MCMS
The world of insurance claims often appears straightforward on the surface. If you buy an insurance policy, and something unfortunate happens, you can file a claim for the insurance company to pay you based on the terms of your policy. However, what sounds simple in theory can quickly become complicated, especially when the claim is contested. A disputed claim is any claim where the insurance company and the policyholder cannot agree. This is a common insurance industry scenario that affects property insurance, home and commercial alike.
The subject of disputed claims should not be taken lightly. When dealing with a community of homeowners or an organization responsible for the well-being and financial stability of a large group of people, such as a municipality, or property management firm, the stakes are naturally high. A single disputed claim can lead to prolonged legal battles, strained community relations, financial burdens, and more. The insurance industry manages risks by transferring losses from individuals to the larger community and strives to offer a stable and important security source for both the public and private sectors.
Henry Rodriguez is the CEO of Municipal Claims Management Services (MCMS). He is an accomplished insurance claim expert with over thirty years of experience working with policyholders and insurance companies to settle disputed claims through the appraisal process. His story begins in 1992 when Hurricane Andrew devastated South Florida. At the time, he was renovating two of his apartment buildings in Miami.
He helped many friends and family members with their recoveries because he had both available people and what had become limited resources on hand.
These events led to his first reading of an insurance policy and negotiations of underpaid claims. He completed his renovations and never looked back.
BRINGING ABOUT CHANGE
A disputed claim occurs when the insurance company and the policyholder do not see eye to eye on one or multiple aspects of the claim. This could be over the valuation of the loss, the extent of damage, or whether parts of the claim have coverage. This, unfortunately, is too common an issue in the insurance world, affecting every type of insurance policy. Imagine a Condominium or Homeowners Association (HOA) that suffered extensive water damage from a burst pipe. The HOA files a claim for repairs, but the insurance company disputes the cost of the repairs.
The insurance company attributes some damage to poor maintenance, which is not covered by the policy. As a result, the insurance company offers a much lower payout than what the HOA believes is necessary for adequate repairs. Insurance experts such as MCMS make the process manageable. Years of experience and thousands of satisfied clients have honed the art and resulted in the identification of preferred experts in most supporting and related industries such as remediation, fenestration, engineering, and even specialized law firms— all working in concert toward resolving these disputes.
MCMS has represented many leading insurance companies, condo associations throughout Florida, and even municipalities like New York and Miami. In addition, law firms, many of which represent condominium organizations but lack familiarity with the intricacies of damages and insurance, also frequently engage MCMS. This alleviates a tremendous body of work from the property manager and speeds up the recovery.
FEATHERS IN THE CAP
Henry has been court-appointed Special Master- an official appointed by a judge to hear and evaluate evidence on behalf of the judge and offer recommendations to the judge to resolve the case.
Interestingly, Henry is often called upon to act as the neutral Umpire to settle differences between the two disputing parties’ representatives through the appraisal process. Two signatures on the appraisal award define the valuation of the loss; these could be from both appraisers or one appraiser and the umpire. While it only takes two signatures, Henry prides himself on resolving differences between appraisers to achieve agreements and a unified three-signature award.
As an appraiser, Henry recently settled a dispute between a condominium association and their insurance carrier. Initially, the payment was under $50,000, but after MCMS was contracted, the claim was settled for $3.7 million. All three parties agreed to the award, thereby avoiding drawn-out litigation for policyholders and possible bad faith suit for the carrier—a win-win.
UNIQUE CUSTOMER EXPERIENCE STRATEGY
Once MCMS is engaged and the disputes are defined with specificity, a team of experts will examine the building and document every facet of the loss. Everything related to the loss is overabundantly documented, and estimates are created using widely recognized software, methodologies, and digital imagery. Information is then exchanged between the representatives, and the negotiations begin.
Oftentimes, there is one responsive insurance carrier for the main structure and many for the individual units. Knowing how to coordinate expert representatives and delineate areas of responsibility is key to achieving a successful outcome. Whereas the court system might take years and then face appeals, the appraisal process can usually bring much-needed indemnification within a few months.2024 is forecasted to bring an active hurricane season, as the ocean temperature in April was akin to July norms. MCMS readies staff and reaffirms relationships with partners and experts they rely on for the professional outcomes they are famous for. The team at MCMS consists of professionals in an industry that is difficult to master. They are sensitive to the hardships brought about by catastrophes and treat their clients like family.
