|  | | Author | Messages | |
randell morgan
 Posts:9

 | | 11/07/2007 5:36 PM |
| Irrespective of the policy forms and endorsements, do you always apply the same criteria for general contractor overhead and profit, (applied when 3 or more trades are involved). That criteria being when overhead and profit is included, do you always pay 10% and 10% on an “ACV” basis regardless of the type of policy or endorsements?
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| Bob Harvey Gold Member California, Central Coast
 Posts:379


 | | 11/07/2007 5:46 PM |
| There has been litigation on this subject. Not all carriers view this the same way. Unless a specific carrier is instructing you otherwise, if O&P is allowed on a repair, then 10 & 10 on the ACV should be allowed. For example that is the default result you would get if you did the estimate in Xactimate. There has also been litigation on the "3 trades" rule, and I think the one involving State Farm came out with a ruling along the lines of O&P whenever it is reasonably expected that a General Contractor would be needed to do the repair. So that is not a hard and fast rule that you have to have 3 trades. You will find policies and endorsements that comment on ACV, but I'm not aware of any that specifically describe or limit O&P. I believe that carriers who had a standard practice of refusing O&P prior to completion of repair have gotten their hands slapped. | | | |
| randell morgan
 Posts:9

 | | 11/07/2007 6:10 PM |
| | Do you remember what State Farm was doing in regards to this matter after Katrina? | | | |
| Bob Harvey Gold Member California, Central Coast
 Posts:379


 | | 11/07/2007 6:18 PM |
| I worked State Farm claims at Katrina for 5 months and they allowed O&P on the ACV of the claim, if that is your question... The litigation regarding when to allow O&P was prior to Katrina. | | | |
| joseph lombardo jr. Adjuster Clearwater, Florida
 Posts:111

 | | 11/08/2007 5:31 PM |
| Bob, We hold back OH&P until we receive a signed contract with a GC involved or until we receive a certificate of completion and satisfaction from the insured and contractor. So far we seem to be okay with the State of Florida on this as we are not denying the OH&P, we are just holding it until a Licensed and insured GC is involved.....The State is pushing for repairs to be done by a licensed and insured GC, so I think that is why we in Florida do not get a lot of grief on it. | | | |
| Bob Harvey Gold Member California, Central Coast
 Posts:379


 | | 11/08/2007 6:03 PM |
| Hi Joseph, gotcha on how it works in Florida. Over the years I have had many carriers do that same requirement, but more often in California these days the carriers seem to be OK on paying O&P on the adjusted value of ACV claim.
For those who are into boring reading, here is an article that summarizes some of the issues http://www.adjustersinternational.com/ATpdf/3032_Overhead_and_Profit.pdf on page 5 it mentions: the
Property Loss Research Bureau
(PLRB), a recognized resource used
by insurers in the interpretation of
property insurance policy provisions,
has taken the position that
“contractor’s overhead and profit
are included in ACV, because they
are part of replacement cost.” The
PLRB concludes that “any estimate
of actual cash value should include
overhead and profit.”
on page 6 it says: Other industry groups are taking
similar positions. The Fire, Casualty
& Surety Bulletins (FC&S), a
National Underwriter Publication
used by insurance professionals
in the interpretation of property
insurance policy provisions, is one
notable example. In response to a
question describing the practice of
not including the costs of GCO&P
as part of an ACV payment, an
FC&S editor explained:
“Both [general contractor overhead
and profit as well as subcontractor
overhead and profit] are to be used
in calculating final replacement
cost, since they are obviously a
part of the function of repairing
or replacing the building, and it is
from this that the actual cash value
settlement is derived.”
... Furthermore, many insurers include
both general and specialty
contractor/subcontractor overhead
and profit when estimating the replacement
cost that determines the
limit of liability upon which a policyholder’s
premiums are based.
As the Texas Department of Insurance
so aptly stated in its bulletin,
“if the insurer in determining actual
cash value excludes costs that
are included in the determination
of liability limits, on which the
insured’s premium is based, the in-
surer reaps an illegal windfall because
the insurer receives premium
on insurable values for which loss
may never be paid.” as I mentioned earlier on this thread, not all carriers view this the same way. You have to "dance with the one that brought ya". | | | |
| Bob Harvey Gold Member California, Central Coast
 Posts:379


 | | Bob Johnson
 Posts:2

 | | 11/08/2007 8:56 PM |
| As a staff Catastrophe adjuster for one of the large companies I can tell you that we have pretty strict standards when it comes to O&P. Usually to be considered for O&P a claim has to be over 20 thousand dollars and there must be extensive covered damage to both the inside and outside of the structure. These claims are usually fire claims and large tornado/hurricane claims. Usually your standard hail/wind claims do not qualify for O&P under our guidlines. For example, if an insured has hail damage to roof, gutters, window screens, siding, and paint on the outside of their home we would not allow O&P. The claim is not complex enough for the insured to require a general contractor. In most cases the roofing companies will do all of the work as a lot of roofing companies also do siding, gutters, etc. This especially when you have the storm chasers working the storm and going door to door soliciting claims. That is why one of the first questions the storm chaser will ask you is if you allow O&P on 3 or more trades. They will always "find damage" to include roof, paint, siding, and gutters thus ensuring that more than 3 trades are represented even though their crew will do all the work. | | | |
| Ray Hall Adjuster Houston, TX
 Posts:783

 | | 11/08/2007 10:13 PM |
| Something is "odd" about tornado damage not standing out for an experienced adjuster. A lot of structural damage would be very apparent. If it was a liability claim from blasting, I bet the liability adjuster could find find some witness that would tell a story of this "leaning house" was a condition before this storm . The lean/ rack may not be related to weather, or this weather event. I will also guess the Haig report and opine is along this line. Bet this case is reversed on appeal. My 2 cents. | | | |
| Ray Hall Adjuster Houston, TX
 Posts:783

 | | 11/08/2007 10:39 PM |
| This is kinda off topic.... The adjuster looks at a loss and does an accurate scope and detailed estimate. When he gets his mail he finds an estimate for roof shingles on and off $, gutter repairs$, drywall ceiling repairs $, ceiling paint $ clean up and trash haul $. It is signed by the contactor the insured selected and will use to do the work for a total of $1,000.00 less than the adjusters estimate that is due when the work is complete. 1.Do you say the estimate is not detailed enough and not acceptable ? 2. Turn in both and recommend the contractor's amount be paid ? 3. Call the insured & contractor and say you can only recommend your estimate amount as its more accurate ? 4. Tell the insured who is an officer of the insurance company that he left some $ on the table. 5. Tell the insured to send $1,000.00 back to the claim department as you get paid by the amount of the loss and it make a differance to YOU. | | | |
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