American Modern Claims Process

Questions and Answers

What is the percentage for overhead and profit (O&P) when three verifiable trades are involved?

10%

30%

40%

20% (correct)

O&P is applied to the roof.

False

Tree and tree debris removal is allowed for general tree debris clean-up of the property after a storm.

False

What is the policy limit for removing tree debris from residence premises?

$500 Signup and view all the answers

What is required in the narrative report for claims?

All of the above Signup and view all the answers

All claims must include the line 'Depreciation has been applied based on the age and condition of materials at the time of inspection' in the narrative.

True Signup and view all the answers

Which item is NOT allowed in the estimate?

Mold remediation line items Signup and view all the answers

The minimum charges line items are allowed in the estimate, but discretion should be used. The general waste guidance for simple roofs is ___%.

5 Signup and view all the answers

Study Notes

General Claims Guidelines

Narrative report must be titled "#3 Ryze Final Narrative Report - Property".
Mortgage company verification is essential and noted in the narrative.
Inspection details: date, time, participants (names and relationships) are required.
Prior losses or repairs must be documented; contact AMIG DA for details.
Identify subrogation and salvage opportunities; notify the insured to retain damaged parts.
The cause of loss must be detailed, documented, and photographed.
Include "Depreciation has been applied based on the age and condition of materials at the time of inspection" in all claims narratives.

Estimating Protocols

Include Ryze logo and header address on estimates.
Write all damages in estimates; use "Tear Out" for removal line items unless repair.
Differentiate between mobile homes and site-built home items in estimates.
Diagrams for damages are required, including specific elevation and interior layouts based on damage extent.
No waste is claimed for mobile home insulation or materials like felt and ice/water shields.

Photo Documentation

Photos must document the cause of loss, including close-ups and comprehensive descriptions.
Capture all elevations and details for hail/wind claims, including close-ups of exterior structures.
Interior inspection photos are essential, especially for damaged areas and layouts.
All images need to be clear, with no blurred photos or unnecessary items like moisture meters.

Roof Guidelines

For hail claims, a minimum of 8 hits per test square is required for damage assessment.
Wind damage requires visible tearing, creasing, or missing shingles; unsealed shingles and overdriven fasteners don't count as damage.
If 75% or more of the roof is damaged, a full replacement is allowed, taking age and condition into account.

Diagram Requirements

Diagrams are mandatory for any damaged roof, exterior elevation, or interior area.
Diagrams must show damage locations, annotating areas captured in photographs.

Interior Damage Handling

Painting procedures involve sealing and applying one coat to both damaged and adjoining surfaces.
Vinyl and carpet repairs should reflect the room’s diagrams without unnecessary replacements.
Cabinet replacements require thorough inspection and justification before proceeding.

Overhead & Profit

Overhead and profit (O&P) is justified with the involvement of three trades and is applied only when a contractor is required.
O&P is not applicable to roofing costs.

Contents and Other Structures

Personal property damages should be documented with photographs, not included in estimates.
Coverage for other structures allows replacement cost value (RCV) for buildings recognized as having “four walls and a roof”.

Tree Removal Guidelines

Tree removal costs are covered only when the tree has caused damage to covered structures.
Tree debris cleanup is not covered unless it's from a structure-related incident, with limits generally set at $500.

Miscellaneous Claims Procedures

A first contact note must be completed in the requisite systems, along with any necessary follow-ups.
Weather reports are required for weather-related claims to support inspection findings.
Claims over $20,000 necessitate a reserve email and proper documentation within the appropriate system.
All estimates should align with specific coverage items, avoiding "no coverage" totals.

Description

This quiz covers the essential components of the American Modern claims process. It includes key aspects such as narrative reports, inspection details, and prior loss information to ensure all claims are properly documented. Test your knowledge on the requirements and verification steps in handling claims.