Sagesure Exam

Claims Information

• Claim number, policyholder, and insurance company details are essential to file a claim.
• Important dates include the date of loss, date of contact, and date of inspection.
• Each report must have a carrier-specific header.

Inspection Reports

• Summarize the estimator's findings thoroughly unless assigned under Managed Repair Program.
• Identify type of damage and cause of loss; if cause is undetermined, findings are shared with claims handler without an estimate.
• Verify location details, insured parties, and lienholders.
• Assess condition of the risk and any underwriting concerns.
• Document any prior losses and potential for subrogation or salvage.
• Outline observed damages and scoping decisions that support estimates.
• Include follow-up instructions as needed.

Estimates Documentation

• Justify quality and quantity of damaged materials.
• Recommend whether to repair or replace damaged property.
• Document depreciation based on age, condition, and obsolescence.
• Provide dimensions of damaged rooms and a diagram of all affected areas.
• Supporting documentation must be included if measurements can’t be taken in estimating software.
• Any deviations from standard estimating should have a line-level note.

Coverage Considerations

• All estimate lines must correspond to appropriate coverage; lines marked "none" should be corrected.
• Manually enter applicable limits from the loss summary policy section.
• Clarify any additional coverages or deductibles needed; claim handler should provide directions.

Additional Guidelines

• Bid items are prohibited when estimators can issue a comparably functional estimate.
• Include cost documentation for contents inventory or specific remediation activities.
• Every use of premium materials requires a line-level note.
• Avoid including costs for generators purchased or used by contractors in estimates.
• Include comprehensive photo documentation within the estimator bundle.

Content Manipulation Rules

• Content manipulation must align with room size, estimates should not be hourly rated.
• Contents should be reset only once per room unless multiple resets are justified with documentation.
• Manipulation relating to repairs must be charged against the dwelling or structures.

Demolition Guidelines

• Costs related to tear-out or procedure adherence should not exceed applicable deductibles.
• Proper alignment with state-specific requirements for repairs and material replacements is crucial.

Roofing Guidelines

• All roofing estimates must align with roof diagrams and reports in the claim file.
• Tear-off charges should reflect total roofing area; steep and height charges apply to specific criteria.
• Maintain documentation and notes for any accessory metals or roofing components replaced.
• LKQ materials must align with existing materials; upgrades stipulated by code should be marked PWI.
• Waste calculations excluded for starter rows and ridge caps require individual entries.

Permits

• Permits cost should not be included unless verified at the inspection.
• Attach permit invoices if available; if not, contractors submit them as supplements.
• Include line-level notes clarifying purposes for required permits.

Plumbing Regulations

• Outline specifics for removal and resetting plumbing fixtures without including non-essential components.
• Document and photograph any prior damage affecting the current claim.

Conclusion

• Thorough documentation, adherence to coverage guidelines, and precise reporting are crucial for effective claims management and estimation processes.### Solar Panel Replacement and Repairs
• Estimates for solar panel replacements and repairs should only come from licensed contractors using bid items.
• Estimators must verify the cause of loss and damage before proceeding.
• LKQ (Like Kind and Quality) should be confirmed by checking material usage type and origin.
• Supporting documentation, such as installation agreements and material descriptions, must be secured.
• Ownership and responsibility for damages should be confirmed, including reviewing lease agreements.
• If a new bid lacks removal, adjusters can use a tear-out line item for all panel removals, applicable to partial repairs only.
• For roof damage under mounted solar panels, estimates must include costs for detaching and resetting panels and necessary accessories.
• The method for detaching and resetting panels depends on the panel usage type, which affects whether costs are calculated by square footage or per panel.
• Total square footage or number of panels must be documented in the estimate.

Subcontractor Bids

• Estimates can use pricing from estimating software, but subcontractor quotes may be utilized for line items not found in the database.
• Any use of subcontractor bids must be documented, explaining the reason for their inclusion.
• Subcontractor bids must be written, without redacted costs or materials, and include contact information.
• Overhead, profit, and tax charges should not be included in subcontractor quotes if already accounted for in the main estimate.
• If these charges are present in the quote line item, they must be removed and marked as tax-exempt.

Siding and Stucco Damage Evaluation

• Age and condition of siding should be considered when evaluating damage from wind or hail.
• All elevations must be documented with photos and measurements; a hover report is required.
• If siding is deemed irreparable due to storm events, clear documentation must justify this conclusion.
• Deduct any missing walls, doors, windows, or other deductions during the estimation process.
• Estimating software can automatically deduct missing elements if a diagram is used for damage scope.
• Follow state statute guidelines for matching siding or stucco if matching is not possible.
• Painted damaged areas must be replaced and the affected elevation repainted accordingly.

Scaffolding Considerations

• Scaffolding costs should not be included in estimates unless justified.
• Labor costs for setting up and removing scaffolding may supplement repair work.
• Justification for scaffolding should include detailed notes in the estimate.
• For large projects requiring rented scaffolding, invoices for rental costs must be provided.

Temporary Facilities

• Temporary toilets and portable restrooms are to be included in overhead, not the estimate.
• If required by law, these facilities need a detailed line level note and marked as PWI until documentation is available.

Importance of Diagrams

• Diagrams are crucial for validating measurements and quantities in estimates.
• Diagrams must have a 1-inch margin of error and clear naming for quick reference.
• Required diagrams include details of interior damage, multiple ceiling heights, and roof damage specifics.

Estimating Tools

• Use Rollout Calculator for carpet or vinyl estimations, ensuring accuracy in seam methods and waste percentages.
• Roof sketches should detail damaged slopes, categorizing slopes as subgroups to minimize waste.

Photograph Requirements

• Digital photographs are mandatory for all assignments, uploaded to the estimating software.
• Photos must document all damaged areas and include date and captions for clarity.
• Include required angles (four elevations of the dwelling) and address verification in photographs.

Roofing Documentation

• Roof damage photos must be taken directly from the roof; use ladder assists when necessary.
• Capture a comprehensive image set for hail damage, including overall views, intermediate, and close-ups.

Internal and Content Photos

• Full shots from multiple angles are essential for assessing interior damage.
• Include close-ups of damaged materials and content manipulation should be based on room size.

Estimating Best Practices

• Any trim removal should account for interruptions; baseboards only removed if damaged.
• Cabinet repairs should be prioritized before considering replacements.

Demolition and Debris Removal

• Use the smallest dumpster that meets debris removal needs.
• Follow recommended capacities for various dumpster sizes based on removal volume and content type.

Depreciation Guidelines

• Depreciation rates should not exceed 80% per item, considering age and condition.
• For specific states, ensure labor costs are not depreciated.

Roof and Hail Documentation

• Use outlined test squares for hail damage verification; require at least eight hits for replacement consideration.
• Clearly label all photos and annotations to specify observed damage accurately.

Guidelines for Solar Panels

• Three options exist for the replacement of solar panels within the claims framework.

These notes encapsulate key points on estimating requirements, guidelines on documentation, and best practices, ensuring accuracy in claims assessments.