Many homeowners and business owners find themselves disagreeing with their insurance company’s analysis of their insurance claim. However,Guest Posting most are unaware that they can dispute the insurance company’s findings via the Insurance Appraisal Clause! Even though the policyholder (you) submits a contractor’s estimate, receipts for repairs or materials, or even photos showing damages that the insurance company did not include for repairs… they still won’t budge.

Most policyholders are unaware of how to dispute and resolve their claim with the insurance company. Policyholders have a choice and a voice within their policy for this very purpose. It’s called The Appraisal Clause – also know as The Appraisal Provision. Now, don’t let this scare you. It may seem like a fancy clause that would take a law degree to understand. However, a simple way to understand the clause is that it’s the insurance industry’s version of arbitration. Although similar, the Appraisal Clause is NOT an arbitration or mediation and the umpire is not an arbitrator, mediator, or judge. Insurance Appraisal, Mediation, and Arbitration are separate things.

In short; Arbitration requires attorneys and a legal process, where Insurance Appraisal does not require attorneys or a legal process. Arbitration is a dispute between two parties for any reason, where as, the Insurance Appraisal Clause is a for disputes between the “value,” of property only – bee it an automobile, plane, train, couch, house, commercial building, etc.

Most Policies Have the Appraisal Clause.

If you feel you’re at a dead end with your insurance company and want to resolve your claim you’ll need to check your policy for the Appraisal Clause. Most policies will have the provision listed under the “What to do after a loss,” section or the “Conditions” section of the policy. Below, you will find a sample of a typical Insurance Appraisal Clause included in most policies. Keep in mind that policies can be different in each state. Therefore, you should read your own policy to see if this clause exists. It will say something similar to the following ;

“APPRAISAL – If you and we fail to agree on the amount of loss, either one can demand that the amount of the loss be set by appraisal. If either makes a written demand for appraisal, each shall select a competent, independent appraiser. Each shall notify the other of the appraiser’s identity within 20 days of receipt of the written demand. The two appraisers shall then select a competent, impartial umpire. If the two appraisers are unable to agree upon an umpire within 15 days, you or we can ask a judge of a court of record in the state where the residence premises is located to select an umpire. The appraisers shall then set the amount of the loss. If the appraisers fail to agree within a reasonable time, they shall submit their differences to the umpire. Written agreement signed by any two of these three shall set the amount of the loss.”

OK, But How Does The Insurance Appraisal Clause Work?

The Appraisal Clause allows the policyholder (you) to hire an independent appraiser to determine the value of their damages. In turn, the insurance company will also hire their own independent appraiser. The two appraisers will then get together and select an umpire. The umpire is basically the arbitrator, or what you might call the judge. If a disagreement between the two appraisers arises, they can present their differences to the umpire who will make a ruling.

OK; so far so good, the basics of the insurance appraisal process are beginning to come together. We have an independent appraiser for the policyholder. We have an independent appraiser for the insurance company. Finally, there is an Umpire. These three individuals are known as The Appraisal Panel. The object of the Appraisal Panel is to set or determine The Amount of Loss. The Amount of Loss is the total dollar amount needed to return the damaged property back to its original condition, either by repair or replacement.

Once the Appraisal Panel is set, the policyholder’s chosen appraiser and the insurance company’s chosen appraiser will review the documents, estimates, and differences between them. The two independent appraisers will try to discuss and resolve the differences in damage and in cost. For example; the insurance company may determine that brick on a home does not need to be replaced. Where as, the contractor or appraiser for the policyholder says that it does have to be replaced. The two appraisers will discuss their reasons for their position and try to come to an agreement, first if it should be repaired or replaced, and secondly the cost to return the brick back to it’s original condition prior to the loss.

One benefit of this process is that the two independent appraisers have not been subject to the bickering and anger between the policyholder and the insurance company. Basically, it’s the hope that cooler heads will prevail. All the appraisers really have is the amount of the damage and the difference between the two estimate numbers. They do not have the previous baggage or anger that led up to the Appraisal. The process was designed so that these two individuals, who have no interest in the outcome, could discuss a settlement based on the facts presented to them.

Sometimes issues arrive where the two independent appraisers can’t agree on certain items. In this event, the two appraisers will submit their differences to the chosen umpire. The three will discuss the issues and try to reach an agreed settlement of the differences. As stated above; the settlement or final number is called The Amount of Loss. The final amount is known as the Appraisal Award. The Award is signed by the individuals who agree on The Amount of Loss. However, only TWO of the three individuals need to agree. (An agreement between the two independent appraisers, or the umpire and either appraiser) Once any TWO of the three individuals on the Appraisal Panel sign the award… the dispute is over! The amount on the Award binding and is paid by the insurance company, to the policyholder.

Can I Use An Insurance Attorney To Dispute My Claim?

The Appraisal Clause was initiated to lower the number of lawsuits filed against insurance companies. The courts found that many lawsuits were entering the legal system where the cost to repair or replace damaged property was being disputed. In many cases the suites were being resolved when professional engineers and contractors could address the issues. The Appraisal Clause was created to get such individuals together and keep these disputes out of the courtroom. Assuming you acquired an estimate of repair to your property for $100,000, from a contractor or insurance claims expert. Your insurance company has created an estimate for $30,000. This would be a clear dispute between the amounts of damage. This type of dispute is exactly what the Appraisal Clause was developed to resolve.

The clause allows parties on both sides of the insurance policy to dispute their differences using this less costly provision. Let’s face it; the courts are filled with lawsuits. The Insurance Appraisal Clause and process allows for the dispute to be settled out of court. Using Insurance Attorneys and lawsuits can have insurance claims tied up in court for years. The Appraisal Provision was designed to keep these disputes out of court for a less costly and timelier resolution.

Insurance Claim Attorneys will usually represent policyholders for bad faith practices. Bad Faith is a whole other issue and sometimes happens after the Appraisal Process has been completed. Bad Faith claims are for much larger suites against insurance companies when it is alleged that they did not act in good faith of the policy they sold to the policyholder. In summary; disputes between the amount of damages and repairs will follow the Appraisal Clause before entering into the legal system. Many Insurance Attorneys will also advise the policyholder to engage in the Appraisal Process before any lawsuits will begin.

How Do I know if the Insurance Appraisal Clause is a Good Option for My Claim?

If the Appraisal Clause is in your policy then it is always an option. However, it’s wise to point out that Appraisal is usually an option when there is a substantial difference in the amount between the two estimate totals. For example; let’s say a fire completely destroys a house and the homeowner’s personal property within it (Know as the Contents). The differences between what the insurance company wants to pay and what you wish to receive is $5,000. In this situation, the Appraisal Clause is not the best idea. After paying the fees involved for the appraisal, you may not end up with much of the $5,000 being disputed.

Now, if we take the same fire that destroys the property and the dispute between the policyholder and the insurance company is $40,000, appraisal should be considered. The policyholder now has a chance to recover substantially more money than originally offered.

Also, the Appraisal Clause is only applicable if a dispute arises from a covered loss. If the insurance company denied the claim as something not covered then this is not a dispute on the amount to repair, but rather a dispute on coverage. For example; homeowners and business policies due not cover damages from flooding. Flood policies are purchased separately. So, if there is no coverage for the flood damage then the Appraisal Clause is not an option.

Simply put, the Insurance Appraisal Clause is to determine the “amount of loss,” to property only. The Appraisal Panel is not to determine coverage, policy provisions, deductibles, how much was previously paid on the claim, etc. Let’s say there was an appraisal for a grand piano that fell off a delivery truck on the highway. The Appraisal Panel’s job is not to determine who’s at fault, the policy coverage limit, if the truck had a registration, or anything other than “How Much is the Piano Worth.”

As with our example earlier, if the insurance company offers a settlement of $10,000 to repair a roof and the policyholder has contractor bids for $15,000, then the Appraisal Clause may not be the best option. The process may cost more than the $5,000 that’s being disputed. Unfortunately, the differences in repair/replacement costs are usually much greater. When an insurance company generates an estimate for a claim of $75,000 and the policyholder has acquired professional bids from several contractors of $200,000 or more, its time to invoke the appraisal clause.

Beginning The Appraisal Process.

Either party associated with the policy can invoke the A

If you live in a flood-prone area,Guest Posting you should prepare for a flood and keep certain things in mind. Here are some tips that can help you minimize flood damage:

* Prepare for a flood by getting insurance coverage

Prepare for a flood by getting an insurance which provides adequate coverage against flood damage. Flood water can destroy your house and all the things inside your house. Restoration will take time and a lot of money. Proper insurance coverage will help minimize flood damage costs.

* Prepare for a flood by learning all flood-related terms

If you live in a low-lying area, prepare for a flood by learning all the terms that can help you understand a flood situation. Flood watch means flooding is possible. Flash flood watch means be prepared for a flash flood and move to a higher ground. Flood warning means flooding has already begun or will begin soon. Flash flood warning means that a flash flood has begun and you should immediately shift to a higher ground. Familiarizing yourself about these terms will help minimize flood damage and could save the life of your family.

* Prepare for a flood by ensuring flood protection for your house

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If you plan to build a house in a flood-risk area, prepare for a flood while building it. While your house is being constructed, elevate it. Reinforce it by building barriers around your property. The barriers can be in the form of floodwalls, levees or beams. In flooding situations, these barriers will prevent the flood water from entering your house too soon and help minimize flood damage.

* Prepare for a flood by getting a flood kit ready

Some floods may take days to develop slowly, but flash floods can happen quite quickly giving you no time to get your things together if you need to evacuate. So make sure that you prepare for a flood by always having a ready flood kit stored in a safe place. This emergency kit should include bottled water, non-perishable or canned food, a battery-operated radio, a flashlight, warm clothes and blankets, a first-aid kit, and any other item that you might need. In a flooding situation, this emergency kit will be of great help in case of an evacuation advisory and will help minimize flood damage to human life.

If you live in an area which has the potential for flooding, always be prepared. Learning as much as possible about flooding situations and teaching your family about what to do during a flood can help minimize flood damage in terms of losses to property and life. So if you live in a low-lying area, make sure that you use these tips to prepare for a flood and minimize flood damage.

In this article we discuss the Indian insurance market and the trends that will help companies in the United States evaluate how they can leverage from this untapped market.

The research has been conducted by the VA consulting team working with inputs from several insurance leaders in the Indian market that have worked with early entrants like Met Life,Guest Posting Zurich, ICICI and others.

Background to the Indian economy
Ever since the economy was opened up in 20 years ago India has been growing as an economy at nearly double digits.

As the working middle class becomes a sizable number the insurance industry has started growing at an incredible rate. It has grown over 200% since 2006. Even last year that insurance industry has grown by over 45%. Analysts predict the industry is going to grow at least 10% in 2010 to become a $42Billion industry. Even with this growth rate only 5% of the country is actually covered by any form of insurance.

The research has been conducted by the VA consulting team working with inputs from several insurance leaders in the Indian market that have worked with early entrants like Met Life, Zurich, ICICI and others.

There are insurance governing bodies have been formed and governing bodies have brought about a number of changes to standardize the insurance sector but more changes are expected especially in the personal and life area.

There are many factors to probe into as an investor or venturing into the Indian market. Our guidance to companies that are interested in entering the Indian market is:

The consumers as well as the investors should be focusing on the insurer’s financial strength and capability to meet ongoing responsibilities to its policyholders.
The fundamentals of the insurance company should be strong and should not indicate a poor investment opportunity as this might also deter growth.
Key FindingsTaking into account the changing socio-economic demographics, rate of GDP growth, changing consumer behavior and occurrences of natural calamities at regular intervals, the Indian life insurance market is expected to reach the value of around $42 Billion in the year 2010. The market is expected to grow at a CAGR of more than 200% YOY from the year 2006.

In 2006-07, pension premium contributed about 22.11% to total premium income of insurers.
Interestingly, the figure in the first nine months to December 2005 was 25.22%.In the non-life segment, the established players control 65% of the market. So it is their monthly performance that determines how the market as a whole would perform.
In Motor Insurance Business, Public sector covers almost 68% of the market value whereas the private sector just had 32% market share till September 2006.
In Accident Insurance Business, private sector players have almost 53% market share with ICICI Lombard as the lead player. Public sector players constitute about 47% market value with New India as the leading player followed by United India.
Overview of the market
The insurance business in India much like the US insurance industry is divided into four classes:1) Life Insurance business2) Fire3) Marine 4) Miscellaneous Insurance.Life Insurers transact life insurance business; the rest is transacted by General Insurers. No composites are permitted as per law at this time. This is being reviewed.The business of Insurance essentially means defraying risks attached to any activity over time (including life) and sharing the risks between various entities, both persons and organizations. Insurance companies (ICs) are important players in financial markets as they collect and invest large amounts of premium. Insurance products are multipurpose and offer the following benefits:1. Protection to the investors2. Accumulate savings3. Channelize savings into sectors needing huge long term investments. ICs receive, without much default, a steady cash stream of premium or contributions to pension plans. Various actuary studies and models enable them to predict, relatively accurately, their expected cash outflows. Liabilities of ICs being long-term or contingent in nature, liquidity is excellent and their investments are also long-term in nature. Since they offer more than the return on savings in the shape of life-cover to the investors, the rate of return guaranteed in their insurance policies is relatively low. Consequently, the need to seek high rates of returns on their investments is also low. The risk-return tradeoff is heavily tilted in favor of risk. As a combined result of all this, investments of insurance companies have been largely in bonds floated by GOI, PSUs, state governments, local bodies, corporate bodies and mortgages of long term nature. The last place where Insurance companies are expected to be over-active is bourses.

A recent trend of ICs is to venture into the pension and the mutual fund market. Life still constitutes a major share of the insurance business.

Regulators

Insurance is a federal subject in India. The primary legislation that deals with insurance business in India is: Insurance Act, 1938, and Insurance Regulatory & Development Authority Act, 1999. The Insurance Industry has ombudsmen in 12 cities. Each ombudsman is empowered to redress customer grievances in respect of insurance contracts on personal lines where the insured amount is less than $45,000, in accordance with the Ombudsmen rule.Insurance Regulatory & Development Authority (IRDA)IRDA was constituted by an act of parliament. The Authority is a ten member team consisting of: (a) Chairman (b) five whole-time members (c) four part-time members (1) Subject to the provisions of Section 14 of IRDA Act, 1999 and any other law for the time being in force, the Authority shall have the duty to regulate, promote and ensure orderly growth of the insurance business and re-insurance business. (2) Without prejudice to the generality of the provisions contained in sub-section (1), the powers and functions of the Authority shall include, – (a) issue to the applicant a certificate of registration, renew, modify, withdraw, suspend or cancel such registration; (b) protection of the interests of the policy holders in matters concerning assigning of policy, nomination by policy holders, insurable interest, settlement of insurance claim, surrender value of policy and other terms and conditions of contracts of insurance; (c) specifying requisite qualifications, code of conduct and practical training for intermediary or insurance intermediaries and agents;(d) specifying the code of conduct for surveyors and loss assessors; (e) promoting efficiency in the conduct of insurance business; (f) promoting and regulating professional organizations connected with the insurance and re-insurance business; (g) levying fees and other charges for carrying out the purposes of this Act; (h) calling for information from, undertaking inspection of, conducting enquiries and investigations including audit of the insurers, intermediaries, insurance intermediaries and other organizations connected with the insurance business; (i) control and regulation of the rates, advantages, terms and conditions that may be offered by insurers in respect of general insurance business not so controlled and regulated by the Tariff Advisory Committee under section 64U of the Insurance Act, 1938 (4 of 1938);

(j) Specifying the form and manner in which books of account shall be maintained and statement of accounts shall be rendered by insurers and other insurance intermediaries;

(k) Regulating investment of funds by insurance companies;

(l) Regulating maintenance of margin of solvency;