In February of 2019, the owner of a popular family Italian restaurant in Pittsburgh and his employees cleaned up for the night and headed home not knowing that when they locked the doors, it would be for the last time. What happened over the next number of months became a lesson in what can happen with what appears to be a straightforward property insurance claim and why it can help to have a public insurance adjuster advocating for you.
That evening, the second-generation owner/manager had just settled down from a busy night when he received a call that would change his life. The call came from an employee whose mother happened to have a police scanner app on her phone who heard the restaurant was on FIRE! The owner immediately called his brother (who is a part owner) and they rushed to see what was going on. They watched in disbelief as flames engulfed the business their father started over 60 years ago.
Once the flames were extinguished and under control, the brothers called it a night and agreed to assess the damage in the morning. The next day they alerted their insurance agent who filed a property loss claim through their insurance company. They also met with county fire investigators who needed to document and assemble their reports. Upon walking through the building, it came as no surprise that virtually everything was destroyed from the fire, water or smoke damage. A few days later the brothers were met by an Origins and Cause (O&C) Inspector hired by their insurance company to determine the cause of loss. From this moment on, the brothers new they were in the weeds which is a restaurant term when things get complicated and overwhelming. Questions were being asked that made them feel like they did something wrong, like they were at fault when they were doing nothing but cooperating with the investigation. Shortly after the questioning and investigation the brothers were contacted by an attorney who represented their insurance company and advised them he would be their point of contact regarding their claim. Again, a series of questions were asked giving the impression that they were being coerced to admitting to something they had not done. Still cooperating the brothers did all they could to provide information to assist their insurance company with the “investigation”.
Months went by with little to no progress on the claim, no funds were provided to begin repairs to the business that was bringing in no income to support their families and employees. Frustrated, confused and now a bit irritated, the two brothers decided they needed professional help and contacted claims adjuster, Zach Flora of Tutwiler & Associates Public Insurance Adjusters.
Mr. Flora immediately set appointments with the owners, documented the loss site, assembled a repair estimate, and began getting the claim on the right track. After compiling and submitting the proper documentation to the insurance company, the insurance company invoked their right to what is called an Examination Under Oath (EUO). The EUO is listed in most insurance policies under the Loss Settlement section where if requested to fulfill your post loss duties you must cooperate.
Since an EUO is a legal sworn statement under oath Mr. Flora knew from experience that the insurance company had escalated the seriousness of this claim. He recommended his clients seek legal representation. Once arranged, the brothers had to endure an eight-hour Examination Under Oath where most of the questions previously asked and answered were asked once again.
Around 3 weeks went by and with the persistence of Mr. Flora he was able to coordinate a joint inspection of the loss site. Rather than fairly pay the claim, the insurance company retained the help of a building consultant. Although it took a couple of additional inspections to align and negotiate the proper scope of loss, Mr. Flora was able create a cooperative environment with all parties and assemble the claim. Mr. Flora’s ability to answer the consultants technical and cause of loss questions resulted in a seven-figure settlement that allowed the brothers to get their business and their lives back on track.