Issues Public Adjusters Face
There are two issues that Public Adjusters are facing today. The first is, what happens
when you follow all of the proper rules in your attempted adjustment of a loss and either the loss
is underpaid and/or denied by the insurance company and your insured has to hire an attorney?
What is the legal status of your fee on the final result? As a general rule, the attorney is using
your work product in dealing with the insurance company. Now the attorney achieves a result
which also includes extra contractual damages even though most insurance companies in a
settlement will not so label them.
There is no settled law on the right of the Public Adjuster to get a fee on the additional
funds obtained by the attorney. Joseph Khoshlesan has handled two of these cases. In the first
case, he convinced the trial judge to not only award the Public Adjuster a fee on the additional
sums obtained on the structure, but also to collect his fee on the extra contractual portion
obtained by the insured’s attorney. Unfortunately, the insured never appealed our victory so
there is no appellate decision one way or the other. From the feedback we received, the trial
judge did not like the insured and perhaps that is why he awarded the Public Adjuster a fee on
the extra contractual damages.
Another trial judge in the same courthouse had a different opinion. Her opinion was that
the Public Adjuster was only entitled to a fee on the portion of the settlement that solely related
to the property damage and not any extra contractual amounts obtained either in settlement or
trial. Again no appeal, so no quotable authority.
Another area of contention that has come up recently is the interpretation of Cal. Code of
Civil Procedure Section 1282.2 regarding whether the procedure in an Appraisal is formal or not
formal. Insurance Code Section 2071 sets forth that it is informal. The dispute arises under
Section 1282.2(2). There are insurance companies that are taking the position that since all
appraisals involve more than $50,000.00 that changes the proceeding from an informal to a
formal proceeding. That position is wrong. When you read the first sentence of 1282.2 it
provides “Unless the arbitration agreement otherwise provides”. Insurance Code Section 2071
is the agreement and it “otherwise provides”. The Appraisal provision in 2071 is not voluntary
on the part of either the carrier or the insured. The provision is part of the Code and is standard
in every policy. Therefore, that provision governs the course of the Appraisal. The confusion
comes in because our State has a fulltime legislature and every time a case comes down and if it
deems proper, it adopts a new code provision. There was a property insurance case where one of
our appellate courts held that Appraisal is a form of Arbitration. However, since the Appraisal
Panel can only decide actual cash value of the loss, the formal provisions of discovery do not
apply.