# Insurance Invoice



## RBR (Feb 26, 2008)

Have a new situation re: insurance work...

Carrier sends a CAT adjuster out and he tells me that they are not allowed to include O & P on the estimate even though we have about 6 trades going. But, then he says I could invoice for it later if I want.

Anyone have any experience invoicing for O & P after the work is completed? Usually, I can include O & P without any problems....my feeling is that the CAT unit are trying to keep the claims down (obviously), but I cannot tell if this adjuster is letting me in a secret or just trying to pacify me into accepting no O & P....

Ray


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## larryb (May 23, 2008)

RBR said:


> Have a new situation re: insurance work...
> 
> Carrier sends a CAT adjuster out and he tells me that they are not allowed to include O & P on the estimate even though we have about 6 trades going. But, then he says I could invoice for it later if I want.
> 
> ...


The CAT adjuster is simply trying to pass the buck and hopes you won't bother after the fact. Carriers (and adjusters/claims deprtments) are becoming increasingly aware that they need to pay O&P on 100% of each ins job (without deducting for 1 trade, usually roofing on exterior work) based on the reality that full O&P is actuarily figured into the premiums charged to their customers/insured's.

CAT guy is probably using Xactimate which does allow the adjuster to input for full O&P. And, make sure you charge O&P the right way, not the way that insurance companies attempt to pay it. And, make cure you are charging RTA rates rather than lowball Xactimate rates. 

FYI, if you are using Xactimate (or similar), you are cheating yourself. If you want a contractor friendly alternative that doesn't cost you an arm, leg, foot, feel free to PM me (no add's here).

Want to be paid proper O&P on every job? Ask and you will (should) receive!


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## Boz (Jun 20, 2012)

I would like more info on your experience and the O/P issues as they relate to insurance claims. Insco's across the board routinely deny O/P to G.C.'s , I would like to open dialog on this issue and your experiences


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## CompleteW&D (May 28, 2011)

It's been my experience that if you try and work with the adjustor and present a concillitory (sp?) attitude rather than being confrontational right from the start.... you will get your O&P. 

The last company I worked for before I started my own, there were two of us sales guys named John. On a big CAT 5 storm in 2006, it was all insurance 24/7. Well, the other John was a former hammer swinger and took the attitude that he knew it all and every single adjustor was out to screw him. And, he would try and get all kinds of things bought that weren't even storm related. IOW, he would lie through his teeth and then scream bloody murder that he knew what was needed more than any adjustor through the entire process. 

Every time I called the State Farm claims center to discuss a project and identified myself as John from Majestic Home Improvement, I would hear this deflated Oh.... and I would say, no.... I'm the _OTHER_ John and the whole tone of the call would change. Most of these guys are smart enough to realize that you're a businessman and are not out to try and take advantage of them or the insurance companies. When they realize that.... they are way more apt to work with you on all aspects of the claim including O&P.


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## Astrix (Feb 23, 2009)

The Insured is not supposed to profit from the claim. That is where the idea of not paying for O&P comes from. On the flip side, the Insured is not supposed to lose out either. The insurance principle is that you are to be put back into the same position as you were in just prior to the loss; no more, no less.

The insurance contract is between the insurer and the building owner. It is not between the insurer and you, the contractor. Therefore, if the owner has to pay the contractor a certain bottom-line price that includes overhead and profit, then that bottom-line price is what the insurance company should be compensating the owner for.

I'll defer to larryb as I am not an adjuster or claims expert (I work in the risk management side of the insurance business; advising clients on what coverages they need, etc.). But, in my experience, adjusters will change their viewpoint on claimable items if this is explained to their satisfaction. They are not there to try to weasel out of paying, but it is their job to make sure they only authorize justifiable payments.

Similar, but different, I do recall a claim which occurred on a job in progress (covered by a contractor-purchased builder's risk policy). In this case, the contractor was the Insured, and not a third party building owner. The contractor wanted to do the re-construction, and the insurance company originally stated that they could not claim profit on the 2nd construction. 

Our brokerage stepped in to help out by making the argument that the insurer had a choice. Our contractor would not do the work for no pay. So, they would have to get a 2nd contractor to come in which would be entitled to include a profit margin in their work. Plus, they should note that this 2nd contractor would be more expensive then using our 1st guy because they would have to mobilize their own equipment, etc., whereby our guy was already on site. So, in the end, it would cost the insurer more. They changed their mind, and our contractor did the re-construction and received their rightfully earned profit on the job.


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## Boz (Jun 20, 2012)

Who has an arguement FOR the O/P that causes INSCO to lean towards payment of the O/P


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