies to the damaged property. If the amount to be paid for the actual damage to the property plus the debris removal expense is more than the limit of liability for the damaged property, an additional 5% of that limit of liability is available for debris removal expense.

Labor is expressed as a component of the debris removal just as with the ash that would have to be removed from the property. Demo in all its glory is debris removal.

The amount that would be allocated for debris removal expenses is 5% of the newest policy limit of $253,461.00 which equates to $12,673.05

The Kings have already paid a $6436.01 in contents debris removal plus an estimated $7000.00 in dwelling debris removal which easily covers the additional coverage item. Liberty Mutual claims management is balking at this expense.

Furthermore, SECTION II – Additional Coverages
We cover the following in addition to the limits of liability:
1. Claim Expenses. We pay:
The policy has a change under item 1.c.
Item l.c. under Claims Expenses is amended as follows:
Reasonable expenses incurred by an “insured” at our request, including actual loss of earnings (but not loss of other income) up to $250 per day, for assisting us in the investigation or defense of a claim or suit.

The Kings, through Liberty Mutual, have paid the architect $7,928.16 and paid out of pocket the Engineer’s $6,187.50 bill. Liberty Mutual claims management is balking at the engineer’s bill.
Additionally, the Kings have had to exhaust vacation time which is paid leave and have requested to be reimbursed for this expense but Liberty Mutual has not even addressed the claim for reimbursement. The value being claimed at 32 days X $200= $6400

16. What becomes very clear is the huge waste of time in between requests and responses. Most exasperating for the Kings is the persistent attempt to raise the policy limit to negate paying the additional coverages. Simply put, the raising of policy limit by Liberty Mutual claims management has been in specific response to demonstrated omissions. The dollar figure revised in each new scope was deliberately set below the limit so that when permits are calculated in the new dollar figure it would be below the policy limit. So the question becomes: Why didn’t Liberty Mutual claims management from the beginning, March 17, 2008, have (LM Structure Adjuster) inform the Kings of all their coverages?; or do so at a second opportunity back in September when we had agreement that the client was under insured? Yet Liberty Mutual claims management put the Kings through great anxiety for no justifiable reason and has brought the Kings to the end of their one year ALE without the home being complete to move back into.

17. It took two months for (LM Contents Adjuster) to send the King’s /PA’s contents scope with markings to show differences. This was received on October 22, 2008.

18. The Kings and PA requested a meeting with (LM Contents Adjuster) to discuss the differences; the meeting took place at the loss site on November 10, 2008. That is over 4 months from his presentation of contents lost and two and one half months from receiving the PA’s contents scope. On November 5, 2008 a letter was sent to you from a Liberty Mutual Unit Claims Manager, where he states that the public adjuster;
a. Increased a bulk of the pricing
b. And added items
c. Then resubmitted it in no particular order
d. Kings took upon themselves to have the whole house demoed, which in their opinion was not necessary.

As to increasing the bulk of the pricing the PA did not place one price on a single item, these prices were generated by Chris and Dawn King and are documented to be accurate with actual store pricing.

As to adding items, it is Liberty Mutual that has adopted the PA’s contents scope in its entirety after we demonstrated through pictures that (LM Contents Adjuster) didn’t do an adequate job.

As to resubmitting the scope in no particular order is a bold exaggeration. Please see attachment and judge for yourself.

As to the Kings taking upon themselves the demo and debris removal, the Kings were informed by (LM Structure Adjuster), (LM Contractor), PA, ServPro, and the structural engineer that the house needed to be totally gutted.

At best (LM Management) has misstated and may wish to recant his remarks, or would he rather be known as lying to an official investigator from DOBI? No matter what he does, the facts just do not support his remarks.

19. (LM Contents Adjuster) accepts the PA/King’s contents scope on December 28, 2008, which stands in stark contrast to the scope presented by him with over 1100 items missing.

Additionally, (LM Contents Adjuster) has chosen an arbitrary depreciation schedule that has no basis in reality. Some examples are:
a. Socks and sneakers depreciated 5 yrs. for young girl whose feet have grown every year.
b. Dress shirts depreciated 8 yrs. for Ariella who is 13 years old. This would mean she was using the shirts at age 5.
c. 5 year old toilet paper in the bathroom with 9 people using the only bathroom.

(LM Contents Adjuster) has demonstrated that he has not exercised equitable depreciation to accurately represent the loss items and in the entirety of the contents portion of the claim. Instead he is holding ransom $63,667.19 in depreciation value. Additionally, (LM Contents Adjuster) has stated that he wants item for item replaced with receipts before he will release the depreciation money, so as one item is purchased he would release that amount of depreciation.

With this type of absurd treatment, the Kings, who have nine people to shop for and who have virtually no time to put toward this intense scrutiny, need to hire a third party to do this shopping for them. Besides a one for one replacement doesn’t take into account that over nearly a year the children have grown and so has the expense of the articles. Even with purchases from the internet so they would not have to waste time in traveling and the frustration of taking seven children with them to shop, the shipping and handling would be an added cost.

20. (LM Contents Adjuster) receives my original handwritten thirty plus pages of contents scope with no expression to me or the King’s of wrongdoing or even a raised eyebrow.

I appeal to you and your office to intervene on behalf of the Kings to stop Liberty Mutual in their exercise of aggressive claims procedures and give the much need relief to an unfortunate circumstance.


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