Professional Documents
Culture Documents
§
Plaintiff
§ GALVESTON COUNTY, TEXAS
V.
§
TEXAS WINDSTORM INSURANCE
§
ASSOCIATION, PACESETTER
§
CLAIMS SERVICE, INC. AND BLANE
E. BERGAN,
Defendants
§ 56TH JUDICIAL DISTRICT
VAAO,'@@o Nxa A 4
M. Scott Incerto
State Bar No. 10388950
Katherine Mackillop
State Bar No. 10288450
Fulbright Tower
1301 McKinney, Suite 5100
Houston, Texas 77010-3095
Telephone: (713) 651-5151
Facsimile: (713) 651-5246
PLAINTIF S"
352104M. I
McLEOD, ALEXANDER.
POWEL & APFFEL, P.C.
David P. Salyer
State Bar No. 7549680
Ervin A, Apffel, Jr.
State Bar No. 1278000
802 Rosenberg; P.O. Box 629
Galveston, Texas 77553
(409) 763-2481 Telephone
- Facsimile
(409) 762-1155
-
CERTIFICATE OF SERVICE
This is to certify that on September 8, 2009, a true and correct copy of the
foregoing was served by certified mail, return receipt requested, upon Plaintiff s counsel.
A T. Schrarnek
852104M.1 2
- -
INITUL OBJECTIONS
I
Thc "Definitions" state that the interrogatories cover a ten-year period. A
period for discovery makes each of the interrogatories overly broad and
ten-year
burdensome and would result in requests for information that is not relevant to the issues
information. Unless stated otherwise in any given response, Defendants will respond
with respect to information dating back to one year prior to Hurricane Ike.
inconsistent with both the Texas Rules of Civil Procedure and the neaTowly-drawn and
included within the definition of "Defendant," particularly in light of the exemption from
discovery contained in Texas Rule of Civil Procedure 193.3(c). Defendant will define
"Defendants" as TWIA.
its many different computer systems, servers, and databases and are, accordingly, overly
broad and burdensome. Defendant further objects as overly broad and burdensome the
without limitation backup tapes intended for disaster recovery; legacy data from obsolete
3
85210409.1 - -
("PDAs"); and mobile devices including cellular phones. Defendant further objects to
the production of data in its native form because the integrity of such documents cannot
To," "Concerning," "Communication," "Pertains To," and "Pertaining To," are overly
broad, and make each of the requests for information unduly burdensome and as a result
ask for information which is not relevant nor reasonably calculated to lead to the
discovery of admissible evidence, and are also inconsistent with the Texas Rules of Civil
Procedure. Defendants will give these terms their ordinary meaning in accordance with
common usage.
therefore making each request unduly burdensome and seeking information that is neither
Defendant will give these terms their ordinary meaning in accordance with common
usage.
85210409A .4 -
INTERROGATORY NO. 1:
Identify each of TWIA's members for each year for the last ten years.
ANSWER:
Subject to and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant responds as follows:
INTERROGATORY NO. 2:
Identify each of TWIA's board members for each year for the last ten years.
ANSWER:
Subject to and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant responds as follows:
INTERROGATORY NO. 3:
State whether TWIA paid property taxes for real property or business personal
property for each consecutive year for the last ten years and the amount of property taxes
paid.
ANSWER:
Subject lo and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant further objects to the portion of the
interrogatory asking for the amount of property taxes paid and the years in which any tax
was paid because such information is irrelevant and not calculated to lead to the
discovery of admissible evidence. Subject to and without waiving its objections,
Defendant responds as follows:
TVIIA has not paid real property taxes but has paid business personal property
taxes.
85210409.1
INTERROGATORY NO. 4:
TWIA paid federal income taxes in any year for the last ten years,
State whether
and if so identify the year and amount paid.
ANSWER:
Subject to and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant further objects to the portion of the
in which any tax
interrogatory asking for the amount of property taxes paid and the years
was paid because such information is irrelevant and not calculated to lead to the
discovery of admissible evidence, Subject to and without waiving its objections,
Defendant responds as follows:
INTERROGATORY NO. 5:
ANSWER:
Subject to and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant further objects to the interrogatory because it
improperly attempts to force TWIA to marshal its evidence. See Tex. R. Civ. P. 197, cmt
1. TWIA refers Plainiff to TWIA's Motion for Summary Judgment and Response to
well
Motion for Summary Judgment filed in this case concerning sovereign immunity, as
as any amending or supplemental briefing. Subject to and without waiving its objections,
TWIA responds as follows:
INTERROGATORY NO. 6:
ANSWER:
Subject to and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant further objects to the interrogatory because it
P. 197, crnt
improperly attempts to force TWIA to marshal its evidence. See Tex. R. Civ.
852104WA - 6.
1. TWIA refers Plainiff to TWIA's Motion for Summary Judgment and Response to
immunity, as well
Motion for Summary Judgment filed in this case concerning sovereign
as any amending or supplemental briefing. Subject to and
without waiving its objections,
TWIA responds as follows:
INTERROGATORY NO. 7:
Identify by name each lobbyist employed by TWIA in the last tcn years and the
ANSWER:
incorporated herein
Subject to and without waiving its initial objections, which are
by reference as if fully restated, Defendant finther objects to the to the
portion of the
irrelevant to this
interrogatory asking it to identify the amount paid to each lobbyist as
admissible evidence. Subject to and
case and not calculated to lead to the discovery of
without waiving its objections, TWIA responds as follows:
Hunter &
TWIA has retained, including in the year 2007, lobbyist Todd Hunter of
78478, Phone
Handel, 555 N. Carancahua, Suite 1600 Tower II, Corpus Christi, Texas
(361) 884-8777, Fax (361) 984-1628.
INTERROGATORY NO. 8:
State whether TWIA or TWIA's employees have accepted a gift in excess of $500,
the identity of the donor, identity of the recipient, description of the gift and the purpose
therefor for each gift in the last ten years.
ANSWER:
incorporated herein
Subject to and without waiving its initial objections, which are
because it
by reference as if fully restated, Defendant finther objects to the interrogatory
and is not calculated to
asks for information irrelevant to the issues material to this case
lead to the discovery of admissible evidence. Defendant further objects that the
it mks for all gifts given to
interrogatory is overly broad and unduly burdensome because
and would include gifts exchanged
any TWIA employee from any person in any context
between family members. Subject to and without waiving its objections, TWIA responds
as follows:
7
952 1
OM. I
- -
INTERROGATORY NO. 9:
State the amount of money TWIA received from the State of Texas' general
revenue fimd in each year for the last ten years.
ANSWER:
Subject to and without waiving its initial objections, which are incorporated herein
by reference as if fully restated, Defendant further objects to the interrogatory to the
extent it asks for the amounts as such inforrnation is irrelevant to any issue material to
this case and not reasonably calculated to lead to the discovery of admissible evidence.
Subject to and without waiving its objections, Defendant responds as follows:
Since 2007, TWIA has received money that would have gone into the General
Revenue Fund as a result of premium tax collections but was sent to TWIA instead (with
such taxpayers receiving a premium tax credit for such payments).
85210409.1
8
- -
THE STATE OF TEXAS
COUNTY OF TRAVIS
BEFORE ME, the undersigned authority, on this day personally appeared Jim Oliver, on
behalf of Texas Windstorm Insurance Association, known to me to be the person whose name is
subscribed to the foregoing and after having been duly sworn stated on oath that with the
exception of intemptoiiis atioii@@6n-s-wl'ilik@-ow-,Ial,g-e id iihwa-it F"I ui-af -W--Iii@i W-, 8"- fail!'
contentions, and answers based on information obtained from other persons, the above answers
to interrogatories are true and correct.
9.
From: Reggie Warren
Sent: Wednesday; July 16. 2009
To: GaM Kaufman
Thanks for understanding Garry and I agree with your approach and suggested response to Molony. We do our best to make solid decisions about all
aspects of claims handling. That includes being fair and honest with vendors.
Reggie
_-Original Message----
From; Kaufman [mailto:Garn,.Kaufmana)gia-tx.comI
Garry
Sent: Tuesday, Julv 15, 2008 7:31 PM
To: Reggie Warrcn
Subject: RE: Tim Molony
Thanks that helps a lot. I was not going to call this guy back because I
knew why he was calling mid I told in@ assistant if he called again Loll him lie
...
needed to speak with you. On his last call he said he had already spoke with you so I figure he wont stop calling until I call him back and tell him he
has done all he can do and I can be of no help.
Does be not know you are the Claims God and your word is the final word'? I will make sure he knows that. I
hate it when people try and go
Garry
Garry P. Kaufman
President
Galveston Insurance Associates
Galveston League City
(409) 740-1251
(281) 442-7663
Fax (409) 740-0513
vvwwgia-vzom
Please remember that insurance coverage cannot be put into effect or changed via messages on our email or voicemail systems.
CONFIDENTIALITY NOTICE
The information contained in this communication, including attachments is privileged and confidential. It is intended only for the exclusive use of
the addressee. If the readcr of the mcssagc is not the intcnd cd recipient, or the employee of agcnt responsible for delivering it to the intcndcd
recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received
this communication in
error. please notif us by telephone iiiiiiiediatelN.
Garry,
1,&. Molony is well aware of our procedures of selecting and using IA firms to handle TWIA and TFPA claims. Quite frankly, I am very surprised he
onLacted Oli@, er. I had previously explained
lids contacted you about this. He contacted Craig Eildnd about Us less than a year ago. He also c
everything to his marketing person and thought he and she understood. Apparently he feels the way to get approved by TWIA is to make a political
end-runandwecannotdobusinessthatway. Wetreatallqualified]Afirmswithfaimessandre.Tect.butNAecanonlytLse@.;olnanyegpeciallyduring
non-cat periods.
His firm is on the "Cat List" but there are other firms ahead of his fum if and when the tune comes to add another dedicated firm to handle our
claims. I can discuss with you our philosophy about claims handling and the balancing of adjusting resources if you like ............. it is too long for an
email.
PLMPMFPS TWIA-Instit-00015139
EXHIBff
Deggie Warren
Om: Reggie Warren
Nday, September 19, 2008 `12:36 PM
sent:
To- Reggie Warren
Subject: Hurricane IKE Adjusters I Borro%ving or renting adjusters
All,
TWIA
Presently, 36 adjusting firms have committed various numbers of adjusters to handle only
and/or TPFA claims. We are assigning these claims by territory to each
firm based on the number of
adjusters on it's list and the capability of those adjusters (commercial, residential, complex losses
etc.).
We have recently gotten reports that some firms did not actually have the adjusters they
firm making
promised they are having to borrow them or rent them through another source/ A
............
some sort of special deal.
firm, total
We cannot have thisl If we assign losses to your firm and you re-assign to another
and it was
control is lost at our end. think most
I
of you have seen this happen in other storms
ineffective causing many delays and litigation issues.
RI
I
know which firms are doing this. Please stop
let us know.
If cannot handle the number of losses we are sending, be professional and
your firm
A couple of firms have done this and that
We can stop or slow down the assignments as necessary.
means a lot to me and TWIA.
Thank you,
Reggie Warren
TWIA Claims
Austin, TX
512-899-4902
:',NT
PLAINT1 FF
@ki;;,
-EXHIBrr
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TWIA 1nstft_Doooo261
TWIA/TFPA Claims Organizational Chart
Reggie Warren Vp Clours
TW A IF
- PA
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Bill
C01.1rorne
Knots
-
office
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McFix lin
0991'.
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Rus3ell Slow
-
TFPA
CI lips
Stis1r. Sch*
CoordilolallDr
-
Manager. TV1 Ilk clai,Z @;Yies
- .
stem -
General Au'urlef,
TFPi
I racy Todd C'.1itins
CucMdoilo.,
- TMA
Sara i Ryon
CI-
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EXD,Tvner i
Gayle N Alan Remlum- -
cl Cloom Suporsw
7VVIA
- Clainis
Coordino C-Aeg ;Resnick
TY111A, Examiners TFPA
MY Recn Cut,=
Examiners
- TFPA
I
Kristin Jahren
Claims CLOOMS
Coordinotor TFPA
PLA1NMFFS:7.",--'..
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TWIA-instit-00001824
Primary Adjusting Companies
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Ai". TX 79333,0426 3W.B64-82bb OWAW @600-415-1773 125
ROYCA 678.578-7215
Bud Tftw: 404-705-6407
Jay CmpWIl 4n&.%&i XIO
678-W7-5536
1ay_FawWb@1I0us.c".-@o.c-
3144-69-0100
:c&4 314-308.0477
4 Ct&WfCrd .3100 S.
Geuper Suite 500 Hwston.TX 784864276 713-780-962B '71.3-M8M 5U506%4 simpsmaus
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From: Bill Knaff
Sent: Friday. February 09, 2008 06:51 PM
To: Bill Knaff
I
Subject: TWIA Dedicated Adjuster Program
FW@ (DAP)
and Maint Fees 2007 revised.doc-1
Daft
Fee Schedulel.doc Feb 07.doc;
Attachments:Fee Schedule1dcic Feb 07.doc,
Fee ScheduleIdoc Feb 07.d0c1-
Fee-Schedule4.doc Feb 07.doc
Original Menne--
From: Renle Warren
To- WI Knarr
--Original Message---
from: Renie Warren
'bliff9wardiewvdaims.com!; 'rrathdOwardleviclairm.conn'; Johniliwardiwridams.corn Kevin McFarllm; Kaby Wilmn; Susan ScWller, Courtney Frerich; Gene Kounge; Gayie
----
Needham, Bill Knarr
All,
I
hope things are going well for earch of you.
I
enjoyed seeing you at the annual meeting in West Columbia. Next year, we will have a meeting of the principals only. More
information about next year's meeting will be provided late this year and early next year.
The 2007 hurricane season is upon us. The forecast is for an active season. We hope that that your adjusters are committed to this
programandthatwecandependonthemilTexasgetshit. Yoursupportofthisprogramisverymuchappreciated.
Also, attached are our four (4) adjuster fee schedules that WU be In place for this season. We will decide which schedule to use after a
cat event. Each schedule contains two (2) pages. You are free to share these with our Dedicated Adjusters.
In addition, wanted to let you know that Bill Knarr (previously with GAB) who many of you know is now working for TMArFFPA
I
as
He ha3 essenfially taken Joe Rosentritt's position even though we hope Joe will still come In to help, We
Catastrophe Office Manager.
are very glad and fortunate to have bill and his extensive knowledge of the claims business.
Please make certain your adjusters are aware of how the DAP program works and the commitment we expect from each of them.
Reggie
KANn
A B C D E F G H
MAJUNGAODRE" (MMILING) PHY3ICft ADDRE33 @(PHYSIG All@j PHONE FAX number CONTACT
89 VincerW 281-350
2 AILJ
PO B-73085 TX 77273 Z12 Ponnb.W 4ou0-, TX 7701110 281-872.5555 231.872-4443 C6fyvrICfpv:28I-374-W
Richardhilly" 3514
cVI 301-227-S300
3 Brush PO Bcv,126 TX 7&133-0428
Ahce@ 3611416-1773 381-854.8-2-55 74.29MI56 MM: aDC-416-1773
2114-792-0208
Callasuophe 972-073011641 *c*1Qcmtczl..orn
4 Specialist In& JCSI)
Rod@AIIJX75087 'Rockwell,
500TurftCcwAW,5.fe1I0_ AM Tune Cam SW, Sutio I 10 TX 75037 K13-2115-7057 972473011158 75-262OG411 Ron Garmon
Ruy Cifps @076-576-7
Sual Trice A04-7054M
Joy Caelpbtaf A04-3
Robert9boven: 3
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314-3064417
5 .31 S. SW TX 78496275
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C~na Suite Houston, 713-7809528 713-28&6835 5&050655A f0bed 5WrV%on@UIL.CM.C
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08104r2OO9 PWe 4 of 4
From: David Dicks
Sent: Tuesday. February 10, 200-9
Alan Renshaw; Amelia Key
Ben Glover; Bill Astin:
Bill Hooper: Bill ]ones;
Bill Tassin, Bob Inmon,
Bob Latta; Bob Parrish;
Brad Short, BrwidiVanderneut.
Carl Brown, CathySanders;
Cathy Weidner CharieneCoker-
Chris Zimoro%%,icz,, ChristopherWhite,
Clay Tinnell, Corey Crawford;
Cory Kendrick:- David Dicks;
Dean White, Demian Kolb,
Dennis White; Diana Orta:
Don Fielder, Don Turner.
Donna Giover, Duncan St. Clair-,
Franz Hughes Gene Latbam.
I-
All.
Thdnk you!
David
PLAINTIFFS-"
TWIA Insth D0006608
Cat Plan Additions/Revisions July /August 2007
The DAP is a significant part of the overall catastrophe plan. The purpose of this program is to
secure a sufficient number of qualified adjusters through Independent Adjusting Firms (lAs) that
will be committed to helping TWIA and its policyholders after a significant storm event. These
adjusters must be committed to responding if and when TWIA activates the DAP. They must be
further committed to remaining near the storm site to handle claims for as long as necessary.
This program began in 1997 with five (5) adjusting firms providing ten (10) adjusters each. Due
to growth in policy count and exposure over the asl ten (I 0) years, this program has been
I
increased to ten (I 0) firms with each providing twenty (20) to twenty-five (25) adjusters
japproxinwle?l, 220 as ofJuly 20071. While this is not enough adjusters to fully handle a major
cat event at Galveston or Corpus, it is a good nucleus. The DAP firms plus other firms on our
Cat List have committed to providing additional adjusters outside the DAP if we need them.
The adjusters will work for the IA firms and not directly for TWIA, in most cases. There could
be instances where TWIA hires a DAP adjusters as contract workers to perform various tasks
consisting of claim file supervision, auditing of files and reinspections. These adjusters could
also assist with particular disciplines such as salvage, subrogation, ALE claims, PP/BPP claims,
131/EE claims and/or complex, larger losses.
TWIA determines when to activate the DAP and communicates this through pre-identified
principals at each of the firms. Upon activation, the principals Will contact the adjusters and start
them on their way lo the storm site. The principals will maintain control of their adjusters and
will have them on standby awaiting an orientation meeting and loss assignments.
The DAP adjusting firms will be paid on a TWIA Fee Schedule, per file. The adjusters will
receive a Daily Rate after they arrive until they receive loss assignments. After receiving loss
assignments, they will each receive a retainer fee to help with their expenses as long as they are
handling only TWIA claims and/or until released by TWIA. These fees are all decided at the
time of the storm and are paid to the IA firm who is responsible for paying their adjusters.
TWIA is not involved in the fee arrangements between the firms and adjusters.
Each year, we try to enhance the program to make it attractive fbr qualified adjusters. We have
regular seminars for the adjusters and principals, which provide education and entertainment.
The DAP roster is maintained by a TWIA Claims Coordinator, College IntenVClerk and the
Catastrophe Office Manager.
is likely additional, qualified IA firms and adjusters will be asked to 'oin this
As TWTA grows, it
program.
PLAINTIFFS
TWIA-instit-00005811
From; Bob Tant
Sent: Wednesday, October 0 1, 2008
To: Reggie Warren
With the utmost respect for your busy schedule, I am just Following up with you on Your claims alignments. TIA claims is a texas adjusting
witip,nny with Texas adjusters who can stay here Iting term Lo clean up claims. We have. a cut office established at Houston fur Ike Our
corporate offices are in Dallas and in Colle Se station.
We are really hoping we can get some work from the TWIA on this storm, so
and having to aive out work Lo companies outside ofTcxas.
"I
we can be on your roster. We know that TWIA is swamped
We would like to have the opportunity to get some claims also. We contacted FWIA
earlier in the year, before Ike hit and after Ike hit, and were told you were all set vtrith adjusters.
Since then, we are hoping that the situation may have changed as we am talking with small companies from outside of Texas who are getting new
clainis froin TWIA who were not on your vendor list a few weeks ago. So this is why I
ain following up wilth you. We aic hopuip we would be
given a chance LL, handle claims in our own brickyard.
I have Texas adjusters who havejust finished up in CA, Florida and lAmisiatur that I
car) put to work inuriediately handling homemuiers or
commercial wind claims for I'WLA.
Munk you for ots offer to provide adjusters to luindle IKE losses rot Texus Wind,.Lonn Insurance Associtition (TWIA).
WC are doing our best at evaluating our needs. Some firms and adjusters are in place handling our claims but we are not certain if we have
ennugh.
For two weeks since IKE, we have received many losses and they are still coming in. but at a much slower pace the last couple of days. It is
expected that the pace of new losses will pick up again, but who can be certain.
We also realize how difficult it is for you to retain and manage adjusters.
As,6N,edetemiineotirneedsgoingforward,ilmo5-benec,essaryloaskforadjusterstromyourfirin. Wexillunderstandifvotilvivenonelefiand
that they we all on assignment elsewhere. Our goal is to balance the number of losses for each a4juster and IA firm so they have enough to make
some money. That is very tough to do as you know.
Your inquiry and offer does not go unnoticed arid it is much appreciated bY TWIA and me.
We will let you know when we can if we need morr, adjusters.
Sincerely,
Reggie Warren
VWIA Claims
Austin, TX
!A';.
PLAI"FF&I
rr
•
If IKE takes its present projected path, It could heavily involve 3 of the largest populated counties insured by
TWIA-....Brazoria, Galveston, Jefferson.
•
It could also bring in Houston which has windstorm coverage through TFPA (50,000 policies about).
• So, TFPA Claims is having to gear up and get ready also.
• We should expect to work this weekend, Sat and Sun 9-13 and 14. This all depends on the landfall of the storm and
the workloads
• Work hours will typically be 7:30 am to 6 pm but could change as warranted.
• We are moving the Texas FAIR Flan ClWrns Department to Om front (east end) of the building.
• TWIA Claims will then encompass the area where TFPA Claims is now.
• Russel's new office will be where the NOTLIS training room is currently. Russell's current office will be vacated for the
time being.
• The NOTUS training room will move to Tom's old office in the corner next to Tina Frank.
• Kevin will need to coordinate with Tom on the move of the "Ining room.
• A new set of fax. printer and copy machines will be placed in TFPA Claims! new area up front
• We may need to have another set of machines over by where Carl Brown and Jim Coggin are. if we need to put more
cubicles back In that area. (We would have to move all the fling cabs etc. back in that corner first).
• We should have 2 new temp data entry persons this morning 9-1 1.
• Two more temps for tomorrow, one data entry and one to help Gayle, Norma, Susan, Courtney
• Knarr is keeping a list of temporary support staff to incJude LaJean Warren (part time), Nancy Hrin, Patty Knarr,
Wendy Scarborough.
• We will have others volunteer to work for data entry. maybe Kevin McFarlin's wife, Jim Murphy's wife, Russell Stoufs
wife.
• We will also have volunteers from other departments who can help us before hours, after hours and weekends. Wes
Koehl who works with Lee has volunteered. There will be others from TWtA Underwriting, TFPA Underwriting,
Accounting. We will get a list from each department and Knarr will keep that
• We will be having additional claims supervisors come in in stages for training on Notus etc. Knarr keeps up with this.
Scolty and Woody are return along with some new persons.
• These supervisors wig be in the cubicles vacated by TFPA Claims plus possibly scattered around the building.
The data entry persons will be on the row of cubicles across from Joe, Terry and Ray. The volunteers firmn other
departments may need to work from their personal desk. This will require the NOTUS software to be installed on each
work station.
• Parking will be an issue. There is available parking in the southeast portion of the complex near UNISYS and
hopefully some more parking will free up in the rear (west side) of our building. Apparently members of the adjacent
church park there now.
• Tom and Donna have ordered chairs for the cubicles and phones. IT is installing workstations in most all cubicies
around the building.
• We should have an ample supply of checks and file folders to start out.
• We will leave the large filing cabinets in the middle of the floor and may need to use some more back in the
Operations File room.
• We will discontinue the moWe- office unit in South Texas (Dolly) and move it to a stragegic and visible point near
where IKE makes landfall, to be determined.
We may need 2 mobile office locations depending on landfall i.e. GalvestDiall-louston area and Beaumont ar, -
.............
(hopefully not Corpus too)
We have a motor home and 2 trailers for living quarters available. Turner and Hooper will continue to man the mobile
office. We may need another supervisor to join them at some point
We have made many contacts with adjusting fillms, in advance. getting adjuster numbers for standby. This is Dur
TWIA-Instit 00000247
fourth We have been promised many qualified adjusters and some inside supervisors-
time to do this this year.
15 other firms. And, we may have to reach out
• We have the 12 Dedicated Adjuster Firms and have reached out to
further. We have competition for these resources, espiedially in the aftermath of Fay, Hanna and Gustav.
landfall is made and then communicate that to the
We will do our best to determine adjuster resource needs once
firms.
license info etc.. Plus the princpals
• We *11 then need full lists by firm of each adjuster, phone#s, email addresses,
names. phones etc.
IKE for each IA firm.
• Our system iWill need to have the CORRECT information for
Hopefully everything will work property including NOTUS, printers, taxes, email, check printing etc.
•
in the adjustment of claims. We will consider
• We will be making some changes on what we require from the adjusters
That will be communicated to you asap.
a more strearn-lined process in some areas.
of the initial information in front of you.
• There are many other items to mention, but wanted to get some
Thanks,
Reggie
TMA-instit-00000248
From: Bill Knarr
WcwiUncedsupervisorsmaix)tdtwoorthree%%,erk-sNvbenrepoustartromingin.
Noworkstations.
----Onginal Message-
From: Reggie Warren
Sent: Wednesday. Septetuber 17.2008 12.23 PM
To: Bill Knurr
Suhject: FW: Hurricane IKE Misc. Issues I CAT
# 60 /
STAn IS
Bill: the Walker Oroup has stq:)v if you need them. Reggie
---GTigirad message--
From: Dan Walker imailio:dan.walker(awgckiims.comj
Sent: Wednesday, Septembff 17, 2009 11:28 AM
To: Reggie Warren
/ CAT 9 60 / STATUS
Subject: Re: Hurricane IKE Mse Is"s
Ptqggic: S850?
for Daily rate?
The people we have were collected to work Large Loss and all have 10-40 years experience. What can we offer th=
when?
We will send you some resumes thnt match your time line and pay offering.
Thank you.
Dan Walker
Original Message
-
From: Reggie Warren
To: Dan Walker
Sent: Wednesday, ScpLt2nber 17.2008 10:06 AM
Subject: RE: Hufficane IKE Misc Issues / CAT N 60 / STATUS
ihmugh the storm Please -end names and resumes. We need experience Reggie
We vOl need to ramp up with supervisor- as we gin
-L)npwl Mes-soge-
lairns,com]
From: Dan Walker [mailto:dqn.walk
Sent: Wednesday, September 17, 2008 10:02 AM
To: Reggie Warren
Cc: Caleb Flynxi; Roland Wells
Subject: Re: Hurricane IKE Misc Issues / CAT N
60 / STATUS
Reggie:
1
have gathered severdl CA's wiLb
Can we help you by providing any inside managers, adjmters or file review'!
l1wriks for your hdrd work.
fill
excellent credentials and at this time haven't put them all to work. Let me know.
Dan Walker
cell 650-521-1512
Message
Original
----
From: Reggie Warren
To: Reggie Warren
Sent: Wednesday. Sepicanlvx 17,2008 8:23 AM
Subjeul@ HurticAix IKE N&sc Issucs CAT 601 STATUS
First,thanl,youandyouradjustersforsupportingTA'lAandTFPA We-iUrereivemanylOSSC3MOStlyinGalvcstonBrazona,Chambcrs,HarTis
and Jcffcrsnn Counties.
Soine bullet points, PLEASF READ AND DISTRIBUTE TO YOUR ADJUSTERS AS NEEDED@
2.) We ate terrilorializing the losses by city as hesi we can You will need to fine tune territrifies within your area.
3.) Hopefully, we wfll assign losses toyour firm either in the Heaurnontfl?ort Arthur am OR the Lialveston/Houston area, If we do crossover,
please handle the losses as best vou can. You will receive both commercial and residential losses. We are attempting to assign these the best we
4.) 1
get lots and lots of entails. I try to respond to all if I can
the best we can. We need to roceive your list and revisions in Excel spreadsheet format.
5.) We are trying to manage your Est of adjusters
6.) If you make mvisions to yous list@ let us know the vhanges hi ax: IK)Jy of yout cumil.
7.) Hopefully, 4histers arc making contact and appoinihnents as they can. I know conditions are basi It will take time to get through this, but
%4e will with your help
high volurne of claims. The system is bogging down a little right now, but that will get bettcrAith time.
8.) We are Selling an extremely
10.) Our mobile office is being set up at the Gulf Greyhound Purl on IH-45 near Hitchcock, TX. It %%ill
be marined by Don Turner, Bill
Hooper, Gene Latham and Jim Hill. It should be open this weekend if not sooner
I 1.) They will have 'door limgms' for contact purposes and 'TDI Building Code Brochures' for the ad@justcrs to give to the policyholders when
12.) The mobile office is them to facilitate the adjustment process the best they can. Four (4) people may not be enough, but it is a start.
13.) 1
have sent you the Pricing Cuidelines, TIMA Fee Schedule and an orientation mitline for the adjusters in prior emflilq. I hope you have
gotten this information aid to yoiw adjusters The outline. is informative.
points out fliat,@Ne am "streamlin*' the adjustment process a great deal to make it easier for adjusters. For example, there is
14.) The outline
no requirementfor evaluations of risks, no requirement for an underwriting risk report, no requirement to apply coinsurance penalties, proofs are
%nivcd up to $25.000 paid claim, your principals supci-visors have authority on each claim up to S25,000 paid claim. If your adjuster feels them
is a need to address any of the waived requirement%, thqyshould let us know.
-ED-A-C T-E]
15.) It is important that adjusters go to our welisite and raiew the TWIA Claims I landbook- ww-%&.twia.org p a ss wo r d
16.) We art: trying to schedule uritmuil.ion intwLings with adjusters. They will be next week most likely, one in Nuduiland and one hi flit:
Houston area. We will let you know. No need to email me about fts.
17.) T
will get you information ahnut flomll/sIntin mirge v. wind%lorm damage.
19.) 1
will get you information about condo and condo unit-owTiers losses.
email box at TWIA to submit PDF reposes to- They must be PDF. If you do not have that email box
20.) You should have an individual
address, email Susan Schiller sschillcrq@twhi.org
23.) There is much more that I emild sav right now, but just wanted to give you an update-
24.) Please be safe in your etforts. You are highly important to the recovery process.
Thank you,
TWIA-Instit-00015195
Reggie Warren
and a lot of files open. We have received good marks on our handling of Dolly losses thus far and cannot afford that to
deteriorate.
your adjusters, especially the Dedicated Adjusters, vAth efficient customer
We place a lot of confidence in you managing
service in mind.
Reggie Warren
512-899-4902
you into our vendor system and start assigning claims to your company.
Thank vou.
Reggie Warren
TWIA Austin, TX
512-899-4902
20 to 30 qualified adjusters. We also need the name ofthe principal contact person,.%ith one
We are asking your firm lo provide TkAqA property
back-up person and their contact information for the storm.
Friday Sept. 12. When receive your list of adjusters and supervisors, we
Please provide this information asap, preferably by tomorrow morning, we
,Aill get back with you about the adjuster orientation and other dewls.
file supervisors in Austin, we will contact you via separate email at a later date.
If we determine we need in-house
for Hurricane IKE claims. Please note: The Fee Schedule has been revised
In addition, attached is the TWIA pricing guideline and Fee SchedWe 3
5.) Adjusters arc to handle out losses as 'full adjustments" which means they make every cffort to agree on the estimate and payment amount
with the in3urcd. The finns have $25,000 authority, so it is A that thev mail the insured and agent copies of their estimates prior to submitting
them to us. On the ones over $25,OW paid claim, they should reach a tentative agreement with the insured. submit their report to us for approval,
and when apprnved, they shnuld mail the estimates in ihe insured and agents-
TImnk ) ou.
Reggie
TWIA-Instit-00006650
From: Reggie Warren 1rnai!LO-'-R-HUUl L& QKq I
Scptcmi6c-,6g, 20M 6:36 PM
sent: Monday,
To: Reggie Warren
Cc Bill Knarr-, Kevin McFarlin: Joe Rosentritt; Ray Roe; Don Tumor, Bill Hooper
subject: Hurricane IKE / Adjuster Resources / TWIA
As yoti know, Soath 1'cxg,.; wns hit by Hurricane Dolly on July 23. We have deployed adjuslers to handle those claims and. for the most part, things
seem to be going well.
12 I 33).
I
am sure you are a%%%re that there is the potential of a major hurricane striking the Texas Gulf Coab-,t the latter part ofthis week (Sept or
It may be necessary for us to secure adjuster resources beyond our 'approved/dedicated" adjusting firms. If IKE hits Texas and we need more
can we count on you to provide qualified property adjusters? If so, how man), do you have available? The adjusters that have attended one
rcsourccs,
of our workshops in the last two years are preferable.
is obviously too ently to lxvdict our adjuster needs, but we AanWd to put you and your adjusters un standby just in case.
it
Please mTly Aith the
In addition, we may have the need for experienced property claims supervisors to work at TWIA in Austin through your firm.
numberofsupervi-omyouhaveavailahletoworkatTWlA lfmcneedanysupervisor-;,weeandisru,.@,,payarrangement.,;atthattime
'11mak you for your response ASAP (by tomorrow morning if possible).
Reggie )barren
TWIA and TFPA Claims
Austin, TX
512-WL4902
rcggio(ktwia-org
PLMIMF
TWIA-instit-DO006462
From: Stephen M. Ierulli
Sent- Friday, September 19, 2008
To: Reggie Warren
Subject: RE: Hurricane Ike / TWIA A4juster Orientation Meeting / Galveston, Houston area
Word.Documcrit
MicTosoft Word II
I
contacted Bill direct The remaining adjusters I can offer are finishing their Fay clairris for us in Florida
I
completely agree with you. That is why
and are some of ourmostseasoned adjusters I am going into a meeting right now and will call you in an hour if 5 OU fire available to discuss your
tither quequnns Do you hnve a direct line Ilult T may contact you?
Stcphm M. Icrulli
President
IMS Claims & Catastrophe Services, Inc
(941) 746-3328 ext
11 2
SlorulliCUIMSClaims.com
04 and it caused
We do not endorse finits getting adjusters from other firms. That is what bogged clown the Process in Florida back in inany, many
which finns supplying adjusters I know two of &m are Brush and Brie-it. I
aissunic the) tire paying you a
complaints. I want (L) know you are to.
fee for each. How does that wort? Does vour adjuster work the claim, report to the other IA then they report to us.
I doiYt like that. Let me kno%k
the process.
he getting some daily. They may be slow in coming but that ain't
In the meantime, we are assigning clanns as quickly as possible. Your firm should
always bad- If my prediction is right, there will be plenty of work for all adjugwrs that I know.
that, I
dotft want promises of quality that c4minot be delivered.
Reggie
--Original Message----
From: lertilli Imailto:Dlcrulli.Z)IMSC]aims.Coml
David
Sent- Friday, September 19,2008 7:31 AM
To: Reggie Warren, Bill Knarr
Subjcct: RE: Hunicana Ike I TWIA Adjuster Ofientation Mect4ig Galveston, Houston area
Pi rFF.,
TWIA-instit-DO010684
From: Rav Roe
Thursday, Novernbet 13, 2008
Sent:
Amelia Key; Bill Astin;
Bill Hooper: Bill Jones;
There are quite a few RCC documents coming in and there seems to be some confusion as to how to handle.
Hopefully, ilic following will clm- up some of die Luwcaninty.
1. We reseme RCC to the permy and this sets the ceiling as to recovery. They may spend more but they are limited to the reserve amount for
We do not need to mlicit reopens. or ruippilemental ciqim% when the invoices: revealMOTe expenditure Often ipgrades and otheTchanges
recoveTy.
RCC. Do not allow items not part of the original RCC, such as fences,
account for the Dcrease. Review the documents and be sure they apply to the
i
the paid loss (ACV4RCC) cxcced3 the threshold of $500, the name of the mortgage holder must be included.
2. Assuming
the Documents Package Crcation hit the drop dmNn and pick RCC Statement. This is a fill
3.
in
As to mcftdology, go to the documents tab and "cr
the blank tvpc letter and the insured gcts the original with a copy to the agent.
EXHIBIT,.
TWIA Instit 00004555
From: Reggie Warren
Sent: Friday, October 31, 2008
mblazek(a)littleton-group.com;mbla7ek(alittleton-group.com
To:
Michael,
loss, then some displacement can be allowed. The adjuster needs to determine holy many days the policyholders were
If the adjuster finds a covered
for Primary DAellings only. The exceptions am 'slab' losses. On those, %ve have not made final
evacuated and allow S I 00
per day. This is of course
loss, but we expect that most of those structures had some degree of windstorm damage before thev were
decisions as to the covvred,%%indstorm
have allowed IO days to 25 days of displacement. The average amount allowed by our mobilc office that is on the
,Aitshod away. In thosc cases wc
ground, interviewing policyholder.% etc. is about $1,300 to $1,600.
has evolved a little as we Izve gone diroupJi the storin, but it is necessary to do this as the
1
will admil that flic concept of displaLxuicm payments
information about, lowes becomes more clear
money amount-, and with this Proper explanation, it is not our goal to
It is important that the adjuster reportto us on how they arrived at displacement
rettirn These in the adjimem :_bia to pay them and move on.
I
hope this helps.
Reggie
--Original Message---
From: Bill Knarr
Sent: Fri@, October 31, 2008 3:25 PM
To: 'Michael Blazek'
Cc: Reggie Wttrrcn
Subject: RE: Displacement money
Michael,
Rill
Hill
money? I spoke to Reggie earlier this week and he said that he was preparing
Can you please give me some clarif ication on this displacement
t;."
PLAINTIFF1
TWIA Instit D0004564
something on this issue. Lintil we receive that memo, we have been getting conflicting reports from your examiners on how to apply and where to
place the displacement in estimate. We have n-en been told that TMA no longer pays it. You can see how tills gets confusing to us trvzig to explain
it
to the insured and while submitting a report.
We have been receiving diff1crent iulls frum agents also on LtL, mailer. Thcy arestaLing somebody in TMA told thrm onc thing arid winebod) else
,Aith A is telling them another Ounp. We leave been told (bal other adjwstinp
TM companies arc paying for this even thouph they do not have any
some watputies are Viving a blkaikOL I ddVS IW Mattel how long die
I
stunij dainage lo die sLrtjciw-c. I even bud unc apeiii, Ycsierday StAlled 111hL
evacuation was ir. place. I know this not Correct because of my discussion with Reggie, Can you address this issue to us becausc of the conflicting
advice %kme have receiving from your office.
Michael Blazek
Business Address
Austin, TX 78746
Rmail mbiti7.cki-olitticton-group.coin
TWIA-instft-00004565
Reggie Warren
DM: Reggie Warren
,nt: Thursday, September 25, 2008 7:03 PM
To: Reggie Warren
/ TWIA
Subject: Hurricane IKE Claims Handling Information
Ail,
pig-h.
adjuster westing
outline SEP...
IFF
,Ezell TWIA Instit 00000272
14R
Condo Claim Condo Claim Condo Claim
Corresp 1b.doc lnsbuc*m I.doc... Coffesp 2a.doc
We discussed this at length at the orientations. The adjuster is to meet th e insured at the risk site
and collect as much physical information as possible concerning the risk. The letter, blank Proof of
Loss and blank Inventory should be given to the insured. You can use the check list provided to
secure any information you can from the insured. Follow the instructions as closely as possible.
It is important that you do not tell the insured that we are not going to pay anything for windstorm
damage.
It isalso important that you make no commitments. You are a fact gatherer and TWIA will make the
decision if any payment can be made for windstorm damage and how much. -
We are working with certain experts and others to develop the facts concerning the winds and surge.
Hopefully, this can be done in the near future so we can adjust these claims properly and based on
the TWIA policy contract.
3259_DO1.p&
TWIA-instit-DO000273
From: Reggie Warren Imai1to:REGQ1E(q1.TWlA.ORGJ
Sent: Thursday, September 2 5, 2008 7:03 PM
To: Reggie Warren
Subjcct: Hurricanc IKE Claims Handling Information / TWIA
A117
Below is a considerable amount of imrKmnt information concerning the handling of IKF claims.
It is important if you are a principal of an lA firm that you distribute this information to each and every one of your adjusters and that you make
abid@
certain thev accordingly.
I
am concerned that man) attendees did riot receive the 1.) Meeting outline 2.) Pricing Guidelines 3. TWIA Fee Schedule flat had been
distributedwveraltiniespfiOTtotbemeetings. ItisveryimportantthatvouconveytheinformationtoyouradjusteTs.
Pleasemakeeertainyousenda4justerreporLsto)ourdesignatcdeinailboxes. Watchyourspelling.
-Foe &Iiedule 3
t:ff 09 1 1 081
irv
9 25 08.doc-
Usc the attached letters as appropriate to explain the adjustment process and to allow the Associations to choose their coverage. This should be done
early on in the investigation If the Association has a 280 and 292 endorsement, it is not necessary to give them the letter for them to make a
Selection.
See attached packet. Print for your use in investigating each 'slab' claim.
ItisitisoiiiipoiUiiitLhalvouiiiakt;nueoiniiii(incjjts. Youaircafni;tgatlicicrandTWIAwillinakcLhedet;isionifeiii)-payiileritemibeluadefor
AindstDrin damage and how much.
We are writing with certain experts and othm. to develop the facts concerning the winds and surge. Hopefully, this can he done in the near future so
i%e can adjust these claims properly and based on the TWIA policy contract.
-3259-00I.PdP>>
PUNKM
TWIA-instit-00006471
Clairas issues, TWIA, IKE
October 4, 2008
i
a. Considered for
and the insured must have
b. Must have been part of mandatory evacuation
evacuated.
PLAINMF Fe.,-
c. Must have filed a claim for windstorm damage to their covered property or at
least expect they have windstorm damage.
d. Can be considered when damage is known but cannot return to hortic due to
infrastructure loss (even if a "slab" claim that we have not investigated yet).
e.
$1 00
per day up to 25 days max.
f. Not necessary to document expenses for displacement.
g. Should be coded ALE on payment.
h. Could be a legitimate ALE claim once adjuster inspects and deten-nincs
windstorm damage. Then, the adjuster should handle as usual.
i.
Get good mailing address before issuing check
j. If no evacuation and no windstorm damage are determined, no, ALE or
displacement should be paid.
k. If the adjuster determines flood is the sole cause of the risk being uninhabitable.
we would not owe ALE.
I
0.) When the file is finished, please close the file in Not-Lis or set to RCC- Many fil,,s
arc left open when they should be closed.
1.)
I
We are not pulling the paper claims files as you know. If you have paper docs lor
the file, make sure they get into the file. Leave them in your 'outbox' area for drop
filing.
12.) We are asking for Proofs of Loss for over $25K paid claim.
I Claims under $25K can be approved at the IA level before xve get them. 1ben we
should search for anything that boldly stands out and process the claim accordingly.
14.) If you notice a particular 4uster or firm doing things incorrectly, please notil@
the principal at the firm to do it the correct way going forward. Fax the principal ol'thc
firm a note with your concerns.
1A
15.) It is not necessary to return every file where you see something incorrect.
16.) Logging succinct file notes are a must on every claim. Do not type in what you
wouldn't want to read later in a lawsuit.
17.) Paying attention to wpi-8 requirements OAtindsion-ri building cq&) is important,
especially on roofs, siding, doors, windows, etc. If you do not understand how to do this
in our Notus system. get with Kevin McFarlin or Eduardo Mena (ro.
18.) Pay close attention to the adjusters' invoices and make sure they comply with thc
Fee Schedule we are using for IKE-.
I 9.) Issue advance payments when appropriate. Use good judgment and make sure
you understand there is a covered wind loss. Make sure payments a-re coded
PTOperly to
Loss, Expense, ALE, RCC, etc.
20.) Pay attention to payees on checks. Include mortgagees on dwellings., loss payments
over$500.
21.) Adjuster reports with requests for authority over $100K should go to fail Knarr
for approval.
22.) Be aware of Rolitical entities and persons legislators,'I'WIA Board
........
Members, Judges, school districts, municipalities. Any issues that develop should go to
Reggie.
2-1.) When you think an engineer is needed, get with Kevin McFarlin- Bill Knarr, Joe
Rosentritt, Ray Roe, Terry Partlow for approval.
24.) We do not offer engineers in all situations especially when the file iswcll
documented and stands on its inerits.
2
5.) Consequential Loss:
TWIA-instft-00000283
Clainis issues, TWIA, IKF
Try to manage the use of printers and walking around the office as
29.) nLork smart.
best you can.
deductibles.
30.) Deductibles: Remember, most items on the policy have individual
policy there is a deductible for the Dwelling and another
For example, on the Dwelling
applied to individual repair
deductible for the Personal Property. Deductibles are not
items such as roof%, siding, windows, etc.
a re paying he
31.) Issuin Cbecks Pay close attention to payees. Make sure y u
on 1he check.
the Notate proper comments
correct Person or entity. Verify amount.
Loss, ALE, RCC etc. When
Make sure the check applies to the appropriate coverage,
check with the prior checks that you arc issuing correctly.
issuing supplements, double
Verify mortgagee changes. Make Sure you mail to the correct location.
TWIA-Instft-00000284
From: Reggie Warren
Sent: Sunday, December 14, 2008
Wiley LeBrun (E-mail)- mlebrun.'Ouhrhinc,com;
To:
rn1ebrun@4uhrhinc,corn
It,%-.-as brought to my attention that several of your files arc being kicked back bccausc of poor a4jusunents. I asked one of the supervisors rcyiming
your files lo give tile a brief write tip of tile issues and I Aill sinurnuize in bullet fornial:
Estimating to replace roofs that are not a total loss from windstorm
Paving for roofs with 'liflad" shingles %%hen there is no physical damage or loss
Stating things in your report that are not represented in the photos i.e. 40% of shinghe-s missing but phNrls %how no shingles m living
No evidence to support the adjuster got on the roof Photos being taken with telephoto lenses or at least it appears that way.
Roof diagrams created from ground level measurements
Irdlatinl; the RC estimate to generate a substantial fee bill
Fafling to consider repair v replacement
Estimating tree removal with no documentation or photo of the tree or stump or evidence it darriaW covered property
Not segregating windstorm v flood/surge damagc. Including flood darnagc in the wind cstimatc,
Estimating damage for inherent defects that are not related towindstorm damage
There are some oLhei issues, but yeti should tile point with this list. 'nit: last thing to do is kicL file Imck
Net we want tt to all I& especially after die
insured's expectations have been set.
We "Hni to pay ever) cenl owed undrr [be TW1A palfrey LumIT40 on ench c1mim arid it iN
Milical that we do not overpay or pHy for ilem% not &rnttged
or covered.
Your firm has a substantial number offfles still open. Please improve the quality DI'the a4itistments and have each tile supervised by qualit, control
before submission to TWIA.
We are doing our best to get claims paid and closed and if we have to return riles, it obviously bogs down the process.
Reggie Warren
TMA Claims
Austin, TX
Jodie, I
tried to answer your questions below. Hope this helps.
---Original Message--
From- Indie Roberts Imniho:.TndieRtk)FauityClaiin-Inc.coTnI
Sent: Friday, Febmary 20,2009 9:40 AM
I'm Bill Knarr
Subject: Questions
Importance: High
im,
I
to see if you could answer a few questions
Aziitcd for me. We are hearitig different t]Wigs front rile reviewers and we wanted to clarify some
issues. Also, we are having it hard tune reaching TVIIA examiner's and a lot of messages are going Lmi-clurned.
I
know everyone is busiv but I
warited to bring this to your attention. Should we send an email to a specific address with questions on specific clainis?[Reggie Wan-en) Use
TWIA email address and submit a if there is a question on a file. If you happen to have an Examiner's direct line and want to call him or
your report
her, do that if you prefer.
I
get a supplement for price updates
If we only on a claim, do weJust submit a status report to TWIA so they are aware of the issue? [Reggic
.
Warren] [Reggic Warren) Manv roofers have agreed to repair or replace roofs etc. based on utu pricing 'guidoline". We do not give naines of
We must always consider any new triLDrination that is presented. I
contractors. Our priLv guidhne isjust thut,[RejWie Wan-en) a guidelim.
is a glaring difference in
would secure the estimate that shows thr different pricing, consider it and submit to us if pricing is the only issue. If there
should be made. There many reasons why pricing could vary i.e. access, shingle type
pricing and scope, we need to determine if an adjustment are
%4iiis ina)rreut, two layers instead of one, two slory instead ol'one, steep, special inhwrials swh copper eave
firt
etc. We want it) Imy what we owe but
thisdoesnoimeanweai.itomaticallydeviatefrol@ourpricesjustbwauseaconttactOT%vantstochargemoTe. Keepinmind,thereisalotof
misinformation being circulated out there that we have to overcome when adjusting claims.
If we get a supplement we do not agree mith that does not require a reinspectim do %ve again send in a status report to make MIA
aware'.)
2.
(Reggie Warren] A status report would be ruce to receive along with any new information. In dew situatioris the adjuster should document their
time and it is appropriate to send a reasortable T & E iuvoiceMth your report. [Reggie Warren] Please watch any supplemental billing and make
certain that it is in linc with the work done or it may be rejected.
3. On claims that do not havc a file vxamincr assigned who do we call for qucstions? All wc can do now is call between 9 and 3 to the main
number and are mostly transferred to a voicemail with never a re-turn call. fReggic Warren] You ran call any Examiner on any file. If an
Exaiiiineiliaso%viierslipofaparticidarrile.tlieExmiiimrvoui-eaclicaiiti-ansferv=callttidiatExaiiihier. Or.siitiplvfaxoreLiiailvourquestion
to Lu via 51 2-899-4903 or your TMA small box.
888-295-9477
941-7204717 cell
941-316-0233 fax
S.
IT,
Subject: RE:
Why don't you give Richard Njta@s nurnber. I think it would do them both good. They could talk over old times. etc.
--OnginEll Message----
From: Reggie Warren
Sent: Saturday, JanuarY 03, 2009 12:39 PM
To: Bill Knarr
Subject: 17WIREDACTED
--origaw Mcssagc-
From: RcygieWlarten
Sent. Saturdav. Jamiarv 03, 2009 12.38 PM
To: 'Nits Adcock'
Su@ject: RR
See below excerpt concerning displacement. This was circulated to our stair but is not inconsistent wiith what we are trying go do. I apologize for the
misdirection, but ifvou or your adjusters have strong recominendstions to deviate from these guidelines regarding displacement or anything else,
please have the adjuster make hiAcr cast in their narrative report to TWIA.
I
think Bill Knarr has given some leeway on the displacement payments when TWIA Examiners try to kick them back. It is ii.judgment call as to
%%hat is fair, but based on the below information this is what we expect going fom-ard.
Again, displacement is a difficult for all to grasp including me. so surry for the confusion
"cept I hope displacement is riot aid[ big of an issue
going forward since we are 2 months post Nov I
and their arerft that many new losses being reported.
Thnnks.
Di splaeement Payments:
Thcsc payments were basically to aid those that bad to evacuate their primary dwelling from the storm. Nor to us knowing if thcrc was covcrod
windstorm damqc to the insured property, these payments %%vrc made by our mobile office or us OR recommended by the adjuster. Our average
pavinent for displacement for Ike has been about $1,500, although we set a limit of S I 00 a day for 25 days from evacuation.
l.ater in the i-torm, we decided that if the insured reported their loss or we inspected it after
November 1, we would
not make any displacement allowances. Please %Aatch the adjuster's reports closely as to when the loss was reported and when
they made their inspection. I see some files being kicked back where the adjuster inspected prior to November 1, 2008, found no windstom damage,
but made a tentatwe commitment to the insured that displacement would be allowed. We should not kick those back.
Also,ifthcadjusterfigurodthirlocndaysor$]-;OOaDdyoufcclitsshouldhavebocnnincdavsand$900.donolkickthatback-. Wcrelicdonft
adjuster in the Field to make that call and due to the nominal it
amount; is not appropriate to return the file to the adillStel'. Remember, you are to see
Bill Knarr before vou reject ot- return an adjuster's report.
Message---
From: Nits Adcock imailto:NAdc4)r-ktb_5TM.SC)ainiq.CmnI
Sent: %turday, January 03, 2009 9:56 AM
I'm Reggie Warren
Subject: RE: IREDACTED
Okay,Thanks. Wcjust-AanttogetinthesomebookwithTWIAondmavbeev be same page. Please remember we are all striving to make
I
look forward to hearing back from you.
Thanks,
Nita
From: Reggie
Warren [mai1to:R.EC-GlE(c@.TWlA.ORG1
Sent: Saturday,
January 03, 2009 9:30 AM
To: Nita Adwek
Subject: RE 1KE0804308.DrLACRUZ,BMAIL.pdf
Nita, let mc think more on this. I lave given you sonic contradictory information
inay about displacement based on prior memos I did.
---Original Message-
From: Nita Adcock [maiIto:NAdcock(a)JMSC liums.Com I
Reggie,
rhaveattemptedcontactwilhllelcnasyotire(piesir,dbirtha%-cbeenunabletoreachher. ITovxtler,wecontinuctngetthe.%amein-ttTuctionfrom
severalfi]eTe.viewe.rsatTWIAre.gardingthessmeisstie. NodisplaremenlafterNovemberievenifthere-iswindd8mage Romeinsinictionstellus
toreviseouradju3tinentandinvoicescoDrdinglyandsometellustojustletthemsuredknow. lunderstandthatiribereisnouinddamagethereis
no displacement. However, if I understand your belou instructions they can be paid displacement after No-,member I st ifthey had wind damage and
were displaced.
Am I missing something? If we need to make corrections to (be riles that we have gotten kick backs on that's no problem. It would be helpful irthe
file reviewers would be consistent and tell us what to d o Aith the estimate. insured and invoice. If it's okay lo pay the insured's maybe there is a
inisunderstamling wit1iin the file reviewers at TWI& A lot of die files luivc been sem in fbi u while and we
uTe now getting Uiem btwL I just uout! lo
know so we can stop these before they go to TWIA.
Nita
I tliiiik I talked to Helen about these. If the inspection was made prior to Nov I and there wasv%ind damage and the adjuster agreed on displacement
vm should allow for it. If you inspect the loss or receive a loss assignment after Nov I and there is no windstorm damage found, no displacement
TWIA-instit-00016787
From: Rav Roe
Sent: Thursday. October 30, 2008
Amelia Key; Bill Astin;
Bill Hooper, Bill Tassin-1
Bob Inmon; Bob Latta;
Bob Parrish. Carl Brown.
Cathy Weidner, Charlene Coker;
Christina Turner, Christopher White-,
Corv Kendrick: Dan McGUiTe;
David Dicks; Dean White;
Diana Orta; Don Fielder,
Don Turner. Eric Turner;
Gene Latham; Greg Bners;
Helen Frank; James McRae;
Janie Garcia; Jason Garrett;
Jennifer Armstrong, Jerry Dickerson;
Jerry Lerma; John Hilliard;
To: Josie Fielder; Ken Cannon;
Kenneth Robbins, Kevin McFarlinl-
Kris Weidenfeller; Lou Skinner:
Marie Merida; Michael Cortese-,
Miguel Riverosl- Mike Calvin:
Paula Smith; Ralph Frank;
Ray Drurv- Ray Lang.-
Sam Jones. Sam Wellman.
Satori Sochandamandou.- Shane Gulley;
Sheldon Maxwell; SonnyJenkins;
Susan Herrin; Tamh Morgan;
Terry Partlow.- Thomas Christiansen;
Tom Glow; Von Watson;
WD Scott; Wendy Scarborough,
Weslev Werneking; WilliarnHavgDod;
Woodv McMahon
Here is an emuil froin Reggie in the event it did not reach you.
Ray
----Original lvfessage-
From: Reggie Warren
Sent: Thursday, October 30, 2008 1 1: I 8 AM
To: Reggie Warren
Cc: Reggie Warren
Subject: Customer Service / IKE and Dolly Claims I TWIA
All,
Thaaks to you and your adjusters for all die hard work.
Thkitbeingsaid,ImListiellyouwearegettingatonofciillsfromupsetinsureds.agenLsandoLhers. SomiLnv.&L%ecaML)Lgctourjobdont;in
Austin.
It is highly important that vvegre professional, nice and undemmAing of each persons issues vAlh their individual claim-
An appropriate amount oftime should be spent with each insured to explain the adjustment process. This includes intervieuring the insured and
collecting all the afformation available to assess and adjust the claim.
Based on the calls we are getting, this is not being done mucb of the time.
TWIA-instit-00004568
The ones that are doing the professional job know who they are and this is not mcant for them, but we all need reminders from time to tune.
is to avoid
Our
p" getting calls and complaints which later turn into 13wsuits. We all must do our job better to achieve this goal.
It is
apparcni to mc and otim in this office that our cmails vvith instructions and directions for adjusters arc going Unread and that is
unfbrn=tc
I
feel that your firm is one that wants a continued relationship with T'%1A beyond IKE and DOLLY, and if that is the case, it is imperative that you
rollow ots il)suuctions.
Later todav or tomorrow, I %vill hesending an informational email to you that should help with some of the r ecurring the adjuqtmenu.
isques in
Reggic Warrcn
TWIA Austin
TWIA-instit-ODOD4569
Reggie Warren
assigned to phone duty, please try to stay In your cubicle and answer your phone.
I
Jyou a re
have had numerous calls from Insureds In the last couple of weeks stating that they cannot
get through to an Examiner.
Also, I occasionally review the phone log and find that four or less persons am logged in to
receive phone calls. That is not enough.
I
know many of these callers can be difficult, but we must try to work with them to resolve
issues.
Reggie
PLAINTIFF0
EXHI TWIA Instit 00000384
From: Joe Rosentritt
Sent: Tuesdav. October 14, 2008
Alan Renshaw; Amelia Key;
Bill Astin; Bill Hooper@
Bill Tassin; Bob Iturion;
Car] Brown, Cathy Weidner;
Charlene Coker- Christopher White;
Cory Kendrick. Dan McGuire,
Dave Brockett; David Dicks:
Dean White: Diana Orta;
Don Fielder; Don Turner,
Doug Mattson; Gene Kounse;
Gene Latham; Greg Briers;
Helen Frank. James McRa
=rong;
-
We must make sure that the PDF we are putting in the file belongs to that file.
Open the file arid go to loss details. Once this is done open the PDF and what address did the adj usiff insj@t, do they match, if not you nw to stop
When they both match chock the named insured and make sure that it matches. The adjusters are just like us, ive mix-up rile
and do some checking.
numtoersandin-uredq."i(metimesyouwill-,ee2file.qmixedti)gatheTinthegamePOF. Theonlydifferenceiqoncewepaythelikelyhomof
getting the money back is slirn and none.
Thanks
Joe
"tN: PLAINTIFFS7`C
TWIA-Insfit-00010948
From: Rav Roe
Sent: Wednesdav. October 29, 2008
Amelia Key; Bill Astin;
Bill Hooper: Bill Tassinl-
Bob Inmon; Bob Latta;
Bob Parrish: Carl Brown,
Cathy Weidner, Charlene Coker,
Clu istina Turner, Christopher White,
Cory Kendrick Dan McGuire;
-
Some of us are over-utilizing the cut mid paste or highlight mid paste feature on tlw computer. I iun ixX saying that you should never use it but I t1iink
it should
not be wed for namti@v remarks. We wunt & remarks and eval uation to bc vours. not 111111. Of the a4it.19ter. Besides, his remarks we
available in the report that is being filed into the'docurnents'part of the rile.
Whenyf)urain'.hecomme-ntsthat'lmdwiththeinsuredalbispnmeryTesidence' famprettycertainthatthecommentsarennivour-;hutarethe
adjusters,
We need to know what yen think about the sitimionsime we ran read the adjustees report tinder the'docurnents'lah
Ray
PLAINTIFFS
EXHIBIT.
Reggie, prefer to pay this one as submitted. You will note they My have (6),Mth firul dates. I do intend to look at their final closely and verifv we
have reports mining in from each individual adjuster charged. Prompt payment of their initial -bould demonstrate our scm-4 faith and allow for time
prior to payment of their final.
---Ong=] Message---
From: Reggic Warren
Sent - Wednesday, September 24, 2(08 11:26 AM
To: Russell Stout
Subject: FW: Weekly Time Sheet for TFPA Adjusters
Importance: High
I
would send this luwk drid lei tbt:vn k7w)w ilea 9-21 -08 was the last date for the dai1v rate aWtO %end LhCiTrinal revised hivoice Tlie ones (141 9- 1 8-68
through 9-20-08 arc fimil already.
Russ, per Oliver this morning, I would move quickly to find more space and get some people in to man them. tunes calls are killing us IVIA and
TFPA. We have got to get to a point where the Examiners can take some calls and get out some advances. Push what wc can out to the adjusters but
that will only work so long. Extended hours from all is a must right nmv.
Reggie
---Original Message---
From: Russell ',tout
Sent: Tuesday, September 23, 2008 5:53 FM
To: Reggie Warren
Subject: FW; Weekly Time Sheel for TYPA Adjusters
Importance: High
Russell.
Please see the attached invoice for our Daily Rate adjusters. Please let me know if I
should send this to someone else to process.
Thanks,
BeLiRoss
mobile: 9W-477-2317
e-mail: ti.ross(4momadadjusting.rom
PLAINTIFfS'
EXHIST
TWIA Instit D0013823
From: Reg Warr-en
Sent: Saturday, November 01, 2008
To: Reggie Warren
your adjustcm.
%NiLh
Please review
I
promised anoLhuT email after the one issued on Oct 30 about 'Customer Service".
We am getting complaints from insureds and agents about when they call your main number or adjuster's number and no one answers. They
get a voice mail box and leave a message and no call backs. Or. your mail box is full. Please have someone answer the phone or at least return
the phone calls if a message is left.
We expect you and your adjusters to handle the claims to completion (full adjustment), If the insured or aggent calls you or your a4juster
about something you missed, Please handle regardless if the rile iq open or closed. Do not refer the insureds and agents to us .... reopen and handle.
If you have done the proper investigation on a file and the insurcd or agent calls wanting another inspection, they must supply you with
additional credible evidence that supports another inspection. Such as, roofer estimates, photos, other estimates, engi neer report, ctc. We do not
reopen files when the proper investigation and analysis has been pci formed and just because someone is 'unhappy ".
Point is. most of the time we cannot avoid reinspections especially if there is other information to consider. We want to consider all
available information on each claim. But. do not tell the insured and/or agent that you cannot do anything and that they have to call TA'IA for
approval Nvhen there is other information available or offered.
We are getting many complaints from the Texas Department of Insurance, Man) have to do with the adjuster. Think about that when you
Do everything you can to resolve the claim within the parameters of the policy contract, be fair, be cottileons Rnd I* respectful.
are out there.
rhat always helps, even if you ha ve to deny the claim or a portion of the claim.
Please ask the insured if there has been a mortgapee change. If so, get the new information and ad'%isc us accordingly so A c can include the
'
correct payee on die claim check.
Please get accurate mailing addresses roTAhere checks are to be mailed, ii'different than the address on the policy.
Please mail copies of Your estimate to the insined and agent. If it is over S25K paid claim, it should be appioved by TWIA befoic inailing.
l3efoTc subtrutting a report to us for authority to take a Proof, at least have some tentative agreement on the adjustment with the insured or
their representative.
ILL "FES
TWIA-Instit-DOD06491
Onrooftcplacemcnts,usegoodjudgmentoncuttingv-.,asicalloL%,anee@,,. 15%isnotfoTeverytoof
If you can. p)easc remove the uolor logos from vuur estimates. It takes up extra space on out server and it is not neoessary.
Anached
Displacement are three (3) documents that can be helpful to you and your adjusters regarding "slab' claims, "heavy strwtural" claims. and
money
71unk @ou,
Reggie Warren
TWIA-insbt-00006492
From: Rav Roe
Sent: Friday, September 26, 2008
Bill Hooper; Bill Tassin-1
Carl Brown: Dan McGuire;
Diana Orta; Don Turner;
Doug Mattson- Gene Latham;
ia;@@
Helen Frank; McRae;
Janie Garcia, Jim Coggin;
Jim Hill; John Hilliard;
To:
Michael Cortese; Paula Smith;
Ralph Frank, Ray Lang;
Sam Jones, Sam Wellman:
Sheldon Maxwell; Sonny Jenkins;
Terry Partlow,- Tom Glow',
Von Watson; WD Scott-,
Woodv McMahon
---Original McssaBc---
From: Reggie Warren
Sent: Friday, September 26,2008 11:43 AM
To; Rcggic Warren
Subject. Hurricane IKE inspeclhxis / Adjuster phune munbers
IMPORTANT INSTRUCTIONS
'thank you,
Reggie Warren
TWIA Claims
Austin. TX
TWIA-instit-00016437
From: Bill KnwT
Sent: Wednesday, June 04, 2008
To: Reggie Warren
Reggie,
to send to Joey and Zack. We could send them a certificate %worth 4 CE hours it they
Here are the exam questions and blank answer sheet ifyou %vant
pass.
Bill
Bill Knarr
Catastrophe Office Manager
512-637-2902
ecblank-2.gif,
Attachments:graycol-l.gi P@
Examination Complete.
06/04/2008 08:55 AM
To
cc
Subject
Why don't you take it to see if you can pass it and send it back to me? It won't take but a few minutes.
<<Examination for Certification 2008 TWIA Work-shops 05-07-0g.doc>> (See attached file: Examination for Certification 2008 TWIA Work-shops
05-07-08.doe)
PLAINMFPS
TWIA-Instit-00012896
From: Bill Knarr
Sent: Sunday, September 14, 2008 04:14 PM
To: LDUGGAN
Mike,
Yes, Hart said would be looking them over for GAB. We appreciate it. We are not going to be very strick on any loss imder 25K. There will be
yoLi
no valuations or commercial
on dwelling and no penalties. NO Underwriting Risk Report etc. Just good photo's. complete estimate, statement of
loss and shortcover report.. If you have one that wori't pass muster, have Tracy send it direct to me and I'll pass the thing on through. I do that for
all of Zack Warren's. So, just make sure it comes direct to my email and not through regular charmers. Please call me with any question and I will
help- I am kinda in a different chair this time and can help mi a lot of ways. Glad you are helping out. We anticipate possibly 100.000 Ike losses.
Could be more. We have 27 I)Vs that we are using and have about I 000 adjusters on their lists. We also have about 2000 Dolly losses pending.
Makes time go fast. Call me Ahcn you get started.
Bill
-----
Original Message -----
From: L DUGGAN [mailto:nildug I 9(ftsn-coml
Sent: Sunday, September 14, 2008 9:20 AM
To: Bill Knarr
Subject: Re: Ike photos
Hey Guy:
Regards Mike
..........
-----
Original Message -----
From: Bill Knarr
To: William Knarr (E-mail)
Sent: Sunday, September 14, 2009 9:07 AM
Subject: FW: Ike photos
Interesting FYI
PLNNm-- 9
EXHISrr TWIA-Instit-00016646
13 Li
A
From: Reg Wan-en
Sent: Sunday, September 28, 2008
To: Reggie Warren
After the adjusters have met with insureds, we are getting many phone Calls at TWIA directly from insureds wa questions about their claims.
They tell us the adjusters Fire referring them to us.
We expect the adjusters to adjust the claims. If the adjusters have questions, thcy should first go to their internal supervisor at the firm they are
contracted to. If that does not resolve the issue, then the supervisor- can contact our office.
If it is an emergency question and the adjuster needs an immediate answer, heishe can call Bill Knarr, 512-637-2902.
There will obviously be times when we need to speak to the a4luster directly, but we do not want the adjuster referring insureds directly to us
@hnv ofthe insureds call in here already, so we do not need the additional referrals from the adjuster handling the claim.
Thank you,
Reggie Warren
F"I
TWIA Instft 00016436
From: Reggie Warren
Sent: Tuesdav, November 11, 2008
To: Reggie Warren
handled Hurricane IKE losses and are recontacted by the insureds or agents stating
there is additional damage due to the recent
I )
If your adjusters
,ain%(otothervaliciren%ons),pleareteopenfindhandlear-cordingiv. lldoc,;noimaticTifynixfileisopenorclowdaitheiirne.
AlUiistimc,N,,,earenotereatir*ariewlossessiLaranentandthenewdamage\villbeconsideredpatiol'the
DONO'l retertheinsuredoragenitaus.
Hurricane IKE claim..
If (he adjuster has left the area, another adjuster from your firm should handle.
and the estimate submitted should only be for the new damage. The supplemental estimate should be mailcd to
We only want a justified supplement
the insured and agent.
and agents that are detrimental to its Setting the claims worked.
comments to insureds
By and large, this is not being done. WHY NOT? Please comply with our instructions.
4.) Copies of estimates are to go to the insureds and agents.
5.) Please have the adjusters veii6, the correct mortgagee and advise us accordingly.
Thank you,
Reggie Warren
PLA1NT1FPV-,---$
EXH
TWIA-instit-00016551
Reggie Waffen
agents unless we approve them first (this Is wrong especially on losses under $25K paid claim). am sure there are other I
issues, but these are a few that come to mind. They should come to you or me or Knarr or Kevin for authority to send out
this type of into.
Thanks.
--original Message---..
From; Joe Rosentritt
sent, Saturday, November 01, 2009 7,56 AM
To: Alan Renshaw; Amelia Key, 81 Astin; 00 Hooper; Bit KnarT, B11
Tassin; Bob Inmon; Bob Lim; Bob Parrish; Cari Brown, Cathy
Weidner; Charlem Colw, Christina Turner; Christopher White; Cory Kendrick; Dan McGuire; David DkJm Dean Mite; Diana
Orta; Dan Fielder; Don Twner, Erir Turner; Gene Latham; Greg lbiers; Helen Frank; James McRae; larde Garcia; Jason
Garrett; 3enntfer Arrrs"N; Jerry Dickerson; Jerry Lerma; Joe Rosentritt; John Hilliard; John Jenkins, Josie Fletler, Ken
Cannon; Kbvoeth Robbins, Kevin McFarlin; Kris Weldeddler, Lou Skinner; Marle Merlda; Michael Cortese; Moiel Riveros; Mike
Calvin; Paula Srrutri; Ralph Fir"; Ray
on"; Rey Lang; Ray R= Reggie Warren; Sam Jones; Sam Wellman; SaW
Sodianoarnanclou; Shane Gulley; Sheldon Maxwell; Somy 3er*Jrw, Susan Hernrg Tamrl Morgan; Terry Partiow; Thomas
C1hristlansen; Torn Glow; Von Watson; WD Scott; Wesley Werneking; William hr(good; Woo* McMabon
sukdect; Tmbusirez
We need to keep TWIA business in house. How far we are behind and things of that nature should not be discussed
with insured's and agents.
I
know you want to get them off of your back when on phone duty but that is not the way to
do it
Thanks
Joe
PL AWFF solve..
r, TWIA-Instit-00000324
Reggie Warren
MM Reggie Warren
Sent: Wednesday, November 05, 2008 7:40 AM
To: Reggie Warren
Cc: Reggie Warren
Subject: TWIA losses I Business Income J Causation I Agreeing with Insureds
This email is going to all 1A firms and internal TWIA Examiners/Supervisors. PLEAS PAY
ATTENTION TO THIS EMAIL AND REVIEW WITH EACH OF YOUR ADJUSTERS:
1.) If an insured is presenting a Business Income (BI) claim under Endorsement 17 (required) and
the building has windstorm damage, please immediately determine if money is owed under BI and
what amount. Then, email the request directly to me at bknarr@Wla.org We need to get
this money in the hands of insureds ASAP
There must be windstorm damage to the building and the insured must be out of business due to
IKE. It is
not necessary to secure any documents supporting loss of income.
Ifthe business is partially open, make an effort to agree with the insured as to a percentage of the
daily rate shown on your loss assignment information. For example, 0 it is reasonable to believe that
the insured would have been fully or partially out of business due to windstorm damage and the
business is now parbalty open, we may want to pay the full day rate up to the time the business
partially reopened, then pay a prorata amount up to when it appears the business will fully open
again.
To determine the information, it is imperative that you interview the insured and hopefully make a
reasonable determination.
Ifyou feel the loss was entirely due to flood or surge and no windstorm damage, please submit that
information ASAP as well. We will make the cletermination on any BI payment.
2.) We are adjusting losses for windstorm damage, not flood or surge or any other peril. It is
important that your adjusters do not make statements in their reports or to insureds regarding
tornadoes or microbursts and/or give any other information that they are not certain of. We are
developing information concerning specific causations, through meteorologists, erKjkwws and other
experts and do not have that verified information as of today. So, it is highly unlikely that an
adjuster in the field knows if a tomado or microburst hit a certain area or structure.
And, your loss assignments are generally for Hurricane IKE losses and we are not concerned with
handling claims for old, unreported losses in the middle of handling IKE losses. If the insured wants
to report a loss that happened sometime before IKE, they can do so through their agent.
3.) talked personalty with 27 insureds yesterday. Without exception, the adjuster had met and
1
inspected the loss, but had not gotten back with the insured to review their estimate and to agree on
the amount of covered loss and payment. And, the adjuster reports had already been submitted to
TWIA for payment. Why are you allowing this to happen? We cannot get any work done because
we are taking so many phone calls from insureds and agents and are having to complete the
adjusters'work. This has to stopil Please handle our losses as full adjustments. You should agree
of the estimate
on each loss under $25,000 paid claim and provide the insured and agent a copy
PLAIN71
TWIA- nstit D0000328
only. Onlosses over $25,000, you should have a tentative agreement with the insured before
of the
submitting the report to TWIA for authority to take a Proof. Once approved, then send a copy
estimate to the insured and agent.
instructions and prior instructions sent
4.) Finally, if you and your adjusters cannot comply with these
to you by TWIA, we will begin scrutinizing your service invoices and removing the supervision charge
we have been alloyAng on a trial basis. We can easily see ihat many files are not being supervised
at your office before being submitted to TWIA.
TWIA-insth-DO000329
Page I of I
Reggie Warren
MGD Claims. agree that we should notify the insured and the
I
All,please see note below from Marc at submitted estimate. Send the adjuster a fax or
their
adjuster we pay something different than
if
Thank you.
Reggie
--Original Message---
[mailto:adjusber@k7in9stDn.net)
From: Marc Dubois
PM
Sent: Tuesday, January 06, 2W9 10,.47
To: Reggie Warren
SubJect: Check Lssuanoe
Best Regards
Marc Dubois
M.G. D. Claim Services Inc.
A couple of things.
do not own files.
With the exception of die slab group, we There will be fem, exceptions
Lo this.
u slab cluirn. it is v our cull to handle.
telephone call %ilb an mquin on u purticulur file, other thun
forward the call to the file owner. In
all
If you get u
'claimed and in that case, you should
T@ere ownership for some reason
are a few files where people have
it is yours to handle.
other cases I can think of,,wben the call comes to you,
is $3SX)U
back depreciation when the amount
building. The fact that we no longer opt to hold
Also, there is no to discuss our rules outside the
need
word spreads is that insureds will be calling
The next thin that happens &tier that
with insureds or even adjusters.
or less is not something to discuss
---ePLAII
TWIA Instit 00006623
Claims issues, TWIA, IKE
October 4, 2008
1.) If you leave a note on someone's desk or chair, sign your name to it.
2.) If you identify potential fra of any kind, notify Bill Knarr, Kevin McFaTlin or Reggie.
3
.1.) Make appropriate written file comments. Do not be derogatory or belittling lo 1he
adjuster or anyone else, especially in written communications.
4.) If you get authority to take a Proof, please communicate that back to the adjuster.
5.) Try to find coverage for the claim. Do not look for ways to send the file back to the
adjuster for revision or correction. Use good judgment.
6.) Ifyou desire ownershiD of a particular file(s), the last Log/Comment you put in the file
should indicate you want the file back when the next report comes in. This is the only
way we can manage this. Otherwise, Joe would have to open each PDF and determine
the assigned supervisor.
7-) Phonc@. Stay ready to answer the phones as much as possible. I know it is hard IC) work
files and be on the phone, but we need all supervisors participating in recciving calls. If
this does not worki we will have to do something differently.
8.) "SINIV cl2ims fromstorin sume:
a. We arc forming a unit to handle these, but it will be a couple of weeks until they
are in place.
b. We would like to hold onto these without making a decision until the unit is in
place. This may not be possible in all cases.
c. Please notate the file if it is a true "slab" claim. The complete structure is gone
with maybe the exception of a piling or so still standing.
d. If YOU get a report from an adjuster, we need to get it logged to a spreadsheet.
Wil determine who will manage the spreadsheet asap.
I
e. If you receive a completed Proof from the insured, and the evidence does not
support windstorm damage, we will need to write a letter to the insured indicating
we cannot accept the Proof until we get the remainder of the evidence. Our
claims counsel is drafting this letter for our use.
f. We are evaluating all the weather evidence from IKE and hopefully can use that
with other evidence as to what happened at a particular risk to determine ifit was
possible the structure sustained windstorm damage prior to being destroyed.
g. We will contact with engineers and attorneys to help us with our decisions in
anticipation that theme could be litigation.
h. We will investigate each claim individually.
i. We will not blanketly allow a percentage of the claim on a group Of losses.
J. We willnot blanketly deny claims without an investigation.
k. The adjusters in the field do not have authority to determine coverage on "slab"
claims.
1.
Adjusters submit the evidence to us for determination.
m. We expect the adjuster to determine if there is flood insurance and communicate
with the flood adjuster on each cWrri.
n. We will possibly include the heavy flood v. wind-damaged structures in this unit.
9.) ALE Displacement payments:
a. Considered for Primary Dwellings only.
b. Must have been part of mandatory evacuation and the insured must have
evacuated.
PLAINTIFFS!'..
EXHIBInrrI -'q:.
TWIA Instft D0000282
Claims issuts. TWIA. IKE
c. Must have riled a claim for windstorm damage to their covered properly or at
least expect they have windstorm damage.
d. Can be considered when damage is known but cannot return to horric due to
infrastructure loss (even F a "slab" claim that we have not investigated yet).
i
$ 00
per day up to 25 days max.
1
c.
f. Not necessary to document expenses for displacement.
g. Should be coded ALE on payment.
h. Could be a legitimate ALE claim once adjuster inspects and deten-nines
windstorm damage. Thcn, the adjuster should handle as usual.
i. Get good mailing address before issuing check
j. If no evacuation and no windstorm damage are detennined, M. ALE Or
displacement should be paid.
k. If the adjuster determines flood is the sole cause of the risk being uninhabitable.
we would not owe ALE.
I
0.) When the File is finished, please close the file in Notus or set to RCC. Many liles
are left open when they should be closed.
1.)
I
We are not pulling the paper claims files as you know. If you have paper docs for
the file. make sure they get into the file. Leave them in your 'outbox' area for drop
filing.
12.) We are wsking for Proofs of Loss for over $25K paid claim.
13.) Claims under $25K can be approved at the IA level before we gel them.Then we
should search for anything that boldly stands out and process the claim accordingly.
14.) If you notic& a particular adjuster or firm doing things incorrectly, please nolify
the principal at the firm to do it the correct way going forward. Fax the principal ol'111c
IA firm a note with your concerns.
15.) file where you see something incorrect.
It is not necessary to return every
16.) succinct file notes are a must on every claim. Do not type in what you
Ix)gging
wouldn't want to read later in a lawsuit.
17.) Paying attention to Wi-8 requirements (Mridstgrm building qp&) is important.
especially on roofs, siding, doors, windows, etc. If you do not understand how to do this
in our Notus systeiri, get with Kevin McFarlin or Eduardo Mena ar).
I
S.) Pay close attention to the adjusters' invoices and make sure they comply with thc
Fee Schedule we are using for IKE.
I 9.) Issue advance payments when appropriate. Use goodJudgment and make sure
you understand there is a covered wind loss. Make sure payments are coded properly to
Loss, Expense, ALE, RCC, etc.
20.) Pay attention to payees an checks. Include mortgagccs on dwelling loss payments
over $500.
21.) Adjuster reports with requests for authority over SI OOK should go to Bill Knarr
for approval.
22.) Be aware of political entities and persons legislators, TWIA Board
........ issues that develop shoul go to
Members, Judges, school districts, municipalities. Any
Reggie.
23.) When you think an engineeT is needed, get with Kevin McFarlin, Bill Knarr, Joe
Roscntritt, Ray Roe, Terry Partlow for approval.
We do not offer engineers in all situations especially wben the
I-)
le is we] I
24.)
documented and stands on its merits.
25.) Conseguentiall Loss;
2
TWiA-Instft-00000283
Claims issues, TWIA, IKE
e. Commercial risks must have direct physical windstorm damage lo the heating.
power or cooling equipment on the described building. Something visible. No
power surge coverage for consequential.
f. 'Tbcre will likely be some incorrect adjustments on consequential loss, such us
paying $500 regardless of coverage, deductible etc. If the claim is resolved, do
C2
not send the file back to tile adjuster over this issue. Fax a note to the principal
HI
29.) Work smart. Try to manage the use of printers and walking around the office as
best you can.
30.) Deductibles: Remember, most, Items on the policy have incfividual deductibles.
For example, on the Dwelling policy there is a deductible for the Dwelling and another
deductible for the Personal Property. Deductibles are not applied to individual repail
items such as roofs, siding. windows, etc.
31.) Issuing Checks: Pay close attention to payees. Make sure you are paying tile
correct person or entity. Verify The amount. Notate Proper cornments on the check.
Make sure the check applies to the appropriate coverage, Loss, ALE, RCC etc. When
issuing supplements, double check with the prior checks that you are issuing correctly.
Verify mortgagee changes. Make sure you mail to the correct location.
TWIA-Instft-00000284
From. Ray Roe
Sent: Sunday, Seplember 28, 20OR
Bill Hooper; Bill Tassin;
Carl Brown. Dan McGuire"
Diann Orta; Don Turner,
Doug Mattson-, Gene Latham,
Helen Frank; Jarnes McRae;
Janie Garcia-, Jim Coggin.,
Jim Hill; John Hilliard;
To:
Michael Cortese-, Paula Smith-,
Ralph Frank; Ray Lang;
Sam Jones: Sam Wellman.
Sheldon Maxwell; Sonny Jenkins;
Terry Partlow.- Tom Glow',
Von Watson-, WD Scott,
Woodv McMahon
Ray
PLAINTIFPS
1131T_
- -
All,
David
The goal should always be that the Claims Supervisor would work the file as presented to
them and concludc the filc to completion. Attcntion to comments should be paramount
and
when completing work on a ifile so that any other Claims Supervisor could pick up
complete as needed.
With that said, there will be occasion for a Claims Supervisor to take ownership of a
particular file for various reasons. These reasons could include the size of the file, the
complexity of the file, specific assignment of the file by management or ongoing
monitoring of corrections needed on tlr- file.
The following guidelines should be adhered to as we move forward with regards to File
Ckvnership:
1) Claim Supervisor will send an email to Kenneth Robbins or Bill Hooper for any file
that ownership is taken on with the following information.
Claim Number
Reason ror Ownership
2) Kenneth Robbins or Bill Hooper will physically change assigned supervisor in file if
approved.
3) Once Claim Supervisor has been notified that approval has been given for file
following.
ownership, you will make a note in the comments section of file with the
files
4) As needed, Kenneth Robbins or Bill Hooper may request updates on latus of
with file ownership.
and closing of
The purpose of taking File Ownership should be to expedite the handling
these files. When ownership is taken the Claims Supervisor should be in regular contact
others complete the file as soon as possible. These files
with the adjuster, insured or to
should not be handled as usual with an email only sent for action. The Claims Supervisor
files to
should be physically making contact with the appropriate person to push these
completion.
TWIA Instit-00006611
From: Bill Knarr
Sent: Wednesday, October 08, 2008
To: Joe Rosentntt:Rav Roe-Woody McMahon
I
just sent you a blind copy of my response to one of the IA firms. we are creating more work for ourselves by nit picking at these losses under
25.(M.(X) A glance at the statement or loss to make sure deductilbles have been applied and a quick overview and unless something jumps out as
being drastically it and go They have been here long enough for a learnuip cume. Yes,
wrong, pay on. Please pet this word out to our supervisors.
%kc
an going to miss some things, but we have approaching 80,000 claims to review and get paid. These floodvs windstorm and larger losses will
need our time more than these smaller losses. Thanks.
Bill Knart
Catastrophe Office Manager
512-637-2902
PLAINnFPS""."
Reggic.
I
believethat we think alike in many ways. My intent is feedback on our problems and what I
hear on the street. you may not be seeing
While
of claim-.; and going home. with ycau comment on quality
T
prnblems with the reopen% yet, you will. Ackyustem are giving back their inventories agree
so poor. Many senior people am leaving the industry because of age and the
issues. I have been doing this many years and never has the quality been
lack of consistent work. We are a Citizens of Florida trainer but the number of quality candidates is diminishing. We have to pretty much 'idiot
proof' the process. Bocause of three storm deployments going on at once, many of our senior folks grabbed at 1-;a.v and Gustav deployments that Nvere
available as the@ had not worked in two years.
At this point, we arc going to see how many of the reopens we can handle from the desk. I expect that as the holidays arrive %v will lose most who
have hung around, even if the reopen fees havent driven them off. We have not received a single nc%N- assignment since 10-23-08 so we don't even
have any fresh claims to attract a4justers back. Al this point, you are Probably better off continuing to send them to your core firms. At least you will
have those firms to back you when the reopens get out of control. I do understand the economics of this business.
the most %sell done file is the groundwork for a bad faith claim. That is Nvhv I have asked for consideration on the billing. I do not want to set up
Mil certainly come. At the risk of making you angry, I again ask you to
TWIA nor do I want to cxcercise my E& 0 carrier for the litigation that
consider allowing us to bill from the bottom of the schedule of these very necessary remspections. Before vou answer this request, I urge you to take
file considering the
the temperature on the street.
I
cannot think of a firm or adiuster out there who would want a $200 ($130 to the adjuster) reopen
and their overhead cost to stay in the area. AD of these arc being handled by different adjusters than the original and I don't bclicvc
work, difficulty
issue is growing short, mainly because the
there are enouib local people to handle them if all the a4justers in the area leave. The time to address this
approaching holidays are causing the adjusters to make decisions.
Thank you,
Jeffrey A. Kaiser
Prcsidcni
Specialty Group, Inc.
---Original Message----
I
From Reggie Warren Inutillo:REGGIE( 2TW`IA-ORQ
'
Jeff, I made some comments below at the end of some of your paragraphs.
--Original McssaLzc----
From: Jeff Kaiser [mailto:ikaiser(&specialtygroupinc.comI
Sent: Friday. November 14. 2008 6:21 PM
To: Reggie Warren
Subject. RE: Supplenitmis drid Rrupens I IKE / TWIA
Reggie,
Thank you,
Jeffiuy A. Kalset
President
few
Bel all we wanted. So we continued to move people toward Texas, guaranteeing them Work and standby money, even though we submitted very
We had many adjusters arrive to find that we had no work for them and we helped man)- to find work
Rtandby daily fees to FWI A for reimbursement.
from other clients because we all expected many losses.
elsewhere. As I told you carly on, ive committed to handle TWIA and did not accept losses
and there is no way to predict the number of losses, a huge number of firms and adjusters were
Whileknow that no one can see into the future
I
dcployW by TWIA. When the flow of losses stopped completely and not even a slight flow continued, I had no way to feed those who were en route.
after their losses were scoped out or to rnixwith the reopens. Most left because they could not
I
also had no wav to keep the pood adjusters in Texas
hotel room and iix:urring $200 a day lo livc, While also having to pay fui a home Somewhere
sustain die addifionail expense of livitig in a trailer or
else after the flow of claims stopped.
,
of)
Icft to handle the reopening files. Most of those have said that the (65%
As soda most of the adjusters have gone home and very few arc
travel the loss location, re-inspect, negotiate with die insured and/or
$200 fee is not enough to pay them to review the original report
& estimate, to
starting to reject these assignments becalm they only get $130 plus mileage
contractor, write an estimate, report, bill and close the file. They are now fee schedule
for all this Work. I do not like this response from them at all! I
have said to clients in the past that it really doesn't matter to me what the
is, it muttcrs to the adjusters bLeausc if
it isn't enough to attract them, it is a setup for failure since wc a
draw from the sarric gLne pool of storm
I
have a proposal that I ask you to
toward success and away from failure. However-
adjusters. At this point, I am hard pressed to move this matter
consider.
properly. If Will pay the new adjuster from the original adjimter's proceeds. If there is a price
See if the original adjuster has
done Their job not, we
desk. If it is measurements or missed items, we may be able to handle it from the inside but
difference issix, we should be able to handle it from the told them to dispose of
is saving the original adjuster
many will have to go outside. We are seeing a wave of huge contents claims where the insured
it is You and I
both know the only way to deal with
and the adjuster will tell you not so.
the items and thev want to be paid. We have seen this before difficult to
with the insured and ask them to start justifying their claim. This is very time consuming and it is
these aggressive claims is lo go and sit these claims when the
work through this However, it is also diff icult to pay some of
get adjusters, who feel they are underpaid, to properly process. that these
and we get an inventory for 30 items. Please also keep in mind
insured showed the original a4iuster one item during the initial inspection
TWIA-Instit-00016738
reopen claims; are being handled
by different adjusters who almost always do not have much good to say about the onoal adjuster simply because
they are losing money doing it. Jeff, I arn not buying this.
I
dAU in most cases the
they have to handle the reopen. It gets worse when they feel like
PP claims. Adjusters not interviewing the insureds. They are not creative in adjusting a claim
adjuster didnt do their job initially on these large are
The hun) through and their product illustrates it.
to commit to these adjusters. who have to go out and through some very difficult claims, that they can bill die
"rk
am asking for authority
I
adJusLei fix from the bottom of the ticliedule as if it were a new Claim, We will not bill any of the surchurges, just the adjustei fee. additionml inileage,
would be the adjuster fee. The ones we can handle from the desk will be billed at the $200
additional phoios and exam fee. The only change
minimum based on the difference in fee amounts and the ones v%e find to be deficient, we will not bill TWIA. Jeff. we cannot treat you differently
than the others and I have not had these comment% ftom any other firm.
i
shutoff, would be able to keep a group of ad@iusters
My 14C is that if Ave even had a trickle of claims coming through instead of a total
I
would also be able to mix the reopens with the r)e%v losses as we went along, to keep the
sufficient to spread them out and get the reopens handled.
With all of the other
adjusters interested. With the isolated crew we now have it
is
even more difficult because many are traveling longer distances.
this is looming large and we arc trying very hard to succeed for TWI A, the
demons we are facing as xw try to move this Cat to a conclusion, one
to this
to deal with so am hoping that we can figure out some resolution
I
policyholders in Texas and for you You have been fair and evenhanded
also believe that we may be able to attract ad iustcr3 back
problem
as expect our firm and adjusters are not the orily ones
I who are facing this. I sonic '
ill slow HI
if (here is a 1111MICidl iDLCllLiVC 10 do bv bounuse I believe the claims will continue it) reopen for wine time to curne, Jeff. claims ait: count*
numbers early in a storm. I feel we will continue
Ns time. Our initial predictions were based on information we had at the time. No one can predict busy. I
will initially many as I
first thought, but they are not coming in at a pace to keep any one firm particularly
to get losses for months and get as
work arid those adjustem can handle the reopens. I %wish there weren't so many and
think most finns are hanging on to the real adjusters that want to
and clean
there wouldn't be if the adjusters handled the claims to start with.
I
think adjusters are nceuslorned to having clean tip crews come around
tiptheirmess,butweamnotatthatpoint WeexpectthefimstobandietheelaimsonafLilladjustrnentbasisandthatnicansreopens.
Ifyoubaveindividualsupplmcntsfttrequireaninordinateamountoftime,letusknowandwe%villconsiderdiffffentbilbng. Wedian'twlant
'cat' adjuster I
will have to
We have our issues too. We are all doing our best but if decide be a
I to
No one is perfect including TWIA.
in.
understand that there are no real guarantees on numbers of claims and how fast they will come
Jeffrey A. Kaiser
President
-----
Original Message----
From: Reggie Warren IniAiIto.REC7GIEQT.W1A-O&_G)
Sent: Fri I 1/1 4/2008 1:1 9 PM
To: Reggie Warren
Cc: Reggie Warren
Subject. Supplements and Reopens / IKE / TWIA
Wedonotwmitheoriginalestirnatetobere-wTittentoincludethesupplmnentalitems. Thistakesalotoftimetofigureout.
TWIA-instit-00016739
for the supplemental items with a brief report as to the reason for the supplement.
\Vc only want an estimate
We do not need all the pholos re-sent to us just the new ones, if any.
.
............
ThuiA vou.
Reggie Warren
TWIA-instt-DO016740
Reggie Warren
rom: Jeff Kaiser Ukaiser0speclaftygroupinc.corn]
ant: Saturday, October 18, 2DDS 11:03 AM
170: Reggie Warren
Subject: RE: Status of things
Reggie,
I
will hit you with the quirky billing issues as they come up. As far as the general 2
issues, we were originally told to Bid Cents bill & & APS under Item 1, ALE under Item
and Displacement under Item 3. Then we were told to billwe Bid &
Conts APS Displacement
& &
tinder Item I and all other ALE under Item 2. RerentJy were told to till everything
under Item I which obviously reduces the fee amounts substantially. The adjustors are a
I do want to ruzi uur reupun/reinspection procedure by you to nake sure you are OK with it.
We
starting to get policyholders
are calling us after receiving their estimate and check.
Most want more money.
call think the check is low and missed
who Some cite 5pecifics such as the
djuster didn't look at everything, they something that the Insured has now found,
he policyholder just remembered something or they suddenly don't like the adjuster and
don't thirk the adjuster did a thorough job.
the estimate and report to address each call. The other day we had
a
We are pulling
policyholder call and ask for a reinspection. I looked at the report and it was one of the
I have The insured had a Tiki hut and there wasn't one piece of straw out of
best seen.
and the file was well handled and well presented.
place. There were excellent pictures
After looking at all of this we advised the insured that if they had some evidence or
documentation to show the adjuster did an incomplete job or that they missed something or
we would back out. Short of that, our expert had done their
their pricing was off, come
did anything but a
inspection, in their presence, and we find no reason to indicate they
thorough job. We
leave it at that and refer them to their policy. We do not
tell them we
way to you. Essentially,
to
call we
TWIA. However, I expect they will eventually find their
feel have made a good faith effort and that the burden is now shifted to the insured.
We had another one where the policyholder was on a tear so we looked at the report. Iz
looked pretty good but we thought there might be some holes in it so we sent the adjuster
back out to take another look. After a second inspection the insured was still not happy
so we sent another adjuster. It has been resolved but I must say the third adjuster saw
coming off other
something different. I
actually have a couple uf great mop up adjusters of these problems
deployments. I would like to bring them here because I think the volume
me know.
is going to reacn a fever pitch. if you think you can use them, pledge let
OK
to stand on the report and
Question is: If we feel the adjuster did a good job, are we
gently tell the insured that we need some credible evidence from them in order to come
back out? We usually sugge3t that when they get a contractor involved, any shortages or
inconsistencies will get worked out.
T
was going to keep this email short but I must have gotten too much sleep last night.
Thank you.
Jeff Kaiser
-----
Original Message-----
From: Reggie Warren
Sent: Sunday, November 30, 2008 11:47 AM
To: Bill Knarr
Subject: FW: Supplement Billing / Dolly and Ike TWTA
to go back out on ICC claims. Again, ICCis paid when incurred by the
In addition, depending on the circumstances, it is not always necessary
insured up to the specified limit in the endorsement. IF it is something unusual and costly, it may be necessary to reinspect.
Thanks.
-----
Original Message -----
From: Craig Scott [inailto:cscott(cb,])ascoclaiiiis.coin
Sent: Sunday, November 30, 2008 11:34 AM
To: Reggie Warren
Subject: RR: Supplement Billing / Dolly and Ike / TWIA
Reggie,
does not yield any need for supplement? Do we bill the Flat $200 for re-opened file?
Also, what if the re-inspection
Craig Scott
PLAIhMFPS
EXHIBIT
Li I TWIA-Instit-00019279
PASCO CLAIMS
"Supplement Fee Schedule" attached, effective for Dolly and Ike supplements worked on or
We have enhanced our supplement billing per the revised
after December 1, 2008.
and supplements. We do not like them and are getting way too many because
Please fully read this document and understand our position on reopens
the job was not done properly the first time,
We hope that this revised fee schedule for will aid in getting supplements handled efficiently-
Reggi e Warren
CONFIDENTIAL TWIA-Instit-00019280
From: Reggie Warren
Sent: Thursday, October 30, 2008
To: Reggie Warren
All,
It is highly important that we are professional, nice and undersianding of each person's issues with their individual claim.
An appropriate amount of time should be spent with each insured to explain the adjustment process. This includes intervic'Aing the insured and
collecting all the information available to assess and adjust the claim.
Based on the calls we are geuing, this is not being done much of the time.
not meant for them, bin we all need reminderi from time to time.
The ones that are doing the professional job know who they are and this is
getting calls and complaints which later turn into lawsuits. We all must do our job better to achieve this goal.
Our goal is to avoid
office that our cmails with instructions and directions for adjusters are going unread and that is unfortunate.
It is
apparent to me and others in ths
continued rclafionship with TWIA beyond IKE and DOLLY, and if that is the case, it is imperative that you
I
feel that )'our firm is one that wants a
follow our instructions.
informational email you Lbat Should help with SX)tne of die I tzurring issues in die ddjustments.
Luter (oda5 or toinonow.
I
will bc sending dn
it)
Reggie Warren
TVAA Austin
By Laura Elder
The Daily News
Five months after Hurricane Ike struck the upper Texas coast, thousands of
frustrated policyholders still are awaiting payouts, or are negotiating larger
settlements from the state-backed windstorm insurer.
The Texas Windstorm Insurance Association has received go,656 reported losses and
paid $905 million in claims from the Sept. 13 storm. But 10,500 claims are
unresolved either because they involve very large and complicated commercial cases
or are mired in the murky question of whether wind or storm surge caused the
damage.
Throw in a vast number of claims, battles about whether entire roofs or just a few
shingles need replacing, the work of a few inexperienced adjusters, some
policyholders who want something they don't have coming, unsubstantiated reports
of tornadoes and you have a process bound to bog down, officials say.
'I would prefer, obviously, that we had no open cases and everyone was paid and
happy, but there are so many complicated issues," said Jim Oliver, windstorm
association manager.
Whatever the reasons for unresolved claims, some county residents and business
exactly how much
owners say they can't plan their futures or rebuild until they know
pool.
money to expect from the association, also known as the windstorm
About 3,000 windstorm pool claims were for total losses. Nothing was left of
PLAINTIFPS
insured dwelling but slabs or sticks. EXHIBIT.'.-
Some of those come from the hard-hit Bolivar Peninsula, where Paul Ray Heinri
Hurricane Ike pushed unimpeded storm surge as high as 20 feet over the peninsula,
wiping out almost all the houses in the tightknit Gilchrist community.
The Heinrichs, who were insured for vAndstorm but not flood damage, are living in a
trailer in Hitchcock courtesy of the Federal Emergency Management Agency.
The windstorm pool has given the Heinrichs, some insurance money of
- lo percent
their policy's limit and 5 percent of the contents'value.
But the couple is in limbo until they know how much more insurance money they'll
receive, they say.
'We feel we're still entitled to the full value,' Paul Ray Heinrich said.
Paul Ray Heinrich describes the status of his claim as "pending, pending, pending."
Each week he calls a special number, only to be advised to check in another week, he
said.
"This has been very frustrating for me and my wife because we cannot make any
realistic future plans until we receive final settlement from windstorm," he said.
One bone of contention between some policyholders and the windstorm pool is
whether tornadoes or storm surge flattened houses on Bolivar Peninsula, Oliver said.
Without a property left to assess, the windstorm pool is forced to rely on complicated
computer modeling - based on information experts collected on houses still standing
to decide how much damage was caused by wind.
-
In cases in which the house no longer exists, some delays can be blamed on lack of
photographs or video showing what the house looked like and contained.
Roof Rage
http://www.galvnews.com/story.lasso?tool=print&ewcd=38e69d I
fl 20cbbfl 11/5/09
i tiousanas still awaiting windstorm payouts Page.3 ot.@
One of the most common windstorm insurance disputes involves roof damage.
About 20 percent of Leonpacher's clients have big problems with their roofs and their
insurance, he said. Leonpacher accuses the windstorm pool of changing the rules as it
goes along.
"Last year, significant wind lift of shingles was considered damaged shingles; this
year's it's not," he said.
Buildings are assessed case by case, and each case is different, Oliver said.
In most cases, shingles lifted by hurricane winds will settle back in place, Oliver said.
If shingles are cracked or split, the pool will pay to replace them on an insured
property, he said.
Almost every shingle in areas hit by Hurricane Ike was lifted by wind, Oliver said.
"We can't replace every single roof in Chambers, Galveston and Jefferson counties,"
Oliver said.
Unless the shingles are damaged, they don't need replacing, Oliver said.
If an entire roof needs to be replaced, the windstorm pool will pay for it, Oliver said.
Costly Delays
Island businessman Craig Brown knows how costly the slow claims process can be.
A windstorm pool adjuster asserted damage to the building's roof occurred before the
storm and wasn't covered, Brown said. Brown didn't agree. Shortly after, a rainstorm
caused water to pour into the building, which never happened before the storm,
Brown said.
Brown called the adjuster, but the two could never agree. Finally, Brown hired a
public adjuster.
During all the negotiations, Brown was forced to pay out of his own pocket to make
repairs to the building so he wouldn't lose his loft tenants.
Not everyone has the financial resources to wait insurers out, he said.
"If I was someone who didn't have those resource at that time, I'd just be dead in the
water,' Brown said.
'It would have kept my tenants from getting back in, so it could have turned into
quite a financial concern for me.'
"I think some adjusters are very seasoned and are from this area, and others didn't
have that much experience," Brown said.
"There's a learning curve," Oliver said. 'Some of them were not the greatest - they're
not terrible and when that happens you end up with a second and even a third look
-
at the property."
Complaint Files
As of Feb. 9, policyholders had filed with the Texas Department of Insurance 1,007
complaints against the windstorm pool - the highest of any Texas insurer. Of those,
the insurance department deemed 382 "justified,' resulting in the return Of $5.9
million to consumers.
The top reason for all insurance complaints after Hurricane Ike was slow settlement,
regulators say.
Windstorm pool officials argue the number of justified complaints was a small
fraction of the claims.
Although the pool bad the most complaints of any insurer, it also is the largest writer
of windstorm insurance along the Texas Gulf Coast as private companies flee the risk.
The windstorm pool, with more than 200,00o policyholders, is insurer of last resort
in 14 coastal counties private insurers consider too risky.
The windstorm pool, made of all casualty and property insurers in Texas, had about
$2A billion available to pay claims from Hurricane Ike.
Because it's backed by the state, the windstorm pool has money to pay all claims,
officials say.
"The claims that are remaining are larger or more complicated," Oliver said. "If there
are loose ends to tie, trust me, we're going to tie them, but it takes a little longer."
Copyright @
2009 The Galveston County Daily News
so
PLAINMFF'S".
EXHIBIT
TWA-instit-DOW5946
From: Reggie Warren
Sent: Monday, September 29, 2008
To: Reggie Warren
is a spreadsheet or our latest revisions. The market has driven the prices higher, mostly in the area of pctrolewn based roofing materials.
Attached
We also added a few items.
if it is not on this list, it is A to tise the prices in voter particular adjuster software program
This guideline does not coverall items, so
and adjusters should not tell anyone this is TWIA pricing-.11-1,11it is a gWdeline only.
We expect good judgment when preparing estimates
Most of the prices include all the 'add-ons' etc so plcasc point this out to adjusters.
If there is a variance in the prices. up or down. the adjusters shotild explain in theit report to TVA A.
Thank you,
Reggie Warren
TMA Claims
Austin, TX
PL AIN71FPS:
EXHIBIT
TWIA Instit DOOD6522
From- Bill Knarr
Sent: Thursday, June 19, 2009
To:
ReggieWarren
Reggie,
Richard has report requiests cotton said they could live %vith what we
hist a few recommendations out.
I
have
had'!7
Steve
We should
Vincents report from
put something
8-0
together Monday.
Going to lunch, buy weed cator, and pick up Sherlock. Should be back about 3
or so,
--Original Mn%agc----
Froin: Reggic Warien
Scnt: Thursdav. Junt: 19, 2008 11:50 AM
To: Bill Knarr
Subject: Price Guidelines
comprehensive Glenco and Lon Smith and we obviously need pricing for other items in addition to roofing.
be as as
I
think we aTewaiting on information from:
1.) Steve V incent and Basco (Gene getting info from Steve too)
2.) Merlin Orr, Corpus area
3.) xactiniate
4.) MSB
5.) We have Glenco Rmifing, Fort WoM
6.) We have Lon Smith Roofing, Awstin
PLAINTIFF
Office hours
0 Seven days a week until notified otherwise
0 7:30 to 6:00 most days, weekends 8:00 to TBD (exceptions to be approved by
Reggie, Kevin or Bill Knarr)
0 Goal to get all losses received entered and assigned the same day, possible
Dedicated Adjusters
• Issues-dedicated to TWIA, expected to fully resolve claims assigned to you
• Adjusters prohibited from switching to another Ded. Adj. Firm unless permission
received by TWIA (Reggie Warren or Bill Knarr)
• We must have your contact info, email, license #s and cell phone
• Keep good records of your arrival and departure dates (principals)
Identification Access
• Texas does not have a badging system
• Local officials have authority on entering the storm area
• Make sure you have appropriate ID i.e. Copy of adjuster's license, business
card, information about the company you work for
Assignments
• Assigned as geographically as possible via your principal
• Handle your claims, no subcontracting out to other firms beyond your company
• Watch for excluded items, such as APS, on your assignment sheets
Contact
• Quickly as possible, preferably within 24 to 48 hours
• Drive by, door hangers supplied to principals or at mobile office
• TDI Building Code brochures, I have supply-give to insureds at initial meeting
• Work weekends as dictated by work load
• Return your calls. Keep your appointments. Corrimunicate!M
Temporary Repairs
• Upon initial contact, inform insured
• Keep receipts, take photos, make lists
• Only temporary, not permanent
• You must be able to see the damage to determine causation, coverage and amount
• If permanently covered up, submit question, ROR mk*, be needed
PLMN11FPS
EXHIBIT TWIA Instit 00000229
Advances
• It is important that once liability / coverage is reasonably determined we look into
making early advances, especially for clean-up. Possibly up to 20% of the
potential loss with appropriate follow-up documentation
• Email the requests to your assigned adjuster mailbox at TWIA or call if a big loss
• If over $1 OOKsome explanation for the need of an advance
• Multiple advances, let us know which Item of Insurance is involved in the
advance
• Who do we pay
• Where do we send the check
• How dowe send, regular or overnigght
Inspections
• Prioritize by degree of damage
• Review loss notice, investigate fully, consider all coverages
4P Full adjustments needed
• Take sufficient number of photos, dwelling, building, personal property
• Photos, diagrams (roof, perimeter as needed)
• Ladder rental, get permission from your principal, send invoice to TWIA separate,
not part of the gross loss
• Make inspection under temporary repairs. Must confirm wind damage v.
deterioration etc.
• Secure documentation, invoices, photos, estimates etc. from the insured. We want
to consider all evidence/information available to make a final determination on
the claim.
• If insured asks you to talk to their contractor, you need to do it or make a good
effort to do it. Document your file on these issues.
• Be careful in all aspects of the physical inspection especially climbing roofs, etc.
If you feel it is too dangerous to access part of a building, etc, notify your
principal supervisor and determine the best idea for inspecting and establishing
the covered loss. Supervisors at TWIA can be contacted about this issue as well
Coverage/ Policies
• Dwelling, Commercial and Mobile Home policies
• Direct physical loss caused solely by windstorm and/or hail
• Loss from general power outage not covered
• All policies and endorsements on TWIA website bttv://www.twia.o
• Concurrent causation (rot, deterioration, other perils) not covered
• Commercial, no wind-driven rain -
Deductibles
0 In most cases, each item (building, personal property, flag poles, whatever) has a
deductible shown on the assignment sheet.
* Watch commercial deductible, some by item and some by occurrence
0 No need to prorate occurrence deductibles any longer
9-15-07
2
Humbetu guidelines,
TWIA-instit-00000230
Major Endorsements
* 400--ACV Roof-watch for closely
0 320-ALE, wind-driven
rain, consequential loss
* 431 and 432, ICC (additional insurance, incurred, % of coverage per loss notice)
0 164-RC for commercial (some items excluded from RC such as carpet)
0
365-PP RC coverage, dwelling
0 17-Business Income, Extra Expense
0 280 and 282, Condo Forms
Condo Losses
• See separate paper to follow
• See Section of Adjuster's Handbook
7
• Identify the trustee or president of the association, document and work with that
individual.
• Make certain we can pay the association and the trustee on the loss instead of
including all the morigagees
• Watch for duplicate coverage with unit-owners policies
Tree/Debris Removal
• Reasonable cost to remove off covered property, this means off the premises i.e.
cut up and haul tree off premises. Good judgment needed here on expense etc.
• Not additional insurance above stated policy limit
• Tree values are not covered
• No lawn clean up. Can consider lawn repair if damaged in tree removal efforts.
Reserves
Confidential to TWIA and the adjuster
.
0 Must notify us immediately if $I 0,000 paid claim or over
& Can submit in list format with Claim #s, your follow up report should document
e Email to your assigned TWIA mailbox or call TWIA if urgent
Price Guide
0 If you work in MSB IntegriClaim. and desire a download of prices, please advise
us. Call Bill Knarr at 512-637-2902.
3
Humbeft sidelines, 9-15-07
TWIA-instfl-00000231
• Ernailed to principals last week-let us know if issues with pricing I
• One guide for seaward of Intracoastal and one for inland of Intracoastal, revised in
July 09
• Guideline only, any deviations need to be explained by the adjuster
• Will advise when to change to reflect price increases, if necessary
• Apply depreciation as warranted, tax on materials, oh and p (except roofs, fences,
flooring and single trades)--always consider oh and p, if questions, ask
• Use good judgment (is oh & p likely to be incurred)
• Is it a complex loss requiring a general contractor to coordinate?
• Flexible, changes if necessary, explain why
• No oh and p on temporary repairs or on incurred expenses of the insured i.e.
water extraction, debris removal, tree removal
Adjuster software
• MSB IntegriClaim preferred
Others accepted if all needed information is provided
•
• Make certain your firm's name is in the letterhead of your estimates and reports
Displacement Payments
• If insureds were mandatorily evacuated by government order from their
Primary Dwelling due to Hurricane IKE, we will consider S100 per day up to
25 days for displacement.
• Displacement payment is limited to the days the insureds are not permitted
to return to their home. FOR M THIS VVILL BE CONSIDERED PART
OF THE ALE CLAIM AND SHOULD HE CODED THIS WAY. Typically
no written documentation is needed for the evacuation expenses. It is
predicated on the number of days they were away from home due to the
storm and evacuation.
• It is possible that when the insured returns home they will have a true ALE
claim. This should be handled on based on the language in the 320
endorsement. Incurred, reasonable, necessary increase, normal standard
of
4
liumbedo guidelines, 9-1 5 -07
TWIA-InstLOO000232
• If the insured returns homeand rinds no windstorm damage und we have not
paid displacement prior to your inspection, no displacement for evacuation
expenses are to be paid. We pay displacement for Primary Dwellings where
evacuation was mandatory and where it is expected there is a covered
windstorm loss to the dwelling. We may accidentally make an advance
payment and then rind there was no damage and that is ok. But, we do not
pay displacement money wben it is known there is no windstorm loss.
• Commercial losses are not covered for displacement.
Building Code
0 431 and 432 endorsements, watch for need in ICC, work must be done and
expense incurred
* We do not pay engineer fees for certifications of repairs
0 Engineer fees for design of reconstruction will be considered, no commitments
until reviewed by TWIA
Reporting
* Acknowledgment via PDF and will be dropped in file for supv to review. ID
adjuster, our claim number, insured, adjuster's phone numbcr. Cc agent with
acknowledgement that is mailed to insured.
a First report, 30 days
0 Every 30 days thereafter
* Short form, urJess something unusual
9 Date assignment recd, date of contact, date of inspection, who did you inspect
with
e Email PDF TWIA.adjusterrepts@twia.org or each firm has its own T`WLk
mailbox
e Individual PDFs, no zips
PDFg.
0 If file is too large, may need to break it up in multiple
a Label the PDFs with correct TWIA Claim # and insured's narne.
9-15-07
5
Hurnbeno guidelines.
TWIA-Instft-00000233
Underwriting Risk Reports
• Not required on IKE claims
• But,ifyouseenriskthatyoufeelisundet-insured,includethecommentin
your adjuster report.
Consequential losses
0 310, 320 endorsements
a no deductible under A. 1.
a Under A. 2. of endorsement, $500 off premises, not automatic
0 Personal Property deductible under A. 2.
* Refrigerators and freezers, need some doe, lists etc.
9 Not covered under the Commercial PO&V unless there is physical windstorm
damage to the power, heating or cooling equipment located on the described
premises. Must be physical damage, not surge.
Contractors
9 Make sure they are aware there is a required building code
0 Be cautious of inflation, price gouging
* Large losses, paid estimates if necessary (must by approved by TWIA)
* Make sure you know who you are working with
0 Where are they from, local or out of state
0 Knowledge of code
& Years in business, reputation
Public Adjusters
• Read about PAs on TDI website http:/1www.tdi.stSte-tX.Us/
• Try to work with, but if not, calculate loss and we ran pay undisputed amount
• Public Adjuster has to prove loss above undisputed amount
• We need their Texas Adjuster License and contract with the insured if they want
their name on the checks
Mold
• Not covered
• Will pay to remove mold damaged materials to get to covered loss
• No testing
• No remediation
• If necessary, we can write ROR
Proofs
• Waive Prooti up to $25,000 paid claim.
• 1A firm principals have authority up to $25,000 paid claim.
• Any potential paid clairn over $25,000 must be submitted for approval.
• Provide proofs if not closed in 60 days, blank and/or filled in with your numbers
• DO NOT FORGET to do this.
TWIA-instit-DO000234
0 4'.41 and 432 ICC endorsements
Reservation of Rights/Non-waivers
• Identify the need for-late report of claim, repairs already made, outside policy
period, loss not covered (i.e. mold)
• If someone pushes mold claim
• Permanent repairs with no supporting documentation
• If insured will not sign non-waiver, go ahead and investigate. We can send ROR
later. No commitments.
Engineers/Experts
7
Humberto piddines. 9.15-07
TWIA Instit-00000235
• Segregate windstorm damage from flood damage as best you can. Hopefully,
weather reports post-storm will have Windstorm v surge timelines (hat will
help.
• Be sure to ID the flood carrier and adjuster and report that information to
US.
Asbestos/Slate roofs
• Pay attention to pre-loss condition, old damage and patches
• If more than 2 squares directly damaged by Dolly, allow for complete asbestos
roof and depreciate accordingly
• RCC will catch actual expenditure
• Will have to allow more for tear off .. see price guideline
• Plank decking should suffice for new roof if no gaps more than I inch
• Otherwise will have to fill gaps or re-deck and felt
• Brass fasteners rusted loose
• Remember, we are looking for direct windstorm damage and not maintenance or
long-term problems
• We do not cover reniediation of asbestos
Checks to insured
• We issue all checks from Austin, mail directly to insured usually
• Good addresses ioceded
• May need to send to adjusters to deliver
• Document advances with partial proofs or advance pay receipts
• Check mortgage Company accuracy.... let us know the new information if
applicable
• Recommend payees if different than what policy indicates, get documentation of
mortgagee change
Mail
Regular
Ovemight, U. S. Mail (we may have to overnight things occasionally)
9
Humbrno guidelirm, 9-15-07
TWIA-Instft-00000236
necessary. May need to leave at least one expericriced adjuster per firm at the
Salvagc/Subrogation
• Always consider, use good judgment
• Leave salvage, take credit in the adjustment when you can
• Commercial losses could allow for oDrisiderable salvage recovery
• If necessary, we can use USA Salvage, Tom Shore (972-243-341 1) also Lee
Shore 800-229-0578
• Call us first if you feel we need to involve USA Salvage
Reinspections
in
• Random losses will likely be reinspected by TWIA personnel or others early
the storm
• It is very important that you provide accurate information to TWIA about the loss
Dress Code
• Be professional
• Consider how you look when someone opens the door
• Casual, comfortable
• Do not want to make a definite code
• Any complaints about the way you look, will result in a drastic dress code
Media
• Do not talk to the media
• Refer media inquiries to Reggie Warren
We have a media rep, Jerry Johns with SIIS in Austin. Jeny's cell number is
•
512-965-4001
File Audits
• TDI
• Date contacted, inspected, adjusted and closed documented
• Document your files with narrative activity notes
9
Humbato guiWines, 9-1
W
TWIA-instit-DDD00237
From: Reggie Warren
Sent: Wednesday, January 14, 2009
To: Lopez. Ramon M.
Ramon, ok to proceed Aith Xactimate although your highlights below do not support USAA doing so and I never verbally gave USAA the authority
I
will advise our staff to not kick back Your reports due to pricing as long as you are consistent with pricing at YOUT end.
Also,ltl-iiiik-wesl-ioWdreviewtlieSAPfortliisyear(2009)eventlioughwerecentlysignedaiiewagreeinentwithUSAA. Weneedtodetennineif
this program is feasible from an efficiency standpoint
Thank you.
Reggie Warren
P. S. Joe, A] you please advise the Fxaminers ofthis change via email or ask Ray to do it. 'Ibanks.
----Original Message-----
From: Lopez, Ramon M. [rnailtoRamon.Lopez(ausaa.com.
Sent: Tuesday, January 13, 2009 3:12 PM
To: Reggie Warren
Subject: FW: CONFIDLNTIAL: TWIA Claim Issue
Reggie,
Here are two items based on your request for written documentation in reference to pricing guidelines.
A. 3.) Pricing guidelines (may need revisions as we go through the storm). Same as Dolly
B. Dolly correspondence states, 'pricing guideline (seaward and inland') that we arc asking adjusters to use for TWIA losses. This is only a guideline
in an effort to achieve consistency, but can be deviated from with appropriate explanations.
Approxiiuately 90% of TWIA USAA inernbers have received compensation based on the Xacti-inate pricing guide, the estimates appearto be in hue
,Aith TWIA expeotaLions based on this percentage of submitted claims paid. The estimdtes written in Xactimate/TWIA furmdL are estimates only and
TWIA examiners must feel our estimates are sound based on the par), rate. I hereby request your uonstrit to continue using our XdUtimate pricing
guide in an effort to not place fur(her postponement on these claims. I am certain we will come to an amicable resolution as we have the same goal
in
Kind Regards,
Ramon
PLAINTIFF'S
EXHIBIT
TWIA-Instit-00014221
From: Reggie Warren [mail1oREGUlE(&,,TWlA-QRU1
Sent: Sunday, September 14,2009 12:48 PM
To: USAACIaims045; Louis Slovensky (F-mail) Mike Dugr2er (E-mail)
Cc: Bill Knarr , Kevin McFarlin; Joe Rosentritt; Ray Roe
Subject: Hurricane IKE Info/ SAP/ TW`IA
dous that I failed to send earlier. I know this is a lot Lo take in during a busy time:
Gentlemen. I am attaching suine
9-11-08. Deals with the billing of "no claims" and "no coverage" claims. Please review
1.) TWIA Fee Schedule with slight revision begin=g
closelv.
2.) Outline to adjusters about various issues, to be covered in the orientations when we have them (not scheduled yet).
3.) Pr-icing guidelines (may need revisions as we go through the storm). Same as Dolly
eff 09 I 081 doc>> <<adjtrster meeting outline SEPT 09 l.doc>> -Tx Coastal Repair Cost Guide.XIS July 22 08.Xis-
<<Fee Schedule 3 I
TO POINT OUT ARE THAT WE HAVE STREAMLINED THE ADJUSTER'S WORK AS FOLLOWS FOR HURRICANE
THE MAIN THINGS
IKE CLAIMS:
4.) We do still need diagrams of roofs and structures along with calculatinns.
are still in place. Please look over the outline and get a copy to your adjusters
5) The remainder of the requirements
Thanks,
Reggie
SAP. This nteans if your- insured has a flood loss and policy
WiLli of having flood losses, it is my request that we Handle Dolly under the
the potential
T"AIIA policy you would keep and handle the TWIA loss and report to us as in the past.
with your Company along with a .......
TWIA-Instit-00014222
Reporting Losses
You will only need to email us a list of TWI-A losses daily.
We will need the TWIA policy miniber, insured's natue, insured property location for each loss.
We will set up the file and email or fax the assignment sheet to you.
Adjuster Reports
Please PDF your adjuster reports to TWIAa4just=eptsPtwia.org
-Tx Coastal Repair Cost Guide.xls July 22 08.xIs- -Fuel surcharge memo June 08.doc- -Fee Schedule 3
eff 04-01-08.doc-
Ramon, there must be some misunderstanding if you are saying that I said it is ok to use Xactimate pricing. I may have said it is ok to use Xactimate
but no Xactimate pricing. As a matter of fact, I specifically remember talking to various adjusters in Santa Fe about this very issue. The reason is
this we personally went through an extensive project prior to the stomis to determine fair pricing for various and many repair processes. We
........
caine up with our own price guideline furadjusLers to we whea handling TWIA claiins. The purpose was so we could attempt to achieve cuilsisLenuy
in pricing because we use many IAs and they are allowed to use various software. I would not have given anyone permission to use Xactunate
prices.
If you have a written directive from me or the TWIA Claims Department regarding please provide it to me. Otherwise, our position is
this matter,
that we have always instructed adjusters to follow our pricing guidelines in every including Dolly and Ike. There may be occasion when your
storrit,
estimatewitbXactimatepricingslipsbyanExaminerandwepaytheclaim. Ifthathappens,sobeit. Bu@ifaTvNqAExaininerr-atchesthisand
returns it to you or your adjuster, the estimate should be revised accordingly.
If we allow adjusters to use pricing with each software, the pricing \would be very inconsistent throughout the claiiiis and I perceive that as a
problem. That is %why we consciously we researched and prepared our own guideline.
If the adjuster needs to deviate from our guideline for good reason, that should be explained in the narrative report to I WIA
Also, I have been recently advised that you have one adjuster handle the Dwelling and another handle Personal Property on the same claim file and
TWIA-Instit-00014223
one report and one invoice based on the distributed fee schedules.
send us two separate bills. This is
not the way we want it. We Nvant
WecannotallowourselvestobeoverlyconcemedN,,ith,vN,hatUSAAdoesontheiroNNmclainisandfloodclaims,.%benitcoinestopricing. Basedon
from TWIA policyholders, our pricing, especially roofing, is very close in line with what insureds are
RCC statements and invoices received many
actually expending on their repairs.
I
am not sure why this issue is being presented to me this late in the storms, but the above stated is our position on these matters and the way it has
been since inception.
have the claims pro-.ess in the best possible manner for TWIA and its policyholders
I am sorry for the confusion but we at TWIA to manage
Thank you.
Reggie Warren
(Reggie Warren]
-----
Original Message -----
From: Lopez, Ramon M. [mai_Ito.Rarnon.Tn e7 iY-itsaa corn]
Thank you,
Ramon Lopez
210-315-7190
TWIA-instit-00014224
From: Reggie WwTen
Sent: Sunday, December 14, 2008
Wiley LeRrun (E-mail). nilebrunlouhrhinc.com;
TO: mleb@run@uhrhincxorn
ltivasbrc)utzhttomyattcntionthatscvcmlofyourFilcsarcbcingkickcdb8ckbecauscofpo,ora4iustrncnts. laskodoncofthC3upcrvisorsrc,%.-icwing
up of tic issues and I Aill summarize in bullet forniat:
your files to give ine a briefwrile
Estimatinp to replace roof@ that are not a total loss from windstorm
Paving for roofs with 'lifted' shingles Ahen there is no physical damage or loss
stalingthingsinvotirrepoTit'nalaTenotrepresentedinihephntn,.; i.e. 4ff/oofshingIL@;mi,;.,;inghtttpbcgo..;RhowTx),%binglesmi-,,;inL2
No evidence to support the adjuster got on the root Photos being taken with telephoto lenses or at least
it
appears dial way.
Roof diagrams created from ground level measurements
Inflating the RC estimate to generate a substantial fee bill
Failing to consider repair V replacement
Estimating tree removalwith no documentation or photo of the tree or stinnp or evidence it damaged covered property
Not scgrogating windstorm v flood/surge damagc. Including flood damagc in the wind estimate.
Estimating damage for inherent defects that are not related to windstorm damage
tinder the TWTA liolicy each claim and it is critical that we do not overpay or pay for iterns no( damaged
We want Io rMy ever) cent owed cAmIrnel tin
or covered
Please improve the quality ofthe adjustments and have each file supervised by quality control
Your firm has a substantial
before submission to TWIA,
number of files
"I open.
We am doirig our best to Set claims paid and closed and ifwc have to return files, it obviously bogs down the process.
Reggic Warren
TVAA Claims
Austin, TX
CPS,
TWIA Instit 00016527
From: Bill Knarr
Sent: 'Mursday, September 25, 2W8 10:24 PM
To: bicketts(a)gabrobins.com
showil,
We arc working on the revised price guide, hopefully wc will distribute tom=
wTow. 1%4illhaveado%vnioadavailablethati-Aillk-ndyouto.,harelxith=
the adjusters rising Inlegn. (Arr efforts to hRve a price guide is to h;rve=
consisteritcy among all fmns and adjusters. Sheetrock is one of the items=
@itenor and
including extenor paint that all software vanes greatly. W=
hat we have is higher uint cost for one line item and not the PA add ons of=
remove and replace light switch pla(es, ceiling light fixtures, mask here,=
cover up here etc. We don't Aunt that. I want the pricing for regular im
ams on our price guide to be the Same 90 Our supervisors don' t have to run
Lo
me with every file. IntegTi is our software of choice. If isolusters wa-
nt to inc somothing else, use our prices. If they don't we get roopcncrs o-
n top of reopenm when neighbors compare their esliniflics.
Bill
--originO Messngc----
From: bickettsiftabrobins.corn [maillo:bicketWb!&tbLobinscqmJ
Sent: J hursday, September 2 5, 200b 3:40 PM
To: Bill Knarr
Subject: Pricing
Bill,
Al the meeting on Munday Reggie discussed the fact didt the current pricing
likely would be revised due to increases Do you know if a new price guide
is coming out qoon?
Secondly, fit; mosi or the adjumers are using Xaclimate he something ollier
is it that the pricing be exactly the same.
than IntegriClairn how important
I
know for shingles, decking, siding and the big items we want consistency
but what about drywall, paint and things like that. Is it going to be a
problem ifadjuderq uqe Xactimate pricing on some 4 thisstuff.
I
know you arc busy and I hate to bothar you but let me know your thoughts
on it it
Vou have a minute.
Tliankz
Shawn Rickert
- Supervisor
Cieneral Adjuster
GAB Robins North America, Inc.
8700 Commerce Park Dr
State 235
Houston TX 77036
T: 713-272-3321
F: 713-270-3800
C: 281-384-1165
PL AINTIFFS'.`
> All roofs are not total losses. We owe for direct windstorm damage. If more than 50% of the
roof is damaged and requires replacement, give consideration to the whole roof
> Our prick* guideline previously submitted includes OR & P for roofing prices. Do not allow
OH & P again at the end of your estimate, unless the repairs on the particular loss require a
General Contractor to manage.
> The complete process or replacing a roof is depreciable, including tear off.
> The other prices in our guideHne are unit prices that include labor and material. These unit
prices are depreciated when applicable.
> We do not depreciate minimum charges, debris removal, temporary cover up and other similar
items.
> Depreciation is usually derived from "betterment". Is the insured considered better off with the
particular repair procedure such as a partial replacement or a repair? Maybe and maybe not.
Adjusters should use good judgment in regard to depreciation and consideration of
44betterment".
> Check your loss assignment for prior losses. Identify if repairs have b=n made. If not, you
may need to get the information from us or the prior carrier about the prior loss, especially if it
is a large loss with unrepaired damage. This is part of adjusting a loss.
> APS is actually part of the dwelling and the I OP/o is not additional insurance to the policy limit.
Your estimate should reflect this accordingly. This may make a difference if you are using
software other than MSB IntegriClaim.
> "Slab" Claims with storm surze/flood:
• "Slab" claims are where the risk is completely gone or with only pilings remaining in
the case of an elevated structure.
There seems to be confiision as to what the adjuster is to do.
•
As discussed at the orientation meetings along with ernails to the firm principals, the
•
adjusters are basically on a fact-gathering mission on these losses.
• The adjuster is not to commit on coverage one way or another.
• Meet with the insured at each risk. Provide them the letter, Proof and Inventory forms
attached. Ask them for their help photos, diagrams, anything they may have.
...... Be creative to -rind ouL
Use the attached checklist to develop your investigation.
•
everything you can about the risk.
o Determine if there are witnesses. Interview.
Texas Wimdstorm Insurance Association
Box 99090. Austir% Texas 79709-9090
5700 South MoPac Exptessway, Buildft E, Suile 510, Austit%
Tem 7V49 # P.O.
512-8"-4900 Fax 512-9994950
2
Tams Wiscistorm Insurance Assmi2tion
P.O. Box 99090, Austia, Texas ?87D9-9D90
5700 South WPac Expm-sswvy, Building E, Suite 530, Austin, Texas 78749 *
5 I
2-M-49M / Far 512-299-495n
TWIA-Instft-00000407
HC#W" IftwnMn: ANClIvy
F A R M E R S 11I1(IhVY6
sojjuFt_TX775iO
(40rliAM2
(409)316-1401 - Mdm
Fax r. (4(ftl I 6- 1391
October 4, ZWS
PaxAI-. 1-512499-4953
Estionates
- Rmfing
Rn. Rirric%mr. Wo-.
Sincerel
scope
0/4
Howartl
Mm insar&M E**&AV
rrvl* 110mrUDW zxdWqW
I@L PffMC= Ncw Warld LA )=arm= Comany romm Voroup. Inc.
Mid CAAWry Big OunwWr
-----
Original Message -----
From: Reggie Warren
Sent: Sunday, September 21, 2009 9:08 AM
To: Russell Stout
Subject: RE: Roofing Prices for Houston
fix this unlessvve change based on these numbers and send it out. Prices will
We have provided our price guide to adjusting firms. Not sure how to I have to
Dolly losses in the VALLEY. I will tliiA- about it and come up with something.
likely change again before long plus this could affect our
meet with adjusters tomorrow and Tuesday.
-----
Original Message -----
From: Russell Stout
Sent: Sunday, September 21, 2008 7:57 AM
To: Reggie Warren; Bill Knarr
Cc: Russ Davis
Subject: FW: Roofing Prices for Houston
and/or additional feed back that has occurred. It does not appear our initial
Reggie & Bill, after you guys consider please let us have your thoughts
price guide will hold for long regarding roofing.
-----
Original Message -----
From' Russ Davis
Sent: Sunday, September 21, 2008 7:48 AM
To: Russell Stout
Subject: FW: Roofing Prices for Houston
Russ,
We will be sending in some agreed price closed claims with insured's this
weekend. They will
WORD FROM THE FIELD
I
HAVE CONFIRMFD:
the insured's can find a roofer thatAill replace their roofs. Please call when you have a
on roof- as soon as
open right back tip for supplementals in Houston.
Holden Roofing today. We have dealt with Holden Roofing for years
moment. Attached are the roofing prices we have received from I have
companies in Houston and 1
have dealt with the owner Brett Holden many times myself over the years.
'they are one of the largest roofing
I had requested him to send me his current roof prices as well as a letter from the VP of
known Brett to always ran a fair and honest roofing company.
increase. He has additional letters he has recently received to support
Owens Con-drig dated 9-5-09 about a week before the hurricane addressing cost
will them to me the next couple of days or so. I will forward them as soon as I receive them for your records. Ben
the above statement and he get
insured's. But that when he is trying to get an agreed price on roof claims with
Ralph is telling me he is getting an agreed price for roofs with the
will accept TWIA/ TFPA roof prices for this hurricane. Xactimate has always been higher then
insured's that have roofers, the roofers not
through the 3rd quarter price list update this year on many prices, including roofing
Intigraclaim across the board. Xactimate went up halfway
transportation, to distributors to the roofing contractor and finally
approximately 20% due to fuell cost which effects from the roofing manufacture, to
with insured s that do not have roofers at this moment will supplement due to the roofers will not do
the insured. We know now that the claims closed
south side of Houston on a TFPA claim now. He has
them for current prices on the price guide. Ben is dealing with
J&J Roofing out ofAlvin, Texas,
will not accept an agreed price settlement due to the prices. TWIA/ TFPA
tried to get an agreed price on 2 TFPA roof claims today and the roofers
3 tab is $1 92.00 Roofers are getting from $230.00 to $2 55.00 a square
roof price for remove/ replace for shingles, labor & felt only on a 20yr. square.
lead jacks, valley metal or any type of roofvents. Xactimate
right now before the next material increase. This does not include drip edge, vent stacks,
above mentioned that is included per theTWIA price list guide we have received. Please let me know what
for roofing only includes felt, not all the
PLAINTIFF'S
EXHIBIT TWIA Instit 00015137
59A
with agreed prices with roofers then it is more then likely not true and
management has to say on this matter because if TFPA is getting closed files
supplernentals will. begin very soon. There are way to many storins in the USA right now and resources are stretched thin at the moment. We want to
issue will become explosive very soon for all of us.
get this right from the start or else the supplemental
Thanks,
Kevin Redd
(281) 392-2230
responsible for
Note: The infonnation. contained in this e-mail is confidential. If vou are not the intended recipient, or an emplovee or agent
have received this cominurdeation in error,
delivering this message to the intended recipient, do not distribute or cops, this coininui-iication. If you
please notify us immediately by replying to the sender, and delete this message. Thank you for your cooperation.
TWIA-Instit-00015138
From: Bill Knarr
Sent: Tuesday. July 29, 2008
To: Raymond Stewart (E-mail)
Raymond,
Thanks, Bill
like made.
Roofing
2. The roof pricing only has the replacement cost. Is tear off and felt included?
cstimatc?
used on the cover pagc of the adjusters
Docs TWIA have en opening statement they warit
N.
PLAIN'Mrs,
TWIA-instit-00014217
Thanks
Raymond Stewart
830-305-2461
rqewartl_a)pacesettcTclaims.cnm
RAyinund Stewart
930-305-2461
rstewarigVacesetterclaims-com
TWIA-instt-00014218
From: Bill Knarr
Sent: Tuesday, December 16, 2009
To: Bob Stump
Bob.
High. We are in the 20.00 range plus steep. I guess we could consider a tetabjob at X number dollars I have never figured it thAt way. Too many
variables. I'his crap all staLoed in Florida and prices for reroofshgs are about double in Florida compared toTexas. 400.00 to 500.00 per sq. If you
have a situation that merits authority above this range, let me know and we can discuss. Thanks
Bill
---Original Message-
From: Bob Stump [mailto:rstuinp(ftJw-assoc.comJ
Sent: Tuesday, Decettiber 16,2008 9:09 AM
To: Bill Knarr
Cc: jhd2OO24@aol.wm
Subject: Fw: Phil-RE: ROOF REPAIR
Bill:
sent you an email the other day concerning retab charges and esbmted S1085 for a standard roof. on double steep roofs. I
I A bit more and larger ran
those numbers by several roofers. who have also worked as adjusterr over the years-
Here is
a response from a Flofidw7exas licensed adjuster...who is also
a certified roofer for residential and commercial roofs in Florida.. He confirms
the bottom line numbcr, although be gets a bit more detailed in his approach.1 figirod. on time and material, he is suggesting a S30-S40 pcr SQUARE
charge for regular roofs plus the steep charge added on for tougher ones. That sounds like a reasonable approach If we am going to take the position
the tabs can be resealod/repaired, then N%z need a consistent price to write up and sell to the insured/roofers.
I would like tu send a memo to my people on S30440 per square plus steep if needed. How do these numbers sound to you and your slaM
T'hanks
Bob Stump
Hi Bob, regarding yow hand tabbing charge, your overall total number Ls exactly on at $I 000.
Be careful of the hourly charges of $30.oo per general labor and Exactimate S80.00 for a roofer.
2 roofers can hand tab about 5-7 sq an hour easily on a walkable roof, 6/12 and less. cut it down 7011/o for a steep. Steep roof;2 gills vim do 2-3 square
an hour bemuse of safety planks or one guy holding a rope. U might want to consider S30 to $40 a square for walks and give them the steep charge
for steeps. I would do all inclusive of materials and labor. Because as a roofer, i can argue all day and justify all kinds of extra charges like material
pick-up charges, taxes, additional men charges, safety rope harness charge as per oshdxactimatc, ladder and plank charges, hic& charges, trip
charges, difficult access and base scivicc charges to name a few. I wotild do the height and steep charge as one and note it. What u could got is the
roofer dropping u with incurred charges due to extra hours, etc. Then you are stuck reimbursing the insured, thats how i would hanimer the
insurance. are they going to f igbt over an extra grand? Tougher to fight over a per square all inclusive cost.
Good luck, let me know when you decide because i have a suppleziml done up wiLh hand tabbing a 40 a square Judy to go?
Phillip Coutu
Rooftop Roofing, Inc
I Mited States Ruginwm Development
561-541-2242
PLAIMIFF. &,@-Z'X'
TWIA-Instit-00014227
From: rstump@ciw-assoc-coM
To: phil70coutu@botmail.com
Subject: Fw: ROOF REPAIR
Date: Mon, 15 Drc 2008 16:34:56 -0500
Phil:
lbanks,
Bob
Original Message
--
From: Bob Stump
---
To: Bill Knarr
Cc-: john hinz
Sent: Monday, Dcoember 15,2008 4:34 PM
Subject: ROOF REPAIR
Bill:
PerTWIA memo received lost week, we have broadcast your requirements regarding roof repairs vs. replacements to all our adjusters.
that have aflegedly been xvind lifted and the seals broken, our adjusters are asking what
Concerning labor and matenal costs to reset/rescal shingles
allowances they should make for this ty pe of repair.
.
I
have played with some numbers and figured we could allot a crew of (4) for an (8) hour day at $30 pa hr. That would include all supervisory labor,
If we am going to repair this typo of damage rather than replacing, we've got to give our adjusters soine consistent numbers. The above would be fur
a standard size roof, they adjuster could allot more hrs if the roof was really large.
I'm running thex past some ronfer contacts., but thought I'd get your input,
'Ibanks,
Bob Stump
You live life online. go we put Windows (xi the web. Learn more about Windows Live
TWIA-instR-DO014228
FAX
To: From:
Nelson Howard Reggie Warren
Howard Insurance Agency Vice President - Claims
Mr. Howard, your fax was referred to me. We addressed the increase in roofing prices this
past
week and distributed a new guideline to all adjusters handling TWIA claims. While there is
mur,h more to pricing dm
saying $220-$225 per square,, our new guidelines reflects numbers in
this range when including all the add-ons you mention. There are many types of roofing
materials out there and we have considered the majority of them in our guideline, especially the
ones that contain petroleum products. We are certainly concerned with the price gouging aspect
and the possibility of "fly by nighf'roofers as you mention, but all we can do is allow a fair phice
for the damage covered by the policy, which is our goal to do. We are not Farmers as you know.
Our efforts will be geared to allow the right amount of money ftom the beginning and we do
not
expetipo reopen every file and pay a supplement based on a contractor that possibly overcharged
e Blind Proper review of pricing will be considered when the insured's file their RCC claim
@ir
'withheld
e depreciation.
I
a4#resses sorne of your concerns.
512-899-4902
"'PWNT1
"AM TWIA 1nstK D0000287
From: Ray Roe
Sent: Thursday, November 13, 2008
Amelia Key; Bill Astin;
Bill Hooper. Bill Jones-,
Bill Tassin; Bob Inmon;
Bob Latta; Bob Parrish;
Brad Short Carl Brown.
Cadiy Weidner, Charlene Coler,
Christina Turner-, Christopher White;
CoTv Kendnck, Dan McGuire,
David Dicks; Dean White;
Dernian Kolb; Diana Orta;
Don Fielder; Don Turner,
Gene Latham; Greg Briers-1
Helen Frank; Hugh Meloche;
James McRae. Janie Garcia',
Jason Garrett; Jennifer Armstrong.
Jerry Dickerson; Jerry Lerm
Jim Coggin-; John Hilliard;
To: John Wright; Josie Fielder:
Ken Colestock; Kenneth Robbins:
Kevin McFarlin, Kris Weidenfeller.,
Lance Cooke; Lou Skinner;
Mahe Merida; Michael Cortese-,
Miguel Riveros; Mike Calvin:
Paula Smith; Ralph Frank,
Rzv Drurv: Rai, Lang'.
Sam Jones, Sain Wellman:
SatoriSochandarnandou; Shane Gul1ley,
SheldonMaxwell; Sonny Jenkins-,
Steve Frve, Susan Hen-tn,
Tamfi Morgan; Terry Partlow;
Thomas Christiansen; Tom Glow;
Von Watson; WD Scott:
Wendy Scarborough-- Wesley Wemeking;
WifliamHaygood. Wilson Dunn:
Woodv McMahon
questions coming in as to bids on re-roofing that arc higher than the adJuster's alloAunces.
There are nutnerous
udjusier inore or less autuniutic;ally. ubeek to we if die adj"i ei ubed the ctirwrit pri" on his estanutz. Also check lo
Before referring dieni bulk to &
involved, tell the insured or contractor or agent that our
see if the insured is getting an upgrade. If he did use dw current price or ifan upgrade is
and they just need shop around some more to rind a roofer %%rho
will do the Nvork- for the amount allowed.
prices are sufficient in most instances to
Tf There iq a difference in the number of squarest, cit qnme n1ber imie that Teqtirez that the adjimter he involved, then do qn.
Ray
CV
TWIA Instit 00000658
From: Bill Knarr
Sent: Monday., August 18,2008
To: Ramond Stewart
Raymond,
One other firm had a similar qi=M ion and it tiuns out they wcm able to use some shingles from one of the other roofs that was being replaced that had
giving them it hard lime finale), admitted he had a supply of shingles
major too( damage, Would this be possible" Matter of fact, the roofer that wits
to repair.
I
am not ready to lay over and play dead yet. Check around the neighborhood I'DT a possible solution. I
bet not all the roots we being
for a small slopewith a laminated shingle and then salvage the shingles that are torn off
it
to make repairs on the other
replaced. Sometimes %ve alloA
Bill
--Original Message---
From: Raymond Slewarl
Scnt: Monday, August 18, 2008 11:27 AM
To: Bill Knarr
Cc:'Barrv Coleman'
Subject: Questions rc: Unavailable Roofing Product
Thanks
Raymond Stewan
930-.305-2461
rste.%vart@a,)P.qcesttterc-.Iitims can
is
It an increasing concern that evaluations ofrisks, commercial and residential, are very inconsistent among the firms handling TWIA claims.
Avearorsoago,weprovidedyourfirms,,AiththecapabilityofusingthecaleWatDr. Bachfirm,@,asissiediLsoi@mUserlDandPass%,voTdthatr@inbe
usedbyeachadjuster. IfyouhavcqUCSLionsaboulacocss,corAactBii]Knarrat5l2-6.,7-2902orbknarria-twia.oTg
In additioit. wc have notice that Ujidc-rwriting Risk Rcports arc oftcii inamipictc. Picase mak-c ocrtaiii tlim forms full.% Goinpictcd with accuratc
tuc
itirornwoon. or rtx)rs six agus orstruclures.
Finally, overhead and profit of 1 0 and I 0 should be added to the appropriate parts of the estimate cumulatively, making the total 2 1 %. The " Sample
File" in the bandbnok unfortunately %bnwq this incorrectly, although in Section 7 the inxtruclion;
aresialed correctly. This has heen confusing, so let's
gel on the right Trick and be consistent
Mink you for your attention to these important details. I trust that youAil] review this email with your adjusters and that NAe will quickly notice a
significant improvement in quality.
Tinriks,
Reggic Warrcn
PLAI
Miarr.
TWIA Instit 00017238
From: Reggie Warren
Sent: Friday, June 06, 2009
To: Kevin McFarlin
Lrt's discus.@. According lo I DI, that doesn't matter we need to add OH & P to arrive the rePair/rcPluccinent
.... ...
Al aPPI701311ale
cost. repardless if a
contractor i%
involved.
-----Original Mesrage-
From: Kevin McFarlin
Sent: Friday, June 06, 2008 12:32 PM
To: Reggie Warren
Subject: RE: OH & P possible revisions
Reggie:
Kevin
---Original Mewlge-
From: Reggie Warren
Sent: )`hursday,JuneU5,2LX)V3:48FM
lo: Kevin McFarlm
Subject: Oll & P possible revisions
PLAI FF
E IT
Subject: RE: Bill - Im sorry to bother you but i need some direction - last of the day...
Cort,
As a whole, no OH/P is on roofing as we have alreadv included it in the unit cost on oty price guide. We don't generally allow OH)? on carpeting,
fencing, minimum repairs, temporary repairs, tree removal. If this is a large loss and a General Contractor involved and he has submitted an estimate
including roofing, we will pay it. A General Contractor must be involved. There is no minimum number of trades requirement. Roof and painting
OII@P
involved, you would add on painting not roof. Okay?
Bill
Bill you are super! I certainly wasn't trying to draw any attention to it as a problem.... Just tn1ing to get these things done and done right for
-
everyone... .
The one issue that will REALLY help me is this issue with ohp. Some examiners have told me OK on ohp on roofs and fences when darnages are to
Othersareseridingthefilesback. Ihavenoprobleiiidoingitanywavbtit_iiistneedtodoitoiieway... let me know.
interiorandmultipletrades-...
Thanks SO MI JCH for your help and your responsivenesil I know TWTA is working hgrd to do it right tool
Hanginthere! Fm,@Nithyouthroughthis! J
Best!
Cort,
We are in a learning curve here also, Unless something is drastically wrong on a loss under $25,000.00 we should not send it back. I agree, we are
Creating havoc with this back and forth with reports. I want vou to go ahead and send out your estimates once they have cleared your quality control
check and at thesame time submit your closing report to us- T 'Ail] try to improve our peTforniance on this end as well- Thanks for calling it to my
attention-
Bill
PLAINTIFFS
EXHIBIT
TWIA-Instit-00017365
Al fi
3W
From: Bill Knarr
Sent: Saturday, November 29, 2008
To: wlebrun(q,)urhinc.com
Thanks Wiley, appreciate you taking charge and getting files corrected.
Bill
-----
Original
Message -----
From: LeBrun [iniiilto:wlebiuiaurllirwcoiii]
Wiley
Sent: Saturday, November 29, 2008 3:01 PM
To: Hill Knarr
Subject: RF: FR-EDA-1
Bill.
reference to the use of a GC. As of today we are instructing our adjusters that under no circumstances is O&P to be added oil roofing, fencing, or
carpet in the future regardless if a GC is to be used or not. Of course I have been doing this too long not to use common sense on a claim and realize
thattherearealwaysexceptions. Ihavelookedthroughthefaxesandemailswehavereceivedinthelastfewdays,whichdoesnumberabouta
dozen and they are related to this issue which we did allow because the insured said that they were using a CTC for repairs. Apologi7,e for creating the
problems and we will make the changes and get the files back in.
Wiley
We are getting a terribly poor work product from All Tech. We have had to return a number of files in the last few days. You are not following our
procedures and not adjusting the loss correctly. Is anyone looking at the file before it is sent to us. It is obvious to us dus isn!t being done and if it is,
whoever is reviewing them doesn't know what they are doing, Please help us by sending us a file we can pay.
Bill
-----
Original Message -----
From- Bill KnaTT
Sent: Saturday,November29,20081:52PM
To: Ray Sims
Subject: RE:
Ray,
TWIA-Instit-00014729
This make about a dozen in the last two days or more. I will write All fech also. Proceed as you suggest.
Bill
-----
CTiginal Message -----
From: Ray Sims
Sent: Saturday,November29,200812:50PM
To: Bill Knarr
Subjec,L:
Bill.
The above referenced claim submitted by All Tech Claims has included overhead and PTOfit On the estimate which includes O&P on the roof as well.
for correction.
I would like to make an advance on the building, not to exceed the ACV payment, and return the file to the IA f=
The estimate total with O&P is $ 33,700.80.
Thanks,
Ray
TWIA-Instit-00014730
From: Joe Rosentritt
Sent: Saturdav, November 08, 2008
To: Ray Roe
--Original Message----
From: adjusterkCa-aol.corn
[maiIto:adJusterk(a--aol.coml
Sent: Friday, November 07, 2008 11:21 PM
To: Joe Rosentritt
Subject; Over and profit
Hello.
According to the TVAA Claim Handling guidelines 0 + P should not be applied to roofing items in
most cases. However, it states the obvious that 0
+ P can be added when a GC is required to oversee and schedule, coordinate with other repairs, etc... on a roof. Especially %vben roof framing,
sheadling, overhang rebuilds, etc_ are involved.
I do not undergand bow 0 + P can be denied on a complex roofing repair with a GC. By not adding o + p you are asking the
roofuig portion for
contractor to do the
fm (because he will have to be involved and coordinate and schedule with framing, etc..and will likely even be the purchaser of
Toofing materials). Thc homoowner, in these more complex
cases, cannol be expected to hire a rooferand coordinate the roofer seperate from the
contractor.
Kevin Phillips
832-493-2611
Instant access to the latest & most popular FREE games while.vou browse with the Games Toolbar - Download Now!
Fs
-!..:iEXHIBIT-.
TWIA Instit 00000663
Pre-Storm Dwelling/Stnx;ture Details:
Year built or age
Purchase prize and year
Condition of Dwelling/Structure
Roof age and type
Type of construction - ranch
split level or if comm. type of business
Kind of construction frame, ftametbrick veneer, concrete block,
steel
-
Floor plan, layout, dimensions
Number of stories and height
Break-away wall enclosures and contents
Roof type and age - (gable, hip, etc), kind (comp., metal, wood, etc.)
Exterior wans type for each elevation
Interior walls -type and finish for each room
Flooring -
type and age for each room
-
Unique features identified by insured
Any existing damage before Ike
Repairs completed from Hurneanes lWa/Humberto
Doyou have any other information or supporting documents that you cm provide us in
establishing what happened to your property and how much you claim under your
T.W.I.A. policyl
PLAlKnFr
TWIA Instit 00000266
7777777'.-.-7@
Hurricane IKE, Ad*uster Post-Storm Orientation
Remote office location(s)
• TBD
• Don Turner, Gene Latham, Dill Hooper and others T13D
Office hours
* Seven days a week until notified otherwise
* 730 to 6:00 most days, weekends 8:00 to TBD (exceptions to he approved by
Dedicated Adjusters
• Issues-dedicated to TW`TA, expected to fully resolve claims assigned lo you
• Adjusters prohibited from switching to another Ded. Adj. Finn unless permission
received by TWIA (Reggie Warren or Bill Knarr)
• We must have your contact info, email, license 4s and cell phone
• Keep gnod records of your arrival and departure datL-, (principals)
Identification Access
• Texas does not have a badging system
• Local officials have authority on entering the storm area
• Make sure you have appropriate ID i.e. Copy of adjuster's license, business
card, information about the company you work for
Assignments
• Assigned as possible via your principal
as geographically
• Handle your claims, no subcontracting out to other firms beyond your company
• Watch for excluded items, such as APS, on your assignment sheets
Contact
• Quickly as possible, within 24 to 48 hours
preferably
• Drive by, dooT hangers supplied to principals or at mobile office
• TDI Building Code brochures, I have supply-give to insureds at initial meeting
• Work weekends as dictated by work load
Temporary Repairs
Upon initial contact, inform insured
Keep receipts, take photos, make lists
Only temporary, not permanent
You must be able to see the damage to determine causation, coverage and amount
PLA1NnF:rs---7--
TWIA-instit-OOD00535
Advances
It is important that once liability / coverage is reasonably determined
• we look into
making early advances, especially for clean-up. Possibly up to 20% of the
potential loss with appropriate follow-up documentation
• Email the requests to your assigned adjuster mailbox at TIVIA or call if a big loss
• If ever $11 OOK, some explanation for the need of an advance
• Multiple advances, let us know which Item of Insurance is involved in the
advance
• Who do we pay
• Where do we send the check
• How do we send, regular or overnight
Inspections
• Prioritizeby degree of damage
• Review loss notice, investigate fully, consider all coverages
• Full adjustments needed
• Take sufficient number of photos, dwelling, building, personal property
• Photos, diagrams (root perimeter as needed)
• Ladder rental, got permission from your principal, send invoice to TWIA separate,
not part of the gross loss
• Make inspection under temporary repairs. Must confirm wind damage v.
deterioration etc.
• Secure documentation, invoices, photos, estimates etc. ftom the insured. We want
to consider all evidence/information available to make a final determination on
the claim.
• If insured asks you to talk to their contractor, you need to do it or make a good
effort to do it. Document your file on these issues.
• Be careful in all aspects of the physical inspection especially climbing roofs, etc.
If you feel it is too dangerous to access part of a building etc, notify your
principal supervisor and determine the best idea for inspecting and establishing
the covered loss. Supervisors at TWIA can be contacted about this issue as well
Coverage/ Policies
• Dwelling, Commercial and Mobile Home policies
• Direct physical loss caused solely by windstorm and/or hail
• Loss from general power outage not covered
• All policies and endorsements on TWIA website htty!1/,www.twia.ore/
• Concurrent causation (rot, deterioration, other perils) not covered
• Commercial, no wind-driven rain
• Dwclling wind-drivon rain only with 320 cndors=cnt
• Leaks not covered
• Important to consider if there is a "physical" loss due to windstorm
Deductibles
• In most cases, each item (building, personal property, flag poles, whatever) has a
deductible shown on the assignmentsheet.
• Watch commercial deductible, some by Item and some by occurrence
TWIA-Instit-00000536
* No need to prorate occurrence deductibles any longer
Major Endorsements
* 400-ACV Roof-watch for closely
*
320-ALE. wind-driven rain, consequential loss
* 431 and 432, ICC (additional insurance, incurred, % of coverage per loss notice)
*
164-RC for commercial (some items excluded from RC such as carpet)
* 365-PP RC coverage, dwelling
* 17-Business Income, Extra Expense
* 280 and 282, Condo Forms
Condo Losses
• See separate paper lo follow
• See Section of Adjuster's Handbook
7
• Identify the trustee or president of the association, document and work Vaith that
individual.
• Make certain we can pay the association and the trustee on the loss instead of
including all the mortgagees
• Watch for duplicate coverage with unit-owners policies
Tree/Debris Removal
• Reasonable cost to remove off covered property, this means off the premises i.e.
cut up and haul tree off premises. Goodjudgment needed here on expense eic.
• Not additional insurance above stated policy limit
• Tree values are not covered
• No lawn clean up. Can consider lawn repair if damaged in
tree removal efforts.
Reserves
• Confidential and the adjuster
to TWIA
• Must notify us immediately if S 0,000 paid claim or over
I
Can submit in list format with Claim Os, your follow up report should document
Email to your assigned TWIA mailbox or call TWIA if urgent
TWIA-instit-00000537
Price Guide
• If you work in MSB IntegriClaim and desire a download of prices, please advise
us. Call Bill Knarr at 512-637-2902.
• Emailed to principals last week-let us know if issues with pricing
• One guide for seaward of Intracoastal and one for inland of Intracoastal, revised in
July 08
• Guideline only, any deviations need to be explained by the adjuster
• Will advise when to change to reflect price increases, if necessary
• Apply depreciation as warranted, tax on malerials, oh and p (except roofs, fences,
flooring and single trades@-always consider oh and p, if questions, ask
• Use good judgment (is oh & p likely to be incurred)
• Is it a complex loss requiring a general contractor to coordinate?
• Flexible, changes if necessary, explain why
• No oh and p on temporary repairs or on incurred expenses of the insured i
e.
water octraction, debris removal, tree removal
Adjuster software
• MSB IntegriClaim preferred
• Others accepted if all needed information is provided
• Make certain your firm's name is in the letterhead of your estimates and reports
Displacement Payments
• If insureds were mandatorily evacuated by government order from their
Primary Dwelling due to Rurricane IKIE, we will consider S100 per day up to
25 days for displacement.
• Displacement payment is limited to the days the insureds are not permitted
to return to their home. FOR IKE TMS WILL BE CONSIDERED PART
OF THE ALE CLAIM AND SHOULD BE CODED TMS WAY. Typically
no written documentation is needed for the evacuation
expenses. It is
predicated on the number of days they were away from home due to the
storm and evacuation.
9
ItispossiblethatwhentheinsuredreturnshometheywillhaveittrueALE
claim. This should be handled on based an the language in the 320
TMA-instit-00000538
endorsement. Incurred, reasonable, necessary increase, normal standard of
living, partially or fully unlivable.
• If you adjust this portion of the claim, ok to include in the gross loss when
billing.
• If we advance from office, do not include in gross lorts for billing purposes.
• if the insured returns home and finds no windstorm damage and we have not
paid displacement prior to your inspection, no displacement for evacuation
expenses are to be paid. We pay displacement for Primary Dwellings wbere
evacuation was mandatory and where it is expected there is a covered
windstorm loss to the dwelling. We may accidentally make in advance
payment and then find there was no damage and that is ok. But, we do not
pay displacement Money when it is known there is no windstorm loss.
• Commercial losses are not covered ror displacement.
Building Code
• 431 and 432 endorsements, watch for need in ICC, work must be done and
expense incurred
• We do not pay engineer fees fbr certifications of repairs
Engineer fees for design of reconstruction will be considered, no commitments
•
until reviewed by TWIA
Reporting
• Acknowledgment via PDF and will be dropped in file for supv to review. E)
adjuster, our claim number, insured, a(tiuster's phone number. Cc agent with
acknowledgement that is mailed to insured.
• First report, 30 days
• Every 30 days thereafter
• Short form, unless something unusual
recd, dale of contact@ date of inspection, who did you inspect
• Date assignment
with
• Email PDF T`WIAadjusterrepts(@twia.org or each firm has its own TWIA
mailbox
• Individual PDFs, no zips
TWIA-Instit-00000539
If rile is too larger may need to break it up in multiple PDFs.
Label the PDFs with correct TWIA Claim # and insured's name.
Consequential losses
* 310, 320 endorsements
0 nodeductible under A. 1.
a Under A- 2. of endorsement, $500 off premises, not automatic
* Personal Property deductible under A 2.
* Reffigerators and freezers, need some doc, lists etc.
a Not covered under the Commercial Policy unless there is physical windstorm
damage to the power, beating or cooling equipment located ou the described
premises. Must be physical damage, not surge.
Contractors
* Make sure they are aware there is a required building code
0 Be cautious of inflation, price gouging
a Large losses, paid estimates if necessary (must by approved by TWIA)
Public Adjusters
• Read about PAs on TDI website http://www.tdi.statet3Lus/
• Trv to work with, but if not, calculate loss and we can pay undisputed amount
• Public Adjuster has to prove loss above undisputed amount
• We need their TexEis Adjuster License and cnntract with the insured if they want
their name on the checks
Mold
• Not covered
Will pay to remove mold damaged materials to get to covered loss
•
• No testing
• No remediation
• If necessary, we can write ROR
Proofs
• Waive. Proofs up to $VS,000 paid claim.
• IA firm principals have authority up to $25,000 paid claim.
TWIA Instit-00000540
• Any potential paid claim over $25,000 must be submitted for approval.
• Provideproofsifnotclosedin6Odays,blankandlorfilledinwithyouTnumbers
• DO NOT FORGET to do this.
Reservation of Rights/`Non-waivers
• Identifv the need for-late report of claim, repairs already made, outside policy
period, loss not covered (i.e. mold)
• If someone pushes mold claim
• Permanent repairs with no supporting documentation
• If insured will not sign non-waiver, go ahead and investigate. We can send ROR
later. No commitments.
Engineers/Experts
TWIA Instit-DO000541
• Flood and storm surge not covered by TWIA policy.
ID if this is an issue and investigate thoroughly and provide
• report with
recommendafions.
• Texas different laws, concurrent causation etc.
• Some Single Adjuster, USX4, and State Farm and Farm Bureau
• Could be working vAth flood adjuster
• "Slab Methodology"-if there is extensive damage from windstorm and flood
storm surge and there is an issue on segregation, contact TWIA for direction
• Segregate windstorm damage from flood damage as best you can. Hoperully,
weather reports post-storm will havc windstorm v surge timelincs that will
help.
• Be sure to tD the flood carrier and adjuster and report that information to
US.
Asbestos/Slate roofs
• Pay attention to pre-loss condition, old damage and patches
• If more than 2 squares directly damaged by Dolly, allow for complete asbestos
roof and depreciate accordingly
• RCC will catch actual expenditure
• Will have to allow more for tell off.. see price guideline
• Plank decking should suffice for new roof if no gaps more than I inch
• OtherMse vAll have to fill gaps or rc-deck and felt
• Brass fasteners rusted loose
• Remember, we are looking for direct windstorm damage and not maintenamr or
long-term problems
• We do not cover remediation of asbestos
Checks to insured
Is We issue all checks from Austin, mail directly to insured usually
• Good addresses needed
• May need to send to adjusters to deliver
is Docurnent advances with partial proofs or advance pay receipts
• Check mortgage company accuracy let us know the new information if
applicable ....
• Recommend payees if different than what policy indicates, get documentation of
mortgagee change
Mail
• Regular
• Overnight, U. S. Mail (we may have to overnight things occasionally)
TWIA-Instit-ODOOD542
• We expect a full adjustment, reasonably thorough investigation
• Address all coverages affOTdedunder the policy
• Make every effort to Finalize and agree
• Do not tell insured to simply call TWIA if they find something else. You are to
handle.
• We expect you or your firm to handle reopens. No one likes reopens. Button up
these claims. Communicate. Consider all factors. Listen to insured. Make good
judgments. Document, Secure needed docs. Contact insured experts if
necessary. May need to leave at least one experienced adjuster per firm at the
storm site to wrap up lingering claims of other adjusters
Salvage/Subrogation
• Always consider, use good judgment
• Leave salvage, take credit in the adjustment when you can
• Commercial losses could allow for considerable sah-age recovery
• If necessary, we can use USA Salvage, Tom Shore (972-243-341 1) also Lee
Shore 800-229-0578
• Call us fire if you feel we need to involve USA Salvage
Reinspections
• Random losseswill likely be reinspected by TWIA personnel or others early in
the storm
• It is very important that you provide accurate information to TWIA about the loss
Dress Code
• Be professional
• Consider bow you look when someone opens the door
• Casual. comfortable
• Do not want to make a definite code
• Any complaints about the way you look, will result in a drastic dress code
Media
• Do not talk to the media
• Refer media inquiries to Reggie
Warren
• We have a media rep, Jerry Johns with S11S in Austin. Jerry's cell number is
512-965-4001
File Audits
• TDI
• Date contacted, inspected, a4justed and closed docurnented
• Document your files with narrative activity notes
TWIA-Instit-DOOD0543
(yerhead and Pirefit (0][1 & PI'.
report to TWIA_
is justificaition to do
Bogirining immedidlely, plmse do not hold back rceuvorabIc drprcuidLion Icss than $3,000 unicss th= so.
Tlunks.
A couple of things:
With the exception of the slab group, we do not own files.
If you get a telephone call with an inquiry on a particular file, otherthan a slab claim, it
is your call to handle. There will be few exceptions to this. There are a few files where
neople have claimed ownership for some reason and in that case, you should forward
can think of, when the call comes to you,
I
In all other cases
le call to the file owner.
it is yours to handle.
Also, there is no need to discuss our rules outside the building. The fact that we no
longer opt to hold back depreciation when the amount is $3,000 or less is not
something to discuss with insureds or even adjusters. The next thing that happens
after that word spreads is that insureds will be calling in wanting their depreciation
amounts released prematurely.
Ray
RCC Processing-TWIA
This is a directive of how TW1A wants RCC claims handled. There could be
circumstances with RCC claims not considered in this document, so if you have a
question see a Supervisor.
We process most all RCC. claims without the adjuster becoming involved. When the
ACV payment is issued and we have withheld depreciation, we send a document to the
insuredwith instructions on how to file their RCC claim. Many times this document goes
unread.
Basically, we ask the insured to provide us with documentation that repairs have been
completed. This can include paid invoices, canceIM checks, photos and any other
document or information that supports repairs were done.
While the policies say repairs must the "completed" before RCC can be collected, it is
our decision that we can pay RCC claims on a piecemeal basis with the appropriate
documentation. In other words, if the insured has multiple trades to contend with on the
repairs and they have the roof replaced first and prior to completing the other repairs, we
can pay the Toof holdback only. The insured can then follow-up to collect any other
depreciation available in RCC reserves.
The insured technically has 365 days from the date of loss to complete repairs in order to
recover depreciation. 'Mey can receive a 18D-day extension if requested in writing.
Normally, we allow the full lime period, which is about a year and a half or 545 days.
After a cat event, there could be the possibility of extending the 545 days for various
valid reasons.
Commercial policies with the 164 RC Endorsement have two(2) years from the date of
loss to complete repairs.
Receiving a WPI-8 certificate is not sufficient enough evidence to support paying the
RCC. We need documentation of incurred costs. We are not required to have the
WPI-9(s) Rrior to mWaag a RQQ payment.
Much of the time, documentation received includes only the repair invoice for the full
repairs and is either equal to or greater than the adjuster's gross estimate. 1n these
'PLAINTIIFF&.@@,@'--;!.
TWIA-instft-DO000376
d.
k.n
'@I 7:
7
the full amount of
situations, if everything appears in order, it is appropriate to pay
recoverable depreciation and close the file. There is no need to send a letter with the
what you are, paying and
estimate, just make some "Comments" on the check to support
document the claim file.
2
Jan 14, M9, RCC
mg
p.
TWIA-instit-00000377
If the Trade Summary is not provided, it may be necessary to calculate the holdback by
line item, which could include adding OH & P and tax to the depreciation number.
typically you can pay the full amount of depreciation withheld. If the invoice is less than
allowed, you can take the amount allowed and subtract the amount of the invoice. The
difference can then be subtracted from the withheld depreciation on that item to
determine the payment amount.
Illustration 9 1:
Invoice $10,200
Illustration #2:
Roof est $10,000
Depre,-,-. 1.000,
ACV $ 9,000
Invoice $ 9,600
$ 400
Difference
Deduct $400 from the depreciation amount of $1,000 and pay $600 depreciation
is
holdback on the roof. The insured spend $400 less than allowed, so their recovery
reduced by $400.
item. If the
Or, you can take the invoice amount and deduct the ACV payment on that
difference is equal to or greater than the holdback amount, you can pay the full amount of
the holdback. If the difference is less than the holdback amount, you pay that amount
which will be less than the holdback amount for that item.
Illustrition # 3@
3
inn 14,2009, RCC processing
TWIA-Instit-00000378
Invoice $10,600
Less OewrqL 1,000
i)ifference 600
Pay full depreciation withheld of $1,000 since the invoice is equal to or greater than the
amount allowed on the roof.
lum=gim@
Roof est $10,000
Deprec 1,000
ACV $ 9,000
Invoice S 9,400
Less ACV 9.QQQ
Difference S 400
Pay $400 RCC since insured spent $600 less than allowed on the roof.
do not
Finally, if you are working in a file Lhat is in RCC status or has a RCC reserve,
arbitrarily pay the RCC when it is less than the $3,000 holdback threshold. Leave the
documentation is received and
reserve and let it be processed if and when appropriate
in these situations,
policy conditions have been met. If you feel the RCC should be paid
please see a Supervisor for approval,
TWIA-Instt-00000379
From: Bill Knarr
Sent: Monday, November 17, 2008
To: Ron Garrison
--Onginal Message-
From: Ron Garrison ImailwironA-Weatesi corn]
Sent: Monday, November 17, 20OF 1:08 PM
To: Bill Knorr
Subject: Roof Help
Bill,
Who do you recommerxi I conInCt for any qucstions or issues %ve may nin into
I
don't want to bother
I I
heard Gene Kounse is not with its nnymore.
review work- for IA at home.
you all the time.tBill Knarr] me or Reggic Yes Gene is gone and had hwgerv on his neck. I-le is doing some an
Shingles. The shingles have debris Under them and he states they
2. Bill I
just had c Roofing Contract call und wanted to replace a roof due to Lifted
roof.[Bill Knorr] those shingles had debris under them on Labor Day and the Fourth of3uty.
"ill not seal down. He says they cover 75% ofthc
Charge due Lo a few mitsing shingles. [Bill Krmrr] Probably the right call. Irroofer 1;t:w pushy, tell them lo get a caulk gun "idi
We paid a Minimum
in it and go along all the lifted shftles and restick them and they will stay stuck til the end of their life TWIA does not
some roofing stickurn
We can remember several years back , thr235#3tahshinglet ha t h adnosealdo An it ndtbev
nsider a lifted shingle direct darnage from windstorm.
flapM]intheuindlikeRbirdqwingsandthentheycArneniil%viththe24091-I.qhingle.whichws,;thec.irneqhinL21e,jii4zlhad@.ealdownmjiteriAlo@
en
the backing.
RonGarrison
CSI Supervisor
PLAINnFps 747
Bill:
I
totally agree %%ith
you. We have also suggested Your solution to our field people.
I
just wantcd your takc.
Regards,
I'ony
Tony
We dun't put tiny t.TedcrAx in these two page driveby engineer report.%. If we paid the claim because of lifted
Joe gave me your quesLion to answer, shingle is not damaged and it doesn't adhere
been done. You understand our position If the
shingles, I
didnt know abets it and it should not have pitshed by the inxtired to pay for a new roof
becaiLqc of that
tinder it prohahly wag that way long before Ike.
Solution, if
any longer beeam se debris is
conditior,uewilipayloptitadabofmastic,ittarlikematenalimderthelabsthatareiwseandihey,.%nllslav,gdheredforlherestoflheirlife line
X, have lifted or loose shingics with debris
roof that had a claim. Roofs in Austin,'l
paid for new roofs because of loose shingles we would buy every
under them.
Bill
M"buge--
From: Tony Ellis [ju
L. totellis/d-Ne acyclainis-ilet
Sent: We4nesdav. Dwember 10, 2008 2:02 PM
To: Joe Rosenlritt
Subject, Roof issue - @Aind lift
posed to Reggie Warren. It dealsxith this subject that has been much
What follox%s is an excerpt from a recent cmail in response to a question
discussed latelv. I believe this further asserts the company positk)ii regaidbig this subject.
Ray
mthject:
V
RF ?,nnfq
in place are not necessarily ikindstorm damaged. Our opinion is that the shingle must be
Theere musi be physical windstorm damage. Loosc shingles
blo,@Nm off or if it is blcoAm back, that it causes some damage to the shingles, usually a visible crease in the top ofthe shingle. Our investigation reveals
RMFPS
TWIA Instit D0016500
@099WOO Msul VIAAI
---.Onginal Message----
From: Richard Myers imaillo@Ibchirdmj5@,brusbcountrySlaini3.cOM)
Rent: Wednesday, January 21, 2M9 5:07 PM
To: Bill KnarT
Sublect: Lifted Tabs
Bill
allow to rescal them. This could cause a wave of problems, Labor would cat us alive. Whot a can ol'worm; this will cause
I
have held the adjuster up on getting with the Insured unfil I have Instructions from you.
Plemse let
me know asap
Richard Myers
361-227-5300
PmInIF7
EXH113 ff
Richard
Richard,
Bill
-Original MessaBe-----
From: Richard Myers imailto:Richardm-a),brushcotmuvclaims. aom I
I
uriderstand all
9 this and I
have done this a lot in the past I just did not want to put it
out to the world. We Nvill handle as instructed.
Richard,
to reseal tabs. This is done by a long handle caulk gtm with a flat nozzle sticking out wih a tube of Mastic in the gun. Applicator
25.00/sq
ft
goes%hingleperqbinglethatisnot%tuckdownand.-;hontsadabundeTithitstheshinglevAtbbisbt)otandgoe,,tolhenextnne Tbisuselohedone
alithatimewhenthe2.15.1-ishg,teamentit andtheyu@entedthemtnwAllikethe24ONthatwasthe-ameshirkgicv,,iih-.-aldn%%,nontheirback.-. I
don'tr-arejfyotidoMwantlooffeTil,ti'theshingleissttickdo%kmmttusmatteritissn)cktintilifieyaTelomofftobereplaced Ihisisnollobc
ofTerTedonevcrylossasanoption. C)niyafterallotherdiscussionshavefailed. lfyouwanitorontinuctodenvtheliftedshingIcsNvithno
alternatives, okay. 800-00 on H 40 sq roof settlement is better than going to a hearing.
PLAIWIFFIS:.:!@@--
TWIA-instit-DO014711
From: Bill Knarr
Sent: Saturday, January 10, 2009
Alan Renshaw; Amelia Key;
Ben Glover-, Bill Astin-I
Bill Hooper; Bill Jones-,
Bill Knarr; Bill Tassinl-
Bob Inmon; Bob Latta;
Bob Parrish; Brad Short;
Brandi Vandemeut; Carl Brown;
Cathy Sanders-, Cathy Weidner;
Charlene Coker; Charlotte Phifer,'
Chris Zimorowicz; ChristinaTurner;
ChristopherWhite; Clay Tinnell;
Corey Crawford; Cory Kendrick-,
Dan McGuire; David Dicks;
Dean White-, Demian Kolb;
Dennis White; Diana Orta;
Don Fielder-, Don Turner;
Donna Glover- Duncan St. Clair;
Franz Hughes Gilda Downey,
Grady McClure; Greg Briers;
Harold Philyaw- Helen Frank-
To:
Huck Huckabee; Hugh Meloche;
James Harp-, James McRae;
Jamie Gladman; Janie Garcia;
Jason Garrett; Jason Young--
Jean Burke; Jeff Stockdale;
Jeffrey GoretzkeI- Jennifer Annstrong.-
JerryDickerson- Jerry Lerma- I
ALL,
See attached PDF that is a brief discussion on uplifted shingles not being damaged by windstorm. Not a TWIA publication.
http://www.adobe.com/
PLAINMFFPS
EXHISM TWIA-Instit-00012172
-78A
Section 1: Manufacturing & installation Issues
Oft,
M LE
Unsealed tabs are fairly common occurrence
ori roofs, and may come from a variety of
sources such as original installation, shingle
material, sealant quality or quantity, fastener
location and depth, thermal forces, docking
movement, or weathering effects; and are no
necesscrily indicative of wind damage.
'These shingles
were installed
ina racked Dr
straight-up
pattern. Tabs
straddling
vertical joints
are unsealed
and raised
slightly duc to
forces internal.
roof,
Am-
to the not
wind.
TWIA-Instit-00012173
William Haygood; Wilson Dunn,
ALL,
by the name of Don Tarantola who is in business to rcpair roofs. I enquired his thcory of lifted shingles
I
havc had a conversation with an individual
and if they uvre damaged shingles He said that a lifted shingle was not damaged if it %%,cre not cracked where it mighi have been folded back. He
said most Luisedlud shii*les were wiscaled prioi Lo the hwiicanc. AnywiL. N after that discussion, we c.-Aublishod L-MI if Un insured was having
.
difficulty finding someone L) repair their Tour he would be Mixious io do so kind he was ameptable k) ow raininimn chuTgesallowmice. Healtended
ameetingwbere@&.Oliverspokec)rhecalledandhegaveMr.Oli,verthesamemessage. lampassinghisnamcandphonealongsov@benyouget
inquiries that insured has had several differem roofers out and all say the roof has to he TePIGCod, give them this m ons phone nurnher.
Don Tarantola
Spring,TX (suburb of Houston)
281-202-5361
Company name is 'A"
Bill Knaff
Catastrophe Office Manager
512-637-2902
rs
4:;@
PWKMFP
quin rr
TINIA Instit 00014715
From: Bill Knarr
Sent: Thursday. March 26, 2(K)9
To: Russell Stout.Reggie Warren
Rmqell,
the
unsealed shingles, but have not gotten the results yet. We still contend they are not damaged unless
No change. We have had a hearing involving
shingle is bmken.
Bin
----Original Message-----
From: Russell Stott
Sent: Thursday, March 26, 2009 8:51 AM
I'o: Rcggic Warrcn
Q-: Bill VTIdTT
DollyandIke
Subjw: FW. SupplcmenLs
... EmpluisisunRoofs"I
Ha-.;TWlAunchangedinihisregard?lAqlelliL,,thercistalkofelassoctionintentionshrewinginHarr,;countv..%ofaT%vehFiveheldotirpo%ition
Ozigina] Message-
---
From: Russ Davis
Sent: Thursday,March26,20098:46AM
To: Russell Stout
Subjcct: FW:Supplcmcnts"*EmphasisonRoofs'lI Dollyand1kc
-Original Message--
From: Russell Stoin
Sent! Thur%day,FebruaTyO5,20092A5PM
Ri)ITney-,(@orcyTTnldcri@T)avidlyne.%-.rregReqnick-,JeffRoc!h-,JerTyPiqcek-,JimMfwgan-,KevinMyerz-,]ArrvCrmbc@@l.orcitai:vmgmbiAn-,
To: O'Brien- Stephatme Rafeld Vedra
Marshall Jones;Maurice Green; Michael Canibre-, Richard Beasley;
Roosevelt Johnson; Sarah Ryan; Shelley
JacksDn@ Wendy Palomo; Russ Davis; Shauna Mcginnis; Kristin Jahren; Gavlee Garcia; Nancv Stout
Subject: Supplernents***]--'mphasisonRoofs*** Dollyandlke
-Ongiial Message-
FTont: Reggie Warren
Sent: Wednesday, February 04, 2009 122 PM
Cc: Reggie W
Thank you.
David,
Joe forwarded your question to me to answer. So here is TWIA's position. As a rule, fogged windows are not a direct result from damage b,%
windstorm. A possible excep4ion might be if one window goi hit urith flying debris and broke the seal causing the window to fog If mnre than
one, then very unlikely the damage was the result of windstorm and as You say the result of failed defective seals.
Bill
--Original Message----
Front: David
Ellis fniailto:dcllis@lcpcyclaim3.iiet)
L.
Sent: Friday, December 12, 2008 2:51 PM
Hi Joe. I have kicked back adjuster files for -he last 75 doys for windows that the seals failed. To me, and all of us at Legacy Claim SM-ices,
know that this is a result of failed defective seals on double panc %%endows and not a result of wind damage,
However, we are getting swamped with re onens on this subject. My CILMS6011 is: Does TWIA have any written directives on 1hi s?
Regards.
David L. Ellis
866.461.1770 (officc)
REDACTED
PLAINTIFPS
EX BIT..
TWIA Insbt 00016420
Reggie Warren
While we understand that reopens and supplements are part of the business, adjusters need to strive to handle the claim
fully in an effort to avoid supplements.
We have not bought into the idea of having "clean up' or 'supplement"llearns
to go behind and handle supplements and
adjusting firm who handled the original adjustment to also handle any qualified
reopens. We expect the adjuster and
supplement,
We hope that this revised fee schedule for will aid in getting supplements handled efficiently.
Reggie Warren
cS-7b,
T-J
Supplement Fee
Schedule, Doilly
If they send a written request for Appraisal, please get with Kevin McFarlin to discuss how we want to
proceed.
Always require them to produce their valid Texas Public Adjuster's license and the signed contract
they have with the insured.
Ordinarily, we do not provide copies of anything but our estimate to Public Adjusters.
I noticed they
usually ask for information from our Claim and/or Underwriting files. Tlat is our work product and
we do not provide that to them unless approved by TWIA Claims Management.
Claim Payments:
December 27 will be sixteen weeks since fke made landUl. If you receive an adjuster's report that
and if
documents windstorm damage although the report needs to be sent back for corrections/revisions;
send a brief letter the insured
you can establish an amount to pay, issue a partial payment and
to
explaining that it is partial and that any additional amount owed will be paid once we receive the
insured calls
revised adjuster's report. This is especially true if we have the adjuster's estimate and the
about their claim payment. Try to make some sort of payment at that time to ease the insured's tension
during the times a file is not acceptable to pay and it is
about their claim. As we have said storm, many
Texas Windstorm Insurance Association
P.O. Box 9MO. Aunin. Tem 79709-9090
5100 Soinh Marar Exprcnway, Building E, Suitt 530. Austin. Tom 76749 *
512-899-4900 /Fax 512-8994950
PIAN MW
---I rr
TWIA-instit-00000361
hard to get over that. As much as we want to handle claims properly, we did give S25K authority to
the principals of the TA firms. Their supervision and quality review is sometimes lacking, but on
claims with a payment of less than $25K, try to find a way to get it paid and closed. If you absolutely,
cannot pay based on their recommendations, see Knarr before you return the file.
ALE Claims:
We technically only owe ALE on primary dwellings when the direct windstorm damage causes the
home to be wholly or partially uninhabitable. It is also teclu6ca)ly owed once the insured incurs the
expense to continue a similar lifestyle as to prior to the storm and then only for the increased expense.
We have all issued advances based on the projected ALE and usually is not supported by invoices
ftt
or any reconciliation by the adjuster. Before any additionally ALE is paid after the initial advance, we
should require the appropriate documentation.
Use good judgment on primary homes that sustitined flood and windstorm damage. Maybe a portion
of the ALE is owed, depending on the amount of windstorm damage susWncd.
Displacement Payments:
These payments were basically to aid those that had to evacuate their primary dwelling from the storm.
Prior to us knowing if there was covered windstorm darriage to the insured property, these payments
were made by our mobile office or us OR recommended by the adjuster. Our average payment for
for Ike has been about $1,500, although we set a limit of $100 a day for 25 days from
displacement
evacuation.
Later in the storni, we decided that if the insured reported their loss or we inspected it after
November 1,
we would not make any displacement allowances. Please watch the adjuster's reports
closely as to when the loss was reported and when they made their inspection. I see some files being
kicked back where the adjuster inspected prior to November 1, 2008, found no windstorm damage. but
made a tentative commitment to the insured that displacement would be allowed. We should not kick
those back.
Also, if the adjuster figured thirteen days or $1,300 and you feel its should have been nine days and
$900, do not kick that bac)L We relied on the adjuster in the field to make that call and due to the
nominal amount; it is not appropriate to return the file to the adjuster. Remember, you are to see Bill
Knarr before you reject or return an adjuster's report.
Expense Y2yments:
We expect the adjusters to complete their work per our instructions before we pay their service
invoice. I noticed that many IA firms send a bill vAth every report. I
am not sure why they do that,
other Om it may be system-generated. It is confusing to get multiple bills for multiple amounts
file. If the adjuster is not finished with the file, it is ok to send a fax or
throughout the handling of the
email to the 1A firm and advise them we are not paying their bill until the work is complete.
60 days from the assignment, but they should got our permission to do so.
If you plan to revise the adjuster's bill in any way, see Bill Knarr for approval.
Engineer and other expert bills should be paid timely. Occasionally, we will be interim billed by an
engineer that is working on an extensive and complex project. Ok to pay unless you have a question.
2
Texas Windstorm Insurance Association
Suite 530, Austin, Texas 79749 P.O. Box 99090. Austin, Texas 79709-9090
57DC South Mollac Expressway. Building E, *
512.9"-4900 1 Fax 512-899-4950
TWIA-Instit-00000362
Check Issuance and MadinsE Addresses;
When entering a check always verify that the payee(s) is correct which of course includes the
mortgagee. If the adjuster does not determine the correct mortgagee, many times the one on the policy
is incorrect. While it doesn't make sense: to call each insured before you issue their check, pay close
attention to the adjuster's report and the file comments to see if someone ahead of you has determined
if the mortgagee has changed. If you determine there has been a change, notify the proper person in
Underwriting so they can amend the policy accordingly. Unless you have a reason to suspect
inaccuracy on a mortgagee change, you can take the adjuster's or insured's word on the change.
Otherwise, you should require the necessary paperwork from the insured or mortgagee before issuing
or reissuing a check.
On supplemental checks to insureds, verify as best you can that you are issuing the check to the correct
It is embarrassing to include an old, incorrect mortgagee on a supplemental check or a Te-
parties.
issued check.
Mailing addresses should be verified too. Many times, the insured has a new mailing address or
temporary address. Chcrk your comments to make sure the checks are mailed to the newest and
preferred address, especially and follow up or supplemental checks.
Proofs of Loss-
I
directly from the insured, which are unsupported. am sure
We are, receiving Proofs of Loss, some
all know we have to promptly react to a Proof of Loss when received. Please do not drop it in the
you
waiting on a corrected estimate from a4justeT. We need to
file and forget about it, even if you are
either accept and pay it or send a letter to the insured or sender that we do not have enough information
Proofs can be invalid and unacceptable for various reasons. It could be
to accept or reject at this time.
incomplete, be for the wrong amount, be unsigned, etc.
3
Texas Windstorm Insurance Association ?87D9-9,)%
Austin. Texas
5700 South MoPoo FApresroxy, Building F- Suft 530, Austin, Texas 78749 e P.O. Box 99D90.
512499-4900 / Fax 5 12-M-49"
TWIA-Instit-00000363
From: Jeff Kaiser
Sent: Saturday, November 15, 2008 03:37 PM
To: Reggie Warren
Ruggic,
and what I hear on the street. Wkii le you may not be seeing
I
believe that we link alikc in man, .Y ways. my intent is feedback m our problems
of claims and going home. T agree wilh yot iT comment on quality
problems with the reopens yet, you will. Adjusters are giving hack their inventories
Many, semor people are leaving the industry because ol'age and the
issues.
I
have been doing this many years and never has the quality been so poor.
candidates is diminishing. We have to pretty much "idiot
lack of consistant work. We are a Citizens of Florida trainer but the number of quality
senior folks grabbed at Fay and Gustav deployments that were
pr0o t' the process. Because ol'three storm deployments going on at once, many of our
available as they had not worked in two years.
have any fresh claims to attract ad usicrs back. Al dis point, you arc probably
J better off continifing la send them to your core firms. At least voiluill
I do
understand the economics of this business.
lo back vou when the reopens get out of control.
tb@se firnits
have
the length of my last email and I upologizc for the length or this one.
it is a pleasure: to cAmminanicatu with You. I liked the wriuncrit dbout
As always
I do
not believe I ran stress that enough. I am hopeful that me ran work with you again bit
However. believe this issue is at critical mass and
I
do nof think
pereL nve to he a theater and please
I
I
hope you undei--Aaml that
I
am trying to head orf whal
%Wuldn't blame you ir tba(did not happen.
to protect yotir inierert. This is not a greeditime as the incremental increase is notworth
I
arn a troublemaker. I really intend ibis to he my attempt
that.
Thank you,
Jeffrey A. Kaiser
ftsidcnt
Specialty Group, Inc.
--Original Message---
From: Reggie Warren I aillo:REQGIE(a).TWlA.ORG]
----Original Mc%.wgc--.-
@nLcom@l
From: Jeff Kaiser
Sent: Friday, Novembrr 14. 2(08 6:21 PM
To: Reggie Wairtm
Subjocl: RE: Supplements Lind Reopens I IKE / TWIA
Reggie,
PLARM
TWIA-Instit-DOM6737
Aside from that, for reopens where the adjuster has to change measurements or unit prices, the easiest way to figurc the supp is to rewrite the
I
I
know this doesn't seem to be well received by vour examiners but
estimate and plug in the nem, pricing then deduct the original estimate amount.
these done.
am fighting a losing battle with the adjusters to get
TharA you@
JelTrt:v A. Ktiiscr
Presidcnt
I
will start with an explarmlion (if
files, I have decided send yon ant] m requesi.
your rewnt message mlitmi reupeml to x response-
In response [to
with substantial Along the way many things happened which were
When we received your request to deploy for'IVIA, we responded resources.
of other storms. We were requested to subinit a list of First responders and vm sent list of
a 80
bevond the control of any ofus, namely, a couple
before the), got to Texas because of the old "bird in
ad usters before wexvere told thatwas enough. Some of them ended up taking other deployments
that point had been
the hand" syndrome, We successfully deployed adjusters every da@, and at the end of almost every day, all claims received up to
than 50 losses, even for the most experienced ones. That drew some criticism from the
(assigned out, all while we limited the adjusters to no more
in the past. 'I'hen suddenly the flow of losses to out firrit stopped even though we
greedy ones but we stuck to our plan as v%r have learned that lesson
We could have put out 150 within the month if we
land Cie volume of losses, even -Mtll all of the other storin
had onl) deployed about 65 a4iustcrs.
going the time. Now we could probably put out 250 as many have finished other deployments.
deployments that were on at
of losses. You were always very good in responding and told me we would
ruling otr initial sent you a request for an estimate
deployrrient, I
guaranteeing them work- and standby even though wesubmitted very few
get all we wanted Sowe continued to move. people toward Texas, money.
standby daily fees toTWlA for reimbursement. We had many adjusters arrive to find that we had no work for am
and we helped many to find work
TWIA and did not accept losses from other clients becauge ue
211
expected many losses.
elsewhere. As I told you early on. we committed to handle
is no
-way to predict the nuniber of losses, a huge number of finns and atijusters were
While I
know thatone cart see into the future and there
no
and slight flow continued, I had no way to fccd those who were en route.
deployed by TWIA. When the flow of losses stopped completely not even a
scoped out or Lo mLxwith the reopens. Most left because they could not
I
also had no way to keep the good adjusters in Texas after their losses were
w1ditional of living in trailer or hotel room Lind incuribiLt $200 a day lo live. while also having to pay for a hotut sonicMicte
sustain the expense a
TWIA-instit-00016738
reopen claims are being handled
by different adjusters who almost always do no( have. much good to say about the original adjusteTsimply because
they have to handle the reopen It gets worse when they feel like they are losing money doing it. MY, I am not buying this. I thirA in most cases the
.
ciaims. Adjusters are not interviewing the insureds. They a re not creative in adjusting a claim.
adjuster didn't do theirjob initially on these large PP
The hurry through and their product illustrates it.
I
am asking for authority to commit to these adjusters. who have to go out and work- thrmWl-i some very difficult claims. that they can bill the
adjusici fec from the buiLum of the schedule its if it well a nC% claims We will not bill any of die surchingts. just the adjuster fec, additional nifleage,
be billed at the $200
additional photos and exam No. The only change would be the adjustor
based on the difference in fee arinciurits
fee. T`hc ones we can handle from the desk
and the ones wc find to be deficient. we will not bill TIAIIA. Jeff, we cannot treat you differently
"I
minimum
than 11-se others and I have not had these comments from any other firm
shutoff, I
would be able to keep a group of adjusters
My logic is that if Nvc even had a trickle of claims coining through instead of a total
sufficient spread them and get the reopens handled. I would also be able to mix the reopens with the nevv losses as we went along, to keep the
to old
interested. With the isolated crew we now have it is even more difficult because many are traveling longer distances. With all of the other
adjusters
to move this Cat to a conclusion, this one is looming large andwc are trying very hard to succeed for TWIA, the
dcroons mm arc facing as we
", to deal with so I am hoping that we ran figure out some resolution to this
policyholders in Texas and for you You have been fair and evenhanded
probfein I also believe that %w may he able to attract sonic adjusters back
as I expect out firm and adjusters are not the only ones who are facing this.
it) slow a(
if there is a fincial incentive to do W litudusc
I
believe die claims will coijti@nur (vicupon fui ,@Lxnc time Io curric. Jeff', clauuN are wining
I feel we will continue
this time. Om initial predictions were bdsed on information we had kit the time. No one can predict numberi early in 8 storm
IDOI191S and Uill illitiaRy many as I first thought, but d)cy are Dot COTBuIg in at a pace to keep any ouc firm particularly busy I
to get losses for get as
adjusters handle the I Wish there werLn't so many and
think most farm - are hanging on to the real adjimters that want to Anrl- and those can reopens.
there %%couldn't be if the adjusters handled the claims to Egan %%art I
think adjusters are accustomed to having clean tip errvvs come tiround and clean
tiptheirmess,butwcarenotatthatpoint Wccxpeetthefirrnstohandietheelaimsonafulla4justmcntbasisandthatmeansroopens.
JeiT,th=aresomegoodadjustersouttherebutmanymorcthatareinexperiencedandLbatarcnotgeningthcjobdone.'niatisacrossthc
board. TAIIA"uspromisedquafifiedadjustersfromthebegimiingandqwtefranklv,gotycryfew. Iarnnott3).-ingtobeatupalitheackiusten,but
the general consensus is that Ox products are bad. I know there is a learning curve, but many of the adjustment procedures are not that much
different than any other state.
issues aLad iieeds, but most of this involves issues that necd to IX Managed by an IA firin that considers itself
am not addressing
I
I
am sure your
to be a 'eat' firm.
Ifyouhavein&vidualsupplmentsfttrequireaninordinateamountoftime,letusknDwandwt%villoonsiderdifferentbithng. Wedon'twant
you are the adjusters to go broke, bin we don't went quality from the beginning.
Jeffrey A. Kaiser
President
----Ongirol Message----
From: Reggie Warren [mqilIoREGQIEOaTWIA.ORG1
Sent: Fri I 1/1 4/2008 1:1 9 I'M
To: Rcggic Warren
Cc: Reoe Warren
Subject.: StilifilmenU mid Reoptnes / IKE I TV A
TWIA-Instit-00016739
lu
From: 4y Roe
Sent: Thursday. November 13,2009
Amelia Key; Bill Astin;
Bill Hooper: Bill Jones;
Bill Tassin; Bob Intricin-I
Bob Latta- Bob Parfish;
Sho@;
Brad Carl BFONNM.
Cadiy Weidner, Charlene Coker,
Chnistina Turner, Chfistopher White;
Cory Kendrick- Dan McGuire;
David Dicks-, Dean White;
Dernian Kolb; Diana Orta;
Don Fielder, Don Turner,
Gene Latham-, Greg Briers;
Helen Frank,, Hugh Meloche;
James McRae. Janie Garcia-,
Jason Garr-ett; Jennifer Armstrong,
Jerry Dickerson; Jerry Lerma@
Jim Coggin; John Hilliard;
To: John Wright-, Josie Fielder.
Ken Colestock, Kenneth Robbins:
Kevin McFarlin; Kris Weidenfeller,
Lance Cooke- Lou Skinner;
Marie Merida: Michael Cortese:
Miguel Riveros; Mike Calvin.
Paula Smith; Ralph Frank;
Ray Drury-. Ray Lang;
Sam Jones, Sam Wellman;
SatoriSochandamandou; Shme Gulley,
SheldonMaxwell; Somy Jenkins"
Steve Frve, Susan Herrim
Tarnri Morgan; Terry Partlow;
Thomas Christiansen; Tom Glow;
Von Watson; WD Scott:
Wendy Scuborough' Wesley Werrieking;
Willi@@good-, Wilson Durui'.
Woodv McMahon
They may spend more but they are limited to the reserve amount for
1. We reseme RCC to the penny and this sets the ceiling as to recovery.
the invniceg reveal more expenditure. Often upgradeq and other changes
recovery. We do not need to wificit reopenq nr qupplernental claims "en
i Review the documents and be sure they apply to the RCC Do not allow items not part of the original RCC. such as fences,
account for the nerease. @
but rarely is
On occasion it mav be wise to call the roofer to verify
4. We do not ask an a4justcr to reinspect for completion, we rely on paid invoices.
tinv more than their tweesmi-v.
Subject: Daily Adjuster Retainer Rates Hurricane IKE TVIA and TFPA
Thcy must be committed to handling only TWIA or TFPA claims ifasked. Thoy cannot bc working for multipIc cafficrs. If thcy dccidc to lcavc
your emplo) ment before they start handling I
WIA or'lYPA claim s and we have made a payment to vott, we will expect reimbursement of this
retainer in full.
Use your goDd judgment on what portion of this fee is passed through to the a4itister.
We will be in touch via separate email with the TWIA Dedicated Adjusting firms on other imies.
Thank you,
Rcggic Warrcn
TWIA and TFPA Claims
Austin
512-899-4902
Bill Knarr
Cat Office Manager
EX,7ense when
I,f pro-apyrovedby Texas Windworm Insurance Association, fiks can be billed Time and
additional worA is needed above the routine requirements andlor therrgU loss exceeds the fee s-chedule
above. A a itemk4iion of file activitiff- and expewes il required with 4H
Dwellinz--$105.00(orneeotiatedat@j Commercial -- V 15. 00 (o
T&Einvaices.11ourlyrales
negotiated role) -
2
For Reopens worked on or after December 1, 2008
/ Suppiements
will not be affiected by this schedulE.
to TWIA prior to December
1,
Reopens and Supplemenissubmitted
TWIA-instft-00000350
Reggie Warren
,Om: Reggie Warren
Sunday, November 30, 2008 10:34 AM
,ent:
To: Reggie Warren
Cc: Reggie Warren
Supplement Billing /
Dolly and Ike / TWIA
Subject:
We have enhanced our supplement billing per the revised "Supplement Fee Schedule" attached, effective for Dolly and Ike
supplements worked on or after December 1, 2008.
While we understand that reopens and supplements are part of the business, adjusters need to strive to handle the claim
fully in an effort to avoid supplements.
We have not bought into the idea of having "clean up" or "supplement"teanns to go behind and handle supplements and
original adjustment to also handle any qualified
reopens. We expect the adjuster and adjusting firm who handled the
supplement.
We hope that this revised fee schedule for will aid in getting supplements handled eff iciently.
Reggie Warren
--7&
ran
Supplement Fee
Schedule. Dolly...
PLAINTIFFS
EXHIBIT
O <2
TWIA-instit-DO00034B
From: Jeff Kaiser
Sent: Saturday, November 15, 2008 03:37 PM
To: Reggie Warren
Reggie,
I
believe that we think alike in many ways. My intent is feedback on our problems and what hear on the street. While you may not be seeing
I
At this point, we arc going to see hom, many of the rcopcns,^v can handle from the desk.
I
expect that as the holidays arrive wc will lose most who
hAvc hung around, even if the rcopL-,n foes 6,vcn't driven them off. We have not received a single now a3signment 3incc 10-23-08 so we don't even
have may fresh claims to attract adjusters back. Al this pnint, you are probably better off continiiing to send them to voir core firms. A( least you 'Aill
have those firms lo back- vou when the reopens get out of control.
I do
understailid the economics of this business.
Reggie, we have worked hard to make things as smooth us we @;un. I do not rmessarily agree with you entirely on the reopem@. Of course there Km
thought the losses A-crc coming fast and furious so we trying to
many that have not been handled perfectly the first time around but everyone w=
have R11 taken our time, Fit ]en-.;I my firm. We have also seen
move them Along aq figgi
wild %n we would have capneity In hindsight we could
a; we.
the
the typical policyholder survival patterns and are starling to receive contractor estimaies, PAs, etc... I don't care how thorough the adjiisier was on
first go, when the contractors & PAs start getting involved, that is a
step of the process that cannot be avoided. To deny at least a reinspection on even
for a bad faith claim, That is why I have asked for consideration on the billing.
I do
the most well done file is the groundwork not Nvant to set up
wih I
again askyou to
TWIA nor do I want to excercise my F&O Carrier for the litigation that certainly come. At the risk of making you angry,
consider allowing us to bill fh)m the bottom of the schedule of these very necessary remsprctions. Before you answer this request, I urge you to take
the
ffic temperature on the street.
I
cannot think of a finu or a4juster out there whowoWd want a $200 ($130 to the adjuster) reopen file considering
I don't believe
work. difficulty and their o%vrhcad cost to stay in the area. AD of these are being handled by different adjusters than the original and
people to handle them if all the adjusters in the area leave. The time to address this issuc is growing short, mainly because the
there are enough'ocal
approaching holidays are causing the adjusters to make decisions.
with you. I liked the corrunent. about the length of my last email and
I
apologiLe for Lhe It=l;Lh of this one.
Avs
always is a pleasure, to waimunicatc
it
Tbank you,
JefErey A. Kaiser
Pmidcnt
Specialty Group, Inc.
-original micssage-_
From; Reggie Warren 1rxyJIIo:REQQIEQuTW1A.QRQ1
Sent: Sat I I A 5/2008 9@00 AM
To: Jeff Kaiser
CC:
Subject: RE: Supplements and Reopens t IKE / TIXIA
Jeff, I made, some comments below at the end of some of your paragraphs.
---Original Mc-,Wc---
Jeff Kaiser [mqilto:JkdiscrQ)>pmiq ty Mupi:nL.coml
I
From:
SenL Fi iday, November 14. 2008 0:21 PM
To: Reggie Warren
Subject: RE: Supplements and Roopow / IKE / TWIA
Reggie,
estimate and plug in the new pricuV then deduct the ongiruil estimate amount. I know this doesn't seem lo be well received by your examiners but I
Thura you@
Jeffrey A. Kaibvi-
?resident
Dcar W. Warren,
In ret9onse Itiyour receril mes%dge alitust reopened files, I have decided to send you a Tesp<inse antl a request. I will start with an explarmlion of
Whenwe received your request to deploy for IVIA, we responded with substantial resources. Along the way many things happened which %&we
beyond the control ofarry ofus, namely, a couple of other slorms. We uere requested to submit a list of First responders and we sent a list of'80
adjusters before we v -ere told that was enough. Some of them ended up taking other deployments before they got to Texas because of the old "bird in
the hand" syndrome, We successfully deployed adjusters evm day and at the end of almost ever), day, all claims received up to that point had been
assigned out, all while "c limited the adjusters to no more than 50 losses, even for the most experienced ones. That drew some criticism from the
greedy ones but we stuck to ouir plan as nr have teaseled that lesson in the past Then suddenly the flow of losses to our firm 3tOPped even though wc
had onl) deployed about 65 adjusters. We could have put out 150 within the month if Nve bad the volinnc of losses, c,6-cn with all of the other stonn
deployments that were poing an at the time. Now we could probably pill out 250 as many have finished other deployments
While I
that no one c4m see into the future and there is no way to predict the number of losses, a huge number of falls and a4justers were
knov.-
deployed by When the flow of losses Stopped completely and not even a slight flow continued, I had no way to feed those who were en route.
TWIA.
I
also had no way to kccp the pood adjusters in Texas after their losses were scoped oat or to mix with the reopens. Most left because thev could not
sustain (lyz additional expense of living in a trailer or hutol room and incurring $200 u kV io live, while also having to pay for a lionle Somewhere
else. after the flow of claims stopped.
As such, most of the adjusters have gone home and very few are left to handle the reopening files. Most of those have said that the (65% of)
$200 tee is not enough to pay them to review the original report & estimate, travel to the loss location, re-inspect, negotiate with the insured andior
contractor,write an estimate, report, bill and close the file. They are now starting to reject these assignments because they only get $1 30 plus mileal!e
for all this work. I do not like this response from them at all! I have said to clients in the past that
it really doesn't matter to me what the fee schedule
is, it matters to tha adjusters because if it isn't enough to attract them, it is a setup for failure since we all draw from the same Scric, pool of storm
adjusters. At this point, I am hard pressod to move Ws matter toward success and away from failure. However,
I
have a proposal that I asl you to
consider.
I
am setting up a triage unit to determine whether the reopen can be done from the desk or if it needs to be reinspected. We are also looking to
Ree if the original adjttsier has done their job prnperly, i r not, we *11 pay the new adjustel- from
The original adjuster's procceAls. I
f there is a price
difference issue, we should he able to handle it from the desk If it is measurements or missed items, we may he able to handle it firom the inside bid
insured is saying the original adjuster told them to dispose of
many wfll have to go outside. We are seeing a wave ot'huge contents claims where
the items and they want Lo be paid. We have seen this before and the adjuster will tell you it is not
ft
s@.
You and I both know the only way to deal with
these aggressive claims is to go and sit with the insured and ask them to start justifying their claim. This is very time consuming and it is difficult to
get a4juslers, who feel they are underpaid, to property work through this process. However, it is also difficult to pay some of these claims when the
insured showed the original adjuster one item during the initial inspection and we get an inventory for 30 items. Pie= also keep in mind that these
TWIA-Instit-DO016738
reopen claims are. being handled by different adjusters who almost always do not have much good to say about the. original adjuster simply because
they have to handle the reopen. It gets %%orse when they feel like they are losinf; money doiM it. Jeff, I am noi buvmg this. I in most cases the awl
adjuster didn't do their job initially on these large PP claims. Adjusters are not interviewing the insureds. They am not creative in adjusting a claim.
The hurry through and their product illustrates it.
am asking for authority to commit to these adjusters. who have to go out and work through sorne very
I
difficult that they can bill die
claims,
udjuswi Fee from the butioni of the b0irdulc as if it %vote a nt:@% Claim We will not bill any ordie surchtages. just the fee. additional
ddjusLcz iniludgc,
additional photos and exam rec The only change would be the adjuster fee. The ones we can handle from the desk will be bilicd at the $200
minimum based on the difference in fee amounts and the ones we find to bc deficient. we will not bill TWIA. Jeff, we camel treat you differently
than the others and I leve not had these comments from anv othcr firm
My logic is that if we even had a trickle of claims coming through instead of a total shutolT, I would be able to keep a group of adjusters
sufficient to spread them off and got the reopens handled. I
would also be able to mix the reopens with the nen- losses as we went along., to keep the
adjusters interested. With the isolated crew we now hove it is even more difficult because many are traveling longer distances. With all of the other
demons we am facing as we try to move this Cat to a conclusion, tins onc is looming large aniwc arc filing very hord to succecd for TWIA, the
policyholders in Texas and for you You have been fair and evenhanded to deal with so I am hoping thAt,'Ac can figure out some resolution to this
problem as I expect our firm and adjusters are not the only ones who we facing this. I also believe that we may he able to attract suite adjusters back
if &-re is a fituincial incentive to do so ba-dusc I believe the claims %Nin continur to reopen for xxite Little to ionic, Jr[f. clintub itic Winn* in slow bt
this time Our initial predictions wine bdsW on information we had at the time. No onx can predict numben; early in a slorm I
feel we will confinue
to get losses fcx- montlis andwill initially get as many as I first thought but they are not coming in at a pace to keel) ativ one firm piuliculmly busy. I
think man. t firm q ate harming rin to the real adjusters that want to unrk and those adjamm can handle the reopens I wish there weren't so many and
them wouldn't be if the adjusters handled
up their mcss, but we are not at that point.
ftWechtims to start
expect the firms
with. I think
to handle
adjusters am accustomed lo having cleRn tip cre%%s come ATOlvid and clean
the claims on a fidl adjustment basis and that means reopcns.
Jeff, there are some good adjusters out there but many more that are inexperienced and that are not getting thejob done. That is across the
board. DAYIA was promised qualified adjusters from thebeginning and quite frankly, SotveTy few. I am not tying to beat up all the adjusters, but
the general consensus is that the products are bad. I know there is a learning curve, but many of the Adjustment procedures am not that much
different Lhan env
od= state.
I
am sure I am not adc4essing your issues and needs, but Most Of thi3 iDVUIyCS iSSUC3 that need to be managod by an IA fire that considers itself
to be a 'eat" firm.
If you have individual supplinents that require an inordinate amount of time, Ict us know and we will consider different billing. We don't want
you are the adjuslers to go hiroke, but we don't want quality from the beginning.
No one is perfect including TWIA. We hxve our issues too We are all doing our best but if I
dm-ide to he a "cat' stijiister I %%rif]
have to
understand that there are no real guarantees on numbers of claims and how fast they will come in.
Jeffrey A. Kaiser
President
-0riginal Message----
From: Reggie Warren [mai1to:REGGIEaTW1A.0RG
Sent: Fri 11/14/2008 1:19 PM
To: Reggie Warreri
Cc: Reggie Warren
Subject. Sul';pIctnenk and Retipens / IKE I TWIA
We do not want the original estimate to be rewritten lo include the supplemental items. This takes 9 lot of time to figure out.
TWIA-Instit-00016739
From: John Fontenot
Sent: Tuesday. January 30, 2007
John Fontenot
Dircetor
512-797-6078
johnn_awardlawelaims.com
John, thanks for the list and ID forms. I reviewed the ID forms and
IO of the adjusters are I to 2 vear adjusters. The DAP calls for solid
by experienced adjusters in Rita, this concerns me. Maybe I expect too much, but with all the
property adjusters and in light of the Poor performance
litigation we have going on, inexperienced adjusters could be a problem. Let me have your thoughts. Reggie
-----
Original Message -----
From: Matt D. Fatheree [mailto:FATHEREE MATT DL&wardlawclaims.com]
Sent: Monday, January 29, 2007
1
0: I 0 AM
To: Reggie Warren
Cc: John Fontenot: Matt P. Fatherec
Subject: Wardlaw DAP 2007
Reggie
Matt D. Fatheree
Cell: 254.640.5991
PLAINTIFFS
EXHIBIT
TWIA Instit 00013820
qo
Fax: 877.694.2540
mattd@wardlawclaims-com
wwwwardlawclaixas corn
This communicationis
This electronic communication (including any attached document) may contain privileged and/or confidential information.
intended recipient of this communication, please be advised that any
intended only for the use of indicated e-mail addressees. If you are not an
distribution, copying, or other use of this communication Or any attached document is strictly prohibited. Tf you have
disclosure, dissemination,
in error, please notify the sender immediately by reply e-mail arid promptly destroy all electronic and printed copies of
received this communication
this communication and any attached document.
TWIA-Instit-DO013821
From: Bill Knarr
Sent: Wednesday, August 20,2009
To: Bill Knarr
ALL,
be has met so far, did not have a copy of their estimate. The insured's had their check- but had
Our reirispector is telling us that 901A of the insured's
This is totafly unacceptable. You must make sure that your adjusters are discussing the estimate with the
no idea wbat Aw on the estimate.
insured and then the insured and agent we getting a copy uf the estimate.
lflhtaronemorct=etbatsoandsoisfttspmtedout,youwWhearmesemamaUthe,A,ayfromAustin. You&Ubavedoneagoodjobrontactingthe
msureXs and keeping your appointmenta and we do appreciate that a great deal. We are still getting new losses in and with the heavy rains along the
from
coast yesterday and today, we are getting a number of reopeners due to new or more severe leaks on closed files, plus new losses being reported
these rains
PLEASE Make sure we do not get calls that the personal property or business personal property was overlooked.
PLEASE Make double me that the insured and agent are getting copies of the final estimate to match their loss payment.
Thanks.
Bill Knarr
cataArwhe Office Manager
512-637-2902
PLAINTIFPS:.--:@-".
IBM
TWIA Instit D0000745
Repairing My Roof After a Storm
Beware of a contractor
.......
• Who only wants cash.
• Whose references are all out of state.
• Who wants money before materials are on site.
• Who is not established.
• Who is not bonded or insured.
• Who offers'specials'or'extra-cheap work.'
July 2008
PLAINTIFPS
TWIA Instit D0015128
Roof Installation Requirements to the
Texas Windstorm Building Code
1. Whataretherootproductchoicesformyhouse7
Texas experiences two of the most severe weather conditions a roofing system can
face: high winds and hail. Homeowners have several choices on roof covering material
types. The most common roof covering for residential structures in Texas is asphalt
shingles. If you are using asphalt shingles on your roof, select shingles that have been
tested to and the shingle wrapper indicates compliance with either ASTM D 3161 Class
F or ASTM D 7158 Class H. Asphalt shingle product and other roof covering product
information is available at www.tdi.state.tx.W2or by calling (800) 248-6032.
Page 2 Df 4
Texas Department of Insurance
July 2008
TWIA-insfit-00015129
3. What kind of underlayment should be installed?
A minimum of No. 15 underlayment (feft) is required for asphalt shingle installations. Two
layer of felt are required for roof slopes from 2:12 up to 4:12. For roof slopes 4:12 and
greater, one layer of left is required. Make sure the felt ins installed as required by the
Texas Windstorm Building Code and the shingle manufacturer.
A A N
"IMLS
"Ls
@-
12, 17,
TWIA-instit-0001513D
INSTALL PER THE
MANUFACTURER'S
NSTALLATION
:NSTRUCTIONS
ell
ENT LCOATED
ER EACH TAB
FASTENERS
6. Whatitihaveametalrootparmis,metalshingles,orconcreteroofingtiles?
How should these products be Installed?
Roof covering products shall be installed in strict accordance with the manufacturers
installation instructions and their tested high wind applications. The TDI has roof
covering product listings for Many types of roof coverings by many manufacturers.
Approved product information is available at www.tdi.state.tX. or by calling (8DO) 248-
6032-
7. IfI
want to install or need to replace my skylights, roof vents or roof turbines,
what do need to know about getting the right product for my house?
I
Skylights, roof vents and roof turbines are vulnerable to high winds and hail. You need
to choose products that have a published wind resistance rating. For hail prone and
E
huff icane prone regions, choose impact resistant skylights which are tested to ASTM
1886 and E 1996. The TDI has skylight, roof vent, and roof turbine product listings for
many product manufacturers, Approved product information is available at
www.tdi,state.bc. orcall(800)248-6032.
July2008
TWIA-Instit-00015131
From: Reggie Warren
Sent: Thursday, January 15, 2009
To: Welch Watt (E-mail)
Tliaiiks,
Reggie
TWIA-instit-00006729
Reggie Warren
.Om: Reggie Warren
'sent: Saturday, November 01, 2008 4:05 PM
To: Reggie Warren
Subject: Misc Issues for Adjusters / IKE JTWIA
This email and attachments are going to all IA firms handling TWIA claims. This is the only way we
know how to communicate with all adjusters collectively.
We are getting complaints from insureds and agents about when they call your main number or
adjusters number and no one answers. They get a, voice mail box and leave a message and no
call backs. Or. your mail box is full. Please have someone answer the phone or at least return
the phone calls if a message is left.
We expect you and your adjusters to handle the claims to completion (full ad*ustment). If the
insured or agent calls you or your adjuster about something you missed, please handle
regardless if the file is open or closed. Do not refer the insureds and agents to us reopen and
....
handle.
If you have done the proper investigationon a file and the insured or agent calls wanting another
inspection, they must supply you with additional credible evidence that supports another
inspection. Such as, roofer estimates, photos, other estimates, engineer report, etc. We do not
reopen files when the proper investigation and analysis has been performed and just because
someone is "unhappy'.
• Point is, most of the time we cannot avoid reinspections especially if there is other information to
consider. We want to consider all available information on each claim. But. do not tell the
insured and/or agent that you cannot do anything and that they have to callTWIA for approval
when there is other information available or offered.
• We are getting many complaints from the Texas Deipartment of Insurance. Many have to do with
the adjuster. Think about that when you are out there. Do everything you can to resolve the
claim within the parameters of the policy contract, be fair, be courteous and be respectful. That
always helps, even if you have to deny the claim or a portion of the claim.
• Please ask the insured if there has been a mortgauee change. If so, get the new information and
advise us accordingly so we can include the correct payee on the claim check.
• Please got accurate mailing addresses for where checks are to be mailed, if different than the
address on the policy.
it
• Please mail copies of your estimate to the insured and agent. If it is
over $25K paid claim,
should be approved by TWIA before mailing.
• Before submitting a report to us for authority to take a Proof, at least have some tentative
agreement on the adjustment with the insured or their representative.
PWtMFF8 TWIA
T Instit 00000317
1-44
From: Bill Knarr
Sent: Sunday, September 14, 2008 04:14 PM
To: LDUGGAN
Mike,
Yes, Hart said you would be looking them over for GAB. We appreciate it. We are not going
to be very strick on any loss under 25K. There will be
no valuations on dwelling or commercial and no penalties. NO Underwriting Risk Report etc. Just good photo's. complete estimate,
loss and short cover report.. statement of'
Ifyou have one that won't pass muster, have Tracy send it direct to me and I'll pass the thing on through. I do that for
all of Zack Warren's. So, just make sure it comes direct to my email and not through
regular channels. Please call me with any question and I will
help. I am kinda in a different c1mir this time and can help in a lot
of ways Glai younre helping out. We anticipate possibl@ 100,000 Ike losses.
Could be
more. We have 27 IA's that v%-c arc using and have about 1000 adjusters
on their lists. We also have about 2000 Dolly losses pending.
Makcstimcgofast. Callmewlicriyougetstarted.
Bill
--Onginal Mesqage---
From: L D1_)GGAN [A1fli1tqjn
Sent: Sunday, September 14, 2OU8 9:20 AM
lo: Hill Knaff
Subject: Re: Ike photos
Hey Guy:
Original Me.-mage
-__ ----
From: Bill Knarr
I'm William Knaff (E-mail)
Sent: Sunday. September 14, 1008 9:07 AM
Subject: FW: Ike photos
Interestitig FYI
PLNNM
TWIA-instit-00016646
From: Richard Myers
Sent: Friday, September 26, 2008
To- Reggie Warren
Do You think it is to early to go up before we tested the water, I will send him the vehicle money today which should help him get started. I
know
he i; working as I was there on Wedneqday and they bad him busy
Begged?99919? ?
??
......
Really struggling on the price guide, TWIA will set the market for everyone else. Von! t want to go up too much. I'lic wind flood doc has to be
PDF. Ale do not want the adjusters to havethe capability of changing anything in the letter.
No sets. Ale a 10 min lunch with Ro'Vin yesterday. Did not try for the set She begged inc.
Talked to Joey and told him to take care of business. I am not sure he shouldn't just let the truck go, try to save a little money and see if he can get
another at some point. Renting one today he says. I
doubt he does. They are busy and Don is letting him use the truck we have already rented. That
ha.-t
in sinp
Thanks.
Reggie
----OTiginal MC5SUJ:C--
From: Richard Myers imaillo:Ricbardm'd!brushcountrvclainis.mm)
Sent: Thursday, September 25, 2008 8:14 PM
To: Reggie Warren
Subject: RE Hurricane IKE Claim3 Handling Information / TWIA
Relax and get some sleep if that is possible. I am worried about You. Get set before the sleep
Richard
PLAINnFPS
TWIA-Instit-00006470
From: Reggie Warren [p1Ai1!q:REGGlECa)TW1A.ORGJ
Sent: Thursday, Sc:ptember 25,2008 7:03 PM
To: Reggie Wan-en
Subject: Hurricane IKE Claims Handling Inf4mation / TWIA
All,
Below is a onn-iderable amount of important information concerning the handling of IKF clairns.
It is important if you are a principal of an LA firm that vou distribute this information to each and every one of Vour a4lusters, and that you make
certam theY abide accordingly.
I
am concerned that man) attendees did riot receive the 1.) Meeting outline 2.) Pricing Guidelines 3. i TWIA Fee Schedule that had been
distributed several times prior lo the meetings. It is very important that you convey the information to your adjusters.
Please make certain you send adjuster reports to your designated email boxes. Watch your spelling.
Use the attached letters as appropriate to explain the adjustment process and to allow the Associations to choose their coverage This should be done
early on in the investigation If the Association has a 280 and 282 endorsement it is not necessary to give them the letter for them to make a
selection.
-Condo Claim Corresp lb.doc- -Condo Claim Instructions Ldoc- -Condo Claim Corresp 2a.doc-
See attached packet. Print for your use in investigating each 'slab' claim.
We discussed this at length at the orientations. The adjuster is to meet the insured at the risk- site and collect as much physical information as possible
concerning the risk. The letter, blank- Proof of Loss and blank Inventory should be given to the insured. You can use the check- list provided to
secure any information you can from the insured. Follow the instructions as closely as possible.
It is important that you do not tell the insured that wr are not going to pay any thing for Nvindstorm damage.
We Fire worling with certain expert-, and other-, to develop the facts concerning the windoz and %urge. Hopefully, this can he done in the near Future so
we can adjust these claim- properly and based on the TWIA policy contmet.
-3259 DOl.pdf`-
TWIA-insfit-00006471
Windstorin vs. Storm Surge- .'Non-SLAW Claims
Use your adjusting experience to segregate the windstorm damage, if any, from the surge damage. This does not mean that everything above the
.waTer line' is considered windslorm damaec. You have to imagine what damage their may have been to tha structure (exterior and interior) and
personal properly if had not been a surge.
ftre Investigate fully. Talk to the flood adjuster if possible and dvicnnine flood's course of action.
Prepaic your estimate of covered windstorm damage accordingly. Please coinnumicaLe .N,t!ll with die insumd atid their repieseillative.
Thank you,
Reggie'Warren
TVVIA Claims
Austin
TWIA-instit-DO006472
ADJUSTER FEE SCHEDULE
Schatule 3
S1,000,001 and above are T & E and final biff must be approved by the TWIA Vice President -Claims
or designated manager In the TWIA Claims Department.
Billing is based on gross loss not to exceed policy limit of Hability on each Item of insurance
adjusted.
Total Losses (sq. ft. estJonly when paying limits) 900 1250
These should be billed based on the gross loss per the schedule above for all applicable
coverage& on
a given loss. Item l(Dwelling) and Item 2 (Personal Property) on the same policy we considered
gm Item of insurance. Commercial losses will continue to be billed as indicated on the bottom of
Page 3 of this schedule.
I@NO
CLAIMS-no coverare'
If your investigation reveals there is no coverage for the claim. you should bill your file on Rme and
Expense (T & E). The loss must be investigated appropriately and the insured should understand
why there is no coverage and why no payment will be made. The "no claim" letter outlining all the
reasons for denying coverage should be mailrd to the insured and agent after your verbal
TWIA-Insth-00000388
communication with the insured as to why no payment will be made. TWIA requires your T & E to
be sufficiently itemized to support your invoice.
The following are the-only additional charom allowed on Flat Fee or T & E files, unless them is some
,
extrao which must be
pre-Evroved by TWIA:
-
*Supervision Cbg for firm (NOT Adjuster) of Flat Fee (one time billing per file-max
I 09/6
$500-00)
Mileage SO.65
per mile (pro-rated when applicable)
Fuel surcharge, one time per file $10-00
Photos/ 35mm/digital $2.00 each
Long Distance Phone/Fax/Ccll $5.00 per file (one time billing)
Certified & Overnight Mail (when justified) Actual Cost
Other out of pocket expenses Actual Cost (receipts requimd)
No photocopy charge Unless there is excessive copying
Sales Tax
IntegriClaim $ 1
0.00 (onetime billing per file)
Reapenedid'es:
• If the insured presents additional credible evidence that could lead TWIA to a different
conclusion on the claim, the file can be reopened.
• Files can be reopened If the insured failed to identify damages, hidden damage is found,
subsequent continuing damage occurs or valid invoices am presented after closing.
• If an increase in the "gross loss" results, the file sbould be billed on the difference of the original
invoice and the new schedule incremental fee per above with a S200.00 minimum plus
expenses.
• If no billing change results, TWIA will permit a Flat Fee of $200.00 plus appropriate expenses.
TWIA-Instft-00000389
VaHadons to Fee Schedule:
The Fee ScWule is based on a "full adjustment of the entire claim. 11
-Ckan-U
Unless unexpected circumstances require us to hire adjusters to "clean-up" (handle reopens,
supplements or other issues), TWIA expects the adjusting firm that received the initial assignment to
handle the claim to completion, subject to the billing rules outlined in this document. TWIA expects
the adjusting firms to keep at least one person in the area to do their own "clean-up".
* *Commercial losses with muftole Items sho mid be billed on thefull sch edulefor the largest 5 Buildin
ftems(g= loss to each) iWectedladjusted, eApenses pro-rated when qpUcable- (A Building item and the
Business Personal Property inside that building are to be considered one item).
77#e balance of the items is to be billed an the balance of the gross loss (dedsict the gross loss an thefirst 5
item: bilZedfrom the low gross loss) per the schedule above. Other non-Building or non-Business
Personal Property Menu such asflaVolesfences, antennas, tennis courts, light poles, signs ek. should not
Wed separately MEWS they are the only Items domWed T & E on "No Caim--no coverage" Uems
would be in addition to the above-
OnDwelUnL-lasseswithmorethanSheim,cotgact7'WL4priortobUlingthefde. Thirshouldnotoccur
very often.
If you handle a claim with muWplc items and or hail damage is found but each itcm requires
no windstorm a
septuiste inspection/reportlassessment, contact TWIA for instructions prior to billing the file
Include., 3
For losses assigned on or after Sept 11. 2008- Revisions
"No Claim - billing
TWIA
A ctual T & E on lo&ve-r over $ 1 M grass, approval requ ired by
TWIA-instR-00000390
From: Marc Dubois
Sent: Tuesday, January 13, 2009 12:38 AM
To: Reggie Warren
R 'e F t disagreeing with your instructions. On fileKmActhe roof has not been replaced, the roof was replaced on file On
will allocate a repair as requested noting it is per TWIA instructions.
Time was that insureds didnt sue adjusters, we are only trying to document our files so that we avoid potential lawsuits.
Marc Dubois
Marc, there was a day when independent adjusters did whatever an Examiner at an insurance company asked them to do as long as it was not illegal.
We have adjusters arguing with us and that does not set well. Maybe we are wrong sometimes but we arc the ones who make the final calls and will
live with the results of our decision. If you disagree with our decision on a claim, I would just tell the insured that the decision has been overturned
by TWIA and that you are writing up a repair instead of replacement. The insured has the right to complain to us or send inforniation that may lead
Lis to a different conclusion. Adjusters are trying to pay for way too many roofs that aren't totaled due to windstorm.
That being said, I looked at This roof should probably be allowed for for it-, missing shingles but not the lifted shingles- That being the case
and the roof has now been replaced, we should probably pay- Now, you see the light this puts me in with our Examiner. I have the authority to
overrule, but I don't like doing it.
Are the numbers you have presented the right numbers to pay off of. If so, let me know and I'will get the claim paid.
Thanks.
-----
Original Message -----
From: Marc Dubois [mailto:adjuster@kingston.net]
Sent: Monday, January 12, 2009 4 -.59 PM
To: Reggie Warren
Subject: RE: Roofirig Issues
File4lREDACTED The examiner is Catherine Weidner. Insured dwelling inspected on 10/1 3, roof replaced on I I
/I 4. Our report
submitted on 11/20 and memo informing us that roof replacement was being rejected 12/17.
FR-E-DA-C-T]
For future reference what mechanism is in place if we disagree with the examiners position regarding replacement. Please review file
where our adjuster who is well experienced disagrees with the examiner and informs her that she is not willing to modify her recommendation. As
stated if the examiner wants to allocate a repair she should specific, what repair. We will then modify our estimate with a note that we are following
T.W.I.A. directives-
Marc Dubois
Marc, who is the Examiner? I will communicate with him/her. Realistically, there is probably not a way at this point to back out of the replacement.
Give me the Claim # too.
-----
Original Message -----
From: Marc Dubois [iiiailto:adjuster(d@kinpston.net
Sent: Monday, January 12, 2009 4:28 PM
PLAINnFPS
EXHIBIT
TWIA-Instit-00022601
To: Reggie Warren
Subject: RE: Roofing Issues
We have advised the TWIA examiner that the roof is replaced she insists that we inform the insured that we are only allowing a repair. If we are
being asked to counter our original recommendation then the examiner should specify what repair they want us to allocate. Would it not also be up to
the examiner to inforin the insured that T.W.I.A. is refusing to honor the RC invoice rather than us.
On all files that have been submitted it is clearly indicated to the insured that our recomendatioris are subject to T.W.I.A. approval,howeverthe
insured clearly sees on the estimate that a replacement was recoininended.
Marc Dubois
Marc,iftheroofhasbeenreplacedthereisnotmuchyoucandobutadvisetheTAIIAExaminer. Iwouidjustmak-esurethatyoura4iusters,inthe
future, let the insureds know that if you tentatively agree to their adjustment, that it has to be approved by TWIA otherwise there claim could be
revised and Lhey could be left holding the bag.
-----
Original Message -----
From: Marc Dubois Lmailto:adjuster(iilkingston-net
Sent: Monday, January 12, 2009 3:05 PM
To: Reggie Warren
Subject: Roofing Issues
Good Afternoon Reggie We are having issues in complying with an examiners request to allocate only a repair where we initially recommended
replacement of a roof In some cases the insured has already paid to have the roof replaced and submitted their invoice. If we are being asked to make
repair allocations by someone making that judgement call based on photographs then the examiner should also indicate what they deem to be the
appropriate repair. We made our initial recommendation and if we are instructed in writing to modify it we will however we do not want to be held
accountable by the insured who lids aheady recieved a copy of our recommendations. Even though our leaer Lo the insured clearly stated that all
recominendations were subject to T.W.I.A, approval you can certainly appreciate that in the event of litigation that we all want to protect our
respective positions- Your thought-, are appreciated.
Marc Dubois
M.G.D. Claim Services Inc.
CONFIDENTIAL TWIA-Instit-00022602
From: Reggie Warren
Sent: Sunday, November 30, 2008
To: Reggie Warren
We have enhanced our supplement billing per the revised 'Supplement Fee Schedule' attached, effective for Dolly and Ike supplements worked on or
after December 1, 2008.
Please fully read this docurtient and undersbuid our position on reopens and siq)plements. We do not like them and are setting way too many because
die job wds aut done properly (be firSL time.
While we understaind that reopens and supplements are pan of the business, adjusters need to strive to handle the Claim full@. in an effort to avoid
supplements.
Wehavenotbotightitilotheideaofhaving"cleantip'or"stipplement'tcaiiistogobehindaiidhaiidlesuppleniciitsaiidieoix-jis Weexpeetthe
adjuster and adjusting firm Avho handled the original adjustment to also handle any qualified supplement.
We hope that this revised fee schedule for will aid in getting supplements handled efficiently,
Reggie Warren
pLAINnFPS
TWIA-instit-00004662
SUPPLEMENT FEE SCHEDULE
• The adjuster's supplemental report should clearly demonstrate the validity of the supplement.
• We do not reopen claims just because someone expresses disagreement or unhappiness with
1, 2008
For Reopens / Supplements worked on or after December
3tibinitted to 77M prior to December 1, will not be affected by 11fis schedule.
Reopens evid Supplements
TWIA Instit-00004663
SUPPLEMENTAL ESTIMATES SHOULD INCLUDE ONLY ADDITIONAL
DAMAGES OVER AND ABOVE THE ORIGINAL ESTIMATE
If Pre-wyoroved bp Te-vas Windstorm Insurance Associadon. rdes can he hUkd I-one andExpense vshen
additional work is needed above the rotifine requirements and(or the Pross loss e=eds the fee scheduk
abor4z An i1mmization of'rde activities and exwmes is required with aft
T&Ebavaices.ffourkrams DwellinL-4105.00 rneeofiatedrale) Commercial-S115.00(o
nEgetiatedrare
The Allowing are the only additional chg2ges allowed on Flat Fee or T & E files. unless there is some
cxtraordinarN, expensc which must bc yrc-aMrgvcd bry, TWIA:
TWIA-instit-00004664
From: Jeff Kaiser
Sent: Saturday, November 15, 2008 03:37 PM
To: Reggie Warren
Reggie,
I
believe that we think alike in mattv ways. My intent is feedback on our problems and what I hear on the street. While you mav not be seeing
problems with the reopens yet, you will. A41usters, are giving hook their inventories of clitirns and going home. I agree
%kith
Your comment on quality
people are leaving the industry because ot age and the
issues. I have been doing this many years and never has the quality been so poor- Many senior
lack of consistent work. We are a Citizens of Florida trainer but the number of quality candidates is diminishing, We have to pretty much "idiot
proot' the process. Because ofthTee storm deployments going on at once, many of our senior folks grabbed at Fay and Gustav deployments that were
available as they had not worked in two years.
At this point, we are going to see how many of the reopens we can handle from the desk, I expect that as the holidays arrive we will lose most who
have hung around, even if the reopen fees haven't driven them off. We have not received a single new assignment since 10-23-08 so we don't even
have anv fresh claims to attract adjusters back. At Ns point., you are probabl@ better off contenting lo send them lo your core firms. At least Veil will
have those firras to back you Allen the reopens get out of control.
I do
understand the economics of this business.
As always it is n pleasure to communicute with you. I likod Lbt: comment dbout the length of my last email tLnd
I
8pologize for the length of this one.
However, I
believe this issue is at critical mass and I do riot believe I can stress that enough. I am hopeful that we can work with you again but
wouldn't blame you if (bat did not happen. I
hope you understand that I am trying to hied orf whal I perceive to be a di%aster and pl&tw do not think
I
am a troublemaker
I
really intend this in he my attempt to protect your interest. Thic is
not a greed move sr the incremental increa%e is not worth
that.
Thank you,
Jeffirey A. Kaiser
Prcsidcnt
Specialty Group, Inc.
-0riginad Message----
From: Reggie Warren I IIo:RFQGlEna.TWIA.ORQI
Sent: Sat I I il 5P-008 9:00 AM
To: Jeff Kaiser
Ce!
Subject: RE: Supplements and Reopens I IKE / TWIA
Jeff, I made some comments below at the end of some of your paragraphs.
---Original Message---
From: Jeff Kaiser [Mailtojkais dIty To @imcoml
Sent: Friday, November 14, 2008 6:21 PM
@r
To: Reggie WmTen
Subject: RE: Supplements and Reopens / IKE / TWIA
Reggie,
the email I
am hopuig flus email
I attached a copy of the email I sent you yesterday. I received
have no response or indication that you received
is not your response as this is a problem we do need to address. Please
let me kno-A, your thoughts.
TWIA-instit-00016737
Aside trom that. for reopens where the adjuster has to change measurements or unit prices, the easiest way to figure the supp is to rewrite the
estimate and phig in the new pricing then deduct the original estimate amount. I know this doesn't seem to be well received by Your examiners but I
Thank you.,
Jefficy A. Kaiser
President
R
pecially Grotip, Inc.
When we received your request to deploy for FWIA, we responded with substantial resources. Along the way many things happened which were
beyond the control of any of us, namely, a couple ofother storms. We %vere, requested to submit a list ofFirst responders and we sent a list of8O
adjusters before we were told that was enough. Some of them ended up taking other deployments before they got to Texas because of the old "bird in
the hand" syndrome. We successfully deployed adjusters every day and at the end of almost every day., all claims received up to that point had been
awigncd out, all while we limited the adjusters to no more than 50 losscs, even for the most experienced ones. That drew 3onic criticism from the
greedy ones but we stuck to our plan as wr have learned that lesson in the past. 'then suddenly the flow of losses to our firm stopped even though eve
had only deployed about 65 adjusters. We could have put out 150%vithin the month if we I-sad the volurne oflosscs, even with all of the other storm
deployments that were going on at the tinie. Now we could probably put out 250 as many have finished other deployments
As such, most of the adjusters have gone home and very few are left to handle the reopening files. Most of those have said that the (65% of)
$200 fee is not enough to pay them to review the original report & estimate, travel to the loss location, re-inspect, negotiate with the insured and/or
$1 30 plus mileage
contractor, write an estimate, report, bill and close the file. They are now starting to reject these assignments because they only get
for all this work. I
do not like this response from them at all! I hire said to clients in the past that it really doesn't matter to me what the fee schedule
is, it matters to th.- adjusters bccausc if it isn't enough to attract them, it is a setup for failure since we all draw from the same gene pool of storm
adjusters. At this point, I am hard pressed to move this matter toward success and away from failure. However,
I
have a proposal that I ask you to
consider.
I
am selling up a triage unit to determine whether the reopen can be done from the desk or if it needs to be re-inspected. We are also looking to
see i f the original adjuster has done their job
property. if not, we will pay the new adituter from the orip ,in at a ji i, st e r 's, proceels-.
d I
f there is a price
issue, we should be able to handle it from the desk. If if is measurements or missed items, we may be "ble to handle
it from the inside but
difference
a wave ot'huge contents claims where the insured is saving the original adjuster told them to
dispose of
many will have to go outside. We are seeing
and I both know the only way to deal with
the items and they want to be paid. We have seeti this before and the adjuster will tell you it is not so. You
and it is difficult to
these aggressive claims is to go and sit with the insured and ask them to start justifying their claim. This is very time consuming
who feel they are underpaid, to property work through this process. However, it is also difficult to pay some of these claims iviien the
get adjusters,
insured showed the original ad@juster one item during the initial inspection and we get an inventory for
30 items. Please also keep in mind that these
TWIA-instit-00016738
reopen claims are being handled by different adjusters who almost always do not have much good to say about the original adjuster simply because.
they have to handle the reopen, It gets worse when they feel like they are losing money doing it. Jeff, I am not buying this.
I
think in most cases the
adjusterdidsftdotheirjobinitiallyontheselargePPciaims. Adjustersatenotinterviewingtheinsureds. Theva'renotcreativeinadjtLstingaclaim.
The hurry through and their product illustrates it.
latna -"forautliorir@locoiiimittoilieseadjusters.whobavetogoout&Lid%wrk-througlisoineverydifficultclainis,thattheycaiibilldle
tidjusterfmfroinLlicboitoitiofllit:wlictlulcusifiLwert:ailc,Acluiin.Wowillix)tbillwiyoftliesurcliwges.justtlicddjusicifee.addiLiuiWiiiiit:age.
$200
additional photos and exam fee. The only change would be the adjuster fcc. The ones we can handle from the desk will be biilcd at the
minimum based on the difference in fee amounts and the ones we find to be deficient. we will not bill TIAIIA. Jeff, we cannot treat you differently
than the nthers and I have not had thc%e comments fropi anv other firm.
My logic is (hot if we even had a trickle of claims coming through instead of a total shutoff,
I
would be able to keep a group ofad-Justers
sufficient to spread them out and get the reopens handled. I wouild also
be able to mix the reopens with the ncw losses as we went along, to keep the
adjusters interested. With the isolated cre%v we now have it is even more difficult because many are traveling longer distances. With all of the other
succeed for TWIA, the
demons we are facing as we try to move this Cat to a conclusion, this one is looming large and we arc trying very hard to
this
policyholders in Texas and for you. You have been fair and evenhanded to deal Aith so am hoping that we can figure out some resolution to
I
problem as I expect our firm and a4justers are not the only ones who are facing tells.
I
also believe that we may be able to attract sonte adjusters back
if flierc is a financial inwntivc to do so bemuse I believe tilt: ulaansAill continue Lo reopen forscxne
Little to
come. Tcff. claims aic coininig in slow at
numben; early in a slorm I
feel we will continue
this time. Our initial preclictions were tmseil on information we had "I [he time. No tine can preilict
to get losses far months and will initially get as marry as I first thought. but they are not coming in at a pace to keep any Lmic firin particularly busy. I
thinkmoqtfiTTnsarehangingontotherealadjti-temthaiwanitoworkaridtho.wadjw,,temcanhandlethereopenq Twi-,tithereweren'tqorrianvand
there wouldn't be if the adjusters handled the claims to start with I
think adjusters are accustomed to having clean crews came around and clean
tip
tipthcirmcss,butwearenotaithatpoint. Wccxpeetthefirmstohiindietheelaimsonaftilladjusimcntbasisandthatmcansroopens.
done. That is across the
Jeff, there arc some good adjusters out there but many more that are inexperienced and that are not getting the job
qualified adjusters from the beginning and quite frankly, gotvery few. I am not trying to beat up all the adjusters but
board. TAU was promised
the general consensus is that the products are bad.
I
know there is a leaming curve, but marry of the adjustment procedures are not that much
different than any other state.
Jeffrey A. Kaiser
President
-----
Original Message----
From: Reggie Warren 1mai1to:RBQQIEta)TWlA.QVG1
Sent: Fri 11/14/2009 1:19 PM
To: Reggie Warren
Cc: Reggie Warren
Subject: Supplements and Rotipeiis / IKF / TWTA
TWIA-Instit-00016739
From: ChandlerWilliarn
Sent: Friday, February 13, 2009 04:18 PM
To: Reggie Warren
Mr. Warren.
To make sure we arc discussing the same issue here, let me clarif@ the circumstances concerning these letters. These letters involve situations
where the insured has presented a claim for wind damage under their TWIA policy. An adjuster and in some cases an engineer was assigned to
that there is no covered wind damage.
investigate the loss. Based on the reports from the adjuster and/or engineer, TWIA made a determination
USAA's understanding is that this set of eircLimstancesconsLitutesa"denial"ofcoverageinTexas. Astllisisadenial.itisnotappropriaLeforUSAA
to issue or sign the letter.
clarify our position, we would be willing to have a teleconference to discuss the issue. 'I hank you.
If this does not sufficiently
letters which are not "denial" letters. The "no claim letter should simply state the reason(s) nothing can
Technically ,
we ask you to send "no claim'
bepaidontheelaimandthat,A,ecanconsideranyadditionaleredibleevidencethatmaysupportadifferentclaimdecision.
.
WeexpectthelAfirms
tosendtheseundertheirletterhead,cetheagentandTWIA. AnyforTnaldeniallettersaresentfromTWIAinmosteases. IhopeUSAAcancomply
can visit about our agreement
with this instruction aswe expect USAA to act as any other independent we use to handle TWIA claims. If not, we
going forward.
Thanks.
Reggie Warren
-----
Original Message -----
From: Chandler, William [mailto:WILLIAM.CHANDLER(a)usaa.eom
Sent: Friday, February 13, 2009 9:44 AM
To: Reggie Warren
Cc: Joy, George E.
Subject: Denial letters on TWIA losses
Mr. Warren.
Good morning. It was brought to my attention today that Examiners at TWIA had instructed USAA personnel to write and send out denial
The instructions includedsending the letters out under ITSAA letterhead and under the signature of a USAA employee. Our
lettersfOTTWTA losses.
position is that
Denying TWIA losses to insureds is not within the scope of our adjusting agreement with TWIA
PLAINTIFFS
EXHIBIT
TWIA Instit 00019144
to
IssuingTWIA denial letters under USAA letterhead is not within the scope of our adjusting agreement with'I'WIA
Signing denial letters on behalf of TWIA is not within the scope of our adjusting agreeinentixith TWIA
I have instructed our personnel to cease writing and sending out denial letters on TWIA losses. If you would like to discuss tl-@s
matter please call me
at the number listed below. Thai3k- you for your assistance on this matter.
Executive Director
210-498-1321
it is the noblest of virtues, the true steel which gives the weapon its edge
Boldness - "From the camp follower and the drummer boy up to the general,
and luster. " Karl von Clausewitz
CONFIDENTIAL TWIA-Instit-00019145
New round of criticism hits windstorm insurer Business Chron.corn - Houston Chronicle Page I of 3
rchron 1W/
-com Nowton Chronicle home
del" for o* $3 a week. flave 61%1
Newly uncovered internal e-mails from the In one e-mail exchange, TWA management
Texas Windstorm Insurance Association discusses an engineering report submitted by an
underscore an emerging pattern of arrogance independent firm the insurer hired to help
and intentional bad faith claims practices, determine the extent of damage on a home.
consumer advocates say.
The engineer had concluded unsealed shingles
"As more becomes about how TWA
known on the home were damaged and needed
handled it becomes more and
claims after Ike, replacement. But TWA disagreed.
more apparent that there is a lack of
professionalism at TVVIA and that there is a In a subsequent e-mail, TMA's head of
culture that does not respect policyholders," said catastrophe claims noted that the agency
Alex Winslow, head of Austin-based consumer couldn't tell an engineer what its opinion should
group Texas Watch. be but could use another company in the
-
future if
the "issue" was lifted roof shingles.
TWIA, whose handling of claims from Hurricane
Ike has drawn scrutiny from regulators, Sees a threat
maintains that its practices are fair and that its
e-mails are being misinterpreted by policyholder
Steve Mostyn, an attorney whose firm obtained
attorneys. the e-mails as part of litigation filed on behalf
of policyholders, says the e-mails show TWA
The insurer sells coverage to property owners in
threatened to cut off work from those who
coastal counties and a sliver of Harris County disagree with the agency.
that private companies consider too risky.
engineers that only agree
Hiring with the insurer
According to the consumer group and means the outcome of the report is
policyholders who have read the e-mail predetermined, which is illegal, Mostyn said.
correspondence, it would appear that managers
at the state-created but privately run insurer Jim Oliver,general manager of TWA, said the e-
knowingly skirted consumer protection laws. mails have been misconstrued.
In one e-mail exchange, TWIA management The home in question had wind-related cracking
discusses an engineering report submitted by an in some shingles, he said, but the roof was old
independent firm the insurer hired to help
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PLAINTIFPS
EXHIBff
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http://www.chron.com/disp/story.mpVbusiness/6748375.htinI 12/2/2009
New round of criticism hits windstorm insurer Business Chron.com. - Houston Chronicle Page 2 of 3
",,w
,rchron-com 410/-
Got Nooston Chronicle home delivery for only $3 a week. Seve 61%l
Oliver said the e-mails are being misread and Investigators are examining TWIA's general
that Knarr is actually referring to an accepted claims practices and how the insurer handled
claim in which a payment wasn't made because it claims involving overhead and profit, Hagins
fell below the deductible. That's not the same as said. Overhead and profit payments are made
a denial, Oliver said. when estimating claims for damage that would
likely require the use of a general contractor.
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http://www.chron.com/disp/story.mpl/business/6748375.htmI 12/2/2009
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of 3
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purva.patel@chronxom
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AC mesa COM
http://www.chron.com/disp/story.mpl/business/6748375.htmI 12/2/2009
From: Bill Knarr
Sent: Monday, November 24, 2008 12:07 PM
To: ustwial@gabrobins.com;ustwial@gabrobins.com
Mike,
Incidentally, I bad all the supervisors grade the independents on their wor--
k product. Guess what? GA13 Robins came out on top out of 44. So, you all=
are doing a great job. IntegriClaims is a big help. Keep up the good wor-
k..
Bill
Hey Bill:
Can't believe that game last night- My oldest son went to Texas Tech and
will be wearing a black arm band for the remainder of the season. I am
back working out of the Dallas Office because we had some problems
(computer-wise) working out of my house.
If insured makes claim on structure and contents and the contents is less
than the deductible than we must send the letter on the conLents portion?
I don't think any of us have been doing that, only when the claim as a
"Bill Knarr"
<bknarr0qtwia.0Tg>
To
11/23/2008 07:34 <ustwia l@gabrobms.com>
AM cc
Subj ect
RE: Guidelines for sending "Below
Deductible Letter"
Mike,
If more than I item is involved and that item or items loss falls below the
deductible or the claim being made is not covered, it needs a letter of
PLAWnFPS
EXH18ff TWIA-Instit-00023289
I I
explanation of no payment even thou payment is being made on another item.
This stems from Ann Richards House Bill 2. If a denial is being made it
must be in writing. Hope this helps. How bout those Sooners? What arc
you doing up so early?
Rill
-----
Original Message-----
From: dugganam(a-,)gabrobins.com [mailto:dugganam@gabrobins.com1
Sent: Sunday, November 23, 2008 7:32 AM
To: Bill Knarr
Subject: Fw: Guidelines for sending "Below Deductible Letter"
Regards Mike
....
USTWIA I
Mailbo-JGABRobins
Sent by: Mike To
Duggan bknarr(4,@twia.com
cc
Wick
11/22/2008 02:26 Powell/ICS/US/GABRobins@CjABRobins
PM Subject
Guidelines for sending "Below
Deductible Letter"
Bill:
We are being asked to forward the "Below Deductible Letter" when only the
consequential loss (food) falls below the deductible. I thought this was
done when the entire claim was less than the deductible, notjust one item?
Thanks Mike
....
TWIA-Instit-00023290
800-416-1625
[mailto:RECTCTTF,(-a)T.WTA-O.RCTI
From: Reggie Warren
Sent- FTiday,.Tuly 27, 2007 10:26 AM
To: Richard Myers
Subject: Windstorm definition
Richard, here is some info. Please do not forward this exact email, but you can put it in your own words out to your a4iusters.
<<Windstorm definition.pdf-
Idon't think Texas law is as black and white as the N)XrS paper suggests. Texas law generally defines the term "windstorm" to mean "something
than ordinary gust of wmd, no matter how prolonged, and though the whirling features which usually accompany tornadoes and cyclones
more an
need not be present, it must assume the aspect of a storm."
Using this legal standard, a case might be made that winds under 40 do not constitute a "windstorm;" however, it would likely require expert
testimony. You could hire an wind engineer, atmospheric scientist or meteorologist to give an expert opinion on whether a particular event
constitutes a "windstorm." However, it seems like this would onIv be useful if you have not paid other claims for the same event- Once you have
paid one insured's claim on the assumption that its a "windstorm "
it could be discriminatory to deny other insureds' claim for lack of
;orm. (example, tornado damages house on one side of street but
"windstorm," unless the difference could be explained by local characteristics
not the other).
PLAIPMFPS
TWIA-Instit-00019252
0 Li
I
From: Bill Knarr
Sent: Monday, December 22, 2008 12:42 PM
To: Bob Parrish
Bob,
I will list for you the firms we are using. I have most control with EFI because I know most of the management. You are right Garner is slow.
Here is the list and not in any special order:
1
think Van Fisher and Mark Kubena were involved in a lot of Katrina investigations. Hope this helps.
Bill
Bill,
Will do'.
lIcisalsover@-,veryslowwiththeRFED-A properties.
Thanks!
Bob
P. S. Can you recommend an engineering firm that is really good go work with?
-----
Original Message -----
From: Bill Knarr
Sent: Monddv.December22,20086:19AM
To: Bob Parrish
Subject@ R R FR-E-D-A @Tept from Ciarner co sulting
Bob,
I have had a discussion with 1%&. Gamer on some other invoices that I felt was excessive. The one issue I had is that if you notice he charges 15%
surcharge will not be accepted. We no longer assign @&. Gamer any new
on reimbursable expenses. On invoices after 12-01-08 this expense
all his invoices for service are excessive- We do not try to run his business, but we don't have to use him either. So, go ahead a ad process
ones as
payment as submitted. Thanks for calling it to my attention.
Bill
Bill,
PWNnFPS
EXH18ff
TWIA-Instit-0001 5549
105
Please advise what you would like us to do.
Bob
-----
Original Message -----
From: Greg %ers
Sent: Sunday, December 21, 2009 9:57 AM
To: Bob Parrish
Subject: FW:FREDA reptfromGamercosulting
Bob,
ThisPE\vasoligiiiallyassie-nedtotheFR-EDA-C]Claini@RED landIREDACTED
AttachedisaserviceinvoicefromPE-A,ndreGardner.
Claim #FR-E-DA]
Regards,
Greg Briers
Claim Supervisor
(512)637-4060
TWIA-Instit-0001 5550
From: Bill Knarr
Sent: Friday, March 20, 2009
To: Preston Kuhn
Preston,
We can't tell the engineers what to say or what their opinion should be. W=
e can rise anOtheTfirm in the future if the issue of unsealed shingles is t=
he question.
Bill
-----
Original Message -----
From: Prcston Kuhn
Sent: Thursday, March 19, 2009 4:20 PM
To: Bill Knarr
Subject: RE: @-EDACTED
Bill,
The only problem I have -Mth this report is the Engineer is stating "uplifi=
ting" of shingles as xind damage and has pictures like all the l1A!s claimi=
ng such. There are only 3 cracked shingles on this roof but he is recommend=
ing replacement. I think we need to let EFI know we do not consider "hfted=
"
shingles as direct physical damage by wind.
Preston Kuhn
TWIA Claims Supervisor
512-505-2131
512-899-4950 fax
-----
Original Message -----
From: Bill Knarr
Sent: Thursday, March 19, 2009 11:44 AM
To: Preston Kuhn
Subject: FW:FR-EDACTED
Preston,
Here is EFI engineering report. I assume you wanted to review and give gui=
dance to the adjuster.
Bill
REDACTED
PLAINTIFF'S
EXHIBIT
TWIA-Instit-00022088
From: Bill Knarr
Sent: Tuesday, September 09, 2008 03:05 PM
To: Steven Hille (E-mail)
Steve,
Do not believe either item covered because they are not the result of direct physical damage as a result of windstorm. Both would be considered
be direct physcial damage, the
consequential losses. Had the roof tile hit the pool pump and damaged it because of the hit, then I think- that would
Questions.
same for windstorni blowing debris in pool damaging or staining the plaster. Good
Bill
-----
Original Message -----
FTOM: Joe Rosentritt
Sent: Tuesday, September 09, 2008 8:48 AM
To: Bill Knarr
Subject: FW: overage question
-----
Original Mcssagc -----
From: Steve Hille [maiIto:skI.Ie0)eber.Iscom]
Sent: Tuesday, September 09, 2008 5:51 AM
To: Eberladjreports
Cc' 'Bob Wadeking'
Subject: FR@@Coverage question
Thank you,
Stcvc Hillc
210-215-8193
PLAIPMFPS
EXHIOff
TWIA Instit 00022856
Eberl's Claim Service, Inc.
9/8/2008
Attention:
COVERAGE QUESTIONS
T W IA C L A Im FP-F-n-A-(-- I
Insured: IREDACTED
Property: I
Secondary residence
Limit of Liability -
Building: $500,000.00
Coverage Question: Hurricane Dolly winds seriously damaged the tile roof covering. Damaged roof tile fell from the roof and
broke the pool pump supply line to the pool. Electrical power was loss for a number of days. When power was restore, the
pump ran and pump itself dry and damaged the itself. The estimate to replace the pool pump is $409.00 plus tax. The
estimate to acid wash the pool is 750.00 plus tax.
I
await your instructions,
Bob Wadeking
Adjuster
214-675-5768
CONFIDENTIAL TWIA-Instit-00022857
898ZZOOO-I!Isul-VIAAi WiNMUNOO
Z:86ed
:sainsolou=i
Bui)lopeAA qoS
'AlojeouiS
From: Bill Knarr
Sent: Saturday, December 13, 2008
To: David Ellis (E-mail)
David,
by
Joe forwarded your question to me to answer. So here is TWIA's position. As a rule, fogged windows are not a direct result from damage
fog. If more than one,
windstorm. A possible exception might be if one window got hit with flying debris and broke the seal causing the window to
then very unlikely the damage was the result of windstorm and as you say the result of failed defective seals.
Bill
OTiginal Message
----- -----
From: David L. Ellis [mailto:dellis,'Olega @Iaims@.netl
Sent: Friday, December 12, 2008 2:51 PM
To: Joe RosentritL
Subject: fogged windows
Hi Joe. I have kicked back adjuster files for the last 75 days for windows that the seals failed. To me, and all of us at Legacy Claim Services, know
that this is a result of failed defective seals on double pane windows and not a result of wind damage.
However, we are getting swamped with re opens on this subject. My question is: Does TWIA have any written directives on this?
I am having the adj usLers suggest to Insured's' to go Lhrough their H 0 carriers if they have a glass endorsement.
Regards,
David L. Ellis
866.461.1770 (office)
469.964.5527 (cell)
PLAINTIFPS
EXHIOff TWIA-Instit-00004992
From: Mike Guidry
Sent: Saturday, February 21, 2009 08:31 PM
To: Reggie Warren
Subject: FW: Coverage Question Attn: Bill Knarr and Reggie Warren
Mike
Original Message -----
.....
From: Mcqueen, Maryann [mailto:Maryann.Mcqueen@Lusaa.com
Sent: Saturday, February 21, 2009 7:40 AM
To: USAAadjreports
Subject: Coverage Question Attn: Bill Knarr and Reggie Warren
The subsequent tamping of the roof is damaged only to the ex-tent that it was INTENTIONALLY done to protect the property from further covered
loss (TWIA's) and there is no coverage under the USAA policy as the roof repairs are directly a result of wind damage and specifically excluded by
the HO-140 endorsement on the policy.
Maryann McQueen
Manager
Virtual Catastrophe Unit
PLAINMFPS
TWIA-instit-00019648
I
From: Bill Knarr
Sent: Friday, October 17,2008 09-.29 PM
To: Bob Stump
Cc: john hinz
Subject:RE: FEMA Blue Roofs
Bob,
We do not cover damage other than direct damage by windstorm or hail. FEMA nailing on blue roofs by driving nails through
Suggest insured call FEMA and ask them to correct their mistake. We can't start paying for
perfectly good shingles is not covered.
this.
Bill
-----
Original Message -----
From. Bob Stump [iriailto:rstuni &cw-ass_oc-coniJ
Sent: Friday, October 17, 2008 2:02 PM
To: Bill Knarr
Cc: j ohn hinz
Subject: Fw: FEMA Blue Roofs
Bill:
1. Our adjuster fights the good fight and gets roofer and insured to agree on repair, not replacement
2. FEMA tarps the roof and by using full farring strips and nails, destroys the roof
3. TDT inspector says he won't considersubsequent damage (?)
4. Roofer says he can't do the repair now, and he's probably right
Seems to me, we might owe the roof or insured's caught between (2) agencies
....
What do we do?
Thanks,
Bob Stamp
-----
Original Message -----
From: 13untzjIa)aol.eom
To: rsturnp@ejw-assoc.com
Sent-. Friday, October 17, 2008 3:51 PM
Subject: (no subject)
Bob,
Received a call from insured. We had agreed on the roof repair. The roofer was also in agreement.
THEN
Any direction??
PLAINTIFF'S
EXHUM TWIA-Instit-00016753
-Im-
From: Bill Knarr
Sent: Thursday, January 15, 2009 10:11 PM
To: Nita Adcock
Nita,
We do not pay to match. We pay for direct damage from windstorm or hail.
The word match is not in a TWIA policy-
Bill
Bill,
Indealing,@Nithroofrepairs,manyquestionsarenowcomingupfromPA'sandattomey'sthatarepairwouldnotmatchtheexistingroof Wehave
TWIA does not pay to match. The policy says material of like kind and quality and nothing direct about not
always been under the assumption that
matching.
Nita
PLMNMFrS
125rr
TWIA Instit 00019647
From: Bill Knarr
Sent: Saturday, October 04,2008 11:21 PM
To: OCook4O770(a,,aol.com;OCook4O770(c4,,aol.com
Owen,
Bill
-----
Original Message -----
Froin: OCook40770@aoI.coin [n1ailto:0Cook40770@aoI.com]
Sent: Saturday, October 04, 2008 4:25 PM
To: Bill Knarr
Subject: Asbestos issues
Bill
exposure.
Thanks
Owen Cook
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PLAINMFF'S
EXHIBIT
TWIA Instit 00022595
James W. Oliver
General Manager
Senator Mike Jackson's office asked for a status of Hurricane Ike issues so
I have prepared the
following to update Senator Jackson. I thought that the other members of the Legislative
Oversight Committee would also benefit by getting this information.
Dolly.
Hurricane Ike was a unique storm in the history of TWIA. It was coupled with Hurricane
Combined, the storms will result in over 100,000 reported losses to TWIA. The storm surge
(flooding) in Hurricane Ike was unprecedented in our history and is not covered under the TWIA
policies.
remaining
We have closed 98% of the reported losses from Hurricanes Dolly and Ike. The
losses were either reported recently, are larger and more complicated or are reopened claims
where policyholders have asked for additional payment consideration. We currently have
approximately 832 lawsuits from Hurricane Ike.
key issues.
Recent news reports tied to litigation have misstated TWIA's position on a number of
litigation "slab" losses
Three specific issues that have drawn considerable press coverage and are
sealed
(nothing left of the property but slab or pilings), unadhered shingles (adhesive strip not
Texas iation
5700 South MoPac Expressway, Building PLMWhFFS .0. Box 99090, Austin, Texas 78709-9090
1 ff
and profit. Since each of
between two shingles) and payment of general contractor's overhead
give you too much
these issues is the subject of class action and individual lawsuits, we cannot
specific information but do offer the following:
policies.
1. Slab Losses: Storm surge (flood) is excluded from coverage under TWIA
with slab losses do not have flood insurance.
We estimate that 40% of policyholders
Another 40% are underinsured. In other words, 80% of policyholders did not have
flood insurance or did not have enough flood insurance. This is a problem because
(excluding flood). TWIA
TWIA can only pay the portion of the loss caused by wind
hired independent experts in engineering, meteorology, statistics and adjusting to
determine the wind portion of the loss. Our protocol includes an engineering method
The
and a statistical method of estimation using individual building characteristics.
flood
engineering method estimates the scope of building damage from wind and
with benefits
forces. The statistical method seeks to keep slab claim payments on par
paid to other insureds whose buildings were not destroyed by storm surge. Our
wind damage.
adjustment is based on the method that estimates the highe amount of
the risk of
In this way, we attempted to pay the maximum policy benefits even at
overpayment on an individual building basis. The eight administrative cases heard
before judges of the State Office of Administrative Hearings (SOAH) that have
the
resulted in proposals for decision have findings that affirm TWIA's position, but
Commissioner of Insurance has not yet entered an order affirming, reversing or
"slab"
modifying TWIA's action on the claims. It is important to note that on these
losses the National Flood Insurance Program has consistently paid
its policy limits,
by
affirming that they believe that most of the losses were caused primarily
surge/flood.
2. PMgnent of General Contractors Overhead and Profit (GCOP): Recent news reports
services of a
have misstated TWIA's policy with respect to when TWIA pays for
for these services in an
general contractor and when TWIA includes an amount
The services of a general contractor are sometimes
estimate for repair costs.
other who perform the actual repair
necessary to coordinate the work of contractors
overhead and profit in the
work. TWIA's policy is to include general contractor's
that the
repair estimate whenever the particular facts of the claim demonstrate
If it is unclear at the time
services of a general contractor are reasonably necessary.
needed,
of estimating repair costs that a general contractor's services are reasonably
but a general contractor does become necessary, a policyholder can request a
supplemental payment to include GCOP. In all cases with replacement cost coverage,
exceed the lesser of
the amount TWIA will pay after repairs are completed shall not
the
(1) the cost to repair, (2) the amount actually and necessary spent to repair
damage, or (3) the policy limit.
3. Unadhered Shingles: Most roofs are designed and certified to resist winds speeds
shingles may
higher than what Hurricane Ike delivered. However, some composition
not seal at the time of installation. Seals may also become unadhered because of wear
and tear, inadequate sealant, decking expansion/contraction, foot traffic, improper
experience, winds
nailing, installation errors, lifting by hand, or high winds. In our
tear-off, rip, crease,
high enough to break a previously sealed adhesive strip will also
damage, it
fold or delaminate tabs or whole shingles. When we don't see this type of
by wind. Independent adjusters should
is a sign that the shingle was not damaged
2
Ike caused previously sealed adhesive
attempt to establish that wind from Hurricane
the shingle), and estimate the
strips to delairninate (or other physical damage to
application of asphalt roofing cement
reasonable cost of repairs. The repair may be
according to manufacturers' instructions.
under the comers of each unadhered tab
will no longer shed water, or if there is tom,
The shingle may need to be replaced, if it
visible damage is widespread,
creased, folded, or gouged material. When this type of
the Texas
the roof may need to be replaced. A new Certificate of Compliance with
TWIA insurance when
Windstorm Building Code is not required to maintain
required because of windstorm
unadhered shingles are outside of the scope of repairs
administrative action taken by the Texas
damage. We believe the highly publicized
Department of Insurance is based on a
misconception of TWIA's policies and the
burden of proof. Seven prior administrative cases heard before SOAH Judges have
but the Commissioner of Insurance
resulted in findings that affirm TWIA's position,
or modifying TWIA's decision on
has not yet entered an order affirming, reversing
the claims.
systems in the
TWIA is implementing changes to its processes, procedures and computer
and increase readiness for the 2010 hurricane
following areas to enhance customer service
with the Texas Department of
shared its findings and recommendations
season. TWIA has of them.
that the Department concurs with many
Insurance, and it is our understanding
that
• Improve communication of the claims process at time of claim so
(TWIA has hired a public
policyholders and agents know what to expect.
relations firm to assist in preparing appropriate
materials to educate policyholders
about proper coverages,
and/or agents, not only after a storm but prior to a storm,
processes/procedures following a storm, etc.)
email or over the
Provide a system for policyholders to get information either by
•
claims. (TWIA is in process of adding
intemet to have a current status of their
and/or policyholders to get a status on
features to its website that will allow agents
claims.)
3
its permanent staff of claims
TWIA will be adding additional personnel to
and the
employees. They will help prepare for larger, more complicated storms
careful and not add too
various issues that surround these storms. (We need to be
enough to do should there not be
many additional employees who will not have
be prepared for a storm of Ike's size or
any significant storm activity. We want to
that are unnecessary and will
larger, but do not want to have day-to-day expenses
force TWIA's Board to seek rate increases.)
James W. Oliver
4
From: Bill Knarr
Sent: Fridav. October 24,2008 12:06 PM
Creaf 'Tinder
To:
Word.Doemnent
Microsoft Word 10
could have been windstorm, ie shingles missing, tirm gone, chimney vent
Windstorm would contribute to some degree if it is believed some damage
is of flood. Many insureds do not have flood coverage. What flood does really makes us no difference, wewant
missing, etc. Windstorm not excess
of loss, Each loss will be evaluated on its own merits.
to know, but it does not have a bearing on our amount
-----
Original Message -----
From: Creal Tinder [mailto -.CTinder0ins rou P -net I
Sent: Thursday, OctobeT23, 2009 6:13 PM ---
To: Bill Knarr
I PROMISE Both Windstorm & Flood Hurricane Ike
Subject: RE:LASI'QUESTION -
It is a what "if" questions and I hate those questions, but I know it is just You and me talking
Creal Tinder
Houston, Tx 77027
713-541-7272 Office
713-620-4413 Direct
713-620-4461 Fax
713-302-7450 Cell
PLAI"FPS
EXH TWIA-Instit-00023691
Ila,
Original Message -----
-----
From: Bill Kwur [mailto.bknarr@TWIA.ORG-1
Sent: Thursday, October 23, 2008 5:54 PM
To: Creal Tinder
Subject: RE: Both Windstorm & Flood - Hurricane Ike
by Flood.
No, we have seen some claims from storm surge paid
CrealTinder
Houston, Tx 77027
713-541-7272 Office
713-620-4413 Direct
713-620-4461 Fax
713-302-7450 Cell
-----
Original Message -----
From: Bill Knarr [mailto:bkna rr,-&, TWIA.ORG
Senti Thursday, October 23, 2008 5:44 PM
To: Creal Tinder
Subject: RE: Both Windstorm & Flood - Hurricane Ike
TWIA-instit-00023692
Sent: Thursday, October 23, 2008 5:32 PM
To: Bill Knarr
Subject: Both Windstorm & Flood -
Hurricane Ike
PICKINGYOURBRAIN: IftherewasahouseonCrvstalBeachthatwastotallygoneandtheo,,Nner
had a windstorm policy and a flood policy, both having the maximum coverage
Has it been deten-nined which policy will respond for the Crystal Beach area where most
Creal Tinder
I Iouston, Tx 77027
713-541-7272 Office
713-620-4413 Direct
713-620-4461 Fax
713-302-7450 Cell
TWIA-Instit-00023693
From: Bill Knarr
Sent: Friday, August 0 1, 2008 02:5 5
PM
To: Louis Slovensky
Louis,
I will get back to you. We do not want the TDI Inspectors adjusting our losses. Reggie had a
We are checking into the situation and either Reggie or
in San Benito. Reggie will be back tomorrow andwe should be back with you on this issue and
face to face discussion with Mike Babin last evening
by Monday. Thanks for calling this to our attention.
others relating to TDI inspections
Bill
-----
Original Message -----
ky. coml
From: Louis Slovensky
[
Bill.
Please review the info below and contact me to discuss ..... thanks
Bob,
office to discuss Windstorm inspection certifications. In general, the TDI officials told
Earlier this morning 2 TDI officials came by Agent Joe Jones replacement. This has caused some concern
the shingle be damaged and would warrant
1,&. Jones debris blown under the shingles would cause to
TDI Officials:
Mike Babin
Quality Control Specialist
Windstorm Inspections
979-848-0953
Welch V. Watt
Manger
Windstorm Inspections
512-322-2203
PLAIPMFFS
E"I ff TWIA-Instit-00023277
James W' Oliver
General Manager
On October 30, 2009, Commissioner Geeslin sent members of the Windstorm Insurance
TWIA claims handling
Legislative Oversight Board a summary of TDI's initial review of
this letter is to respond to certain issues
processes during Hurricane Ike, The purpose of
entire report.
presented in the TDI report, and provide additional context for the
FFS
t
adjustments had
Obviously, in 2008 with more than 102,000 claims reported, necessary
TWIA staff implemented its existing
to be made to manage this unprecedented volume.
We added the
catastrophe plan, which had been reviewed with TDI in advance.
and
appropriate trained and experienced staff to existing space and added new space
All of our systems, computers, telephones, etc,, were adapted as we
work stations.
scaleable while
expanded, These systems were set up in advance to be adaptable and
had low claim volumes.
providing cost efficiencies during years when TWIA
It was a Category 2
Hurricane Ike was a singular storm event for TWIA and for Texas.
under TWIA policies
wind event with a Category 4/5 surge. Flood/surge is not covered
working for TWIA, had to sort out the
so independent adjusters and other experts,
Since TWIA provides coverage on
covered wind losses from the excluded flood/surge.
more than 901/6 of the residential and commercial
properties in the areas most affected by
complaints from policyholders who did not
surge, the Association received hundreds of
TWIA records show that
have flood insurance or adequate flood insurance'
and
approximately 40% of policyholders with flood losses did not have flood insurance
approximately 40% were underinsured. We believe only about 20% of policyholders
with surge losses had adequate flood coverage. TWIA has faced inaccurate and unfair
for their
criiticism (and litigation) from many policyholders who do not have coverage
devastating losses.
2
dwellings that
their dwellings and contents. TWIA writes the older, more damage-prone
are not built to stronger building codes. ne private
market intentionally writes newer
dwellings built to the more recent windstorm building codes.
with TWIA's
Some of the proposed changes in the TDI report are helpful and consistent
internal recommendations. TWIA instituted a voluntary review of its processes and
report was
procedures and was already implementing appropriate changes before TDI's
findings, including the
issued, There are a few areas of disagreement with TDI's
following:
"justified"
I
.
TWIA has asked TDI for a process to review TDI's rating of
complaints. Many cases are disputed by TWIA.
2. We disagree with TDI's characterization of "delayed claim handling".
rated
Although not described in a TDI rule, bulletin or order, TDI apparently
handled accordance with
complaints as "justified" even when the claim was in
Code Chapter 542
the claim handling deadlines provided in Texas Insurance
The benchmarks implied in TDI's
("Prompt Payment of Claims Act`@.
the time periods prescribed by Chapter 542,
investigation do not conform to
operations on the scale
and they are sometimes unrealistic for catastrophe
disconnect
required because of Hurricane Ike. We have asked to review this
with TDI. Of course, we will continue to implement technology and training
when we already comply
to improve customer service and efficiency even
with statutory deadlines.
such as scheduling
3. Many complaints relate to customer service issues
understanding
inspections, receiving estimates, obtaining claims status, and
the basis of a payment. TDI often rates customer service complaints as
accomplished within statutory
"justified" even if the loss adjustment is
deadlines, and the grievance has no bearing on the total amount paid.
3
regarding the
4. A TDI complaint can be TWIA's first notice of disagreement
has to do with the amount
amount of a covered loss. When the complaint
investigation of
paid, TWIA typically responds with reevaluation or additional
a claim for
the differences' and attempts to obtain any evidence supporting
additional benefits. This includes follow-up request to policyholders for
improperly
information that was requested but not previously supplied. TDI
is an
assumes that responsible follow-up investigation and reassessment
indication of initial failure.
James W. Oliver
4
E-mails show wind insurer had early wave of complaints
I
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AL
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E-mails show wind insurer had early wave of complaints -
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business in
"We need to keep TWIA Some of the reviewed files showed no
house," one e-mail said. evidence of communication with
policyholders. Others showed claims
The e-mails indicate TWIA tried to hide checks were often sent without an
that it was missing claims-handling explanation of how the amount was
deadlines provided by the policy and determined. There were also no reports to
consumer protection laws, said Steve track the status of pending claims, and
Mostyn, the attorney who filed the e-mails some claims weren't processed within the
with a court case. time limits promised by the policy, the
review showed.
Oliver said he didn't know those e-mails
were sent and "would not ever tell anyone The state also found that the insurer often
to cover up" anything. handled claims inconsistently and lacked
adequate training for its adjusters.
A review by the Texas Department of
f
Insurance confirmed some of the Before the storm, TWIA contracted with 12
rustrations laid out in the e-mails. firms that each promised up to 25
adjusters to help handle claims. But, the
The department, which received nearly report said, the sheer volume of claims
1,700 complaints as of June about the
1
forced TWIA to use adjusters who had
insurer, reviewed 350 claims and 50 little training from the insurer.
complaints this summer and recently sent
its findings to members of the Windstorm The regulator is considering enforcement
Insurance Legislative Oversight Board. actions related to TWIA's failure to
process claims in a timely manner and is
Of all the companies it received investigating s )me of its other claims
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Got Houston Chronicle home
del"
"Do you want to do that? Or do you want a But Alex Winslow, head of Texas Watch,
system like ours that is scalable?" he said. called on lawmakers to conduct an
independent investigation.
Ina letter to lawmakers, he said hundreds
of complaints came from homeowners 11TDI playing catch-up because their
is
who didn't have adequate flood insurance oversight wasn't vigorous enough
and wanted the windstorm insurer to pay immediately following the storm and
for flooding damage. TWIA is bellyaching that TDI is picking on
them," Winslow said. "Give me a break.
He also expressed surprise at the TDI and TWIA both fell down on the job,
department's criticism since he was in
and TWIA's customers are the ones having
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