LITIGATION | Storm Operators Command Center - SOCC

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WEEK 4: INSURANCE CLAIMS

PHASE I: MISSION BRIEF — THE BIG PICTURE

STAGES OF CLAIMS PROCESS (3:52)
RETAIL SALES PROCESS (1:34)
INSURANCE RESTORATION WITH FILING A CLAIM - HOMEOWNERS P.O.V.
INSURANCE RESTORATION WITH FILING A CLAIM - CONTRACTOR P.O.V.
INSURANCE & SUPPLEMENTING JARGON
ACTIVITY: CLAIMS FLOW CHART

PHASE II: INTEL & DOCUMENTATION

HOW TO READ A INSURANCE SCOPE (1:36)
WHAT A INSURANCE SCOPE LOOLKS LIKE
UNDERSTANDING INSURANCE MONEY
WHAT A SUPPLEMENT LOOKS LIKE
ACTIVITY: SCOPE SPOTTING DRILL

PHASE III: SUPPLEMENTING & SALES FLOW EXECUTION

MANAGEMENT DECISION AUTHORITY
SUPPLEMENTING (1:17)
WHAT IS SUPPLEMENTING (19:23)
TOOLS TO HELP YOU GATHER THE RIGHT DATA (20:31)
EFFECTIVE COMMUNICATION WITH CONTRACTORS (20:16)
WHAT CONTRACTORS NEED TO KNOW ABOUT INSURANCE (35:23)
THE SECRET WEAPON FOR SUPPLEMENTING (34:04)
APPRAISAL
PUBLIC ADJUSTER
LITIGATION
APPRAISAL / PUBLIC ADJUSTER / LITIGATION – When the claim gets escalated
ACTIVITY: ESTIMATE BREAKDOWN DRILL

PHASE IV: FIELD OPS — LIVE OBJECTIONS & ADJUSTER ENGAGEMENT

COLLABORATING WITH ADJUSTERS & ADVOCATING FOR HOMEOWNERS
INSURANCE DENIALS BY ADJUSTERS
REINSPECTIONS
WHAT TO DO WHEN IT'S OUT OF YOUR HANDS

COMMON ADJUSTER DENIAL EXCUSES

"THAT DAMAGE IS COSMETIC.”
“THIS ISN’T STORM-RELATED.”
“WE DON’T PAY FOR CODE UPGRADES.”
“THE SHINGLES ARE MATCHED CLOSE ENOUGH.”
“WE DON’T PAY O&P ON THIS JOB.”
“THERE’S NO DAMAGE HERE.”
“THERE’S NO FUNCTIONAL DAMAGE.”
“THAT’S PRE-EXISTING DAMAGE.”
“WE ALREADY PAID ENOUGH.”
“WE DON’T PAY FOR FELT / UNDERLAYMENT / ICE & WATER.”
“THAT'S MAINTENANCE-RELATED.”
“YOU’RE JUST TRYING TO MAX OUT THE CLAIM.”
“WE WON’T PAY FOR DRIP EDGE / FLASHING — IT’S REUSABLE.”
“THE ROOF STILL HAS LIFE LEFT.”
“NO COLLATERAL DAMAGE = NO COVERAGE.”
“WIND SPEEDS WEREN’T HIGH ENOUGH.”
“THE DAMAGE IS DUE TO INSTALLATION DEFECTS.”
“THE DAMAGE WASN’T VISIBLE FROM THE GROUND.”
“ONLY THE DAMAGED SHINGLES NEED REPAIR.”
“THE DAMAGE IS DUE TO WEAR AND TEAR, NOT STORM IMPACT.”
“YOU DIDN’T NOTIFY US IN TIME.”
“THE CLAIM VALUE IS LESS THAN YOUR DEDUCTIBLE.”
“THERE’S NO HAIL IMPACT ON THE SHINGLES.”

ARGUE DAMAGE WITH PHOTO EVIDENCE: HOMEOWNER EDITION

“It doesn’t look that bad to me.”
“The roof isn’t leaking though.”
“Are you sure this isn’t just wear and tear?”
“That just looks like normal discoloration.”
“Can’t they just repair that one section?”
“How do I know insurance will cover this?”
“Why hasn’t another roofer mentioned this?”
“That just looks like regular roof wear.”
“My roof is new — this shouldn’t be a problem.”
“If it’s that bad, why didn’t the last contractor say anything?”
“The insurance adjuster already said there’s no damage.”
“I don’t want to deal with insurance — it sounds complicated.”
“Are you just trying to sell me something?”

PHASE V: TACTICAL SALES INTEGRATION

DELIVERING A FULL INSPECTION-TO-DEMO PRESENTATION
JUSTIFYING FULL REPLACEMENTS WITH BUILDING CODES
BUILDING CODES - HOMEOWNER GUIDE
HOW TO TRANSITION FROM DAMAGE TO CONTRACT
WHAT CONTRACTORS NEED TO KNOW ABOUT INSURANCE

🧾 CORE CODES YOU NEED TO KNOW (AND USE)

IRC R908.1
IRC R908.3
IRC R905.2.7.1
IRC R905.2.8.2
IRC R903.2.1
IRC R905.2.8.5
IRC R905.2.4
IRC R905.2.8
IRC R905.2.8.6
IRC R908.6
Texas Administrative Code Title 28, Rule §21.203 – Prompt Pay Law
Texas Insurance Code §542A.001 – Matching Standard
Manufacturer Specifications (CertainTeed, GAF, Owens Corning)

ADDITIONAL TRAINING MATERIALS FOR INSURANCE CLAIMS

Intro to Insurance Claims
Proper Expectations with Claims
Insurance Claim Cycle
Homeowner Insurance Policy Types
Adjuster Types
Intro to Filing Claims
Great, Good, and Bad Approval Odds
How to file a claim with a homeowner
Insurance Claims' Phone Number / Email Address
Date of Discovery vs Date of Loss
Giving Consultant Info to Insurance
Intro to Adjuster Meetings
Preparing for Adjuster Meeting
Running the Adjuster Meeting
Coming up with plan for Adjuster Meeting
Ending the Adjuster Meeting
Intro to Claim Denial / Partial Approval
Communicating with Homeowner during Denial Process
Communicating with Insurance Adjuster during Denial Process
Full Claim Denial Process
Establishing the Last Straw for Approval
Supplementing Process
How to Prepare an Itel Report
Understanding the different Itel Match Types
How to read an Itel Report
Sample Itel Reports
Comparing New Itel Matches with Existing Materials
Marking Damage Photos for Supplements
The "Damage Supplement Request Form"
Intro to Claim Approval Process
Claim Approval Checklist
Uploading Scope of Work
Reading Insurance Scope
AVRR Sample Approval Scopes
Preparing Final Contract for Approved Claim
Calculating for Non-Recoverable Depreciation on Final Contract
Finalizing Details with homeowner after Claim Approval
Supplementing Expectations During Install

BONUS SECTION: ADVANCED SUPPORT TOOLS

ENHANCIFY (7:21)
SOLAR
BANKS
BOOTCAMP RESOURCES (2:10)
PUBLIC ADJUSTER BACKING LETTER

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