SageSure Estimating Guidelines v.1.17.24 (1).docx

**General Estimating Guidelines** **General Rules:** - All claims should be created, and estimates written utilizing, the estimating software - All supporting documentation should be housed in the SageSure claim documents folder and submitted with the claims bundle to...

**General Estimating Guidelines** **General Rules:** - All claims should be created, and estimates written utilizing, the estimating software - All supporting documentation should be housed in the SageSure claim documents folder and submitted with the claims bundle to Snapsheet - **[SSDocs]** folder in the Mobile Claims file - Estimates should adhere to state and local laws - Each specific service requires a separate estimate - (Example: water mitigation, abatement, reconstruction, etc.) - The estimate should be written with the most current price list at the time of creation - Supplemental estimates and revisions should also reflect the most accurate price list - Matching to when the work was completed or date range of any provided contractor's bid when attempting to reach an agreed scope and price - All files should contain the most accurate sales tax for the loss location - Any issues with validating the tax rate for the address should be directed to the claim handler via the claim specific email address on file - All line items must have a quantity value greater than zero **For Third Party Administrators and Independent Adjusters, and Staff Field and Desk Estimators, the estimate cover page should include:** - The estimator\'s name and phone number - Florida adjusters should include their license number on all estimates and for any email correspondence. - Claim number, policyholder, and insurance company information - Date of loss, date of contact, and date of inspection - The carrier specific header **Inspection reports should include:** - A detailed summary of the estimator's findings (unless it is a Managed Repair Program Assignment) - Type of damage involved (cause of loss) - In the event cause of loss has not been determined or there are coverage questions at the time of inspection, the estimator will present their findings and recommendations to the claims handler for direction with NO estimate written - Location description and address verification - Identify any other parties involved if known - Confirm all insureds and lienholders applicable to the policy - Identify the condition of the risk and any underwriting concerns present at inspection - Identify any prior losses associated with the risk - Address any subrogation potential or salvage opportunities - Provide details surrounding damages observed and scoping decisions to support the estimate - Additional claims follow up instructions if necessary **Estimates should document and justify:** - Quality of materials damaged - Quantity of materials damaged - Recommendation of repair or replacement of damaged property - Depreciation withheld (considering age, condition, and obsolescence) - Damaged room(s) and their dimensions - A diagram of ALL damaged areas - If areas cannot be measured or a diagram cannot be created in the estimating software, supporting documentation to verify the measurements should be attached to the document folder - (i.e., Roof aerial report) - Any deviations from standard estimating guidelines should be supported by a line level note - Examples include but not limited to: - Labor only lines - Waste amounts beyond recommended percentage - Bid items when allowed **Coverage:** - All estimate lines should correlate to the proper coverage - Estimates with any estimating lines set to "none" should be collaborated or rejected for correction as coverage will be provided on every claim - All applicable limits should be manually entered (if not already listed in the loss summary policy section) with the provided limit and deductible per the dec page on file - Additional coverages or deductibles should be applied if necessary - Directions to exclude deductible should come from the claim handler - Questions regarding application of coverage should be directed to the claim handler - Depreciation should be set to recoverable or non-recoverable based on the policy provisions **Additional items for consideration:** - Bid items are not allowed when the estimator can feasibly provide a comparable estimate within the estimating software - No bids should be included in the estimate for items such as a contents inventory sheet, mitigation, tree debris removal when an invoice is provided, or other remediation that should be estimated outside of any IA reconstruction estimate - These bids should be taken and included as supported documents in the estimator's file bundle for review by the claim handler - If materials cannot be properly evaluated within the estimating software, use the system labor rates by trade for removal and installation as needed and include the provided bid for materials - Miscellaneous and bid line-items should include a note of explanation - Premium or above average line-item grades require a line level note of explanation - Additional guidelines may exist for certain materials (i.e., ITEL for flooring) - Bulk line-items should be broken down whenever possible with supporting file documentation - Generators purchased by the insured are never to be included in any estimate - Generators used by a contractor are a cost of doing business and should not be included - If special circumstances warrant generator usage, the item should be accompanied by a line level note - Scaffolding is considered a tool of the trade for contractors. Therefore, the purchasing of scaffolding should not be included in any estimate - When scaffolding is necessary to complete a covered repair, the labor necessary to set up and take down the scaffolding may be used to accommodate the additional work needed - Any use of scaffolding in the estimate should be supported by a line level note that clearly explains the reasoning  - Large or complex losses where additional scaffolding may need to be rented by the contractor should be supported by an invoice reflecting the rental costs and time period for use  - Temporary toilets and portable restrooms should be included in overhead and not allowed in the estimate - If temporary toilets or portable restrooms are required by code or law, the item should be supported by a line level note and marked as PWI until supporting documentation is supplied. **Diagrams:** Diagrams are key supporting documentation that confirm the accuracy of line-item quantities and accurate measurements for each damaged area. Diagrams should be as accurate as possible with all measurements having a maximum margin of error of 1 inch and should use concise naming conventions for rooms that would allow quick reference to line-item groupings and photographs attached to the estimate. **Diagrams are required to support all quantities, including:** - Interior damage including the presence of all door and window openings, cabinets, tubs, vanities, multiple ceiling heights, and offsets - When estimating carpet or vinyl sheet goods for replacement, the Rollout Calculator should be used to determine seam method and waste percentage - Replacement of one or more exterior elevations on any damaged dwelling or other structure - Roof damage when at least a single slope on the roof system should be repaired or replaced - The roof sketch should specifically indicate the damaged slopes - When completing a roof sketch, individual slopes should be set as subgroups of the main roof area to prevent excessive waste due to the estimating software system rounding - Diagrams should reflect accurate measurements with the maximum margin of error of 1 inch - Sketch annotations are not required, but when used, should not reference language to recommend or suggest a committed cause of loss or peril (i.e. hail damage) - **[Note: ALL claims with exterior and/or roof damage should utilize Hover as the basis for measurements (No Exceptions)]** - **Note:** Any other structures that are not buildings or items that cannot be estimated with a diagram should utilize a General Items box and indicate the measurements under Properties - **Ex:** Fences can be estimated under the General Items method adding the linear footage under perimeter. Estimating decisions should be properly explained in photos and the narrative report **Photographs:** - [Insufficient photographs will result in a request to return to the site to capture the needed detail] - Digital photographs are required for all assignments and should be uploaded to the estimating software - Sufficient photo documentation is critical and should be provided to fully support the entire scope of repairs or replacement being estimated - Upload as many photos as necessary to support the scope of repairs - All emergency service/mitigation photos should be uploaded in the mitigation estimate separately - Any additional photos should be uploaded into the general contracting estimate - Photos should not be duplicated unless required - Photos depicting all four elevations of the dwelling are required - And a photo for address verification of the numbers on the home or mailbox - Photographs should be labeled according to the room or area and should illustrate damages associated with the loss - At least one photograph for each area of damage visually documenting the damages noted in the estimate - All photos should contain the date taken and include a caption within the photo sheet outlining the location and explanation of the photo content - Photos of multiple layers of material (roofing, shingles, flooring, etc.) are required - When possible, avoid the inclusion of individuals in photos - All photos of poor quality, repetitive, or otherwise unrelated to the loss should be omitted - DO include photos of any underwriting concerns that may be unrelated to the specific loss, such as a trampoline, evidence of neglect or excessive wear, or any risks that may otherwise impact underwriting related decisions **Roofing/Exterior Photos:** - Photographs of roof damage should be taken from the subject roof - If the adjuster is unable to access the roof, or the roof meets the necessary requirements listed in the SageSure Staff Field Expectations, a ladder assist vendor should be utilized when available - If safety prohibits the adjuster from accessing the roof, photos from the ladder are sufficient if the estimator can reasonably make all necessary recommendations and scoping decisions for repair or replacement - Photographs of hail hits should give an overall roof field view, intermediate shots, close-up shots, and should be taken for all slopes requiring repair/replacement - Photographs should be labeled to indicate the slope that they represent - Photos of collateral damage, i.e., gutters, flashing, and metal roof vents and other accessories should be included - Any accessory metals included in the estimate should be accompanied by a supporting photo - Photos of unrelated damages, such as mechanical damage, footboards, excessive wear, or blistering, should be included to provide a basis for establishing condition of the roof - Photos of the pitch and roof material gauge should be included for all roof claims - Shingle gauge or metal roof gauge depending on material - A photo to confirm layers of shingles, presence of accessory metals, such as drip edge, should be included - Damage to any exterior siding should be confirmed on all elevations with photos of the condition of each elevation - All other structures should be properly documented with photos following the same guidelines - Photos of damaged fences should contain at least one photo of the fence height **Interior/Contents:** - All interior photos pertaining to damaged rooms should include a full shot of the room, from multiple corners if needed, and the photo should contain the room name in the caption - Close up photos are required to depict damage to each trade, such as drywall, trim, and flooring - Floors that are continuous beneath base cabinets, vanities, or built-ins should be supported with photos - Contiguous flooring with no damage should be supported with photos to explain the reasoning for inclusion in the estimate - Photos of a straight edge placed on wood flooring to show cupping should be provided to confirm extent of damages to flooring - When necessary, include photos of undamaged items to support scoping decisions - [This is critical to explain variances in scoping decisions in reference to any insured or contractor submitted estimate] - Photos should be provided of adjacent rooms to damaged areas to confirm no damage - Photos of damaged contents should be provided including close-up photos, such as for furniture, electronics, or other contents of high value - If repairs have been completed or items are no longer available for inspection, then repairs or the location of missing items in question should also be documented with photos Best practices -------------- **Base & Trim:** - When estimating to remove/replace/paint baseboard, shoe mold, chair rail, or any other trim estimated using the perimeter of floor quantity, all interruptions in material (door openings, cabinets, tub/shower, window, etc.) should be deducted from the quantities regardless of the linear feet of the opening - Quarter round trim or similar trim paired with baseboards should be removed and replaced when removing flooring or sanding and refinishing hardwood flooring - Baseboards do not need to be disturbed unless damaged - Exception: If removal of the baseboards is necessary to complete a covered repair - add detach and reset of the affected baseboard - add one coat of paint - add base mold caulking to seal between wall and top of the painted baseboard **Cabinetry:** - Cabinet repairs should always be considered first. If repair is not possible, consider replacing the portion that is damaged and refinishing the undamaged portion - Always detach/reset countertops initially unless there is a documented need for replacement - Openings such as range, dishwasher, refrigerator, etc. should be deducted - Above-average grade should be supported with line-item notes as well as photo documentation - Review the line-item description to ensure the like kind and quality of the cabinets are appropriate - [Refer to the ITEL policy regarding utilization to confirm quality and repairability of materials when needed] **Cleaning:** - General cleaning is not required on all estimates when the removal of materials is sufficient or there is no inclusion or intent to clean by the contractor - Final cleaning may be added to the estimate when the post construction condition of the loss areas warrants it due to the types of trades involved - I.e., refinishing of hardwood floors, large drywall jobs - Cleaning of areas should be calculated based on the square footage of the room size - Any deviation from this rule or use of labor hours SHOULD be supported by a line level note **Code Upgrades:** - The estimator should work with the contractor when a code upgrade situation is identified - If the assignment is for the Managed Repair Program, the contractor will contact the claims handler to discuss the Code Upgrade - The claims handler will review the applicable coverage and work with the contractor to add any covered upgrades to the reconstruction estimate - Estimate lines included due to code upgrade (s) that were not previously present or increase the quality or quantity of materials should be sorted out into separate coverage line in the estimate - Code upgrade lines should be marked as Paid When Incurred (PWI) - Line items should be supported by a line level note including the referenced code - Common Examples: - Drip Edge and Ice and Water Shield - Documentation of the specific code requiring the upgrade(s) should be secured whenever possible **Contents Handling:** Sagesure utilizes various content vendors and software services to inventory and/or validate pricing. **[The estimator SHOULD NEVER include any contents applicable to Personal Property coverage in their scope and estimate of work. ]** - The estimator bundle SHOULD contain photos to reflect the overall condition of contents in each room (described in the photographs section of the guidelines), including close up photos of damage, verification of any high value items, and model numbers or serial numbers when applicable - The narrative report should indicate the presence of damages to contents and any recommendations for handling - The estimator may provide a copy of a contents inventory form to the insured, but this action should typically be handled by the claim handler at the desk **Content Manipulation:** - Content manipulation should be based on the room size in the estimating platform and not estimated hourly - If labor is used in lieu of room size, a line level note should explain the reasoning - Line items based on room size should adhere to the associated square footage as stated in the estimating software: - Ex: Small Rooms (\< 101 sf) - Any deviation from the room sizes stated in the estimating software should be accompanied by supporting documentation and a line level note - Content manipulation bids should never be included in the estimate - Contents should only be reset once per room - Any deviation requiring multiple resets should be supported by documentation and noted at the line level - Manipulation of contents directly related to any mitigation or repairs to the structure should be applied to the dwelling or building coverage, or other structures, where applicable **Demolition and Dumpster Use:** - Tear Out vs. Removal - As a default the Tear Out line item should be used when writing estimates - The Remove line items should be used as an exception and only when a particular item should be 'Skillfully removed, without damage' - Each use of the Remove line item requires a line-item note explaining why the Remove line item is being chosen - The total quantity of tear out for an item should not exceed the total square foot area in the diagram - No waste should be included to the tear out quantity - Demolition is considered a trade for the purpose of removing a structural area whereby specific trade labor should be used - If demolition or tear out is included within the line-item description, it should not be listed separately - Trucking & Hauling ½ Ton (Approximately 2 CY) should be used when the debris being removed does not support a dump truck or dumpster - Estimating multiple Trucking & Hauling ½ Ton entries are discouraged as the preferred estimating method would be to consider Trucking & Hauling ½ Ton or dumpster - Any additional labor applied beyond what is recommended for debris should be supported by a line level note - Minimum charges for debris removal are not allowed when debris is already included within any line items The preferred method to apply debris removal to an estimate is to utilize the debris calculator located within the estimating software. The debris calculator will display the capacity of the debris container (s) chosen versus the volume of debris accumulated. Adherence to the calculator should include the following: - The green bar (Capacity) should always exceed the blue bar (Volume) - The smallest container (s) should always be used that will meet the debris removal needs - Deviation from the debris calculator recommendations should be supported by a line level note and may include: - Extra consideration for weight or size of items not automatically calculated by the estimating software - Bid items that are allowed in the estimate that do not contain debris removal within the bid - If the debris calculator is not applicable or available to apply to the estimate line items, use the following dumpster capacity recommendations listed for each construction debris line-item container - Trucking & Hauling, 1/2 Ton - Up to two (2) cubic yards - When removing 1 to 4 squares - Dump Trailer, Tandem - Up to 5 cubic yards - When removing between 4 and 13 squares - Dump Truck, Single Axle - Up to 5 cubic yards - When removing between 13 and 16 squares - Dumpster 10 Yard - Up to 10 yards or 2.5 tons - When removing between 16 and 20 squares - Up to 2,500 sf of drywall - Up to 1,400 sf of vinyl/aluminum siding - Up to 2,475 sf of carpet or pad - Dumpster 20 Yard - Up to 20 yards or 5 tons - When removing between 20 and 40 squares - Up to 5,000 sf of drywall - Up to 2,800 sf of vinyl/aluminum siding - Up to 4,950 sf of carpet or pad - Dumpster 30 Yard - Up to 30 yards or 5 tons - When removing between 40 and 60 squares - Up to 7,500 sf of drywall - Up to 4,200 sf of vinyl/aluminum siding - Up to 7,425 sf of carpet or pad - Dumpster 40 Yard - Up to 40 yards or 7 tons - When removing between 60 and 80 squares - Up to 10,000 sf of drywall - Up to 5,600 sf of vinyl/aluminum siding - Up to 9,900 sf of carpet or pad **Depreciation:** - Depreciation should be applied based on the state specific guidelines - Maximum depreciation shall not exceed 80% for any estimate or single line item - Age and condition should be considered when determining the amount of depreciation being applied - The estimating software depreciation line-item function should be used whenever possible - Condition should be considered and adjusted where appropriate - **[For losses in the states of Mississippi and California, the estimator should ensure depreciation is not taken on labor ]** - Depreciation to structures that are not buildings should be set to non-recoverable unless any policy specific language states otherwise. Those items include, but are not limited to: - Fences - Swimming pools - Unless above ground and not permanently affixed - Gazebos - Car ports - Patios and decks not attached to the main dwelling - Docks and bridges - Depreciation should be applied to all claims regardless of size - Do not apply depreciation to the following: - Cleaning - Content Manipulation - Contractor Equipment - General Demolition - Dumpsters - Landscaping - Permits and Fees - Temporary Repairs - Water mitigation and/or mold remediation - Labor where applicable - Repair only items - Remove/Reset and detach actions **Drywall:** - When estimating to repair drywall with a textured finish be sure not to use "remove and replace" texture as the texture would be removed when removing the damaged drywall - Estimating to install 5/8" drywall in areas other than the ceiling should be supported with a line-item note or preferably a photo of a tape measure next to the drywall - When estimating small repairs that support a drywall patch, use one patch line-item for small repairs that total up to 4 square feet - Do not use **more than two** patch line-items for small repairs in a single room - Do not use additional labor for drywall associated with a patch - Adjust for any missing walls or openings and permanent components (cabinets, vanities, tubs, doors, and windows, etc.) - When estimating to replace all acoustic ceiling, do not include to paint ceiling as it is unnecessary in the application - Light fixtures should only be detached and reset if within the area of drywall being replaced or repaired and should be supported by documentation and a line level note - Masking should be used to protect floors from drywall removal, including acoustic ceiling - Unless the flooring has been removed or will be removed as part of the repairs **Finished Carpentry:** - When estimating to detach and reset door slabs only, be sure to estimate only the slab as the detach interior door unit line-item allows compensation to detach and reset the jamb and casing as well - When both the doors and hardware are not being salvaged, the line-item for knobs should be estimated replace only - There is no need to detach the knob from a door slab when both are being discarded - Knob sets that are undamaged should be removed/reset for reuse on the new door slab - Detached trim should be painted with one coat - If flooring replacement causes either an increase or decrease in flooring height, door slabs may need to be reset to adjust for clearance **Flooring** - Quantities for rolled flooring only (carpet, vinyl, etc.) should be broken down into separate removal and replacement - Waste is not allowed on removal - [All waste calculated on rolled flooring should utilize the rollout calculator tool in the estimating software] - Any waste factor outside of the rollout calculator method for establishing waste should be supported with an explanation added as a line-item note - Application of the rollout method should use best practices to minimize waste and the number and placement of seams for all rooms - Consideration should be made for continuous flooring into multiple rooms to follow a similar pattern - If flooring is only damaged in one room, settlement is based on that room only unless there is a continuous run throughout other rooms - If a closing door, change in direction, or transition strip separates the room, or the run is not continuous into the next room, replacement of undamaged areas should not be included without further explanation - For the sanding and/or refinishing of wood floors, if there is no designated break of flooring (transition strip, stain color change, etc.), you may continue extending the scope of the floor sanding to another room until a break exists - When using dustless floor sanding the clean-up needed should be minimal - Detaching and resetting the baseboards is not necessary when the floors will be re-finished - The line-item to refinish the floors includes edge sanding - Before estimating to detach and reset an appliance for flooring repairs/replacement, consideration should be given into whether the flooring runs continuous under the appliance  -  Kick plates can be removed to repair or replace the flooring   - ITEL for Flooring - ITEL samples are **required** (unless we have documentation to support the higher quality item) to confirm pricing for all flooring when: - The area of damage is **greater than 200 square feet** - AND the suggested line-item quality setting is **greater than "Very Good"** (see the estimating software quality settings) - **AND** the insured or insured representative has presented an estimate where the material cost exceeds the **"Very Good"** setting with no documentation to support the estimated value **High Grade Materials:** - Use of high-grade materials should be documented with a line-item note explaining the type of material used - Example: An estimate for a high-grade window should include a line level note identifying the name of the manufacturer and any high-grade components - ITEL Guidelines should be utilized for estimate compliance-- **[(][see attached guidelines](https://insightcatastrophegroup-my.sharepoint.com/:w:/g/personal/neil_atkins_sagesure_com/EVE4cQuhGAtHtWFvGVtNoRYB2vTZpo-CKXnZ4So4bwxeQw)[)]** - The ITEL report should be attached in the Mobile Claims file and submitted with the claims bundle - Use the SageSure specific documents folder: [(SSDocs)] - The estimate should reflect that ITEL was utilized by combining the following line items: - ITEL install - ITEL remove - ITEL supply - The material cost from the ITEL report should be entered under this item **Insulation:** - When replacing insulation in the walls you should only include exterior walls as interior walls are not normally insulated (unless verified with photos or other supporting documentation) **Matching:** - Refer to the following chart for information on each state's matching law: **State**  **Application**  **Statute/Regulation/Case Law**  --------------------------------------------------------------------------------------------- ------------------------------------ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Alaska  Uniform Appearance  If replacement parts do not match, insurer should replace all such property required to create a uniform appearance. Insured is not responsible for any costs besides applicable deductible.  Alabama Actual Damaged Property  A replacement cost policy only requires the insurer to pay for the pieces of property that were actually damaged.  California Reasonably Uniform Appearance  If the replacement items do not match, the insurer should replace all in the damaged area to conform to a reasonably uniform appearance.  Connecticut Reasonably Uniform Appearance  If replacement parts do not match adjacent items, then insurer is required to replace all such items to create a reasonably uniform appearance  Florida Reasonable Repairs or Replacement  Insurers are required to make reasonable repairs or replacement of items in adjoining area if they do not match.  Louisiana Uniform Appearance  If partial replacement cannot be matched, insurer should replace the entire material to match. Texas Actual Damaged Property  In residential loss, court held that "Physical loss" cannot be fairly construed to mean physical loss in the absence of physical damage. Under ordinary definitions of the terms, physical loss requires a distinct, demonstrable, physical alteration of the property. The insurer was only obligated to pay for the cost of repairing the damaged roof tiles and not the remaining undamaged portion of the roof.  Massachusetts, Mississippi, North Carolina, New Jersey, New York, South Carolina & Virginia None  None **Minimum Charges:** - Minimum charges should be reviewed on every estimate and verified if relevant - The estimating software will trigger minimum charges on the totals page - Exclude minimum charge trades if they will be completed within another trade - (Examples: HVAC for roofing vents, electrical for remove/reset Outlet/Receptacle, Cover Plate) - Multiple minimum charges should never be used for the same trade **Missing Walls:** - When related to wall painting, wall masking, or any other item that would be estimated using the wall dimensions, any openings should be accounted for as a missing wall opening **Other Structures:** - Fences, Decks, and Walkways - When possible, an outline of the fence perimeter should be noted and annotated on the diagram to reflect which runs are being repaired or replaced - For desk adjusted claims, supporting documentation and a line level note should be included indicating which elevation of fencing is being repaired or replaced - Photos should support quality and dimensions of materials used - The complete run of fencing should be painted or stained to match when sections are replaced - Any fence, deck, or walkway permanently affixed to the dwelling is considered part of the dwelling and covered under coverage A - Photos should support this coverage decision - Swimming Pools- Standard coverage groupings (unless dictated by specific policy provisions) - In Ground pools should be identified under Coverage B unless any component of the construct of the pool is attached to the dwelling - Above ground pools with no permanence should be considered under Coverage C **Overhead & Profit:** The decision to pay O&P and the percentage allowed will be determined by the local economic factors, the environment in which the contractor is operating, complexity of trade, and the amount of supervision required by the contractor. The general contractor should have significant involvement in the daily operation of the repairs. - The percentage of O&P will be negotiated and will not exceed, in any combination, a total of 20% - Application of Overhead and Profit is determined by the complexity of repairs and not the number of trades involved - The estimator may apply O & P to the estimate if the above conditions are met and it is likely that a general contractor would be needed to facilitate repairs - If a disagreement should occur between the adjuster and the insured's selected contractor regarding O&P, the adjuster will request additional documentation from the contractor to justify payment of O&P - Documentation [may] include a signed contract with itemized estimate, subcontractor invoices, and or estimates including a breakdown of the project manager hours to justify the amount of supervision provided - To offset General Contractor administrative costs on assignments that do not warrant overhead and profit, the Residential Supervision/Project Management labor hours can be added in certain situations. The amount of time needed to complete the General Contractor administrative tasks (up to 5 hours) can be included when the following conditions are met:  - Overhead and Profit are not warranted and have not been included in the estimate  - At minimum, a portion of the work is being sub-contracted and not completed in-house  O&P should not be applied to claims where single trade services are being supplied by a contractor. In these situations, the Residential Supervision/Project Management Labor hour guideline should be considered. **Painting:** - Drop cloths are considered tools of the trade owned by contractors and should not be included in the estimate. - These are usually included in the prime and paint estimate line items (please check the item properties to verify) - High charges can be applied for both cleaning and painting ceilings when the surface is 10' or more above the finished floor - When estimating seal/prime drywall that has been repaired, the area replaced should reflect seal/paint area and then the entire wall with one coat of paint to match - Repairs that require sealing/priming the entire wall should be supported with a line-item note - When priming and painting the same surface area, do not separate the two tasks in the estimate - Use single line to prime and paint - The use of shellac should be exclusive to odor control and is not considered a standard line for prime - Any use of this line should be accompanied by a line level note - When estimating to remove & replace finish trim, seal and paint baseboard, shoe mold, chair rail, or any other trim - MDF material typically is purchased pre-primed therefore it is not necessary to estimate to seal/prime this material - Before masking is applied to the estimate, consider the need for masking as it relates to the service being performed and/or whether a skilled painter would need masking to protect surfaces - Examples include but are not limited to: - Masking cabinetry, built-in's, fireplaces, or other similar items - Protection of walls and floors while removing and applying texture - Ceiling fans and light fixtures above average size - Masking to protect floors from drywall removal - High traffic areas **Permits:** - If a permit is required, do not include it in the estimate, unless the actual cost is known at the time of the inspection - The permit should be marked PWI (Paid when incurred) unless payment of the permit has been verified - A copy of the permit invoice or receipt should be attached to the estimate - Otherwise, the contractor performing the work should submit as a supplement - A line level note should accompany any permit explaining the purpose for the permit **Plumbing:** - Removal of plumbing fixture does not include any faucet, showerhead, p-trap, supply line, or drain assembly - A reset does include supply lines and drain assembly, but the reset of the faucet may still be needed - Toilets should not be detached and reset unless the flooring is damaged, or will be removed in repairs, and requires removal to facilitate repairs **Prior Damage:** - Prior damage located within the loss affected area should be documented and photographed within the estimating software - If document is available, the estimator will be provided these documents to review at the time of assignment - The estimator will deduct any portions of the scope associated with the prior loss, if repairs were not completed, and note those items in their report - If no prior claim exists, the estimator will need to notify the claims handler immediately **Roofing:** - All roofing line items used in the estimate should consistently match to the diagram and/or roof report in the claim file - Tear-off is equal to total roof area and separated for multiple types of roofing by slope or area as needed - Steep and height charges should match only to the areas that meet the criteria **(without waste)** - Steep charges must match to the specific portion of the diagram for roofs greater than: - 7/12 to 9/12 - 10/12 to 12/12 - Greater than 12/12 - Height charges must match to the specific portion of the diagram for elevations: - 2 stories - 3 stories - Additional labor outside of these line item charges must be supported by a line level note - Inclusion of any accessory metals in the estimate should be accompanied by a line level note explaining the reason for replacement - Application of roofing accessories, such as drip edge and ridge cap, should match to the linear footage in the diagram utilizing the estimating software generated allotment for waste - Painting of roof accessories is typically not needed as they are available in multiple factory finishes - The typical action would be to detach and reset the items unless damaged - Use of painting roofing accessories should be explained in a line level note - Chimney chase should not be included on the estimate when siding has not been removed - Chimney flashing should only be considered when damaged or tear out is required to facilitate repairs - Individual components, i.e., step flashing, apron flashing, counter flashing, should not be added when the chimney flashing kit is being replaced - Chimney crickets should be validated for code when not present and marked as PWI as applicable - Soffit and Fascia equal to quantity of roof rakes utilizing the estimating software generated allotment for waste - LKQ materials should be used for replacement items equal to the current materials on the roof - When code dictates upgrade to materials or repair method, those items should be marked paid when incurred (PWI) - Felt should be set to 15 LB without supporting documentation or evidence another material was used with exceptions for: - Code material upgrade - Marked as PWI - Known state precedent - Ex: Florida requires 30 LB felt for all roofs - Slopes less than 2/12 should utilize rolled roofing - Slopes 2/12 and 3/12 require double rolls of felt or 30 LB felt - Slopes 4/12 to 10/12 require single roll of felt - Slopes 10/12 or greater [may] apply 30 LB felt due to safety concerns or ripping of 15 LB felt during installation  - ONLY is first verified and supported by contractor documentation  - Marked as PWI unless completion of work is verified  - Replacement of ridge cap materials should be a separate line item and is not included in waste - Ridge cap materials should match to the quality of the shingle material being replaced - Example: - Ridge Cap Shingles, Fiberglass to 3-tab shingles - Ridge Cap Shingles, Fiberglass, Laminated to Laminated/Architectural shingles - Metal roofing quality should be verified with a metal roof gauge - The standard waste factor within the estimating software should be applied - Waste does not include starter row, ridge cap/shingles, or ice/water shield and these items need to be added to the estimate separately for replacement - Any variation from this waste factor should be manually added to the estimate and include a note of explanation - Standard waste percentages would include: - 10% gable or small hip - Anything higher than 10% should be supported by a line note and other documentation if applicable - 5% for rolled roofing - The Tear-off line item should be used for roof replacements in place of removal - Waste is not allowed on material tear-off - Removal of felt, nails, starter row, and ridge cap shingles are included in the tear-off of the shingles and should not be estimated separately - Haul off fees should not be included in the tear off and estimated separately - Ex: \"Tear Out - Shingles, Laminated/Architectural Good\" in conjunction with appropriately sized dumpster based on debris calculator - Replacement of roofing materials always requires the initial tear off over the same area for all LKQ materials prior to repairs, including: - All asphalt shingle types - Modified bitumen - Rolled roofing - Rubber roofing (perimeter and fully adhered application) - Multiple layers of roofing should be included in the estimated tear off - The tear-off line item includes a minimal amount of re-nailing for anticipated loose sheathing - Re-nailing of all sheathing requires a line level note with explanation - **[Note:]** Florida claims **may require** full re-nailing of sheathing based on specific code language and adjusters should adhere to any existing statutes - **FBC -- Existing Building Section 706.7 establishes the requirement that the roof decking is to be re‐nailed. NOTE: Structures that already comply are exempt from this requirement, (i.e., permitted under the 2004 code or newer)** - Allowance for steep roofs should be supported by photos of a pitch gauge in place or provided satellite imagery - Steep and height charges are applied to removal and replacement of materials (without waste) - When estimating ice and water shield, ensure the square footage of the ice and water shield is removed from the felt replacement quantity - Estimating a magnetic sweep of the perimeter of the home should not be included as this is a standard service performed by a roofing contractor - Fall protection is considered a standard tool of the trade and should not be included in the estimate - Any consideration for additional labor will be captured in pitch and height charges added to the estimate separately - Estimating to mask landscaping or protect driveways with plywood should not be estimated as this task is considered a standard service provided by a roofing contractor **Roof Documentation for Wind and Hail:** - Estimates written for potential hail damage should include digital photographs of an outlined 10' by 10' test square with all potential hail marks circled - [At least one (1) test square should be documented in all directions ] - [Test squares should contain at least eight (8) hail hits to support replacement] - Additional consideration for replacement vs repair may be given if additional factors would make repair an insufficient remedy to the covered damage observed  - For each slope, depict (by drawing in the test area) the test square location and number of marks as well as slopes with no damage - The test area name should reflect the slope directionality and the total number of impacted/affected shingles within the test square that could be considered hail - DO NOT USE H to reference perceived Hail issues - Ex: North Slope with 10 hail hits (N=10) - Ex: Left slope with 8 hail hits (LS=8) - Document a 2^nd^ label (R=6W) to document any wind related issues - **[Circle]** all Marks that are consistent with hail - When circling hail hits only, one hail hit per shingle should be circled - **[Underline]** all marks that are questionable with regards to the storm - **[Mark]** **[with a W]** any wind affected shingles - Run chalk sideways over soft metal surfaces to uncover any potential hail impacts - LABEL ALL PHOTOS IN THE FOLLOWING FORMAT: - A full shot of each roof slope with the slope name or direction   - An intermediate shot of each test area reflecting the test area name and number of potential wind and hail hits within the test area - Close-up photos of damage or condition should reference the slope or test area name within the caption along with one of the following categories: - [BLEMISHES] - Marks or damage that are potentially related to a storm - [NON-WEATHER RELATED (NWR)] - Unrelated damages typically associated with: - Wear and Tear, including excessive granule loss - Nail pops - Broken seals - Blistering - Mechanical damage or foot traffic - Defective materials or installation errors - [WIND ] - Any wind related issues (creased or missing shingles, wind damaged siding) - [CONTRACTOR CONSIDERATION] - Photos of any contractor markings or a request by a contractor to mark an area - [UNKNOWN or OTHER] - Noted damage or roof condition that cannot be explained without further evaluation - Photo caption example - Photo of blemish in north slope test area **Solar Panels:** Mobile Claims provides three options for solar panels for replacement. Given the wide range of use types, materials, and variance in cost, solar panel replacement and repairs should only be estimated utilizing a bid item from a licensed contractor. - Bid items may be included in the estimate that reflect tear out and replacement or partial repairs when the following actions are completed: - The estimator should verify cause of loss and damages - Verify LKQ of bid to original materials by confirming the usage type and material - Secure any supporting documentation to verify the bid, which may include: - Prior installation agreement and material description - Confirm ownership and primary responsibility of damages - Confirm and secure lease agreement for review - If the new bid does not include removal, the adjuster can use the tear out line item to account for removal of all panels - The remove line item should only be used for partial repair - In the event of damage to the roof on slopes where solar panels are installed but not damaged, the estimator may estimate for detaching and resetting the panels and any necessary accessories installed to the roof - The estimator should confirm the panel usage type to align with the proper method of reset - The usage type will dictate whether the detach and reset method is by square foot or per panel - The correct unit method should be confirmed for either square footage or per each panel - Total square footage or the total number of panels should be calculated and documented in the estimate and at the line level **Subcontractor Bids:** - The estimate should contain pricing from the estimating software, however in the rare event that a line-item cannot be found in the database, a subcontractor quote will be considered - If subcontractor bids are utilized, the reason for use should be documented - Subcontractor bids should be received from the subcontractor in writing without redaction of costs or materials used and include contact information for the subcontractor - If the estimate includes overhead and profit and tax, the subcontractor quote should not include these charges as well - If these charges are included in the quote line-item in the estimate they should be removed for consideration of overhead and profit and be set to tax exempt **Siding and Stucco:** - When evaluating siding damage for either wind or hail losses, the estimator should consider age and condition - The estimator should clearly document all elevations with photos and measurements - **[HOVER REPORT REQUIRED ]** - If the siding is not repairable from a covered hail or wind event, then the estimator should provide clear documentation as to why the repairs are not a feasible option - The estimator should deduct all missing walls, doors, windows, or any other deductions while creating the estimate - The estimating software will do this automatically if a diagram is used to scope damages - If siding or stucco cannot be matched, reference matching guidelines per state statute - If siding or stucco is painted, replace the damaged area(s), and paint the affected elevation. If paint cannot be matched or does not present a reasonably uniform appearance, reference matching guidelines per state statute - [Refer to the ITEL policy regarding utilization to confirm quality and availability of materials when needed] **Supplemental damage:** - If a reinspection of the loss is required or any supplemental changes are made to the estimate, any new items will be in addition to the original scope and noted on the estimate and in the supplemental narrative report - If any original estimated line items are changed or removed, those items also need to be noted in the supplemental narrative as well - The original and supplemental estimates should be merged in the bundle **[All requests for supplemental work to a closed file SHOULD come from the claims handler. If the estimator receives any requests for revisions or supplements by the insured or their representative, immediately notify the claims handler through the claims specific email or verbally as needed. ]** **Temporary Repairs and Board up:** - Bid estimates or invoices for temp repairs and board up should not be included in the estimate - If no estimate has been received at the time of inspection and temp repairs are necessary to prevent further damage, the estimator can include in the estimate - Roof tarping can be included under the roof grouping - Other board up and temp fees should go under a general item and named appropriately **Wallpaper:** - Wallpaper with a quality grade greater than Very Good should be supported by a line level note documenting how the quality was confirmed - Both wallpaper and border should be set to replace only when drywall is being removed - Border should be set to replace only when removed with the wallpaper as both will come off during the same action - Wallpaper should never be installed on top of existing wallpaper - All openings, missing walls, cabinetry, plumbing fixtures, and other items that would reduce the square footage of wallpaper should be deducted regardless of size - Wallpaper and border should match the square footage or linear footage of room space, minus any deductions - Removal and replace should utilize the estimating software generated allotment for waste - Any additional waste allotment should be supported by documentation and include a line level note - Example: Wallpaper with unique or hard to match patterns may require additional waste allotment **Waste:** - Waste is already factored into each line-item when warranted - Waste adjustments outside the estimate guidelines should be explained with a line level note **Water Mitigation and Mold:** - The estimator should refrain from including mitigation or mold remediation items in their estimate unless directed by the claim handler - If a mitigation estimate is created, it should be separated in the Mobile Claims file under **Emergency** - When writing a mitigation estimate, adhere to the Institute of Inspection Cleaning and Restoration Certification guidelines - Emergency and Structure estimates should be free of duplicate items, such as removal of the same materials, content manipulation, and general cleaning - Whenever possible, photos should show the exact number of equipment utilized during mitigation - Labeled photos of moisture readings are required to support the need for mitigation - For files with known involvement of a mitigation company, the estimator should make every effort to secure and review the estimate to ensure there is no duplication in the estimate - This would include any extraction or tear out lines already completed in the mitigation estimate - In the event the mitigation estimate only includes a partial tear out, the estimator will include the remainder of the tear out after deducting the portion already removed - These estimating decisions should be supported by a line level note - In the event the estimator is unable to secure a copy of the mitigation estimate where it is known work was performed, the estimator should prepare their estimate based on the condition at the time of scope - Mold remediation line items should be applied to mold coverage in the estimate - Manually create the coverage line for mold with the policy limit - Removal of damaged materials by water is not considered mold remediation and should apply to the normal dwelling limit. Mold remediation would include: - Any equipment and equipment decontamination used exclusively due to the presence of mold - Special or additional cleaning (HEPA) as part of the remediation efforts - Antimicrobial line items are not considered as part of the remediation process if solely used as mold prevention - Containment barriers, PPE, and other accessory items used exclusively for mold - Any cleaning or replacement of contents or materials damaged by mold only