Do's and Don'ts of Insurance Claims
AUG 12, 2022
Description Community
About

Andy Gurczak is a private insurance adjuster and the Founder of AllCity Adjusting. Andy has more than 10 years of experience. He helps and represents others with their insurance claims and advocates for them. So with no further ado, let’s dive in and listen as Andy shares how he works in the field. 

 

00:00 - 05:26] Opening Segment

  • Who is Andy Gurczak
    • Andy started in construction sales
  • Public adjusters are private adjusters who represent their insurance companies and advocate for them.
  • There is a right time to get a public adjuster involved; the sooner, the better.

 

[05:26 - 10:40] Agents Advise Property Owners on How to Combat Insurance Companies

  • The importance of agents educating their clients on their policy
  • One of the main points is to avoid being in a hurry, as this can lead to mistakes and poorer outcomes for the client.
  • Commercial clients are typically more willing to wait for a settlement, while residential clients may be more eager to return home.

 

[10:40 - 16:47] How to Prepare for an Insurance Claim

  • When you have a claim, the insurance company will ask you a hundred questions and record everything.
    • Saying the wrong thing can affect your claim, such as being delayed, denied, or even worthless if you had just spoken to the insurance company directly without first consulting a Private Adjuster.
  • It is essential to consult an attorney or PA when you have a claim to make sure you present it in the best way possible.
  • There are many nuances to insurance policies that can be difficult to understand on your own. It is helpful to have an advisor who can help guide you through the process.

 

 

 

[16:48 - 19:24] Closing Segment

  • Reach out to Andy
    • Links Below
  • Final Words

 

 

Tweetable Quotes

“All the policy is written for the consumer, right? So it's not supposed to be written as an attorney is supposed to interpret it. It's supposed to be easy to read, but they're never easy to read. They're so complicated.” - Andy Gurczak

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[00:00:00] Andy Gurczak: A lot of people wanna be in a hurry. And the agents say, well, I got a guy that's gonna, help you out. He's a, contractor and the adjuster's got a guy and everyone's got a guy and everyone wants to push you to move the claim and keep going, and get it done because the quicker they can settle it, they know it's underpaid the quicker they can close out the claim.

[00:00:17] Andy Gurczak: It's more when it comes to the residential claims, I think a lot of those people with families, they just wanna be back in the house.

[00:00:23] Andy Gurczak: And then at the end they're like, wow, well, we don't even have enough money to fix our house. Well, you were in such a hurry. You just let them do anything. And now you're out of money. 

[00:00:30] 

[00:00:42] Sam Wilson: Andy Gurczak is a public adjuster, recovering investors, tons of money, Andy, welcome to the show. Thanks for having me, Sam. Hey man. The pleasure's mine. There are three questions. I ask every guest who comes in the show in 90 seconds or less. Can you tell me, where did you start? Where are you now? And how did you get.

[00:00:58] Andy Gurczak: started in construction sales fell into adjusting, meeting someone that was already a PA learning the ropes. Since then we've we opened honestly adjusting and it's been like this on my own about over 10 years now. 

[00:01:11] Sam Wilson: Okay. Absolutely awesome. What is just for our listeners? So they understand.

[00:01:16] Sam Wilson: What or who is a public adjuster? 

[00:01:19] Andy Gurczak: Yeah. Easy terms cuz public adjusting, I guess it's when people think public, it's kind of not a turn that everyone knows. I would just easily say it's a private adjuster. It's an adjuster you hire that represents you and your insurance claim and advocates for you.

[00:01:32] Andy Gurczak: Not he's he doesn't work for the insurance company. He's not hired by any insurance company parties. He's only there to represent. 

[00:01:39] Sam Wilson: Is there. And maybe this will be, one of the, one of the things that we were gonna largely focus on in this episode is the dos and don'ts of insurance claims. And I guess, and if we're gonna cover this later, tell me, but is there a right time to get a public adjuster involved?

[00:01:55] Sam Wilson: And is there a wrong time to get a public adjuster involved? 

[00:01:58] Andy Gurczak: I would, we would advise the quicker the better. So for our commercial clients, they call us as soon as something happens, then we file the claim and we do everything for them. They're all hands off. So the only thing they know is once the claim is settled, the amounts and that's it.

[00:02:13] Andy Gurczak: Got 

[00:02:14] Sam Wilson: it. Okay. Okay. Let's dig right in then let's get into the meat of this, which is the dos and don'ts of insurance claims. Can you just break that 

[00:02:22] Andy Gurczak: down for us? Yeah. Dues, if I'm gonna give you your client tips on the dues of claims, when you're filing claim know when you're actually calling yourself to set their reserve side, to actually tell 'em that it's a large claim don't meaning when you're calling the claim, they'll usually.

[00:02:39] Andy Gurczak: How much damage there is cuz they wanna set a reserve for that claim and amount. And what happens is if the Reserve's low and the claim's actually a large claim then to actually go and estimate and negotiate over those limits or the reserves they saved, it goes through like three, four managers. And it's just a long process.

[00:02:57] Andy Gurczak: And it's a very tedious, that's usually a lot of our new clients when they call us, is that process when they call us a little bit too late our reserves were set low. Instead of a hundred thousand dollars claim, now we're at a $300,000 claim and you're going through this whole process of getting, that, that money approved or that claim approved.

[00:03:13] Sam Wilson: So you're saying on the back end at the insurance company, you call in, you say, Hey man, we had a fire in one of our units and I don't know, you're kind of running off the back of a napkin math. You look at it and you say, by the time we get the fire damage remediated and whatever, now water damage to the property and maybe a hundred grand.

[00:03:32] Sam Wilson: And your estimate was way off, but that's what you told. The insurance company said a hundred grand. And so they're sitting on their back end going, okay, we'll tag a hundred thousand dollars in the reserve account for, Sam's claim. And now you're saying that causes problems. When you go back and say, actually, no, sorry guys, we're gonna need about 300 grand, a hundred percent.

[00:03:50] Sam Wilson: Correct. That's really interesting. That's really interesting. I mean, it seems like an insurance claim would be, and obviously I'm wrong, but it just it's, it is what it is, but that's not the 

[00:04:00] Andy Gurczak: case. No they have certain amount of reserves they have to put in when there's a claim filed. When that amount is low, like I said, it hurts your claim going forward.

[00:04:09] Andy Gurczak: So if you're calling a claim and it's a fire, just might as well just say it's a total loss. Even if it's not exaggerate the damage, say it's more damage set, those reserves higher. And that way and then, adjusters also insurance adjusters have incentives to stay under the reserve.

[00:04:22] Andy Gurczak: There's bonuses and their stuff when they say under the reserves. So it's a haul, it's a, it's an entire process. They have it's entire game. They have. So you wanna get off to the right foot. So not only is it, when you call in sending the reserves high enough, but also saying the right stuff.

[00:04:38] Andy Gurczak: So a lot of people, they jeopardize their claims by how they call them in meaning they'll call and. We had a leak in the basement. Well, they might take that, write it down. Then you might get a call a day later saying, Hey, your claim's denied because we don't cover leaks. That's over time.

[00:04:53] Andy Gurczak: Leaks are not covered. Well, you said it was a leak, but tactically, it was a pipe burst, which a pipe burst is covered. Right. 

[00:04:59] Sam Wilson: Gotcha. So it, I mean, it seems like there's a lot of gaming involved in this where it's like, I mean it, should it be that way or is there a better, is there a better way to do this or would you see, do we see a brighter future in this industry?

[00:05:13] Sam Wilson: Or is this just, no, you gotta learn play 

[00:05:15] Andy Gurczak: game. It's only going the wrong way. And the reason is for the local, the staff adjusters all the more experienced adjusters are leaving and they're bringing all these, they call 'em cat adjusters or out of state adjusters. They're bringing those in and just more inexperienced adjusters that never handle the claim, but all they know is they get a piece of paper and say, these are our guidelines.

[00:05:34] Andy Gurczak: We don't pay for this. We pay for this. Right. So then when we come in and we're meeting with these adjusters you're talking about someone that just finished college, that's got a laptop and saying, okay, well, I don't pay for this and we can't do this. And this is not covered. They have no clue what.

[00:05:48] Andy Gurczak: Most of the time, what they're talking about, 

[00:05:50] Sam Wilson: How do you combat that? Like what do you guys do in that process that maybe the, us as just average Joe property owner, just simply wouldn't understand. 

[00:05:59] Andy Gurczak: Yeah. With the experience we have in construction estimating we're always our company, especially something that's huge on our end is knowledge and learning as we go forward is taking more seminars and learning and actually knowing how to combat insurance companies negotiate it, having the right tools to do.

[00:06:18] Andy Gurczak: So, if you, cuz you just can't tell the insurance, Hey, you need to pay for this or you need to do that. Like you have to support everything. So providing those supportive documents is huge. Gotcha. 

[00:06:28] Sam Wilson: That makes a lot of sense. So one of the first things you said here on the due side is on a large claim, just say it's a total loss.

[00:06:35] Sam Wilson: The second thing is to identify actually what happened, not a pipe leak, it was a pipe burst. And then of course getting accurate estimates. There. Are there any other dues on the front end that you say, man, this is something that people absolutely should be doing. 

[00:06:48] Andy Gurczak: Yeah. Mitigate the damage, meaning actually have someone on your team that if you have a fire, they board up the windows.

[00:06:54] Andy Gurczak: If you have a water loss, they extract the water. If you don't mitigate they can deny your claim, that's in your policy. So knowing your policy. And actually knowing what's in there, there's a section called duties. After loss, that's the first thing you should know. That's the first thing we get when we would get the policy from an insurance company.

[00:07:12] Andy Gurczak: The first thing we read is the duties after loss, because there's so many things you have to do to actually make sure your loss is covered. 

[00:07:19] Sam Wilson: That's really a really good advice. That's not a section of the. Of any insurance policy I think I've ever read is what are the, 

[00:07:27] Andy Gurczak: no, I don't think anyone's ever read any 

[00:07:28] Sam Wilson: of their policy.

[00:07:30] Sam Wilson: Actually. I've read a fair amount of it. Cause I kind of nerd out on that stuff. It's like, oh, okay. but I still didn't know that page existed. Like, so clearly I haven't, and that's 

[00:07:37] Andy Gurczak: the most important page. There's usually like 10 bullet points. And it says all the things now they'll pay a claim, even if you don't perform some of the duties.

[00:07:45] Andy Gurczak: But at the end, if it was they, if it went to litigation or it keeps going further in negotiation stuff, they can say, well, you never filed the proof of loss. You never mitigated there's other stuff you didn't do. You didn't, we have claims with commercial properties where let's say it was vacant, or it was under construction.

[00:08:00] Andy Gurczak: They denied it saying you didn't you heat the property. They can deny the claim, right? You didn't maintain heat in the. Right, right. But then there's a clause that technically we can overturn that saying, well, if you're, if the property's under construction, then it, the claim is covered. So just knowing the policy, knowing the duties after loss would highly re a good agent, should be able to explain all that to you.

[00:08:23] Sam Wilson: Right. Right. And that was gonna be, my next question was at what point in time is this the responsibility of the agent selling you the policy to help educate you and say, okay, here's what you should be doing. And then at what point in time is it where you say, all right, you're playing for the insurance team and I'm gonna have to go find my own, private 

[00:08:42] Andy Gurczak: adjuster.

[00:08:43] Andy Gurczak: Correct. And a lot of the leads we get, or a lot of referrals we get are actually from insurance agents especially on the commercial. Because they don't really know the policies. They're pretty comprehensive policies there go there's co-insurance clauses, there's all these clauses and exclusions.

[00:08:58] Andy Gurczak: They sell these policies. It's hard to find a good commercial agent, but if you are gonna start investing to commercial highly recommend that you do diligence, find an agent that can actually tell you, look, well, this is the business I have. I, storage ly is I have this 20 unit, these are all the people and make sure there's coverage for everything.

[00:09:15] Sam Wilson: Yeah. And how do you, I guess, and that's something probably when you work through with our insurance agent is finding them to say, Hey, these are the 25 scenarios. This is what we need coverage for. So that's really, really fascinating. Thanks for sharing the due side.

[00:09:28] Sam Wilson: What are the don'ts 

[00:09:29] Andy Gurczak: What are the don'ts? Let's see here. Don't don't be in a hurry is my number. A lot of people wanna be in a hurry. And the agents say, well, I got a guy that's gonna, help you out. He's a, contractor and the adjuster's got a guy and everyone's got a guy and everyone wants to push you to move the claim and keep going, and get it done because the quicker they can settle it, they know it's underpaid the quicker they can close out the claim.

[00:09:51] Andy Gurczak: That's the number one thing, don't be in a hurry. Our commercial clients are our favorite because they're usually are more, Hey, I'm not in a hurry. I have my own contractors. I'm, let's get it settled. It's more when it comes to the residential claims, I think a lot of those people with families, they just wanna be back in the house.

[00:10:08] Andy Gurczak: And then at the end they're like, wow, well, we don't even have enough money to fix our house. Well, you were in such a hurry. You just let them do anything. And now you're out of money. 

[00:10:15] Sam Wilson: that's really, really sound advice. So don't be in a hurry. What else you have after that? I guess, are there things we should, and shouldn't say, are there people that we are there documents we shouldn't sign?

[00:10:26] Sam Wilson: Are there anything along those lines where you say, and maybe that's part of the, don't be in a hurry thing? Is there just something we should categorically avoid? 

[00:10:33] Andy Gurczak: Yeah, I think just saying the wrong stuff in terms of don't be in a hurry, don't start calling. And because the insurance company, when they, when you call the claim, when you're speaking with them, they'll ask you a hundred questions and they'll record everything.

[00:10:48] Andy Gurczak: And then if you say the wrong thing, then. We get called and say, well, there's this whole trace of, we have to go back and like, look, go through a whole story of what happened in the last three months. Well, you started out with telling them that this happened and that's what got the claim delayed, Deni delayed and now technically denied.

[00:11:05] Andy Gurczak: So no one what to say, and actually maybe consulting someone a PA or an attorney when you have a claim to make sure you present it to an insurance as well 

[00:11:13] Sam Wilson: Give me a case study and they come to mind where you say, Hey, this is what happened. This is how we could, how we helped something 

[00:11:21] Andy Gurczak: like that. was another investor, actually, your area of Memphis, he had a 16 unit building.

[00:11:27] Andy Gurczak: His claim was denied called us was referred by one of his XG students. One of his listeners his claim was denied because they said it was sewer backup and his claim wasn't covered technically. And there's a big tip for all your listeners. If they ever a claim where it's sewer backup and they don't have sewer backup limit.

[00:11:42] Andy Gurczak: Well, sewer backup is sewer that backs up from usually the sewers, like the streets or, overflows or something. Most of the time it's called it's called a soft clog, meaning something actually gets clogged in the pipe. That's why the pipe overflows. Okay. That's covered under your main limit.

[00:11:59] Andy Gurczak: So that loss, for example, that case study, that loss was denied. Cuz two of the units got damaged. I think we finished at 70,000, so he had zero denied after months of fighting with them. And then we ended up finishing a claim at 70,000. 

[00:12:11] Sam Wilson: Wow. And what did you call that? A soft clog versus a sewer box soft.

[00:12:16] Andy Gurczak: Yes. So the two, no, two different things. Soft clog and sewer backup, two different things. 

[00:12:20] Sam Wilson: That's again, it goes back to just the nuance of this where it's like, we, I feel I'm not the sharpest knife in the drawer. I freely admit that, but it's like, there's it just, there's so much nuance to this. That's like, this should seem seemingly be more straightforward where it's like, there is sewage.

[00:12:36] Sam Wilson: In our building, but how that sewage got there or what caused that sewage to get there is the difference between $0 from the insurance company and $70,000 from the insurance company. And how do we as commercial real estate investors educate ourselves on that? I mean, cuz again, you said these policies are hyper nuanced, right?

[00:12:57] Sam Wilson: What should I be doing to make sure that I understand this on the front? So, 

[00:13:02] first 

[00:13:02] Andy Gurczak: of all, the policy is written for the consumer, right? So it's not supposed to be written as an attorney is supposed to interpret it. It's supposed to be easy to read, but they're never easy to read. They're so complicated.

[00:13:13] Andy Gurczak: Even when we go to read them, we're, we're looking 'em up and we have definitions. Cause they're very confusing. Yeah. So, so they're not written in your favor. Also, the adjuster is supposed to have eye for coverage. They it's what they used to call an eye for coverage. They technically were always stopped that, they had an eye for coverage, meaning they want, they should always look to cover your lumps.

[00:13:33] Andy Gurczak: But once insurance companies took the, took in the McKinsey model and I don't wanna get into this whole Allstate McKinsey thing, but they accepted this model McKinsey model of how they handle claims. Now, most claims are denied. They're never looking to cover. Instead, they're more looking, okay, what's this.

[00:13:50] Andy Gurczak: Or how can we deny this instead of how can we cover it? That's every claim how we see going now is it's. How can we deny it instead of how can we cover it? Then we have to come in and look at, okay. That pipe there was leaking. Well, was it leaking over time? Did something hit it, did it how to burst. You just have to find the real culprit to see and then to see if there's coverage in the policy for it.

[00:14:12] Sam Wilson: that is absolutely correct. And then that's, and that's one of the things, I guess, that as business owners, as real estate investors, that's really frustrating in this space is, and again, I was signing a policy here for our renewal on a commercial building and I just started reading through it and I got halfway through.

[00:14:27] Sam Wilson: I'm just like, I don't understand what I'm reading anymore. Like, I don't know, this is I, 

[00:14:32] Andy Gurczak: they get fine. I mean, they get those commercial. That's why I say, four unit lasts the residential, those policies, just, they're, I dunno 60 pages, those commercial ones. I mean, they get thick, those binders get thick.

[00:14:42] Andy Gurczak: I mean, there's a lot in them, 

[00:14:43] Sam Wilson: a lot in them. And by the time I feel like it's a, it's a spider web of like, You know if this, then that, but that then, and by the time it's all done, it's like, I don't know. This is a ball of, exclusions and things that are covered that I can't even begin to remember.

[00:14:56] Sam Wilson: So I guess 

[00:14:57] Andy Gurczak: your point, when you say education learning or where can you, there's really, it's hard because everything's so skew. If you go online and say, do I need a public adjuster or should I hire a PA you'll find half articles. Yes, all good. And then half bad. And those bad ones are all written by insurance companies.

[00:15:11] Andy Gurczak: No one even tells you that you can hire a PA. A lot of people don't know there's actually a private adjuster. You can hire to look over your claim and you don't even have to hire us. You can just literally have us look over your claim to see. It was, I went to one yesterday was a fire. It was a friend that called looked over the claim.

[00:15:25] Andy Gurczak: I'm like, there's a couple of things missing, but I'll give you the tips and advice. What you tell 'em to get it paid. There's nothing else for us to do. I'm just saying it doesn't hurt to call because the good PAs and the ones that , are very knowledgeable, don't look over a claim like our firm doesn't take on a claim unless we look over and make sure we can bring value to it.

[00:15:40] Andy Gurczak: So I can't bring value to Sam then there's, then there's no need for us, or I'm not gonna waste your time or you're gonna waste Neil waste each other's time. 

[00:15:48] Sam Wilson: Absolutely. And that brings back us to the last question. And maybe this is , Too granular, too personal to have on a podcast question, but I guess I gotta ask it, how do you guys get paid in this process?

[00:15:59] Andy Gurczak: Yeah, PA usually charges between 10 to, 10, 20, 20 5% depending. We cover 12 states. So we've just taken the model of 10% across the board. When we do commercial en large, we have a scale that drops down the percentage from 10 to after a million dollars. It's 5% we cap it, , for like really large claims for our larger clients 

[00:16:19] Andy Gurczak: but that's our firm. Again, everyone does it a little bit differently. , we do a flat 10% and like I said, when we do the large claims, then we have a scale that kind of goes down based on if the claim is to reach a certain 

[00:16:30] Sam Wilson: amount. Right?

[00:16:31] Sam Wilson: No, I love that. That's great. Last question for you here, Andy.

[00:16:35] Sam Wilson: If someone were to come work with your firm? What makes them a great client for you guys that you say, man, that's somebody I really wanna work with. 

[00:16:41] Andy Gurczak: Someone that trusts us, someone that when I talk to says, Andy, I just want you to handle that claim. Just settle it, handle everything for me.

[00:16:50] Andy Gurczak: Just let me know when we're done here. Let me know the amounts. That's the best client, the client that is the client. That's worried about the percentage upfront, what they have to pay or what's our. Those clients right away. I can tell you then let's not work together because the value I bring to you, literally, we can charge over 50% on each claim and you'd still be better off if you didn't hire us.

[00:17:11] Andy Gurczak: Right. 

[00:17:11] Sam Wilson: That's the. I love that. And that, that, that's a fair and honest reply. And I appreciate that. Cuz everybody has in their own industry, whether you're a broker, whether you're a buyer, a seller, there's like people you wanna work with. And then there's people you're like, Hey, this just isn't a good fit in a good fit for us.

[00:17:26] Sam Wilson: So certainly appreciate your transparency and commercial 

[00:17:29] Andy Gurczak: clients. Like you saying, you guys invest in commercial and your listeners are our favorite. Because they usually have their own team of contractors and roofers all their whole team. So when we come on their team, we're just in charge of getting their claims, paid fully, making sure they have all the money, then they get their own guys.

[00:17:45] Andy Gurczak: They're not having the insurance company take all their money and do their work. Right. So it works out in, it works out in their favor. 

[00:17:53] Sam Wilson: That's awesome. Andy, thank you for coming on the show today and taking the time to break down what a public adjuster or private adjuster is, how you guys work.

[00:18:02] Sam Wilson: What, how you guys get paid, what to do, the right things to do the wrong things to do. And really, I guess bringing a little clarity perhaps and saying that, the industry is just pretty confusing as it is, and there's probably not gonna change any time in the future, but at least you've given us some, some tips and tricks on how to navigate, how to navigate those murky waters.

[00:18:20] Sam Wilson: So I certainly appreciate it. If I, if our listeners wanna get in touch with you or learn more about you, what is the best 

[00:18:25] Andy Gurczak: way to do that? The best way for your listeners. What I'll do is I'll leave you my, my personal cell phone. If any of your listeners wanna call me or text me I'll leave in my cell phone.

[00:18:34] Andy Gurczak: That way that's the quickest way they can save that number in their phone book. Cause again, you might never need me. Or you might have two claims in a year, so, if they want to save my phone number, it's seven oh eight six five five four one eight six seven oh eight six five five four one eight six.

[00:18:48] Andy Gurczak: And that's literally my cell phone. They call me, text me. They have any questions I'm more than happy. I'm very open to helping people, so 

[00:18:54] Sam Wilson: that's awesome. Andy, thank you again for coming on today. I certainly appreciate it. 

[00:18:59] Andy Gurczak: Appreciate it.

 

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