CASUALTY ADJUSTER’S GUIDE 2019/20 ®
Adjusters Find Vendors Nationwide at www.cagworld.com PROPERTY & CASUALTY EDITION, INCLUDING WORKERS’ COMP, SELF-INSUREDS AND RECOVERY & REPAIR EXPERTS COVERING;
WISCONSIN Since 1972
Dahl & Associates, Inc. Fire and Explosion Analysis
Peter Dahl, CFI, CFII, CFEI (612) 229-6019 Dahl-fire.com Dahl-fire.com Dahl-fire.com peter@dahl-fire.com
fire and explosion investigations. Professional and explosion investigations. Professional fire CFII, CFEI peterdahl@mchsi.com Peter Dahl, CFI, Peter Dahl, CFI, CFII, CFEI peterdahl@mchsi.com
Peter Dahl, CFI, CFII, CFEI
peter@dahl-fire.com • (612) 229-6019 Dahl & Associates, Inc. Fire and Explosion Analysis • P.O. Box 159 Webster, MN 55088
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Casualty Adjuster’s Guides
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Index, Editions & References
1
Index & References
Page
01
CASUALTY ADJUSTER’S GUIDE®
Automotive
Page
7
Automotive Claim Guide
Page
10
Of Wisconsin
Property
Page
Property Claim Guide
Page
23 25
Medical
Page
Medical Claim Guide
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35 37
Legal
Page
45
Consultants & Experts
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55
Published by; Paul Lorang PO Box 363 Pipestone, MN 56164 Phone: 507-215-2687 E-Mail: paull@cagworld.com Copyright © 2019 Paul Lorang
No portion of any material in this publication may be reproduced for personal or commercial use without the express permission of the copyright owner. TRADEMARK REGISTERED WITH THE U.S. PATENT AND TRADEMARK OFFICE, WASHINGTON D.C., NO, 1.604.598
Inclusion or omission of vendors herein, implies no special endorsement or inference. The Publisher does not assume, and hereby disclaims, any liability to any party for any loss or damage in connection with the compilation and publication of the Guide.
Independent Adjusters Page 68 & Appraisers Adjusters’ Roster Milwaukee Area
Page
77
Greater Wisconsin & Surrounding Areas
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89
Casualty Adjuster’s Guide™ of Wisconsin - 2019
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Independent Licensed Publishers by Edition
Connecticut . . . . . . . . . . . . . . . . . Michael Smith . . . . . . . 603-580-4739 Iowa/Nebraska. . . . . . . . . . . . . . . Paul Lorang . . . . . . . . 507-215-2687 Massachusetts Metro Boston . . . Michael Smith . . . . . . . 603-580-4739 Minnesota . . . . . . . . . . . . . . . . . . Paul Lorang . . . . . . . . 507-215-2687 Missouri St. Louis . . . . . . . . . . . . Cindy Hertlein . . . . . . . 636-675-1739 Wisconsin . . . . . . . . . . . . . . . . . . Paul Lorang . . . . . . . . 507-215-2687
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For all other editions please contact CAG USA Phone 918-215-2238
Index, Editions & References
3
2019 WISCONSIN CLAIMS ASSOCIATIONS
President ................................................................... Jim Sutter Society Insurance ................................................920-948-9578 jsutter@societyinsurance.com Vice President.................................................. Joseph Balcaitis Acuity....................................................800-242-7666 ext 1681 joseph.balcaitis@acuity.com Secretary ........................................................ Susan McClone Society Insurance ....................................... 920-933-5905 smcclone@societyinsurance.com Treasurer ................................................................. Scott Wittliff Acuity...................................................................262-378-4055 scott.wittliff@acuity.com Executive Committee ............................................Sara Helbing Society Insurance ................................................920-933-5986 shelbing@societyinsurance.com Executive Committee ....................................... Jamie Loiacono Acuity...................................................................920-458-9131 jamie.loiacono@acuitycom Executive Committee ................................................Bill Bunzel Society Insurance ................................................888-576-2438 bbunzel@societyinsurance.com Executive Committee ....................................... Stacie Grafton
Society Insurance ....................................... 920-933-5750 sgrafton@societyinsurance.com
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Index
WISCONSIN CLAIMS COUNCIL 2019 Officers
CAG Full 4-1/4 x 7-1/4 or 4.25 x 7.25 H&A Wisconsin Fire Loss WI 071719-1
4
Index, Editions & References
Index
2019 WISCONSIN CLAIMS ASSOCIATIONS
WISCONSIN FIRE LOSS ASSOCIATION BOARD MEMBERS 2019 Brad Bailey .........................................Sheboygan Falls lns. Co. 920-467-4613 Joe Sprangers .............................. Fox Valley Technical College 920-232-6012 Marty Jaeger ....................................................................Acuity 800-242-7666 Ext 1370 William Marske .................................Associated Claim Service 920-739-4468 Jane Sterrett ...................................................... AAA Wisconsin 920-469-3249 Scott Gartman ........................................ Wilson Mutual Ins. Co 920-458-3359
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Index, Editions & References
5
2019 WISCONSIN CLAIMS ASSOCIATIONS
President ..............................................................Jamie Senner Jamie_Senner@gbtpa.com Vice President.......................................................Matt Kurudza mdk@workcomp-defense.com Secretary ........................................................Arlene Chambers Arlene.v.chambers@EMCins.com Treasurer .................................................................... Kelly Etzel ketzel@maxmedimprovements,com Meetings every other month, @ various locations. Visit www.miaassoc.org for more information. MIAA PO Box 782 Brookfield, WI 53045 info@miaassoc.org
FOX VALLEY ADJUSTERS ASSOCIATION 2019 Officers President .......................................................... Travis Dudovick travis@foxvalleyadjusters.com ............................920-318-1154 Vice President..........................................................Ryan Felker Secretary/Treasurer ...........................................Cory Swedberg info@foxvalleyadjusters.com .............................. 920-224-7147 Regular meeting of the FVAA are held every third Friday of the month (except the months of June, July, and August) visit foxvalleyadjusters.com for more info. Contact info: PO Box 7701, Appleton, WI 54912 or info@foxvalleyadjusters.com
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Index
MILWAUKEE INSURANCE ADJUSTERS ASSOCIATION 2019 - 2020 Officers
Index
6
Index, Editions & References
Social Security Number Allocations The Social Security Administration (SSA) changed the way Social Security Numbers (SSNs) are issued on June 25, 2011. This change is referred to as “randomization". It eliminated the geographical significance of the first three digits of the SSN, referred to as the area number, by no longer allocating the area numbers for assignment to individuals in specific states. Previously unassigned area numbers were introduced for assignment excluding area numbers 000, 666 and 900-999. The chart below is strictly historical data showing the first 3 digits of the social security numbers assigned throughout the United States and its possessions, prior to the “randomization” change on June 25, 2011. The same area, when shown more than once, means that certain numbers have been transferred from one State to another, or that an area has been divided for use among certain geographic locations. 001-003. . . . . . . . New Hampshire 004-007. . . . . . . . Maine 008-009. . . . . . . . Vermont 010-034. . . . . . . . Massachusetts 035-039. . . . . . . . Rhode Island 040-049. . . . . . . . Connecticut 050-134. . . . . . . . New York 135-158. . . . . . . . New Jersey 159-211 . . . . . . . . Pennsylvania 212-220. . . . . . . . Maryland 221-222. . . . . . . . Delaware 223-231. . . . . . . . Virginia 232 . . . . . . . . . . . North Carolina 232-236. . . . . . . . West Virginia 237-246. . . . . . . . Not Issued 247-251. . . . . . . . South Carolina 252-260. . . . . . . . Georgia 261-267. . . . . . . . Florida 268-302. . . . . . . . Ohio 303-317. . . . . . . . Indiana 318-361. . . . . . . . Illinois 362-386. . . . . . . . Michigan 387-399. . . . . . . . Wisconsin 400-407. . . . . . . . Kentucky 408-415. . . . . . . . Tennessee 416-424. . . . . . . . Alabama 425-428. . . . . . . . Mississippi 429-432. . . . . . . . Arkansas 433-439. . . . . . . . Louisiana 440-448. . . . . . . . Oklahoma 449-467. . . . . . . . Texas 468-477. . . . . . . . Minnesota
478-485. . . . . . . . Iowa 486-500. . . . . . . . Missouri 501-502. . . . . . . . North Dakota 503-504. . . . . . . . South Dakota 505-508. . . . . . . . Nebraska 509-515. . . . . . . . Kansas 516-517. . . . . . . . Montana 518-519. . . . . . . . Idaho 520 . . . . . . . . . . . Wyoming 521-524. . . . . . . . Colorado 525,585 . . . . . . . . New Mexico 526-527. . . . . . . . Arizona 528-529. . . . . . . . Utah 530,680 . . . . . . . . Nevada 531-539. . . . . . . . Washington 540-544. . . . . . . . Oregon 545-573. . . . . . . . California 574 . . . . . . . . . . . Alaska 575-576. . . . . . . . Hawaii 577-579. . . . . . . . District of Columbia 580 . . . . . . . . . . . Virgin Islands 580-584. . . . . . . . Puerto Rico 586 . . . . . . . . . . . Guam 586 . . . . . . . . . . . American Samoa 586 . . . . . . . . . . . Philippine Islands 587-665. . . . . . . . Not Issued 667-679. . . . . . . . Not Issued 681-690. . . . . . . . Not Issued 691-699. . . . . . . . Not Issued 700-728. . . . . . . . Railroad Board 729-733. . . . . . . . Enumeration at Entry 750-772. . . . . . . . Not Issued
www.ssa.gov/employer
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
7
Automotive AUTO BODY REPAIR Crest Cadillac ................................................... 8 TRUCK/TRAILER REPAIR, PARTS, SERVICE Lakeside International Trucks ........................... 9
Claim Guide Information Pages Automotive Red Flags .................................... 10 Brake Reaction Tables .................................... 12 Windshield Replacement Chart ...................... 13 Effects of Anti-Lock Braking System .............. 15 Important Information About Airbags .............. 17 Travel Reimbursement .................................... 20 Skid Chart ...................................................... 21 Vehicle Identification Number ......................... 22
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
Index
Automotive
8
Auto
Auto Body Repair
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9
Truck/Trailer Repair, Parts, Service
C OLLISION & P AINT C ENTER SERVING WISCONSIN AND NORTHERN ILLINOIS FOR 34 29 YEARS
Offering you the following products and services:
All Types of Welding Axle Alignments Collision Repairs Custom & Regular Painting Downdraft Bake Booths Fiberglass Repairs Frame Straightening (Black Hawk Power Cage) Graphics & Decals Light Duty Truck & Vans Recreational Vehicles Sandblasting Towing – All Sizes of Vehicles Truck/Trailer Rental Trucks, Buses, Trailers, Construction & Materials Handling Equipment Windshield Repair
11000 W. Silver Spring Road, Milwaukee, WI (414) 353-4800 Contact: Rodney Rowland Monday – Friday: 7:30 a.m. to 4:00 p.m.
www.LakesideTrucks.com Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
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Automotive
10
Automotive
Auto
Automotive Claims - Red Flags While most claims are legitimate, it is obvious from some behaviors and actions that some claims may be exaggerated or fraudulent. “Red Flags” of a general nature can help the adjuster in determining whether or not it is necessary to take a closer look at a claim to identify the possibility of fraud. And, while none of these are evidence of illegal activity, these “Red Flags” can provide the adjuster credibility to his/her suspicions.
General • The Claimant: - willing to accept responsibility immediately and settle. - quick to threaten to see an attorney or a physician. • No street address is available for the claimant. • Claims always made in person at adjusters office.
Suspicious Accident and Claim • The Claimant: - reports show claimant has active claims history. - does not show prior insurance coverage. - is not reporting or claiming medical injuries. - does not want to have his vehicle repaired locally. - vehicle not available to be evaluated by an independent appraiser. • Police were not called to the scene of the accident. • Newly purchased or registered vehicle. • A lien or other documents filed of record date is the same day as the accident or within a few days of the filing date. • The other vehicle in the accident is a rental vehicle. • All vehicles in the accident are taken to the same repair shop.
Rental Car Accident • The Claimant: - incorrect address or phone number. - is not currently employed. - no physical home address. • The rental vehicle is obtained using cash, although a credit card may have been used as verification or collateral. • When renting a truck or van to move either himself or others, claimant cannot remember the address. • Shows few miles driven. • The accident occurs shortly after renting the vehicle. • Police were not called to the scene of the accident. • History of prior claims involving rental vehicles. • Renter refuses to make a statement concerning the accident. • Accident occurred in remote location or not involving another vehicle. • All injured parties in the accident seek treatment from the same clinic or doctor on the same date. • Renter is a passenger. • Additional drivers or passengers are in the rental vehicle. • The physical damage to the vehicle is not extensive enough to warrant the injuries claimed. • The claimant: - cites a malfunction in the rental vehicle. - has damage repaired before inspection. - contacts an attorney immediately after the accident. - does not contact their regular doctor for treatment. - aggressive in pursuing a settlement.
Vehicle Theft • The Claimant: - has not lived at their current address for longer than six months. - has not worked at current employer for longer than six months. - address is a post office box or mail drop.
(Continued on next page)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
11
Automotive Claims - Red Flags (continued from previous page)
• The Vehicle: - was not purchased with a loan, there is no bill of sale or proof of ownership. - was recently purchased. - was not purchased locally or at exceptionally high or low purchase price. - is custom, classic or antique. - was advertised as “for sale” prior to theft. - was found by friend or insured, but stripped in careful manner and owner wants to retain salvage although repair appears impractical.
- VIN number did not match title or was not original manufacturer model or did not match police report. - safety or inspection sticker is altered. - has theft or salvage history. - when found, no sign of ignition or steering damage is evident. - when found, major mechanical problems are evident. - is recovered shortly after claim, stripped and burned. - is a lease vehicle with excessive mileage.
Vehicle Theft Coverage • The claim was reported within one month of the issue of coverage or within one month of expiration. • A notice of cancellation was sent to insured shortly before claim was reported. • The claimant obtained coverage in another location or area not near his residence or place of employment. • The coverage is for a minimum liability but full coverage on collision or theft and the vehicle is a late/expensive model. • Claimant recently increased or added coverage to the vehicle.
Vehicle Theft Reporting • The claimant has not or delayed filing a police report. • The claimant did not contact insurance carrier within one week after theft of vehicle. • The license number submitted by claimant does not match motor vehicle records as belonging to vehicle. • The title to the stolen vehicle is a copy. • The title on the vehicle does not have verifiable addresses on the history. • The only lien on the vehicle is for an individual as opposed to bank or financial institution.
Other Vehicle Theft • Prior owner of vehicle is unavailable or cannot be located. • The vehicle is burned when found. • VIN numbers were removed before fire.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
- only gives a mobile number for contact. - home address or phone number has changed frequently. - does not offer valid contact information, and utilizes a hotel, bar, friends or family members home instead of his own information or place of employment. - always makes contact in person at the adjusters office - no telephone calls or correspondence by mail. - is currently unemployed. - is currently self-employed but evasive about their business and actual duties/ activities. - has current financial problems or is currently involved in a divorce or separation from spouse. - driver’s license is currently not valid; recently suspended; recently issued; or, an out-of-state license. - has recently increased or added coverage. - has accumulated parking tickets on vehicle. - pushes for quick settlement, may become angry, and often offers inducement for quick settlement. - has first-hand knowledge of claims industry including claims process and insurance terms. - value of vehicle is not comparable with income. - claims unverifiable extensive valuable merchandise was in vehicle at time of theft. - is employed at another insurance company. - wants other person to pick up settlement check. - is currently behind in loan payments on the vehicle.
Automotive
12
Reaction & Braking Distance Table
Auto
Not applicable for vehicles with anti-lock brake systems.
REACTION TABLE 20 mph ....................22 feet 3/4 SECOND AVERAGE REACTION TIME
Distance a car will travel before foot reaches the brake.
30 mph ....................33 feet 40 mph ....................44 feet 50 mph ....................55 feet 60 mph ....................66 feet 70 mph ....................77 feet 80 mph ....................88 feet
BRAKING TABLE 20 mph ....................22 feet Additional distance traveled after braking, before stopping.
30 mph ....................49 feet 40 mph ....................88 feet 50 mph ..................137 feet 60 mph ..................198 feet 70 mph ..................269 feet 80 mph ..................352 feet
TOTAL REACTION 20 mph ....................44 feet AND BRAKING 30 mph ....................82 feet DISTANCE TABLE 40 mph ..................132 feet
Total distance car will have traveled from the moment the emergency is perceived until the car is stopped.
50 mph ..................192 feet 60 mph ..................264 feet 70 mph ..................346 feet 80 mph ..................440 feet
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
13
Windshield Replacement Guide Under Comprehensive Coverage WINDSHIELDS SUBJECT TO REPLACEMENT
ONLY TWO CONDITIONS UNDER BREAKAGE BEAR CHECKING 1. On new cars, less than ninety days old, a windshield with a strain crack, which shows no point of impact should be referred to the selling dealer with every effort being made to replace it under car manufacturer’s warranty. 2. On old cars, where discoloration appears along the edges of the cracks, which indicates old breakage, check both the effective date of the policy and a glass expert to prevent payment for old damage. In between many fine stone nicks and outright breakage, the common types of damage are shown below. The area of this damage is of primary importance for SAFE vision (refer to sketch below).
Driver’s Side
CRITICAL AREA
ACUTE AREA
NON-CRITICAL AREA
Passenger’s Side
That portion of windshield cleaned by normal sweep of wiper blades.
Center of critical area, directly in front of driver: 8-1/2" wide by 5-1/2" high.
All of the area outside of the critical area.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
This includes glass that is shattered, cracked, either inside or outside sheet of glass, or glass with a star break. A star break is one which is vented. It has cracks radiating from the point of impact, generally in a star shape. As a rule, it is but a short time before cracks continue across the glass. Windshields damaged by sand storms, Star Break where vision is greatly reduced, are, of course, covered.
Automotive
14
Windshield Replacement Guide Damage
Auto
Bull’s Eye Half Moon
Stone Nicks or Chips
Description
Replace
Do Not Replace
Circular or Semi-Circular Inner Glass Fractures (Not Vented)
Any in the acute area
Glass Chips which are dislodged from the surface of the glass
Over 1/16 inch in acute area
Less than 1/16 inch in acute area
Over 1/8 inch in critical areas
Less than 1/8 inch in non-critical area
In a non-critical area
Over 1/4 inch in critical areas
GLASS FACTS • Such marks do not grow in size. • They do not affect the prime purpose of the windshield to provide perfect vision. • Windshields are made to look through, not at.
• The small appearance defect should be classed the same as a paint chip on the hood, also caused by flying stones. • Tell owner coverage is still in effect.
DUPLICATE PAYMENTS
Cash settlements cannot be made for glass replacements. Reasonable assurance that the glass has been replaced is necessary.
Extra precaution at the time of car trade should include prescription and positive assurance replacement has been made.
IF NOT FOLLOWED, A LOSS REMAINS A LOSS FOR YOUR AND ANOTHER INSURANCE COMPANY.
N o substitution of the more expensive tinted windshield without owner paying the additional cost.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
15
Effects of Anti-Lock Braking System Wheel lockup: slippery when wet.
The pumping heart of an antilock brake system. ABS works with your regular braking system by automatically pumping them. In vehicles not equipped with ABS, the driver has to manually pump the brakes to prevent wheel lockup. In vehicles equipped with ABS, your foot should remain firmly planted on the brake pedal, while ABS pumps the brakes for you so you can concentrate on steering to safety. More specifically, ABS automatically changes the brake fluid pressure at each wheel to maintain optimum brake performance—just short of locking up the wheels. There is an electronic control unit that regulates the brake fluid pressure in response to changing road conditions or impending wheel lockup.
How to know if your vehicle is equipped with ABS. Most newer vehicles offer ABS as either standard or optional equipment. To find out whether your car has an antilock brake system, and what type, read your owner’s manual. You can also check your instrument panel for a yellow ABS indicator light after you turn on the ignition. And when you buy, lease or rent a vehicle, always ask if it comes equipped with ABS.
There’s more than one kind of antilock brake system. Four-wheel systems, including those found on cars and minivans, are designed to keep all four wheels from locking up. Rear-wheel-only systems, found on some pickups, vans and sport-utility vehicles, keep the vehicle from spinning out of control, but the front wheels may lock up, resulting in a loss of steering control.
The feel and sound of ABS. When ABS is activated, you may experience a slight vibration or a rapid pulsation of the brake pedal—almost as if the brakes are pushing back at you. At times, you will feel the pedal suddenly drop. The valves in the ABS unit may make a grinding, scraping or buzzing noise. This means your ABS is working. Continue to apply firm pressure and steer. Do not take your foot off the brake pedal.
(Continued on next page)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
When your wheels lock up on wet and slippery roads or during a panic stop, you may lose traction and control, causing your vehicle to spin. Antilock brakes keep your wheels from locking up, so your car maintains directional control around hazards if you can’t make a complete stop in time.
16
Automotive
Effects of Anti-Lock Braking System (continued from previous page)
Auto
Do cars with ABS stop more quickly than cars without? Perhaps, but that’s not the main purpose of ABS. It is a system designed to help you maintain control of the vehicle during emergency braking situations, not necessarily make the car stop more quickly. ABS may shorten stopping distances on wet or slippery roads and most systems may shorten stopping distances on dry roads. On very soft surfaces, such as gravel or unpacked snow, ABS may actually lengthen stopping distances. In wet or icy conditions, you should still make sure you drive carefully, always keep a safe distance behind the vehicle in front of you, and maintain a speed consistent with the road conditions.
Stop and get to know your ABS. After you consult your owner’s manual for more details, give your ABS a mini-road test. In an unobstructed parking lot, drive your vehicle at a speed above which the antilock brake system activates (usually above 10 mph) and apply the brakes firmly. The antilock brake system is speedsensitive and will not activate at very slow speeds. Also, it’s easier to activate ABS on a wet and slippery surface. The antilock system should prevent the wheels from skidding. Practice NOT pumping the brake.
Other considerations for better braking. How effectively you can stop your vehicle can be influenced by many factors including: • Road conditions, since wet and slippery roads provide less tire friction and will therefore result in longer stopping distances than dry roads. • Vehicle condition, including properly inflated tires that have good tread, and a properly maintained brake system that is free from defects such as worn linings, air or dirt in the brake fluid, or leaks that reduce the available braking force. • Driver reaction time. At 60 mph, your car travels 88 feet each second. Reaction time, that is the time it takes a driver to identify a braking situation and then apply the brakes, will affect the overall distance to stop. A onehalf second reaction time will result in a vehicle stopping 88 feet shorter from 60 mph than a one-and-one-half second reaction time. That is why it is important to always pay attention to the road and other traffic. • Type of brake system. When faced with a panic braking situation, ABS allows a driver to rapidly apply the brakes without worrying about wheel lockup, and the vehicle begins to stop immediately. Without ABS, a rapid, hard brake application could cause wheel lockup and loss of vehicle steering control, if the driver does not pump the brakes correctly or limit the brake pedal force to prevent wheel lockup. Therefore, more driver skill is needed to obtain short stops without ABS. Provided by National Highway Traffic Safety Administration
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
17
About Air Bags
Because air bag sensors measure deceleration, vehicle speed and damage are not good indicators of whether or not an air bag should have deployed. Occasionally, air bags can deploy due to the vehicle’s undercarriage violently striking a low object protruding above the roadway surface. Despite the lack of visible front-end damage, high deceleration forces may occur in this type of crash, resulting in the deployment of the air bag. Most air bags are designed to automatically deploy in the event of a vehicle fire when temperatures reach 300 to 400 degrees Fahrenheit. This safety feature helps to ensure that such temperatures do not cause an explosion of the inflator unit within the air bag module. Front air bags are not designed to deploy in side impact, rear impact or rollover crashes. Since air bags deploy only once and deflate quickly after the initial impact, they will not be beneficial during a subsequent collision. Safety belts help reduce the risk of injury in many types of crashes. They help to properly position occupants to maximize the air bag’s benefits and they help restrain occupants during the initial and any following collisions. So, it is extremely important that safety belts always be worn, even in air bag-equipped vehicles. Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
Air bags are typically designed to deploy in frontal and nearfrontal collisions, which are comparable to hitting a solid barrier at approximately 8 to 14 miles per hour (mph). Roughly speaking, a 14 mph barrier collision is equivalent to striking a parked car of similar size across the full front of each vehicle at about 28 mph. this is because the parked car absorbs some of the energy of the crash, and is pushed by the striking vehicle. Unlike crash tests into barriers, real-world crashes typically occur at angles, and the crash forces usually are not evenly distributed across the front of the vehicle. Consequently, the relative speed between a striking and struck vehicle required to deploy the air bag in a real-world crash can be much higher than an equivalent barrier crash.
Automotive
18
Auto
About Air Bags When a crash occurs, the vehicle rapidly decelerates while its structure absorbs the majority of the crash forces. Unbelted occupants continue to move forward at the vehicle’s original speed until the vehicle’s interior (the steering wheel, instrument panel, windshield, etc.) stops their movement. Belted occupants come to a more gradual stop by being secured to the vehicle’s structure. In severe crashes, even properly belted occupants may come into contact with the vehicle’s interior. Air bags supplement the safety belt by reducing the chance that the occupant’s head and upper body will strike some part of the vehicle’s interior. They also help reduce the risk of serious injury by distributing crash forces more evenly across the occupant’s body. Some air bag technologies use nitrogen gas to fill the air bag while others may use argon gas. The gases used to fill airbags are harmless. From the onset of the crash, the entire deployment and inflation process takes only about 1/20th of a second, faster than the blink of an eye. Once an air bag deploys, deflation begins immediately as the gas escapes through vents in the fabric. Deployment is frequently accompanied by the release of dust-like particles in the vehicle’s interior. Most of this dust consists of cornstarch or talcum powder, which are used to lubricate the air bag during deployment. Small amounts of sodium hydroxide may initially be present. This chemical can cause minor irritation to the eyes and/or open wounds; however, with exposure to air, it quickly turns into sodium bicarbonate (common baking soda). Depending on the type of air bag system, potassium chloride (a table salt substitute) may also be present. For most people, the only effect the dust may produce is some minor irritation of the throat and eyes. Generally, minor irritations only occur when the occupant remains in the vehicle for many minutes with the windows closed and no ventilation. Once deployed, the air bag cannot be reused and should be replaced by an authorized service department. Source: National Highway Traffic Safety Administration (NHTSA)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
19
Why do air bags sometimes fail to deploy during a crash?
!
The crash conditions may be sufficiently moderate where an air bag would not be needed to protect an occupant wearing a seat belt. The seat belt may provide sufficient protection from a head or chest injury in such a crash.
!
Many advanced frontal air bag systems automatically turn off the passenger air bag when the vehicle detects a small-stature passenger or child, child in a child restraint system, or no occupant in the right front passenger seat.
!
Some advanced side air bag systems will similarly shut off the passenger side air bag system when detecting a smallstature passenger or child in the right front passenger seat who is positioned too close to the side air bag.
!
Some vehicles, such as pick-up trucks or sports cars without rear seats, may have a manual ON-OFF switch for the front passenger air bag. If the manual ON-OFF switch is positioned in the "off" position, the front passenger air bag will not deploy.
!
An air bag may also not deploy or work properly if the vehicle's air bag readiness light is illuminated. When illuminated, the air bag readiness light warns consumers of potential problems with a vehicle's air bag system. (If an air bag readiness light is illuminated, the vehicle should be serviced without delay.)
!
In used vehicles, a possible reason for the air bag not to deploy is that the air bag may not have been replaced after a previous crash. NHTSA recommends that 1) Air bags always be replaced after a deployment and 2) If, for any reason, a deployed air bag is not replaced, this information about the non-functioning air bag should be disclosed to the new owner upon the sale of the vehicle. /www.safercar.gov
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Auto
The activation of an air bag in a crash is dependent on several important factors including: the characteristics of the crash (e.g., speed, other vehicle(s) involved, impact direction, etc.); the individual vehicle air bag system's design strategy; and the crash sensor locations. Air bags are not intended to deploy in all crashes. There may be circumstances when an air bag does not deploy. Some possible examples follow:
Automotive
20
Auto
IRS STANDARD MILEAGE RATES for 2019 Beginning on Jan. 1, 2019, the standard mileage rates for the use of a car (also vans, pickups or panel trucks) will be: ª ª ª
58 cents per mile for business miles driven. 20 cents per mile driven for medical or moving purposes. 14 cents per mile driven in service of charitable organizations.
The business mileage rate increased 3.5 cents for business travel driven and 2 cents for medical and certain moving expense from the rates for 2018. The charitable rate is set by statute and is unchanged. It is important to note that under the Tax Cuts and Jobs Act, taxpayers cannot claim a miscellaneous itemized deduction for unreimbursed employee travel expenses. Taxpayers also cannot claim a deduction for moving expenses, except members of the Armed Forces on active duty moving under orders to a permanent change of station. Taxpayers always have the option of calculating the actual costs of using their vehicle rather than using the standard mileage rates. Source: www.irs.gov
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
21
Skid Computation Chart Not applicable for vehicles with anti-lock brake systems.
Auto HOW-TO-USE: For an indication of the likely speed which produced a set of skid-marks, total the length of skid marks and divide by the number of wheels. This provides a distance in feet to locate in column ‘D’. Select the type of road surface in column ‘F’. Where the line crosses column ‘S’ is an estimate of the speed of the vehicle.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
22
Auto
Vehicle Identification Number A Vehicle Identification Number (VIN) is a unique serial number used by the automotive industry to identify individual motor vehicles. Prior to 1980, there was not an accepted standard for these numbers, so different manufacturers used different formats. Now all manufacturers who produce more than 500 vehicles a year must use a standardized 17-digit vehicle identification number which do not include the letters I, O or Q. Components of the VIN l l l l l l l l
Postion 1-3: World manufacturer number Position 4: Restraint system type (passenger car only) brake type and GVWR class (trucks and vans only) Position 5-7: Line, series, body type Position 8: Engine type Position 9: Check digit Position 10: Model year Position 11: Assembly plant Position 12-17: Production sequence number
Identify Model Year Find the model year by reading position 10 (this is the eighth character from the right). Below is a chart with the letter or number that indicates the model year. Example of typical VIN: 2G1WN52M1A9229747. Model year is A, which represents the year 2010 (or 1980).
Code A= B= C= D= E= F= G= H= J= K=
Year 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989
Code L= M= N= P= R= S= T= V= W= X=
Year 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
Code Y= 1= 2= 3= 4= 5= 6= 7= 8= 9=
Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Code A= B= C= D= E= F= G= H= J= K=
Year 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Source: http://en.wikipedia.org/wiki/Vehicle_Identification_Number
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
23
Property Index CONTRACTORS – FIRE/WATER RESTORATION “R” Van Rite Construction & Restoration......... 24
Claim Guide Information Pages
Property Claims Red Flags.............................. 25 Fujita Scale...................................................... 28 Enhanced Fujita Scale..................................... 29 Beaufort Wind Force Scale.............................. 30 Saffir-Sampson Hurricane Scale...................... 31 Tables of Weights & Measures......................... 32 Residential Construction Tables...................... 33
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
CLEANING SERVICES – EMERGENCY FIRE – SMOKE – WATER - RESTORATION Paul Davis Restoration.................................... 24
Property
24
Cleaning Services -Emergency - Fire - Smoke - Water
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Property
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Contractors - Fire/Water Restoration
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
25
Property Claims - Red Flags
General • The Claimant: - is extremely aggressive in wanting to settle. - has first-hand knowledge of claims industry including claims process and insurance terms. - doesn’t want to bother with documenting all losses and is willing to settle for smaller amount. - has contacted their agent recently to ask about the extent of their coverage. - and/or family members are not home or in the area at the time of the loss. - has just renewed policy, increased coverage or coverage is about to expire. • The claims were always made in person at the adjusters office - no telephone calls or correspondence by mail. • The amount of the claim exceeds the amount considered comparable for their place of residence or income. • A large amount of cash lost is included on the claim. • Claims include equipment, machinery or merchandise sold or used in seasonal business enterprise and the end of the peek season - i.e. lawn equipment in the fall; coats & winter weather wearables in the summer.
General Fire or Arson • The Claimant: - had previous claim on contents or other items at the same location during previous year. - lists old merchandise/equipment and/ or non-sellable inventory. - is experiencing financial difficulties, personal or business. • The property and/or contents were for sale. • The property was recently purchased. • The family pet was not at home at the time of the fire. • There are multiple mortgages or liens on the property or the contents listed on the claim.
Scene of the Fire • The property lacks proper maintenance and is in deteriorating condition. • Insurance coverage on the property/contents was high based on the perceived value during fire investigation. • Investigators show: - the absence of certain items listed on policy covered by floaters: coins, jewelry, etc. - the absence of items used to justify the increase over normal 50% contents such as pianos, antiques, electronic equipment, etc. - the absence of sentimental items such as photo albums, bibles, etc. - the absence of normal items found in a home after a fire (except in the case of a total burn) such as appliances, electronic equipment, food, furniture, music collections, musical equipment, jewelry, clothing, toys, lawn equipment, sporting equipment (such as golf clubs), etc. - the absence of normal items found in a place of business after a fire (except in the case of a total burn) such as office equipment, computers, inventory, and business records that should have been stored in fire proof cabinet.
(continued on following page)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
While most claims are legitimate, it is obvious from some behaviors and actions that some claims may be exaggerated or fraudulent. “Red Flags” of a general nature can help the adjuster in determining whether or not it is necessary to take a closer look at a claim to identify the possibility of fraud. And, while none of these are evidence of illegal activity, these “Red Flags” can provide the adjuster credibility to his/her suspicions.
10
Automotive
Auto
Automotive Claims - Red Flags While most claims are legitimate, it is obvious from some behaviors and actions that some claims may be exaggerated or fraudulent. “Red Flags” of a general nature can help the adjuster in determining whether or not it is necessary to take a closer look at a claim to identify the possibility of fraud. And, while none of these are evidence of illegal activity, these “Red Flags” can provide the adjuster credibility to his/her suspicions.
General • The Claimant: - willing to accept responsibility immediately and settle. - quick to threaten to see an attorney or a physician. • No street address is available for the claimant. • Claims always made in person at adjusters office.
Suspicious Accident and Claim • The Claimant: - reports show claimant has active claims history. - does not show prior insurance coverage. - is not reporting or claiming medical injuries. - does not want to have his vehicle repaired locally. - vehicle not available to be evaluated by an independent appraiser. • Police were not called to the scene of the accident. • Newly purchased or registered vehicle. • A lien or other documents filed of record date is the same day as the accident or within a few days of the filing date. • The other vehicle in the accident is a rental vehicle. • All vehicles in the accident are taken to the same repair shop.
Rental Car Accident • The Claimant: - incorrect address or phone number. - is not currently employed. - no physical home address. • The rental vehicle is obtained using cash, although a credit card may have been used as verification or collateral. • When renting a truck or van to move either himself or others, claimant cannot remember the address. • Shows few miles driven. • The accident occurs shortly after renting the vehicle. • Police were not called to the scene of the accident. • History of prior claims involving rental vehicles. • Renter refuses to make a statement concerning the accident. • Accident occurred in remote location or not involving another vehicle. • All injured parties in the accident seek treatment from the same clinic or doctor on the same date. • Renter is a passenger. • Additional drivers or passengers are in the rental vehicle. • The physical damage to the vehicle is not extensive enough to warrant the injuries claimed. • The claimant: - cites a malfunction in the rental vehicle. - has damage repaired before inspection. - contacts an attorney immediately after the accident. - does not contact their regular doctor for treatment. - aggressive in pursuing a settlement.
Vehicle Theft • The Claimant: - has not lived at their current address for longer than six months. - has not worked at current employer for longer than six months. - address is a post office box or mail drop.
(Continued on next page)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
27
Property Claims - Red Flags (continued)
Catastrophe - Fire or Flood • The insured’s property was not in the area affected. • The property was in poor condition. • Only this residence or business was affected in the area.
Catastrophe - Non-resident Owners • The landlord claims the value on renter’s contents. • Claim is submitted as primary residence when actually a rental unit or vacation home.
Property Repair • The Contractor or Provider: - does not have a local office and uses an out-of-area or cell phone for communication. - cannot provide references, especially local. - wants to be pre-paid, cash preferable. - does not have the right equipment to complete work. - comes to the site without solicitation from owners/adjusters. - makes estimates well below standard for area, without details - makes offer of cash or other incentives to get the job. - is not bonded, insured, or licensed or cannot provide documentation; or shares license number with others.
Claims Process • The claimant: - unable to produce identification or proof of ownership of home or property - has too many documents to verify losses, including receipts for older items - does not have receipts or cancelled checks for items purchased recently or that have a high value but is able to produce the same for items with a lower value. - produces receipts with incorrect or no sales tax; no company logo; figures are incorrect; or receipts are from same vendor with sequential numbers, some in reverse order of purchase date. - provides multiple receipts on same stationery or written by same person (handwriting is identical). - provides credit card receipts with no approval or incorrect codes. - produces inventory report showing recent high number of purchases, especially those of high dollar value - cannot remember place of purchase on recent purchases - exhibits high level of stress related to examination under oath concerning loss - does not have current bank statements or credit card records of recent purchases. - has multiple policies with multiple claims on same items - no longer has or will not produce damaged item(s) for viewing or appraisal. - claims some damage a result of unrepaired damage from earlier disaster.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
- has no receipts or documents supporting value or actual existence of items reported • Receipts submitted do not bear the insured’s name/address, or have another persons information • The area of the residence on the claim was not evacuated after the catastrophe • There was little or no security in the affected area. • Only this residence or business was affected in the area.
Property
28
The Fujita Scale The Fujita Scale is used to rate the intensity of a tornado by examining the damage caused by the tornado after it has passed over a man-made structure, measuring both the path length and path width of the tornado.
Property
F0
F1
Gale tornado
Moderate tornado
40-72 mph
Some damage to chimneys; breaks branches off trees; pushes over shallowrooted trees; damages sign boards
43-112 mph
The lower limit is the beginning of hurricane wind speed; peels surface off roofs; mobile homes pushed off foundations or overturned; moving autos pushed off the roads; attached garages may be destroyed.
F2
Significant tornado
113-157 mph
Considerable damage. Roofs torn off frame houses; mobile homes demolished; boxcars pushed over; large trees snapped/uprooted; light objects missiles generated
F3
Severe tornado
158-206 mph
Roof and some walls torn off well constructed houses; trains overturned; most trees in forests uprooted
F4
Devastating tornado
207-260 mph
Well-constructed houses leveled; structures with weak foundations blown off some distance; cars thrown and large missiles generated
261-318 mph
Strong frame houses lifted off foundations and carried considerable distances to disintegrate; automobile sized missiles fly through the air in excess of 100 meters trees debarked; steel re-inforced concrete structures badly damaged.
319-379 mph
These winds are very unlikely. The small area of damage they might produce would probably not be recognizable along with the mess produced by F4 and F5 wind that would surround the F6 winds. Missiles, such as cars and refrigerators would do serious damage that could not be directly identified as F6 damage. If this level is ever achieved, evidence for it might be only found in some manner of ground swirl pattern, for it may never be identifiable through engineering study.
F5
F6
Incredible tornado
Inconceivable tornado
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
29
The Enhanced Fujita Tornado Scale The original Fujita scale bridges the gap between the Beaufort Wind Speed Scale and Mach numbers (ratio of the speed of an object to the speed of sound) by connecting Beaufort Force 12 with Mach 1 in twelve steps. The equation relating the wind velocities (V in mph) with the F scale (F) is V = 14.1 * (F+2)1.5.
The EF-scale was unveiled by the NWS to the public and the full meteorological community early in 2006. On 1 February 2007, the Enhanced Fujita scale replaced the original Fujita scale in all tornado damage surveys in the United States. It is important to note that, despite the improvements, the EF-scale still remains a set of wind estimates based on 8 levels of damage to 28 different types of structures and vegetation. Below is a table comparing the estimated winds in the original F-scale and the operational EF-scale that is currently in use by the NWS.
FUJITA SCALE F Number
OPERATIONAL EF-SCALE
Fastest 1/4-mile 3 Second Gust (mph) (mph)
EF Number
3 Second Gust (mph)
0
40-72
45-78
0
65-85
1
73-112
79-117
1
86-110
2
113-157
118-161
2
111-135
3
158-207
162-209
3
136-165
4
208-260
210-261
4
166-200
5
261-318
262-317
5
Over 200
Source: www.ncdc.noaa.gov
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
F1 on the original Fujita scale is equal to B12 (73 mph) on the Beaufort scale, which is the minimum wind speed required to upgrade a tropical storm to a hurricane. F12 on the Fujita scale is equal to M1 (738 mph) on the Mach scale. Although the Fujita scale itself ranges up to F12, the strongest possible tornadoes are in the F5 range (originally estimated to be between 261 to 318 mph).
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Property
Beaufort Wind Force Scale
Property
Originally devised for large sailing craft, the Beaufort scale of wind velocity was devised by Sir Francis Beaufort. This is a rough guide only: wind speeds are averages, and gusts up to the next force should be allowed for. Sea conditions more severe toward land.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Automotive
18
Auto
About Air Bags When a crash occurs, the vehicle rapidly decelerates while its structure absorbs the majority of the crash forces. Unbelted occupants continue to move forward at the vehicle’s original speed until the vehicle’s interior (the steering wheel, instrument panel, windshield, etc.) stops their movement. Belted occupants come to a more gradual stop by being secured to the vehicle’s structure. In severe crashes, even properly belted occupants may come into contact with the vehicle’s interior. Air bags supplement the safety belt by reducing the chance that the occupant’s head and upper body will strike some part of the vehicle’s interior. They also help reduce the risk of serious injury by distributing crash forces more evenly across the occupant’s body. Some air bag technologies use nitrogen gas to fill the air bag while others may use argon gas. The gases used to fill airbags are harmless. From the onset of the crash, the entire deployment and inflation process takes only about 1/20th of a second, faster than the blink of an eye. Once an air bag deploys, deflation begins immediately as the gas escapes through vents in the fabric. Deployment is frequently accompanied by the release of dust-like particles in the vehicle’s interior. Most of this dust consists of cornstarch or talcum powder, which are used to lubricate the air bag during deployment. Small amounts of sodium hydroxide may initially be present. This chemical can cause minor irritation to the eyes and/or open wounds; however, with exposure to air, it quickly turns into sodium bicarbonate (common baking soda). Depending on the type of air bag system, potassium chloride (a table salt substitute) may also be present. For most people, the only effect the dust may produce is some minor irritation of the throat and eyes. Generally, minor irritations only occur when the occupant remains in the vehicle for many minutes with the windows closed and no ventilation. Once deployed, the air bag cannot be reused and should be replaced by an authorized service department. Source: National Highway Traffic Safety Administration (NHTSA)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
32
Table of Weight and Measure
Linear Surface
Square Feet Square Yards Square Inches Square Feet Square Yards Acres Square Miles
Cubic Inches Cubic Inches Cubic Feet Cubic Feet Cubic Feet Cubic Yards Cubic Yards
0.000579 16.387 0.037 0.0283 0.0078 0.7646 764.55
Fluid Ounces Pints Quarts Gallons Cubic Feet Fluid Ounces Cups Quarts Gallons
0.0625 0.5 0.25 231 0.1336 29.574 0.2366 0.9464 3.7854
Pints Quarts Gallons Cubic Inches Gallons Milliliters Liters Liters Liters
Ounces Ounces Pounds
0.0625 28.35 0.4536
Pounds Grams Kilogram
Property
Inches Inches Inches Inches Feet Feet Miles Miles
Volume
To Get
Liquid
Multiply By
Weight
To Convert From
Reverse
25.4 2.54 0.0833 0.0278 0.333 0.3048 5280 1.6093
Millimeters Centimeters Feet Yards Yards Meters Feet Kilometers
144 9 6.4516 0.0929 0.8361 0.4047 2.5898
Square Inches Square Feet Square Centimeters Square Meters Square Meters Hectares Square Kilometers
0.00694 0.1111 0.155 10.764 1.196 2.4711 0.3881
Cubic Feet Cubic Centimeters Cubic Yards Liters Cords Cubic Meters Liters
1728 0.061 27 0.0353 128 1.308 0.2842
Casualty Adjuster’s Guide™ of Wisconsin - 2019
0.0394 0.3937 12 36 3 3.2608 0.000189 0.6214
16 2 4 0.00433 7.485 0.0338 4.2266 1.0567 0.2642
16 0.0353 2.2046
Property
33
Residential Construction Details
Property
1. Louver 2. Eave 3. Brick Veneer 4. Drain Tile 5. Footing 6. Ridge Rafter 7. Rafter 8. Diagonal Bracing 9. Corner Post 10. Cement Plaster and Foundation Coating 11. Collar Beam 12. Insulation 13. Sub Flooring 14. Sill 15. Dormer 16. Plate 17. Cross Bridging 18. Fire Stop 19. Lally Column 20. Chimney 21. Roof Sheathing
22. Studding 23. Finished Flooring 24. Girder or I Beam 25. Sheathing 26. Building Paper 27. Window Sill 28. Gutter 29. Downspout or Leader 30. Siding 31. Storm Sewer 32. Shingles 33. Valley 34. Ridge 35. Roofing Felt 36. Stucco 37. Wood Shingles 38. Concrete Floor 39. Masonry or Concrete Foundation 40. Gravel
41. Soffit 42. Floor Tile 43. Sill Sealer 44. Sheathing Board 45. Plywood Roof Sheathing 46. Overhead Door 47. Shutter 48. Cupola 49. Stucco Mesh or Lath 50. Gable Roof 51. Cornice 52. Floor Joist 53. Ceiling Joist 54. Area Wall 55. Lath and Plaster 56. Concrete Stoop 57. Cripple 58. Soil Stack
Casualty Adjuster’s Guide™ of Wisconsin - 2019
STOP
Property
Fishing 34 Half land DH 12-27-06
4-1/2 x 7-1/2
4.5 x 7.5 Property
Fishing For Answers
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
35
Medical Index REHABILITATION & CASE MANAGEMENT CompAlliance...................................................36
Claim Guide Information Pages
Medical Red Flags............................................37 Skeletal Charts/Medical Diagrams....................39 Prescription Abbreviations................................44
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
Medical
36
Rehabilitation / Case Management
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Medical
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Simplified Heat Index Outside Temperature F°
90° Relative Humidty
95°
100°
105°
Apparent Temperature F°
Heat Stress Risk
30%
89º
96º
104º
114º
90° - 104°
40%
92º
101º
111º
123º
Heat Cramps/Exhaustion Possible
50%
96º
107º
119º
135º
105° - 130°
60%
100º
114º
129º
148º
Heat Cramps/Exhaustion Likely Heat Stroke Possible
70%
106º
122º
141º
163º
80%
112º
131º
154º
180º
90%
119º
141º
161º
199º
130° - Up Heat Stroke Highly Likely NOTE: Exposure to full sun will significantly increase all risks.
Source: National Oceanic and Atmospheric Administration
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
37
Medical Claims - Red Flags While most claims are legitimate, it is obvious from some behaviors and actions that some claims may be exaggerated or fraudulent. “Red Flags” of a general nature can help the adjuster in determining whether or not it is necessary to take a closer look at a claim to identify the possibility of fraud. And, while none of these are evidence of illegal activity, these “Red Flags” can provide the adjuster credibility to his/her suspicions.
Lost or Reduced Wages • The Claimant: - only offers a post office box for the address on the employer. - submits lost or reduced earnings on plain paper.
Falling, Food & Product Liability • Claimant submits claim with use of prop to support their claim - broken glasses or dental plate. • Claimant immediately produces eye witness to accident. • In the case of food contamination or foreign objects, claimant no longer has the product, only the container.
WC - Employee • The Claimant: - is not in good standing with employer - either upset, disgruntled, soon to retire or facing dismissal or layoff. - is a seasonal employee facing layoff. - was absent from work for lengthy periods immediately prior to claim. - is not returning to work in a period of time deemed reasonable for the injury. - has an unstable work history of short employment periods with multiple employers. - is a new employee. - is facing financial problems and/or currently in the process of divorce/ separation from spouse. - has recently purchased private disability policies. - receives release to return to work and changes doctor or medical clinic. - has history of reporting minor injuries. - does not tell employer of injury until after being fired or laid off from job. - disputes amount of wage without supporting documents. - immediate family members also receiving benefits from workers compensation, social security, unemployment, etc.)
(continued on second following page)
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
Fraudulent or Inflated Claims • All occupants of vehicle (3 or more) report similar injuries. • Claimant immediately communicates typical symptoms, such as headaches, muscle spasms, back aches, etc. • The damage to the vehicle is minor, but claimant reports extensive medical injuries. • Injured parties in accidents all submit medical bills from same doctor or clinic. • Original receipts are not submitted - only copies. • Detailed medical bills are not submitted - only summary charges without dates and descriptions. • The insured indicates he was not at fault. • Claimants hire an attorney immediately after reporting the accident. • The medical report and subsequent bill is always the same regardless of the severity of the accident. • Treatments are prescribed identically for different accidents - the number of visits or physical therapy needed. • Routine exams or treatment for the claimant can be on weekends or holidays.
- is in new job or self-employed. - reported lost or reduced wages is not compatible with their residence, the length of time they are off work, or their rate of pay cannot be verified. • Direct contact with employer cannot be obtained - the phone number given by the claimant is to a messaging service or immediately is answered by a machine. • Employer cannot verify actual employment of claimant.
Medical
Medical
38
- is aggressive in wanting quick settlement or decisions and demands quick payment for medical reimbursements or providers. - has an above average level of understanding of workers compensation laws and handling processes. - is consistently uncooperative. - employment application contains false information. - refuses home visits for rehabilitation. - is never at home. - disagrees with release to return to work. - does not keep appointments for diagnostic evaluation about reported injury. - does not use correct Social Security Number. - does not have appropriate identification or refuses to produce this verification. - has not told family/friends about the claim. • Anonymous tips and/or surveillance tapes indicate that claimant is working. • When returning calls to claimant, unusual sounds or background noises indicate claimant is not at home.
WC - Accident Circumstances • The accident occurs late on Friday or early Monday morning. • There are no witnesses to the accident, or the witness statement does not agree with the claimant. • Claimants injuries to legs or arms are during lunch or break. • Rumors or stories are heard that the claim is not legitimate. • Accident or injury takes place in area of business that claimant normally does not work. • Accident is not equal to job description - i.e. office worker lifting heavy boxes in warehouse. • Accident occurs immediately before claimant is going on strike or before probationary period ends. • Claimants first report of injury to employer does not match the report in medical history. • Claimants account of accident is not consistent with report, has contradictions or is not credible • Claimant does not immediately report injury or accident to supervisor/employer.
WC - Medical Treatment • The Claimant: - uses physician noted for handling suspect claims. - submits photocopied reports and bills. - symptoms are typical claims - headaches, nausea, inability to sleep, trauma, back aches, etc. - is referred to psychiatrist for evaluation based on original claim of stress. - has pre-existing injury or health problem relating to same injury. • The treatment is not consistent with the diagnosis. • Although accident was minor, extensive medical treatment is diagnosed as necessary. • Obvious copied, or generic medical reports are submitted by doctor, often not even with the claimants name, age, or gender correct. • Double billing is generated and accepted from both workers comp insurer and medical health carrier. • Physician submits only summary medical bills without dates or description of treatments. • Physician refers claimant to separate facility for treatment without notification to adjuster (especially when physician has vested interest in separate facility.) • Medical reports show treatment dates that facility would normally be closed - Sundays, holidays, etc. • Physician utilizes expensive medical equipment for minor injuries.
WC - Claimant Attorney • The Claimant: - hires attorney early in claims process. - hires attorney known for handling suspicious claims. - receives all mail and correspondence through his attorney. • The Claimants attorney: - threatens legal action if claim is not settled quickly. - questions buy out early in claims process. - has unusually large number of claims applications for workers compensation from various claimants
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
39
Anatomical Terms SKELETON - FRONT AND BACK VIEWS
BACK
Medical
FRONT
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
40
Anatomical Terms
Medical
SPINE
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
41
Anatomical Terms SKULL - LATERAL VIEW
Medical
FOOT - TOP VIEW
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
42
Anatomical Terms JOINTS
Medical
SHOULDER
ELBOW
KNEE
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
43
Anatomical Terms
HAND - BACK VIEW
NECK
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Medical
HAND - PALM VIEW
Medical
44
Medical
Prescription Abbreviations aa. a.c. ad a.d. ad lib. a.m. amp. aq. a.s. ASA ATC a.u. b.i.d. BM BP BS BSA c. cap. cc. or cc CHF comp. dil. disc or D. C. disp. div. d.t.d. DW D5W elix. e.m.p. et ex aq fl or fld ft. g. / Gm. / g gr. or gr gtt. . H h. or hr. HA HBP HC h.s. HT ID IM inj. IV IVP IVBP LCD M. m2 or M2 mcg. or mcg mEq mg. or mg ml. or ml mOsm / mOsmol MS N&V NF
of each before meals up to right ear at pleasure, freely morning ampule water left ear aspirin around the clock each ear twice a day bowel movement blood pressure blood sugar body surface area with capsule cubic centimeter congestive heart failure compound dilute discontinue dispense divide give of such doses distilled water dextrose 5% in water elixir as directed and in water fluid make gram grain drop hypodermic hour headache high blood pressure hydrocortisone at bedtime hypertension intradermal intramuscular injection intravenous intravenous push intravenous piggy back coal tar solution mix square meter microgram milliequivalent milligram milliliter milliosmol morphine sulfate nausea & vomiting National Formulary
NMT noct. non rep. or N.R. NPO N.S. or NS NTG O. o.d. oint. o.l. o.s. o.u. o2 p.c. p.m. p.o. p.r.n. pulv. q qd qh qid qod qs qs ad R R.L. or R/L s. Sig. SL SOB sol. s.o.s. ss. stat. subc or subq or s.c. sup. susp. syr. tab. tal. tal. dos. tbsp tid tiw top TPN tr. tsp. U or u u.d. or ut dict ung. URI USP UTI VS w/ WBC w/o X y.o. ZnO
not more than night do not repeat nothing by mouth normal saline nitroglycerin pint right eye ointment left eye left eye each eye both eyes after meals afternoon, evening by mouth as needed powder every every day every hour four times a day every other day a sufficient quantity a sufficient quantity to make rectal Ringer’s Lactate without write on label sublingual shortness of breath solution if there is need one-half immediately subcutaneously suppository suspension syrup tablet such such doses tablespoonful three times a day three times a week topically total parenteral nutrition tincture teaspoonful unit as directed ointment upper respiratory infection United States Pharmacopeia urinary tract infection vital signs with white blood cell count without times year old zinc oxide
Source: Public Informnation
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Legal Tabs MSP08 JW 10.21.07
Legal Services
45
Legal
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
23
Property Index CONTRACTORS – FIRE/WATER RESTORATION “R” Van Rite Construction & Restoration......... 24
Claim Guide Information Pages
Property Claims Red Flags.............................. 25 Fujita Scale...................................................... 28 Enhanced Fujita Scale..................................... 29 Beaufort Wind Force Scale.............................. 30 Saffir-Sampson Hurricane Scale...................... 31 Tables of Weights & Measures......................... 32 Residential Construction Tables...................... 33
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Property
CLEANING SERVICES – EMERGENCY FIRE – SMOKE – WATER - RESTORATION Paul Davis Restoration.................................... 24
Legal Services
47
Legal Index MINNESOTA Minneapolis Arthur, Chapman, Kettering, Smetak & Pikala, P.A................................................. 48 Waldeck Law Firm........................................... 49 Twin Cities Metro Jardine, Logan & O’Brien P.L.L.P..................... 50 WISCONSIN Green Bay Simpson & Deardorff, S.C................................ 52
Milwaukee Crivello Carlson, S.C....................................... 51 Simpson & Deardorff, S.C................................ 52
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Legal
Hudson Arthur, Chapman, Kettering, Smetak & Pikala, P.A................................................. 48
48
Legal Services Minneapolis Minnesota
ARTHUR, CHAPMAN, KETTERING, SMETAK & PIKALA, P.A. 500 Young Quinlan Building 81 South Ninth Street Minneapolis, MN 55402 (612) 339-3500 Fax (612) 339-7655 www.ArthurChapman.com
811 First Street Suite 201 Hudson, WI 54016 (715) 386-9000 Fax (612) 339-7655 www.ArthurChapman.com
Legal
Services Provided: Litigation needs of businesses, the insurance industry, and self-insured entities specializing exclusively in civil litigation, trials, and appeals throughout the U.S.; Appellate, Automobile Liability, ADR, Business Litigation, Commercial Litigation, Construction Law, Employment Law, Fire Litigation, Fraud, General Liability, Insurance Coverage, Liquor Liability, Product Liability, Professional Liability, Railroad (FELA), Subrogation, Trucking Litigation, and Workers’ Compensation. Representative Clients: Accident Fund Insurance Acuity Ins Allina Health System Allmerica Financial/Citizens Andersen Windows Aspen Specialty Auto Club Group Auto Owners Ins Co Bimbo Bakeries BNSF Railway Co Canadian Pacific Railway Chubb Group of Ins Cincinnati Ins Constitution States CorVel Corporation Cummins Power Generation EMC Ins Co Employers Encompass Ins ESIS/ACE USA Farm Bureau Mutual Ins First Group America Gallagher Bassett IAT Ins Group Illinois Casualty Ins Installed Building Products Lexington Insurance Liberty Mutual Ins LSG Sky Chefs Manpower, Inc
Mayo Clinic MetLife Auto & Home MN ARP National Indemnity Co Nationwide Ins Nautilus North Star Mutual Ins One Beacon Ins Philadelphia Ins Co Progressive Ins Progressive Rail RAM Mutual Ins Co Resolute Systems Risk Administration Services Sedgwick Claims Management Selective Ins Co Society Ins Co The Hanover Group The Mentor Network The Thomson Corp/West Group Travelers Ins Co U S Bancorp United Fire & Casualty Co United Properties United Rentals Wells Fargo West Bend Mutual Ins Windsor Windows & Doors Wright Risk Management York Risk Services Group
Visit www.ArthurChapman.com for information on individual attorneys.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
world.com
Legal Services
49
Minneapolis Minnesota
WALDECK LAW FIRM P.A. 121 South Eighth Street, Suite 1400 Minneapolis, MN 55402 (612) 375-1550 FAX (612) 375-0647 Website: www.waldeckpa.com Practice: Trials and Appeals. Insurance Defense. Representative Clients: Argo Pro Ins. Co. Aspen AXA Brotherhood Mutual Church Mut. Ins. Co. Cincinnati Insurance Companies Colony Specialty Esurance General Star Mgmt. Co. Harco National Ins. Co. IFG Companies Markel Corporation Maxum Specialty Ins. Group
NSI, A Division of West Bend Occidental Fire & Cas. Co. of NC RSUI Group, Inc. Scottsdale Ins. Co. Selective Ins. Group Swiss Re United Fire Group West Bend Mutual Ins. Co. Western Nat’l. Ins. Group Wright Risk Management XL Catlin
Memberships: American Bar Association, Defense Research Institute, Minnesota Defense Lawyers Association, Minnesota State and Hennepin County Bar Associations, State Bar of Wisconsin, State Bar Association of North Dakota, Minnesota Hispanic Bar Association, Eagle International Associates, Claims and Litigation Management Alliance and Twin Cities Claims Association. Attorneys licensed to practice in Minnesota, North Dakota and Wisconsin
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Legal
Firm Members: Peter M. Waldeck, 1975. Drake University (B.A. 1997). John Marshall Law School (J.D. 2000). Admitted to bar, 2000, Minnesota; 2006, Wisconsin; 2016, North Dakota. pwaldeck@waldeckpa.com Theodore J. Waldeck, 1982. Creighton University (B.A. 2004); University of St. Thomas School of Law (J.D. 2008). Admitted to bar, 2008, Minnesota; 2009, Wisconsin; 2016, North Dakota. tjwaldeck@waldeckpa.com Lindsey J. Woodrow, 1981. Gustavus Adolphus College (B.A. 2004); Hamline University School of Law (J.D. 2008). Admitted to bar 2008, Minnesota; 2016, North Dakota and Wisconsin. lwoodrow@waldeckpa.com Jason M. Stoffel, 1984. St. John’s University (B.A. 2006); University of Minnesota Law School (J.D. 2010). Admitted to bar 2010. jstoffel@waldeckpa. com Allan M. Tritch, University of Iowa (B.A. 2009); University of St. Thomas School of Law (J.D. 2014). Admitted to bar 2014, Minnesota. atritch@ waldeckpa.com
Legal Services
50
Twin Cities Metro Minnesota
JARDINE, LOGAN & O’BRIEN, P.L.L.P. 8519 Eagle Point Blvd., Suite 100, Lake Elmo, MN 55042 (651) 290-6500 FAX (651) 223-5070 E-mail: jlolaw@jlolaw.com Website: www.jlolaw.com Practice: Defending companies, insurers and individuals throughout the State, Federal and Administrative Law Courts in Business Litigation, Construction Litigation, Employment Law, Environmental, Mold and Toxic Tort, General Liability and Negligence, Government Liability, Health Law, Insurance Coverage, Licensing and Regulation, Motor Vehicle Liability, Premises Liability, Products Liability, Subrogation Claims, Transportation Liability, and Workers’ Compensation. Representative Clients: Available upon request
Legal
All Lawyers Licensed in MN. Some Lawyers Also Licensed in WI*, IA, ND & SD
Firm Members: Bernadette Theis Administrator Thomas L. Cummings Managing Partner George W. Kuehner Patti J. Skoglund* Timothy S. Crom* Lawrence M. Rocheford* James G. Golembeck* Joseph E. Flynn*
Elisa M. Hatlevig* Matthew P. Bandt* Patrick S. Collins* Vicki A. Hruby Tessa M. McEllistrem Tal A. Bakke Shari R. Albrecht Nancy M. Younan* Joseph S. Koe Matthew J. Praetorius
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Legal Services
51
Milwaukee Wisconsin
CRIVELLO CARLSON, S.C. 710 N. Plankinton Ave., Milwaukee, WI 53203 (414) 271-7722 E-mail: cc@crivellocarlson.com Homepage: http://www.crivellocarlson.com Services Provided: General Trial and Appellate Practice in the State and Federal Courts and State Agencies, including Insurance Law, Products Liability, Environmental, Professional Liability, Workers’ Compensation, Civil Rights and Municipal Law, Employment Law, Construction, Transportation, Personal Injury, Trademark and Copyrights and Intellectual Property. Northland Ins. Co. Partners Mutual Ins. Co. Philadelphia Insurance Co. ProAssurance Rockwell Automation, Inc. Scag Power Equipment, division of Metalcraft of Mayville, Inc. Sentry Insurance Co. The Travelers Ins. Co. U-Haul Corp/U-Haul Co. of WI United States Liability Insurance Co. UTC Fire & Security, a division of United Technologies Corp. Victoria Insurance Village of Shorewood West Bend Mutual Ins. Co. Western National Insurance Co. Western World Ins. Co. Wisconsin Municipal Mutual Ins.
Firm Members: Donald H. Carlson Patrick W. Brennan James A. Niquet Jeffrey T. Nichols Nick G. Kotsonis William W. Ehrke Mary E. Nelson Eric D. Carlson Lawrence J. Drabot Amy J. Doyle Laura E. Schuett Agatha K. Raynor Ryan G. Braithwaite Travis J. Rhoades Nathan J. Bayer Zachary J. Davis Stacy K. Luell Samuel C. Hall, Jr.
Noelle C. Muceno George S. Peek Daniel K. Mullin Sara C. Mills Timothy M. Johnson Ashley E. Webber Benjamin A Sparks Todd D. Jex William E. Keeler III Kiley B. Zellner Susan C. VenRooy Megan Q. Peccarelli Andrew R. Rider Philip J. Tallmadge Jose A. Castro Steven C. McGaver Charles E. Polk lII William P. Dineen, Of Counsel
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Legal
Representative Clients: Arch Insurance Group Amerisure Insurance Companies A.O. Smith Corp. Briggs & Stratton Corp. Catholic Mutual Group City of Milwaukee CUNA (Credit Union National Assoc.) First Nonprofit Insurance Co. Great American Insurance Co. Integrity Insurance Liberty Mutual Ins. Manitou Americas, Inc. (formerly Gehl Company) Manitowoc Co. Magnetek, Inc. MetLife Auto & Home Mitsui-Sumitomo Insurance Co. Motorists Commercial Mut. Ins. Co. Nationwide Insurance Co.
52
Legal Services Milwaukee Wisconsin
SIMPSON & DEARDORFF, S.C. 311 E. Chicago St., Ste. 410 Milwaukee, WI 53202 Tel: 414-273-8550 Fax: 414-273-8551 www.simpsondeardorff.com
Legal
Services Provided: Insurance Defense, including Insurance Coverage Analysis, Automobile Liability, Uninsured/Underinsured Motorist, Premises Liability, Safe Place Litigation, Worker’s Compensation, Product Liability, Toxic Tort, Bad Faith Litigation, Construction Litigation, Subrogation, Propane Litigation, and General Litigation. Representative Clients: Acuity, A Mut. Ins. Co. American National Prop. & Cas. Co. Caterpillar, Inc. CBCS Erie Ins. H.J. Martin & Son, Inc. Intercontinental Hotels Grp. Liberty Mut. Ins. Mercury Ins. of Illinois Miron Construction Co., Inc.
Philadelphia Ins. Co. QPS Employment Grp. Rural Mut. Ins. Co. Society Ins., A Mut. Co. The Hanover Ins. Grp. UPS West Bend Mut. Ins. Co. Wilson Mut. Ins. Co. Zurich North America
Firm Members: Thomas J. Binder Stuart R. Deardorff Eric L. Hafferman Kelsey R. S. Kerr Lauren A. Luckenbill Paul M. Miller
Joseph M. Mirabella Nicole R. Radler Christine M. Rice Arthur P. Simpson Brittany L. Van Roo
Green Bay Wisconsin
SIMPSON & DEARDORFF, S.C. 414 E. Walnut St., Ste. 280 Green Bay, WI 54301 Tel: 920-770-4087 Fax: 920-544-4110 www.simpsondeardorff.com Firm Members: Heidi D. Melzer See Milwaukee, Wisconsin listing.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Full MI 06-1 DH x-x-06
4-1/2 x 7-1/2
4.5 x 7.5 Legal Services
53
They need you. You need them. So, why not call?
Don’t forget, your patronage is your “THANKS” to them for providing this free service to the claims industry.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Legal
The vendors in this book can provide the solutions you need for settling claims. They are all insurance claims specialists, providing the right answers for your needs. Call to see what they can do for you!
CAG Half Wide 4-1/4 x 3-1/2 or 4.25 x 3.5 H&A Dahl & Associates H WI 071519-4
54
Consultants & Experts Featured Advertiser
Dahl & Associates, Inc. Dahl & Associates, Inc. Fire and AnalysisInc. Dahl &Explosion Associates, Fire and Explosion Analysis
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
55
Consultants & Experts Index CERTIFIED PUBLIC ACCOUNTANTS/FORENSIC ACCOUNTANTS INSIGHT Forensic Accountants....................... 57 Matson Driscoll & Damico............................... 56 ENGINEERS Biehl Engineering............................................. 59 Building Envelope Consultants, Ltd................. 58 Hansen Engineering......................................... 63 Northland Consulting....................................... 63 Roofing Consultants, Ltd................................. 60 Semke Forensic............................................... 61 Sand Forensic................................................. 62 Synergy Technologies, LLC............................. 62 SEA Limited..................................................... 63 INVESTIGATORS Blue Eagle Investigations................................. 64
Casualty Adjuster’s Guide™ of Wisconsin - 2019
C&E
INVESTIGATORS – FIRE Agosti & Associates......................................... 65 Dahl & Associates...................................... 54, 66 (Also see Roster Page Bottom Display)
56
Consultants & Experts Certified Public Accountants
C&E
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
57
Certified Public Accountants
world.com
C&E
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
58
Engineers
Building
Envelope Consultants, Ltd.
Engineers
•
Roof Consultants
EXPERT THIRD PARTY PROPERTY CLAIMS ASSISTANCE COMMERCIAL • RESIDENTIAL • INDUSTRIAL Roofs / Walls / Foundations Storm Damage Hail • Wind • Ice • Mold Faulty Workmanship Collapse / Chimney Fires Structural Fire Analysis Moisture Testing Subrogation / Appraisals High Steep & Low Slope Roof Inspections
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888-549-1930 www.building-envelope.net E-mail: info@building-envelope.net
Chicago, IL • Waukesha, WI • Minneapolis, MN City, MO • Denver, CO St. Louis, MO • Kansas
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
59
Engineers
BUILDINGS / SAFETY / STRUCTURES TECHNICAL INVESTIGATIONS Structural Failures Subrogation Hail Damage Slip & Fall Construction Defects
Building Problems Foundation Failures Product Failures Accidents Roof Evaluations
world.com
Casualty Losses Water Leaks Machine Guarding Fires Wind Damage
CERTIFICATIONS Professional Engineering Building Inspection Snowmobile Safety
Structural Engineering Civil Engineering Electrical Inspection Boating Safety
Experienced, Stable Staff
BIEHL ENGINEERING, INC. 4360 N. 142nd Street Brookfield, WI 53005
www.BiehlEngineering.com
(262) 251-8251
Steve@BiehlEngineering.com
Serving the Insurance Industry Since 1960
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
C&E
Because you can’t see everybody, every day
Consultants & Experts
60
Engineers
d.com
SPECIALIZING IN COMMERCIAL & RESIDENTIAL ROOF & WALL SYSTEMS Property Claim Investigations Structural Hail Wind Snow/Ice C&E
Mold Faulty Workmanship Manufacturer’s Defect Additional Services • Expert
Testimony
• Non-Destructive
Moisture Testing
• Roofing/Building
Envelope Seminars • Specification
Design
• Project
Management
• Appraisal/
Umpire Role
800.549.0802 | RCLeng.com MILWAUKEE, WI • CHICAGO, IL MINNEAPOLIS, MN • ST. LOUIS, MO • INDIANAPOLIS, IN
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
61
Engineers
gworld.com
C&E
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
62
Engineers
SAND FORENSIC ENGINEERING,INC.
d.com
612-499-9670 WWW.SANDFORENSICENG.COM MECHANICAL ENGINEERING INVESTIGATIONS Propane & Gas Fueled Appliances Plumbing Failures Heating Failures - Freezing/Flooding Fire Sprinkler Systems - Wet & Dry Wood Burning Fireplaces & Chimneys Exhaust Venting Issues Natural Gas & LP Gas Supply Systems Private Water Wells Kitchen Hoods & Fire Suppression Systems Industrial Equipment Failures Commercial & Passenger Vehicle Failures Laboratory Testing & Examination
C&E
ld.com
Double Click Quarter DH 6-23-06
4-1/2 x 1-3/4
4.5 x 1.75
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Find Vendors Nationwide at
www.cagworld.com Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
63
Engineers
world.com
HAIL · WIND · COLLAPSE · MOISTURE · CONSTRUCTION VIBRATION
·
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gworld.com
Consulting Services in Electrical & Forensic Engineering & Fire Investigation
Electrical & Forensic Engineering - Explosions Fire Investigation - Expert Witness Fire Protection, Life Safety & Suppression Systems Lab Analysis & Examinations - Lab Rental Expert Evidence Removal & Climate Controlled Storage Subrogation/Liability Consultations - Failure Analysis
24 Hour Immediate Response
800-319-2632 • 630-495-3853 www.rmhansen.com
Casualty Adjuster’s Guide™ of Wisconsin - 2019
C&E
gworld.com
Hansen Engineering Services
Consultants & Experts
64
Investigators
INVESTIGATIONS & SURVEILLANCE EXPERTS 800-720-2583 • WWW.BLUEEAGLEINVESTIGATIONS.COM
d.com
You can’t get elected if you don’t ADVERTISE Landslide Warning Signs C&E
Springs, seeps, or saturated ground in areas that have not typically been wet before.
New cracks or unusual bulges in the ground, street pavements or sidewalks.
Soil moving away from foundations. Ancillary structures such as decks and patios tilting and/or moving relative to the main house.
Tilting or cracking of concrete floors and foundations. Broken water lines and other underground utilities. Leaning telephone poles, trees, retaining walls or fences. Offset fence lines. Sunken or down-dropped road beds. Rapid increase in creek water levels, possibly accompanied by increased turbidity (soil content).
Sudden decrease in creek water levels though rain is still falling or just recently stopped.
Sticking doors and windows, and visible open spaces indicating jambs and frames out of plumb. Source: http://landslides.usgs.gov
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
65
Investigators - Fire
world.com
C&E
Casualty Adjuster’s Guide™ of Wisconsin - 2019
66
Consultants & Experts Investigators - Fire
Dahl & Associates, Inc. Dahl & Associates, Inc. Fire and AnalysisInc. Dahl &Explosion Associates, Fire and Explosion Analysis
Peter Dahl, CFI, CFII, CFEI Peter Dahl, CFI, CFII, CFEI Peter Dahl, CFI, CFII, CFEI
Fire and Explosion Analysis
(612) 229-6019 peter@dahl-fire.com
Professional fire and explosion investigations. Professional fire and explosion investigations. Professional fire and explosion investigations. ● ● ● ● ● ● ● ● ● ● ● ● ● ●
Industrial Facilities Industrial Facilities Manufacturing Facilities Industrial Facilities Manufacturing Facilities Chemical and Petrochemical Manufacturing Facilities Chemical Petrochemical Facilities and Chemical and Petrochemical Hazardous Materials Sites Hazardous Materials Sites Grain Processing Facilities Hazardous Materials Sites Grain Processing Facilities Commercial Properties Grain Processing Facilities Commercial Properties Commercial Properties
● ● ● ● ● ● ● ● ● ● ●
Residential Properties Residential Properties Aircraft Residential Properties Aircraft Marine Aircraft Marine Automotive Marine Automotive Heavy Equipment and Automotive Heavy Equipment and Machinery Heavy Equipment and
Peter Dahl, CFI, CFII, CFEI peter@dahl-fire.com (612) 229-6019
Dahl & Associates, Inc. Fire and Explosion Analysis P.O. Box 159, Webster, MN 55088.
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Order by phone at 1-866-312-8076 ChoiceTrust is a registered trademark of ChoicePoint Asset Company C.L.U.E.® is a registered trademark of ChoicePoint Asset Company
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Consultants & Experts
67
WARNING ABOUT CARBON MONOXIDE GAS Many people are killed following a hurricane, severe storm or other disaster due to use of gasoline-powered tools or generators that expose them to carbon monoxide (CO). Equipment or appliances that produce carbon monoxide should never be used indoors. Opening doors and windows or using fans will NOT stop carbon monoxide build-up. The gas cannot be seen or smelled. Poisoning can occur in a matter of minutes.
NEVER use a generator inside a home, garage, basement,
When making hurricane or severe weather preparedness plans, remember to install battery-operated CO alarms or plug-in CO alarms with battery back-up, always following the manufacturer's installation instructions. Test CO alarms frequently and replace dead batteries. Source: www.fema.org
Casualty Adjuster’s Guide™ of Wisconsin - 2019
C&E
crawl space, tent or other enclosed or partially enclosed area. Follow the instructions that come with the generator. ALWAYS locate the unit on a dry, outdoor surface, away from doors, windows, vents and air conditioning equipment that could allow CO to seep into the house. Gas-powered generators can be used safely if they are placed in a well-ventilated outdoor area at least 10 feet away from a home or structure. Do not use charcoal or gas grills inside a house, garage, vehicle, tent or fireplace. If electric power is out, do not use gas ranges or ovens to heat your home. Remember that you cannot see or smell CO and portable generators can produce high levels of CO very quickly. If you start to feel sick, dizzy, or weak while using a generator, get to fresh air immediately. DO NOT DELAY. If some one else collapses or is not breathing, dial 9-1-1.
68
Independent Adjusters & Appraisers Featured Advertiser
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Toll Free Phone: 855-215-0658 Office Phone: 920-965-4422 Office Fax: 920-965-4423 Email: aci@accurateclaimsinc.com Website: www.accurateclaimsinc.com
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Independent Adjusters & Appraisers
69
Independent Adjusters & Appraisers
Index WISCONSIN - AREA/STATE WIDE Absolute Adjusting.......................72 Accurate Claims, Inc..............68, 71 Associated Claim Service, Inc...... 70 APPLETON Accurate Claims, Inc..............68, 71 Associated Claim Service, Inc....70 TEC Appraisers, Inc.....................72 DULUTH (See SUPERIOR/DULUTH) EAU CLAIRE TEC Appraisers, Inc.....................72 FOND DU LAC Accurate Claims, Inc..............68, 71 GREEN BAY Accurate Claims, Inc..............68, 71 Associated Claim Service, Inc......70 LACROSSE TEC Appraisers, Inc.....................72
RHINELANDER Accurate Claims, Inc..............68, 71 SHEBOYGAN Accurate Claims, Inc..............68, 71 STEVENS POINT Accurate Claims, Inc..............68, 71 Associated Claim Service, Inc......70 TEC Appraisers, Inc.....................72 SUPERIOR/DULUTH Moe & Nevin, Inc..........................73 WEST BEND Accurate Claims, Inc..............68, 71 Associated Claim Service, Inc......70 WAUSAU Accurate Claims, Inc..............68, 71 ILLINOIS ROCKFORD TEC Appraisers, Inc.....................72
MARINETTE Accurate Claims, Inc..............68, 71 MILWAUKEE Accurate Claims, Inc..............68, 71 Associated Claim Service, Inc......70 TEC Appraisers, Inc.....................72
Casualty Adjuster’s Guide™ of Wisconsin - 2019
IA&A
MADISON TEC Appraisers, Inc.....................72 Wisconsin Adjustment, Inc..........72
OSHKOSH Accurate Claims, Inc..............68, 71
70
Independent Adjusters & Appraisers Area/State Wide
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
Independent Adjusters & Appraisers
71
Area/State Wide
world.com
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Casualty Adjuster’s Guide™ of Wisconsin - 2019
IA&A
Northeastern/Central Wisconsin/Greater Milwaukee area to include Appleton, Fond Du Lac, Green Bay, Door County, Manitowoc, Milwaukee, Sheboygan, Stevens Point, Wausau, U.P. Michigan
72
Independent Adjusters & Appraisers Area/State Wide
Madison
ServingWisconsinfrom•Madison Milwaukee •Appleton•StevensPoint LaCrosse•EauClaire•Rockford,IL Home Office: Rob White 3205 Latham Dr. President Madison, WI 53713 ASECertified•I-CARTrained
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WISCONSIN ADJUSTMENTS, INC. P.O. Box 259210 Madison, Wisconsin 53725-9210
E-mail: jon@wisconsinadjustments.com
608-221-9699 • Fax: 608-221-8388 IA&A
d.com
Roof: Pitch/Factor/Degree PITCH
1:12
2:12
3:12
4:12
5:12
6:12
7:12
8:12
FACTOR
1.00
1.02
1.03
1.06
1.08
1.12
1.16
1.20
DEG
4.76
9.46
14.04
18.43
22.62
26.57
30.26
33.69
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Independent Adjusters & Appraisers
73
Superior/Duluth
Multi-Line Adjusting Service
world.com
Hayward & Superior, WI (Serving Northern & Central Wisconsin) T: 715-394-2051 Fax: 612-524-5771
Escanaba, MI T: 906-932-8473
Fax: 612-524-5771
Minneapolis / St. Paul, MN (Serving West Central Wisconsin) T: 651-436-8629 Fax: 612-524-5771 Email claims to claims@moenevin.com U.S. Department of Homeland Security
CHARACTERISTICS
www.dhs.gov
OF AN ACTIVE SHOOTER SITUATION
m m m
Victims are selected at random Event is unpredictable and evolves quickly Law enforcement is usually required to end the situation
WHEN AN ACTIVE SHOOTER IS IN YOUR VICINITY
1. RUN - Know an escape route 2. HIDE - Lock doors. Silence your phone 3. FIGHT - Last resort conspire with others
CALL 911 WHEN IT IS SAFE TO DO SO Casualty Adjuster’s Guide™ of Wisconsin - 2019
IA&A
HOW TO RESPOND
74
Independent Adjusters & Appraisers Area/State Wide
d.com
855-215-0658
Call Toll Free: Email: aci@accurateclaimsinc.com Web: www.accurateclaimsinc.com Property • Liability • Auto • Inland Marine Heavy Equipment Appraisals Appraisal & Umpire Services • Classic Car Appraisals
IA&A
Serving: Northeastern/Central Wisconsin/Greater Milwaukee area to include Appleton, Fond Du Lac, Green Bay, Door County, Manitowoc, Milwaukee, Sheboygan, Stevens Point, Wausau, U.P. Michigan
Toll Free Phone: 855-215-0658 Office Phone: 920-965-4422 Office Fax: 920-965-4423 Email: aci@accurateclaimsinc.com Website: www.accurateclaimsinc.com
Casualty Adjuster’s Guide™ of Wisconsin - 2019
48
Legal Services Minneapolis Minnesota
ARTHUR, CHAPMAN, KETTERING, SMETAK & PIKALA, P.A. 500 Young Quinlan Building 81 South Ninth Street Minneapolis, MN 55402 (612) 339-3500 Fax (612) 339-7655 www.ArthurChapman.com
811 First Street Suite 201 Hudson, WI 54016 (715) 386-9000 Fax (612) 339-7655 www.ArthurChapman.com
Legal
Services Provided: Litigation needs of businesses, the insurance industry, and self-insured entities specializing exclusively in civil litigation, trials, and appeals throughout the U.S.; Appellate, Automobile Liability, ADR, Business Litigation, Commercial Litigation, Construction Law, Employment Law, Fire Litigation, Fraud, General Liability, Insurance Coverage, Liquor Liability, Product Liability, Professional Liability, Railroad (FELA), Subrogation, Trucking Litigation, and Workers’ Compensation. Representative Clients: Accident Fund Insurance Acuity Ins Allina Health System Allmerica Financial/Citizens Andersen Windows Aspen Specialty Auto Club Group Auto Owners Ins Co Bimbo Bakeries BNSF Railway Co Canadian Pacific Railway Chubb Group of Ins Cincinnati Ins Constitution States CorVel Corporation Cummins Power Generation EMC Ins Co Employers Encompass Ins ESIS/ACE USA Farm Bureau Mutual Ins First Group America Gallagher Bassett IAT Ins Group Illinois Casualty Ins Installed Building Products Lexington Insurance Liberty Mutual Ins LSG Sky Chefs Manpower, Inc
Mayo Clinic MetLife Auto & Home MN ARP National Indemnity Co Nationwide Ins Nautilus North Star Mutual Ins One Beacon Ins Philadelphia Ins Co Progressive Ins Progressive Rail RAM Mutual Ins Co Resolute Systems Risk Administration Services Sedgwick Claims Management Selective Ins Co Society Ins Co The Hanover Group The Mentor Network The Thomson Corp/West Group Travelers Ins Co U S Bancorp United Fire & Casualty Co United Properties United Rentals Wells Fargo West Bend Mutual Ins Windsor Windows & Doors Wright Risk Management York Risk Services Group
Visit www.ArthurChapman.com for information on individual attorneys.
Casualty Adjuster’s Guide™ of Wisconsin - 2019
Roster
76
Tips to Create an EFFECTIVE Print Ad HEADLINE
Is the most important element. Make it clear and concise and addresses your target customers needs. Make sure it dominates your ad regardless of where it’s placed within the ad.
GRAPHICS
Should call attention to and serve the headline, and strengthen the overall look and appeal of your ad. Random web photos or clip-art generally don’t add much value. Actual ‘on the job’ or ‘before and after’ photos can work better. Because CAG editions are printed on high quality color presses we can process most high-res digital photographs.
SUBHEADS & TAG LINES
Can help explain or expand the headline. Should not be used if not needed.
BODY COPY
Can explain your business further. Avoid over cramming your ad space or using too many font styles. Keep it brief and on message with your header.
CONTACT INFORMATION
Roster
Keep it simple. Generally we find regional area codes are preferred over national 800 lines. Don’t forget your web address. Advertising on the printed page is said to convey a higher impact than internet ads, and reaches an identified market. Something the web doesn’t do as well. Most B2B ads are not intended to be direct response ads but to get existing and potential customers to remember your name over time, or be motivated to find out more about you. For help compiling your ad please contact your nearest CAG publisher. www.cagworld.com
Casualty Adjuster’s Guide™ of Wisconsin - 2019
H&A Calendar 2018 ad size 060819-1
JULY 2019 S 7 14
M 1 8 15
T 2 9 16
AUGUST 2019
W 3 10 17
T 4 11 18
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S 2 9 16 23 30
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F 1 8 15 22 29
S 2 9 16 23 30
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M 1 8 15 22 29
T 2 9 16 23 30
NOVEMBER 2019
T 2 9 16 23 30
T 5 12 19 26
T 1 8 15 22 29
W 2 9 16 23 30
F 4 11 18 25
S 5 12 19 26
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S 7 14 21 28
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6 13 20 27
7 14 21 28
S 1 8 15 22 29
F 3 10 17 24
S 4 11 18 25
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S 6 13 20 27
T 3 10 17 24 31
T 3 10 17 24 31
W 4 11 18 25
T 5 12 19 26
FEBRUARY 2020
MARCH 2020 W 4 11 18 25
S 3 10 17 24 31
DECEMBER 2019
JANUARY 2020 W 1 8 15 22 29
F 2 9 16 23 30
OCTOBER 2019
SEPTEMBER 2019 T 3 10 17 24
T 1 8 15 22 29
APRIL 2020
MAY 2020
W 1 8 15 22 29
T 2 9 16 23 30
JUNE 2020
7 14 21 28
W 3 10 17 24
T 4 11 18 25
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SPECIALIZING IN COMMERCIAL & RESIDENTIAL ROOF & WALL SYSTEMS Property Claim Investigations Structural Hail Wind Snow/Ice Mold Faulty Workmanship Manufacturer’s Defect Additional Services • Expert
Testimony
• Non-Destructive
Moisture Testing
• Roofing/Building
Envelope Seminars • Specification
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Umpire Role
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