Claims Administration
Services
Loss Assessments - Are you
paying what you owe?
Claims Administration Services (back to top)
For the past five years, SCS has been offering Claims Administration Services specializing in handling all of your property or property damage type claims...anywhere in the United States. We offer full or limited programs to handle all functions of your property claims department to specific claims needs.
Loss Assessments - Pay what you owe! (back to top)
In many Homeowner policies today, there is an additional coverage provided for Loss Assessment. Unfortunately, too often we find adjusters paying for claims they do not owe and not paying for claims they do. A refresher course in applying Loss Assessment coverage is in order.
There is usually a limited amount payable based upon the policy form or extension of coverage amount. Most important though is that the Loss Assessment must be made based upon a direct loss to the property caused by a peril insured against by the Homeowner's policy (typically as covered under Dwelling-Coverage A). Thus, if the policy covers Dwelling, in this case, for named perils, the Loss Assessment must be due to a named peril loss. The coverage has nothing to do with what the HOA (Home Owner's Association) perils insured are under the Master Building policy. Often, the perils covered by the Homeowner's policy are broader than the HOA's. Thus, the loss may be covered by the Homeowner's Loss Assessment coverage even though excluded by the HOA's policy. Again, it is for a single loss which would have been covered by the Homeowner's policy. Maintenance, Earthquake, and other excluded losses are not reimbursable. It doesn't matter if the HOA attempts to split up an assessment on a single loss, only one assessment per loss. Finally, the Loss Assessment coverage is not dependent upon the insured having an Homeowner's policy when the loss occurred, just when the assessment was made. Thus, it is important that any Insurer consider pending loss assessments before writing a new policy.
Every policy is unique and the above may not apply to your claim. Read The Policy! Hopefully, we will all address our claims in the same manner and not have our insured upset because we didn't pay a claim when their neighbor's insurer paid their claim in error.