American Modern - Ryze Solution Document (1).pdf

AMERICAN MODERN 12/04/2023 Section A: General ALL CLAIMS REQUIRE THE FOLLOWING ITEMS: REPORT: 1. The Narrative Report is the "#3 Ryze Final Nar...

AMERICAN MODERN 12/04/2023 Section A: General ALL CLAIMS REQUIRE THE FOLLOWING ITEMS: REPORT: 1. The Narrative Report is the "#3 Ryze Final Narrative Report - Property". 2. Mortgage company verbally verified with insured and noted in Narrative. 3. Date, time and attendees (listed by name and relationship to claim) of/at inspection. 4. If there is evidence of prior loss/repairs, contact the AMIG DA for prior loss information and ensure any overlapping damages are detailed in the Narrative Report. 5. Identify any Subrogation opportunities. If the loss is due to failed part/product, ensure the Insured is notified to retain the part until advised by the DA it can be discarded. 6. Identify any Salvage opportunities of materials which retain recyclable value. 7. Cause of Loss must be identified, photographed and detailed in Narrative. 8. 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. GENERAL GUIDELINES: 7. RYZE company logo & Header/Address on the Estimate. (Claims Connect, Letterhead.) 8. All damages noted will be written in estimate. If obvious coverage question exists, call: Janet Chandler (972) 934-9967 or email: [email protected]. 9. Use "Tear Out" for line items; not Remove unless it is repair. 10. Ensure correct line items in the estimate; Mobile Home versus Site-Built homes. 11. Most line items will be "Good" quality. (If any grade other than "Good" utilized, details for reasoning must be included in the Narrative Report.) 12. Mobile Home policies do NOT pay for "matching" materials. A "similar, reasonable appearance" is all that is required. 13. Diagrams are required for all damages. This includes a roof, each elevation and interior areas. a. Elevations need to be a separate diagram for each damaged elevation. i. Gutters/downspouts should be on an Elevation Diagram; not Roof. b. Interior: i. One/Two room(s) damaged - that room and all adjacent rooms ii. Three or more rooms damage - an entire floorplan diagram is required.  AMERICAN MODERN 12/04/2023 14. No waste on carpet pad replacement, insulation, felt, ice/water shield, cover and protect and bottom board/belly wrap. a. Flooring items - use 10% waste b. Mobile homes - no waste on insulation or bottom board replacement. c. Deduct the area of Felt from the Ice/Water Shield. 15. While Minimum Charges line items are allowed in the estimate, discretion should be used. 16. NO Mold Remediation or Mitigation line items (air movers, dehumidifiers, anti-microbial agent, etc.) or ALE line items (cleaning drywall on fire losses is allowed) in the estimate; advise DA if suspected mold damage is found. 17. Painting, application will be by Roller; not Brush. a. Use prep and mask, not tape and drape, if needed b. Seal only damaged areas. Paint 1-Coat over all applicable surfaces. 18. Obvious total losses/Fire Losses - do not complete estimate without client approval. Send a first report with photos via email to the AMIG DA to determine if they wish for an estimate to be completed. 19. Allowances for Starter Row are to be included in the estimates. a. Allowances for Ridge Shingles are be included in the estimates. For Simple Roofs (gable) the waste guidance is 5%, for more complex roofs (hip/cut up) the waste guidance is 10%. b. If replacing one slope only, please include the ridge replacement as well. PHOTOS: 21. Photo of cause of loss, two photos per page, & all photos include correct detailed description. 22. Photograph all four elevations showing complete elevations and Photo of address verification. 23. HAIL/WIND claims include (CLOSE-UPS) on all elevations of windows, screens, siding, gutters (pans & faces), downspouts, fascia, A/C unit, doors, shutters, dryer vent, mailbox, light fixtures, ALL outside personal property, satellite, fence, electric meter panel and deck. Damages should be chalked. Close-up photos showing damages or lack of damages are equally important. Abundance of “Collateral Damages” must be present for Full Roof. 24. ALL Roof inspections (Regardless of damages): Pitch gauge, shingle gauge, drip edge, number of layers, gutter width, valley metal, chimney flashing, satellite dish and rain diverter. 25. For all Mobile Homes, a photo of the Serial Plate/Tag is required.  AMERICAN MODERN 12/04/2023 26. Overview of affected interior rooms and close-ups of damaged areas. Capture Openings. 27. An attic inspection with photographs is required when a leak appears to be from the roof. 28. Anytime a metal shed, framed screened enclosure or carport is damaged by wind or hail, we must have a photo of a “stand-alone” magnet on the “framing members.” The purpose is to confirm whether the structure is made of aluminum or steel.. 29. Continuous Flooring or Paint - Photos must show rooms with flooring running continuously and in the same direction. This also pertains to continuous wall paint, baseboards, etc. 30. NO blurry pictures or moisture meters in the photo report. MISCELLANEOUS: 31. First Contact Note must be completed in Radius and Symbility. (Use the required template.) If additional contact information is needed, contact the AMIG DA. 32. Weather report(s) are required for all weather-related (wildfire, wind & hail) claims. Report MUST compliment the inspection findings 33. Full roof inspection (from ON the roof) of the dwelling & other structures is required if the reported cause of loss resulted from the roof or exterior, regardless of opening present. 34. ALL claims over $20k (including combining coverages of $20k or more) need a reserve email sent to the AMIG DA (with photos) and a copy of the Note put in the Symbility Time Line. 35. Upload ALL closing documents from Mobile Claims (Print function) into Radius (Documents Tab) by creating a PDF package in Mobile Claims. Documents needed are: Loss Summary, Diagrams, Estimate and Photo Sheet. Attach Narrative to Documents section of Mobile Claims. Contact is due 24-hours from Ryze receipt of claim. Inspections are due within 4-Days of Ryze receipt of claim. Final Reports (all documentation) are due 24-hours after completion of Inspection. (PDF Print Package and Narrative uploaded to Radius.)  AMERICAN MODERN 12/04/2023 Section B: Roofs 1. HAIL 8 hits per test square needed to total a slope, regardless of type of roofing. Each directional slope must be photographed with a chalked out 10 X 10 test square marked as Front, Left, Back & Right and the number of hail hits identified and marked. A minimum of 2 close-up photos in each test square regardless of damages found. Provide 1 photo documenting the size of hail hits with a tape measure on 1 shingle. 2. WIND Shingles MUST be torn, creased or missing to be considered damaged by wind. All damaged shingles must be marked and photographed. Unsealed shingles, overdriven fasteners, and “zippering” are NOT considered damage (even if roofer states that wind pulled the shingles through the fasteners). Roof Threshold for slope / total roof replacement o Explain in detail in the Narrative Report why replacement is being estimated. o Judgment should be used when determining repair vs. replacement of a slope. Consideration should be given to age, condition and repairability of the roof. o If an IA is making a recommendation for a slope replacement or a total roof recommendation when damages are minimal but age, condition and repairability of the roof are the driving factor, the IA MUST present Flawless Photographic Documentation for proper consideration to be considered. 3. GENERAL ROOF/EXTERIOR ITEMS (applicable to all) Replacement Threshold - IF 75% or more of the roof should be replaced due to direct, physical damage, a full replacement is allowed. Age and Condition can be considered. Roof Waste - Simple Gable Roof = 5% waste. All others = 10% waste. Debris Removal - not included with Symbility line items and must be added to the estimate. 1 container for ALL debris removal for claim. Roof Starter Row – Allow on both 3-tab and Architectural. Roof Ridge and Hip Cap – Add for ridge cap for all full roof replacements or repairs involving the ridge / hip. 5% for simple Gables, 10% for Hip/Cut-Up.  AMERICAN MODERN 12/04/2023 Tear Out vs. Replace - If removing an entire slope/roof, use the Tear Out line item. If only removing a few shingles for repair, use the Remove option. Felt / IWS: Replace only. (Felt will come off with the shingles.) Deduct Felt from IWS. Tarps: All tarps must be removed for Inspection unless there are photographs available from the Insured/Contractor which CLEARLY show damage. Roofs must be clear of snow/debris for inspection. Replace ONLY on vents/items attached horizontally to the roof surface: pipe boots, starter row, ridge vent and ridge/hip shingles when replacing a slope or full roof. o If only replacing vent (not entire slope), then allow for R&R of ancillary item. o Chimney flashing, Step flashing, valley metal, and skylight flashing should not be estimated for replacement unless photos show damage. If damaged, these items are Tear Out & Replace. (Power Attic Vents are Remove/Reset.) o Drip Edge will be Tear Out & Replace. Replace ALL 20-year, 3-tab shingles with 25-year, 3-tab shingles. Allow Tear Out & Replace on Height Allowance for ONLY the 2-story portions of the roof. Height Allowance is NOT allowed if the second-story is accessible from the first- story by walking up to it. Allow waste on Replacement only. Steep charges are allowed on both Tear/Remove and Replace if qualified. Allow waste on Replacement only. Ladder Assist - If the roof is not accessible or unsafe, contact the AMIG DA for Ladder Assist Approval. Once approved, schedule the ladder assist (paid by adjuster) and submit invoice in Radius Invoice. Adjuster must be onsite with Ladder Assist. Tile Roofs - if damage is visible and the adjuster is comfortable on a tile roof, it can be walked. IF there is no visible damage or the adjuster is uncomfortable, photos can be taken from the eave around all elevations of the risk. Do not create damage if otherwise undamaged. Drones - Not allowed unless specifically approved by the DA. Wind-Driven Rain - All roofs must be accessed; no photos accepted from the ground. AMIG doesn't pay for interior damages on most claims unless there is a storm-created opening that allowed the water in, so we need to know the source of the interior leak from the roof/exterior. (As a COL, Wind‐driven rain is not acceptable. Exact entry point and system failure needs to be detailed in the Narrative and Diagram.) Exterior Line Items - Must be estimated/listed on the exterior elevation where damage occurred.  AMERICAN MODERN 12/04/2023 15. DIAGRAMS A Diagram is required for any damaged roof, exterior elevation or interior area. o Roof - a full diagram is required if there is any damaged to or as a result of a condition on the roof. (If leaks are reported, but no storm-created opening is present, a diagram and inspection is still required.) o Exterior Elevation(s) - a diagram of each damaged exterior elevation is required (unless the Symbility auto-create functionality is utilized.) o Interior - an interior diagram is required if there is any interior damage present.  if 1 or 2-room(s) is/are damaged, that/those room(s) and all adjacent rooms must be diagrammed.  if 3 or more rooms are damaged, a full floorplan diagram is required. Aerial Measurement applications can be used and paid for by the adjuster if approved by the DA, but it must be the.XML version so that a diagram can be created. (PDF Diagrams are used only as an exception when the roof is extremely large/complex.) Diagrams must be annotated noting areas of damage that is also captured in the photos. Separate Diagrams are required for each building. 16. GENERAL ESTIMATING PARAMETERS Agreed Scope - If the insured has a CONTRACTOR or PA, ask good questions but do not commit to scope or pricing unless directed by the client. Do not get agreed “PRICE” unless requested by client with ANY party to the claim. Mitigation is not to be included in the estimate unless requested by the DA. Depreciation is based on age, life and condition and is applied based on the age (in years) with a maximum percentage of 50% to any one item, not to exceed 50% of the entire estimate. Depreciation is applied to MATERIALS only. Deductible is typically not provided with the Loss Notice. Apply if available; disregard if not. ITV is not required unless specifically requested by the DA.  AMERICAN MODERN 12/04/2023 ITEL is not required by AMIG. Adjusters should use his/her judgment when determining quality of materials. Trees, Shrubs, Plants (Not Grown for Business Purposes) - Coverage afforded up to 5% of the Dwelling/Building Coverage Limit, but no more than $500 paid for any one Tree, Shrub or Plant. Policy does not allow for Matching. Damaged items should be replaced with current LKQ items up to "line of sight" for a particular slope/elevation. Consideration can be given to harvest material from the smallest elevation for repairs and replacement of harvested elevation. Fire / Police Reports while, not required for file submission, all information pertaining to the filing of such and any reference numbers should included in the Narrative. Contents (refrigerated products) will be handled by the DA. Pools - In-ground pools and/or above-ground pools which have a permanently secured deck/structure are deemed to be "Other Structures" and will be estimated/paid on a RC basis minus Recoverable Depreciation not to exceed 50% on any one item. Above- ground pools which are not attached to any permanently secured structure will be deemed Personal Property. Plumbing Failure/Leak - Coverage afforded for ingress/egress to access damaged plumbing leak/system; however, no coverage afforded for the failed item itself unless the loss is due to a frozen pipe. Coverage also extended for ensuing damages that result from the plumbing failure/leak. Ordinance and Law - Items such as IWS, drip edge and Sheathing standards should be estimated. Provide a copy of the actual code that is being referenced. Limited to 10% of the Dwelling/Building Coverage unless other limit is specified on the DEC and does not increase the limit of liability that applies to the Damaged property. All Line Items must be associated with a coverage. (No "No Coverage" on Totals tab.) Must set estimate "Ready for Review" and "Release Ownership" in Mobile Claims.  AMERICAN MODERN 12/04/2023 Section C: Interior Damages 1. When Painting new materials, seal one coat over the damaged area and allow to paint one coat over the entire surface (remember continuous surfaces). 2. When Repairing drywall damages, a minimum charge or spot repair may be utilized. 3. Popcorn/Acoustic texture should be considered for a repair if only a small area is damaged and one coat of paint should be applied to the entire ceiling area. If the size of the damaged area involved is over 50% of the total surface, a total scrape and re-application would be more appropriate. (Do not paint a full replacement as the paint is in the texture.) 4. When replacing baseboards or door trim (casing) in a room, paint all base and/or door trims in the room. (DO NOT paint doors unless damaged). Only paint the walls if damaged; not automatically because baseboards are being replaced. 5. Masking should be applied if interior repairs completed will "cause a mess". While loosely stated, consideration should be given to the repair technique used and need for masking. 6. Content Manipulation should be included if there are several items in the room which should be removed prior to completed repairs. This is by room size. 7. Flooring: a. Use “Good” grade for all flooring and pad unless verifiable proof is obtained to justify otherwise. No ITEL required. b. All flooring should be estimated based on the Diagram of the room. c. Carpet/Vinyl Roll will seam at a doorway; adjacent undamaged rooms are NOT replaced. d. To properly show warped flooring damage; use a straight edge to demonstrate level. 8. Cabinets / Vanity: a. Always make an attempt to repair prior to allowing for replacement. Most cabinets can be refaced and repainted. IF a full replacement is needed, photos must present evidence. b. When replacement is needed, use “Good” grade. If a higher grade is used, the adjuster must provide appropriate documentation including all of the following: photos of the interior box, exterior box, drawer construction (dovetail/staple), hinges/hardware as well any receipts. c. Always attempt to get a photo of any flooring beneath the cabinets. (Look beneath the dishwasher.)  AMERICAN MODERN 12/04/2023 Section E: Overhead & Profit (OH&P) 1. Overhead and profit will be 10% and 10% (20%) and applied IF there are 3 verifiable trades involved wherein the complexity of repairs will require the coordination of a general contractor. 2. O&P is never applied to the roof. Section G: Contents 1. Personal Property should not be included on the estimate. Take photographs of damaged items including any identifying tags/labels/receipts. Document the narrative report accordingly and advise the insured that the DA will handle this portion of the loss. Section H: Other Structures 1. Allow RCV if the other structure is a "Building", meaning it has "four walls and a roof”. 2. Fences - Coverage for Repairs (anything LESS than corner post to corner post) are estimated at RC. An entire run is considered Replacement and is depreciated on an ACV basis. (Need to verify co-ownership possibilities.) 3. Fence Damages can be estimated using a General Items diagram. Section I: Trees 1. Tree and tree debris removal is only for trees "provided the tree is on a covered structure." It is not allowed for general tree debris clean-up of the property after a storm. 2. If the tree has already been cut off and/or removed off the covered structure at the time of inspection, the adjuster cannot include any tree line items on the estimate. If the Insured is doing the work, utilize the line items in Symbility to account for the removal by Diameter. 3. Allow to remove tree debris from residence premises and haul off to a dump site. – Policy limit is generally $500.