Insurance Reconstruction and Claim-Support Terms

These terms explain the insurance-reconstruction and claim-support services that may be provided by ForgePoint Building and Remodeling (“ForgePoint”) in connection with qualifying property-damage projects.

These terms apply to ForgePoint Building and Remodeling and its authorized operating names and divisions, including ForgePoint Building and Remodeling, a ForgePoint Building and Remodeling company.

These terms supplement the applicable estimate, construction agreement, change order, insurance addendum or other written project document. If a conflict exists, the signed project-specific agreement controls.

1. ForgePoint’s Role

ForgePoint is a California-licensed construction contractor.

ForgePoint may provide construction-related support for qualifying insurance-funded projects, including:

• Evaluating visible property damage
• Documenting construction conditions
• Measuring affected areas
• Preparing photographs and supporting exhibits
• Preparing construction estimates
• Comparing ForgePoint’s construction scope with the carrier’s estimate
• Identifying omitted or under-scoped construction items
• Documenting code-related construction requirements
• Preparing qualifying construction supplements
• Providing factual construction information to the carrier or adjuster
• Coordinating construction inspections
• Providing invoices and progress documentation
• Coordinating reconstruction work
• Providing documents reasonably requested for mortgage-fund releases

ForgePoint’s role is limited to construction scope, pricing, documentation and performance of the work ForgePoint is retained to complete.

2. ForgePoint Is Not a Public Adjuster or Attorney

ForgePoint is not a public insurance adjuster, insurance company, attorney or coverage consultant.

Unless ForgePoint is separately licensed and expressly retained to do so, ForgePoint does not:

• Represent the policyholder in negotiating or settling an insurance claim
• Interpret insurance-policy coverage
• Advise whether a loss is covered
• Determine the value of a claim as an insurance settlement
• Negotiate coverage disputes
• Advise the customer to accept or reject a settlement
• Provide legal advice
• File a lawsuit or regulatory complaint for the customer
• Act as the customer’s fiduciary concerning insurance proceeds
• Guarantee an insurance outcome

Coverage questions, claim-settlement issues and legal disputes should be directed to the insurance carrier, a licensed public adjuster or a qualified attorney.

3. Communication With the Insurance Carrier

At the customer’s request or as authorized in the applicable agreement, ForgePoint may communicate directly with:

• Insurance adjusters
• Claim examiners
• Carrier consultants
• Engineers
• Inspectors
• Mortgage companies
• Loss-draft departments
• Other authorized project participants
• ForgePoint’s communications will be limited to factual construction matters, including:
• Scope
• Measurements
• Pricing
• Materials
• Labor
• Building requirements
• Construction methods
• Site conditions
• Progress
• Invoices
• Supporting documentation

Authorization to communicate does not appoint ForgePoint as the customer’s public adjuster, attorney or representative for coverage negotiations.

The customer retains the right and responsibility to communicate directly with the insurance carrier.

4. Carrier Estimates and ForgePoint Pricing

The insurance carrier’s estimate and ForgePoint’s construction proposal serve different purposes.

The carrier’s estimate reflects the carrier’s evaluation of the loss based on:

• Information available to the carrier
• The carrier’s estimating methodology
• Coverage determinations
• Pricing data
• Policy terms
• Claim-handling decisions
• ForgePoint independently prices its work based on:
• Actual construction scope
• Site and property conditions
• Labor requirements
• Material selections
• Current supplier pricing
• Project complexity
• Access
• Building-code requirements
• Permits and inspections
• Equipment
• Supervision
• Scheduling
• Insurance and warranty obligations
• Other project-specific requirements

The carrier’s estimate does not determine or limit ForgePoint’s construction price.

A difference between the carrier’s estimate and ForgePoint’s proposal does not, by itself, establish that either document is inaccurate. The documents may be based on different scopes, assumptions, quantities, pricing or coverage considerations.

5. Insurance Supplements

A construction supplement is a request for the carrier to review additional or revised construction items that may have been:

• Omitted from the carrier’s original estimate
• Undermeasured
• Underpriced
• Incorrectly described
• Required by applicable construction standards
• Discovered after demolition
• Identified after additional inspection
• Necessary to complete the approved repair properly
• A supplement may include:
• Revised measurements
• Additional quantities
• Photographs
• Construction explanations
• Product information
• Code documentation
• Invoices
• Estimates
• Inspection records
• Other reasonably relevant construction support

Preparation or submission of a supplement does not guarantee approval or payment.

The insurance carrier independently determines whether it will review, approve, deny or partially approve the requested items.

6. No Guarantee of Insurance Approval or Payment

ForgePoint does not guarantee:

• Coverage
• Supplement approval
• Carrier pricing
• Code-upgrade coverage
• Depreciation recovery
• Mortgage-fund release
• Additional living expense benefits
• Approval of customer upgrades
• Payment amount
• Payment timing
• Claim outcome

Carrier or mortgage-company delays do not create responsibility or liability for ForgePoint.

ForgePoint will make reasonable efforts to provide qualifying construction documentation, but the customer remains responsible for addressing policy, coverage and payment issues directly with the appropriate insurance or mortgage representative.

7. Customer Payment Responsibility

Insurance proceeds are a potential source of project funding; they are not ForgePoint’s sole source of payment unless the signed agreement expressly states otherwise.

The customer remains responsible for payment according to the ForgePoint agreement, including:

• Insurance deductible
• Depreciation not yet recovered
• Excluded work
• Noncovered work
• Customer-requested upgrades
• Betterment
• Change orders
• Concealed conditions
• Amounts denied by the carrier
• Amounts priced below ForgePoint’s contract price
• Amounts delayed or withheld by the carrier
• Amounts delayed or withheld by a mortgage company
• Other amounts due under the agreement

The customer’s payment obligation is governed by the ForgePoint agreement—not by whether or when the carrier or mortgage company pays.

8. Insurance Deductible

The customer is responsible for the full insurance deductible required by the policy.

ForgePoint will not:

• Waive the deductible
• Absorb the deductible
• Reimburse the deductible
• Conceal the deductible
• Inflate an invoice to offset the deductible
• Misrepresent the deductible as paid
• Provide inaccurate documents to the carrier or mortgage company

Discounts, credits and promotional offers will not be applied in a manner that improperly avoids or misrepresents the customer’s deductible obligation.

9. Depreciation and Holdback

Insurance payments may include:

• Actual cash value payments
• Recoverable depreciation
• Nonrecoverable depreciation
• Code-upgrade payments
• Supplemental payments
• Other holdbacks

ForgePoint does not control when or whether the carrier releases depreciation or other withheld amounts.

The customer is responsible for:

• Understanding carrier requirements
• Providing requested documents
• Submitting invoices when required
• Confirming completion requirements
• Following up with the carrier
• Promptly transmitting released project funds according to the ForgePoint agreement

ForgePoint may provide reasonable invoices, completion records or photographs related to ForgePoint’s work.

10. Mortgage Companies and Loss-Draft Funds

When a mortgage company is named on an insurance payment, it may:

• Endorse or hold the funds
• Require inspections
• Require progress documentation
• Release funds in draws
• Require customer authorization
• Apply internal processing requirements

ForgePoint does not control the mortgage company’s procedures, inspections, processing times or payment decisions.

The customer is responsible for:

• Promptly notifying the mortgage company
• Completing required documents
• Authorizing inspections
• Following the loss-draft process
• Providing ForgePoint with accurate funding updates
• Taking reasonable steps to obtain timely release of funds
• Paying ForgePoint according to the construction agreement

Mortgage-company delay does not automatically extend a ForgePoint payment deadline or require ForgePoint to continue unfunded work.

11. Customer Communication Responsibilities

The customer must promptly provide ForgePoint with relevant communications concerning:

• Carrier approvals
• Carrier denials
• Revised estimates
• Supplement decisions
• Issued payments
• Recoverable depreciation
• Mortgage-company requirements
• Inspection requests
• Funding releases
• Changes in adjuster or claim personnel
• Other information affecting construction or payment

The customer should provide complete copies of relevant documents—not cropped, altered or incomplete portions.

Failure to communicate material claim or funding information may delay the project, create unnecessary administrative work or affect ForgePoint’s ability to provide documentation.

12. Authorization Before Supplement Approval

Whether work may begin before supplement approval depends on:

• Safety
• Property-protection needs
• Available funding
• Scope
• Contract requirements
• Customer authorization
• ForgePoint’s willingness to proceed

If the customer authorizes work before the carrier approves or pays the supplement, the customer accepts responsibility for the work under the ForgePoint agreement regardless of the carrier’s final decision.

ForgePoint is not required to finance disputed or unapproved work.

13. Concealed Conditions

Demolition or construction may reveal concealed conditions that could not reasonably be identified during the initial evaluation.

Examples may include:

• Hidden water damage
• Deteriorated framing
• Damaged plumbing
• Unsafe wiring
• Mold or moisture
• Pest damage
• Hazardous materials
• Unpermitted prior work
• Noncompliant construction
• Additional affected materials

ForgePoint may document concealed conditions and prepare a change order, supplement or other written recommendation.

Insurance approval is not guaranteed.

The customer remains responsible for authorized work required by the ForgePoint agreement, including amounts not paid by the carrier.

14. Code and Permit Requirements

Applicable construction work may require:

• Building permits
• Plan review
• Engineering
• Code upgrades
• Energy documentation
• Government inspections
• Correction of noncompliant conditions

The carrier independently determines whether the policy provides coverage for code-related costs.

ForgePoint must perform contracted work according to applicable legal and construction requirements regardless of whether the carrier’s estimate included sufficient funding.

When additional code-required work is identified, ForgePoint may prepare supporting documentation, a supplement or a change order.

15. Customer Upgrades and Betterment

The customer may request materials or work that exceed the carrier-funded repair.

Examples may include:

• Upgraded finishes
• Expanded scope
• Improved layouts
• Premium materials
• Additional rooms
• Unrelated remodeling
• Design changes
• Energy or accessibility improvements

Customer upgrades and betterment are separate from the carrier’s coverage decision unless expressly approved by the carrier.

The customer is responsible for the additional cost through the applicable agreement or change order.

16. Emergency and Temporary Services

Temporary services may include:

• Emergency board-up
• Roof tarping
• Water extraction
• Drying equipment
• Debris removal
• Temporary protection
• Other reasonable loss-control measures

Temporary or emergency work requires authorization and may be separately priced.

The customer should preserve receipts and documentation and notify the carrier promptly.

Carrier reimbursement is not guaranteed, and temporary-service costs may be included within or reduce other available claim benefits.

For immediate threats involving fire, gas, major flooding, electrical hazards, structural instability or personal injury, contact 911, the fire department or the appropriate utility provider before contacting ForgePoint.

17. Additional Living Expenses and Personal Property

Unless expressly included in a separate written agreement, ForgePoint does not administer:

• Additional living expense claims
• Temporary housing
• Food or transportation reimbursement
• Personal-property inventories
• Contents valuation
• Business-interruption claims
• Loss-of-use negotiations

These matters should be handled directly with the insurance carrier, a licensed public adjuster or an attorney when appropriate.

ForgePoint may provide reasonable construction schedule information relevant to the expected repair period, but ForgePoint does not determine the duration or amount of insurance benefits.

18. Documentation and Use of ForgePoint Materials

ForgePoint’s estimates, photographs, reports, exhibits and supplement materials are prepared for:

• ForgePoint’s contemplated or contracted project
• Construction planning
• Project documentation
• Communication concerning ForgePoint’s work
• Payment processing related to ForgePoint’s work

These materials remain ForgePoint’s property unless the applicable agreement provides otherwise.

The customer may provide authorized ForgePoint documents to the carrier, adjuster or mortgage company for the applicable project.

The customer may not:

• Alter ForgePoint documents
• Remove qualifying language
• Misrepresent ForgePoint’s price or scope
• Use ForgePoint’s estimate to obtain another contractor’s work
• Present ForgePoint documents as the work of another party
• Use the documents for another property or claim

Expanded use requires ForgePoint’s written authorization.

19. Claim-Support Fees

Any fee for estimating, documentation, project administration, supplement preparation, testing, inspections or other claim-support work will be stated in the applicable written agreement.

ForgePoint does not charge a percentage of the insurance settlement for public-adjusting services.

Unless the agreement states otherwise:

Claim-support work is limited to ForgePoint’s contemplated or contracted construction scope.

Additional or repeated documentation outside the agreed scope may require additional authorization.

Fees are earned for the work performed and are not contingent on carrier approval.

Payment of a claim-support fee does not guarantee that ForgePoint will perform the construction unless the parties execute the applicable construction agreement.

20. Customer Cooperation

The customer must reasonably cooperate by:

• Providing accurate claim and property information
• Providing relevant estimates and correspondence
• Allowing reasonable site access
• Participating in required inspections
• Making timely selections and decisions
• Signing necessary authorizations
• Communicating approvals and denials
• Promptly transmitting project funds
• Avoiding unauthorized changes to ForgePoint documents
• Preserving damaged materials when reasonably requested

ForgePoint is not responsible for delays or adverse claim decisions caused by incomplete, inaccurate, withheld or untimely customer information.

21. No Duty to Continue Unfunded Work

ForgePoint is not required to:

• Advance construction costs
• Finance the customer’s deductible
• Continue work when required payments are overdue
• Continue work while a material scope or safety issue remains unresolved
• Wait indefinitely for carrier or mortgage-company funding
• Perform work outside the signed agreement
• Accept the carrier’s estimate as ForgePoint’s contract price

ForgePoint may delay or suspend work according to the applicable agreement when required payments or authorizations are not received.

22. Independent Insurance and Legal Assistance

A customer may communicate directly with the insurance company at any time.

The customer may also retain:

• A licensed public insurance adjuster
• A qualified attorney
• An independent engineer
• Another authorized claim professional

ForgePoint will reasonably coordinate factual construction information with authorized representatives when appropriate.

The customer is responsible for fees charged by independently retained professionals unless the ForgePoint agreement expressly provides otherwise.

23. Privacy and Authorization

ForgePoint may collect and disclose project information reasonably necessary to provide the authorized construction and claim-support services.

This may include information shared with:

• Insurance carriers
• Adjusters
• Mortgage companies
• Engineers
• Inspectors
• Subcontractors
• Suppliers
• Professional consultants
• Project-management providers

ForgePoint will handle personal information according to its Privacy Policy.

The customer represents that information provided to ForgePoint may lawfully be used for the applicable project.

24. No Expansion of Services

These terms do not:

• Appoint ForgePoint as a public adjuster
• Authorize ForgePoint to negotiate coverage
• Create an attorney-client relationship
• Guarantee insurance benefits
• Require ForgePoint to perform work without a signed agreement
• Require ForgePoint to accept carrier pricing
• Limit the carrier’s authority under the policy
• Modify the customer’s insurance policy
• Modify the signed construction agreement
• 25. Relationship to Other Agreements
• These terms supplement:
• ForgePoint’s construction agreement
• Insurance or mortgage-funds addenda
• Change orders
• Estimates
• Design or preconstruction agreements
• Privacy Policy
• Financing Information and Disclosures
• Promotional Offer Terms
• If there is a conflict:

The insurance policy controls the relationship between the customer and carrier.

The signed ForgePoint agreement controls the construction scope, price, payments and project obligations.

These terms control the general description and limitations of ForgePoint’s claim-support role.

26. Governing Law

These Insurance Reconstruction and Claim-Support Terms are governed by the laws of the State of California.

Nothing in these terms limits a right or remedy that cannot legally be waived.

27. Contact ForgePoint

Questions about ForgePoint’s insurance-reconstruction and construction-documentation services may be directed to:

• ForgePoint Building and Remodeling
• 3600 Lime Street, Building 2
• Riverside, California 92501
• CSLB #1137039
• Licensed • Bonded • Insured
• Email: [email protected]
• Telephone: 1-800-928-0972

Questions concerning insurance coverage, claim settlement or policy interpretation should be directed to the insurance carrier, a licensed public adjuster or a qualified attorney.