Yes, depending on the circumstances and what kind of damage and what kind of policy. Wear and tear is not covered. Under most auto policies with collision coverage, if you are in an accident and the motor gets smashed, or an engine part like an alternator is smashed, its covered. As far as comprehensive coverage for a motor, vandalism is covered and theft is covered.
If you are talking about “warranty coverage” insurance, thats another story.
Can you tell me exactly what the damage is to the engine and the cause as well as what kind of policy (auto, warranty, rental) you are talking about? If you give me the insurance company name, I may have one of their policies I can look at.
While most auto policies are very similar, there can be slight differences, like who pays for your appraiser if your claim “goes to appraisal”, and whether or not you have to accept aftermarket parts if your car is repaired. If you want to compare auto policies from different companies, you can download them for free at http://www.uclaim.com.
In my opinion, if you are shopping for auto insurance and short on time, don’t compare the wording in the policies. Compare how generous they are when it comes time to pay a claim.
An insurance adjuster sent us a claim payment check payable to us and the auto body shop that did the estimate (a dual party check). We asked the aduster to reissue the check with just our name on it as we are unable to get the repairs done any time soon and wish to bank the check. The adjuster reply is they will issue the check to the lean holder of the vehicle. How come they wont just write us a check? If they do write the check to the lean holder will this money go twards principle owed?
Talking to the adjuster is like talking to an angry rock.
Hello Nick,
Yes, an “angry rock” is an excellent description on many adjusters. If there is a loan on the car, the insurer has to protect the lien holder as well as you, or the lien holder could sue the insurer. Actually they should name you and the lien holder, if not you and the body shop. And no, if they do send the check to the lien holder anyway, the lien holder cannot apply it to your payments, unless there is a clause in your loan contract that allows it. This would be highly unusual. They must set the money aside.
Now if you do your own repairs, or find a shop to do the repairs for less than what the insurer paid, then you should be entitled to the left over money.
Of course if you pay off the car, then the money has to go to you.
And Nick, you should give this “angry rock” adjuster a rating on our “Rate Your Adjuster” page. You can also give a rating to your insurance company there.
The damage to the house from the falling tree should be covered. And the cost to get the tree off the house to access repairs should be covered. A “generous insurer” or adjuster will cover the cost to haul away the tree debris after the tree is cut up and removed from the roof. A “tight wad insurer” will leave the debris on the ground. If your lucky and your contractor makes a lump sum estimate for “tree removal” without separating the cost for cutting up the tree and hauling away the debris, the adjuster may pay it all without question. If the adjuster asks your contractor to break the costs apart, or “itemize it”, you will know what he is setting you up for – a partial denial of payment.
Most insurers HO-3 policies don’t cover wind damage to the tree itself and I’m sure Allstate is the same. An HO-3 policy “covers everything” unless there is a named exclusion, so look at the exclusions in the policy booklet and the endorsements. Read about trees and landcaping coverage under “additional coverages” in the HO-3 policy booklet itself.
My sister and I have spent many hours working on an insurance claim for our Mother who was injured in a house fire. Is there any reimbursement for time spent preparing and researching items for a fire loss? The insurance company paid for the inventory to be done, but would they pay anything to a 3rd party for the services mentioned above?
Yes they should pay you as a 3rd party, unless you were “an insured” yourself (that is, a relative who was living in the house with your mother, the named insured, at the time of the fire), they should pay for your time “preparing and researching items for the fire loss” just as they would have paid the inventory company to do this. If they are denying to pay your time, then turn in a bill for your friend’s time who helped you do the research.
Insurers routinely refuse to reimburse “an insured” for the time it takes to inventory a loss, which includes time to get pricing, do research, make phone calls, etc. They cite the policy language in “Your Duties After Loss” that says “you (the insured) will inventory and present the loss”. And sneaky adjusters often don’t make the denial until after the insured or “relative resident” has turned in the inventory.
To get around this, I usually tell policy holders to get a friend or relative not living with them to perform the “duties after loss” like inventory, board-up, security fence, etc.
If they do pay for these “your duty” items, the check should be in the insured’s name, unless the insured signed an assignment of payment form.
You should help your fellow consumers and give a rating on the adjuster and the insurer on the “Peoples Choice” page at http://www.uclaim.com when you are ready. You don’t have to post information that identifies you or your mom personally.
Yes, it should be a total, in my opinion. There are two arguments: mold concern and mechanical and electrical concern. The insurers “restoration company” cannot get inside the inner sheet metal panels of your car to clean them since they are spot welded together. And they will not guarantee in writing that electrical components will not fail prematurely. If the engine had water in it for over 24 hours, most mechanics will tell you that the crankshaft main bearings will fail prematurely.
You should take five minutes and give the adjuster, insurer and their body shop or cleaning company ratings on our “Rate Your Adjuster” page.
What about travel insurance? My foster son has been having horrible sensory problems and is in a study at the University and would not be able to tolorate flying in a plane. We have cancelled our trip ( other family memeber going has to have hip replacement) and we got all these forms and confused by it all. With Dr. sign off will we get some of our money back or will they fight this all the way?
Are you saying you had to cancel a flight because of a medical emergency and you are making a claim to the airline to refund the ticket cost? If so, all I know about this is that I have heard that some airlines will give a discount or a free flight to go to a funeral if you provide a copy of a death certificate.
Normally “travel insurance” is something you pay extra for when you buy a travel ticket, and it does refund the ticket money if you have a medical problem. Did you buy travel insurance?
I’d also think that if they sent you claim forms to fill out that maybe you do have the insurance. That’s good. Let your doctor fill in the form and see what happens.
September 30th, 2008 at 1:20 pm #Charles P Harrington
After the storm the adjuster came out to my house an assest the property. the insurance company sent me the check which now has to be signed by the bank which holds my mortgage account. What happes to the rest of the money after repairs are made and finalized.
Please write back this question is killing me. Niether the bank of the insurance company will give me a straight answer.
Unless the mortgage company can show you a specific clause in your loan agreement that lets them keep left over insurance money, the mortgage company (mortgagee) has to give any left over money to you. They cannot apply it to the balance on your loan. The mortgagee has a right to send their inspector out to verify the repairs were done. And it does not matter if you or a contractor did the repairs, you are entitled to the same money as a contractor.
You should take five minutes to help your fellow man and give the adjuster and insurance company a rating on our “Rate Your Adjuster” page.
IF MY CAR WAS PARKED IN A PARKING LOT AND LOCKED AND IT GOT STOLIN AND THERE WAS A KEY LOCKED IN IT ,HIDDEN OF COURSE WOULD THE INSURANCE CO TRY TO DENY MY CLAIM.
I have not heard of that being a reason for denial, but there is always a first, and some adjusters will try anything to deny a claim.
It depends on who the insurer is and their auto policy. I may have one of their policies that I can read for you if you let me know who the insurer is. If I don’t have their policy, you can fax or email me a copy if you like.
I can tell you that the ISO (Insurance Services Office) generic personal auto policy sold by many independent insurance agents has no such exclusion. But most insurers take the ISO policy and edit it to suit their own needs.
If they are a “fair” company and there is no policy exclusion for this circumstance, then they should pay the claim without question. First read your policy exclusions.
Please help yourself and other consumers. Take 60 seconds to give a quick rating on your insurer and/or adjuster on our “Rate Your Adjuster” page.
I was wondering if you can clarify what the endorsements are on the State farm mobile home policies for Texas. I have the endorsement codes but don’t know what they cover.
Sorry for the delay. I don’t have any Texas State Farm Mobile home endorsements on hand so I could not answer even if you gave the numbers. You could post those endorsement numbers and their titles (if available) in a a reply on this thread and maybe someone will have them.
Your agent and or adjuster must not only tell you what those endorsement numbers are for, they must give you a copy if you request them. If they are being difficult, fax a letter to your adjuster. If no response, fax a letter to Edward Rust ceo for State Farm. Now you have documented your file in case they don’t comply.
Don’t forget to make a rating on your adjuster and insurer on this website at some point and help build our new database for others to reference.
Does anyone know about State Farm’s Texas mobile homeowners policies? They are written through their general Ins co. I am looking for the meaning of the following endorsement codes; FGP-4926, FGE-4886, FP-4978, FE-4669, FE4564 and FE-4706. Anyone with any information would be helpful! Thank you!
we had a hotwater heater burst on vacation damaged our wood flooring,was denied, and we are pursuing the claim further but we just received interregotorie questions that need answering is this legal to ask for 15yrs of questions also list all receipt’s and contractors name address
that did work on the house when we have only had the policy with them for 2yrs.
If you don’t want to ask your agent for those endorsements (for whatever reason), try calling a SF agent/s in another town/s in Texas. You don’t have to give your policy number or full name, just tell them you are not happy with your current agent and are looking for another agent. Who knows, maybe they will even fax or mail you a copy of the actual endorsements. You may have to call several agents before you find one hungry enough to help you.
If your agent refused to give you copies of the endorsements and you don’t care whether he likes you are not, call the SF home office in Bloomington, Illinois and ask them. I’m sure they will want your policy number to confirm you are their policy holder first. You can even ask for a complete certified copy of the policy be mailed to you.
If you have an open claim, ask the adjuster for copies of those endorsements. If he refuses or refers you back to the agent, ask for the claim manager. If he refuses, then go straight to the SF CEO in Bloomington.
Also, try asking the other mobile homeowners who they are insured with. If its in a mobile home park, I’m sure there will be others in the neighborhood insured with SF. Ask to see their policies.
Wow, thats a lot of stuff. When you use the word “interrogatories” that implies your claim is in litigation. Has a lawsuit been filed? Whether or not a lawsuit was filed, the 2 key legal words to focus on are “Reasonable” and “Relevant.” Most insurance policies themselves in “Your Duties After Loss” say you (the policy holder) will provide the necessary information “that we (the insurer) ‘reasonably’ require.” The law is the same in most states. If it’s in litigation, you or your attorney have to file an objection to each question or request for information on the grounds that it is unreasonable, irrelevant, over broad, vexatious, annoying and whatever fancy legal words attorneys like to use. If its not in litigation, just state your objection and reasons in a reply letter. Give them only what you think is reasonable and relevant. If the adjuster, claim manager, attorney persist in an unreasonable, invalid or illegal denial, fax a letter to the CEO of the insurer. Now the insurer will be facing punitive damages if your claim was unreasonably denied.
As to the water damage from the hot water heater, I assume the insurer is saying the damage occurred over a long period of time resulting in rotted wood. If the floor is not rotted, but just delaminated or swollen, that does not constitute “a long period of time”. Adjusters also often call black or stained wood “rot”. If you can’t push a butter knife through the wood, its not rotted. A reasonable insurer should cover the claim.
Don’t forget to make a rating on your adjuster and insurer in the Consumer Ratings section of this website when the time is right.
My car was damanaged beyond repair and insursance company of the person that hit me denied the caim saying he didn’t have insurance at the time of the accident. I’d like to know how much to ask for. The blue book value of the car is approximately $3500 but just prior to the accident (less than a month) I had just under $2000 worth of repair. I’ve been told I can add that to the total I want by some and others say no. So I’d like to know from if I can or not.
thanks
Its a tough situation you are in, but go for it if you have the time. Yes repairs do add some value, but to most buyers (and courts), not much value.
You can’t take the book blue and add the cost of repairs or maintenance. Look at a Kelly or Nada book at your local law library or car dealer and read the introduction pages. No insurer would ever pay it either. But hey, you may be dealing with just the other driver or a judge in small claims court. Dealers will tell you that a vehicle with a newly rebuilt motor that cost $3,000.00 will only raise “the market value” a couple hundred dollars. Call a dealer and ask him how much he would add to a selling price for your new repairs.
The book value should be adjustable based on condition and miles. Getting the book value up is the approach to take. Also getting local dealer quotes, in writing, may get the book value up or down. Also there are different books eg. Kelley, Nada, which can sometimes vary by 25%!
If you are going to small claims court, go ahead and claim the book value and your $2,000 worth of repair receipts. Who knows, the judge may allow a good chunk of that. What have you got to lose? And take some written dealer quotes to show the judge. And pictures too, if you have any showing your car looks above average.
As an Independent adjuster and having to work for many carriers I chose Texas Farm Bureau for my home, truck, 4-wheeler, horse trailer, health, life and my E&O / Liability coverage.
If you have a home inventory done with digital photos, video along a list of electronics, appliances and computers with their make, model and serial numbers, would this suffice to a claims adjuster as “Your duties after loss” in the event of total loss due to fire?
What about in the event of total damage due to flood?
If you do not have a complete record of your belongings and you suffer total loss, does the insurance company pay the full limit of personal property under coverage B?
In an over simple answer to the “Your Duties After Loss” question, No, not unless your adjuster really likes you. Most policies say that you, the insured, will supply the ACV, the actual cash value of the loss, building and contents. Actual Cash Value on contents is the replacement cost less depreciation (in most states). Most insurers will give you an inventory sheet to fill out and you enter the replacement prices and age of items claimed (A “low quality” insurer will tell you to enter original costs and depreciate from that figure). While you have the right to enter the deprecation yourself, most insurance adjusters will steer you to let them do it. There are many ways that a low quality insurer’s adjuster can outsmart you in a contents claim. For the best help in a contents claim, consider the UClaim.com product “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS” $29.95 at http://www.uclaim.com/products.asp .
If you don’t want to be troubled with doing your own inventory, give the job to a friend or relative and bill the insurer for their time. Note, most insurers will not reimburse you, the insured, for “your” time to do an inventory, but they will reimburse for your cost to hire someone else to do it. A few old fashioned insurers will even do the inventory for you (for obvious reasons).
The photos, videos and list are good to help “document” and “prove ownership”. If you don’t want to be troubled with an inventory sheet, try just adding today’s replacement cost prices to the items on your list. If your fire loss was due to arson and the insurer suspects you, they may still do an EUO (Examination Under Oath).
These same general guidelines apply to flood damage, as long as the flood is covered. However, while most homeowners policies cover water damage, they don’t cover flood. That requires a flood endorsement or federal flood insurance.
In answer to the last part of your question: Assuming you have the most common homeowners all risk policy, the “special form”, while the legal burden to “disprove” your claim is on the insurer for the structure portion of your claim, when it comes to contents, the burden to prove ownership is on the insured, you. So if you can’t prove you had something, legally they don’t have to pay it. This is where it pays to have a “quality” insurer.
You should know, Progressive sucks too. I’ve been involved with heavy equipment for years and a friend of mine’s son was hired on by them and got horrible treatment by his employer.
Thanks for the nice comments. Your comments “delay, deny, defend” bring to mind a comment by a former California insurance commissioner (one of the few California commissioners who really cared about the consumer). He said most insurers usual practice is “to pay as little, as late as possible.”
You are very welcome to add your comments to any posts on this website and you should add a signature to your posts something like “Jane, contributor and former insurance claim investigator” (or however you want to word it.
My house burned in the recent California wildfires. The insurance company would like me to sign a “White waiver” before they will discuss settlements of any kind. Is this a smart move? It would appear on its face that this removes any recourse if they negotiate in bad faith (which after looking around the web, I expect them to do). Is this a tricky way to dissuade me from entering into a negotiation with them or is this pretty standard stuff?
A White Waiver is serious, not “standard stuff”. Don’t sign it! It does not stop you from negotiating with them.
A White Waiver basically says that if the insurer makes an offer to cover your claim, or to settle your claim for x dollars, you cannot come back later and tell anyone, including a court, that the insurer previously offered you x dollars. A White Waiver is usually accompanied by a confidentially agreement.
Insurers don’t normally ask you to sign a White Waiver unless they want to deny your claim or seriously cut it down based on a suspicion of fraud or arson. Insurers usually hire a lawyer to do it, and only after they have conducted an EUO (Examination Under Oath) with a court reporter present, or during litigation (after a lawsuit is filed). It usually comes just before they make their decision to deny the claim or “compromise” (seriously cut) the claim.
Nothing in your policy says you have to sign such a document. I have been in insurance claims 28 years and it never ceases to amaze me the new stuff some of these insurers try to pull. Insurers usually try new abusive techniques like this in rural areas (like the San Joaquin Valley) before they try it in Metropolitan areas. Sounds like something Farmers Insurance would do.
The only document you have to submit is a “Proof of Loss”. Which is outlined in your policy. (A “Proof of Loss” can also come with hidden “traps”.)
If you have an insurer asking you to sign a White Waiver, you are probably in serious need of professional help. I would suggest that you consider hiring a “good” public adjuster for a percentage fee. You can read about how to find a good one at this link http://www.uclaim.com/free.asp. Click on the link entitled “About Public Adjusters”. You could also hire a lawyer to help you on an hourly basis for selected issues in your claim, like this White Waiver thing, or even to negotiate for you. If the claim gets denied, then I would suggest you seek a lawyer to work on a percentage (contingency).
Thanks for the heads up. I’ll contact a lawyer. For the record, the insurance company is Fidelity National Insurance Company. I doubt very much they suspect foul play since my house when up with most of the houses in my neighborhood. I’ve been resisting itemizing the thousands of things in my home because it seemed unreasonable for me to remember every hair clip and every roll of toilet paper, just to get reimbursed. Before they will discuss a settlement that would preclude me from needing to create this list and providing receipts for everything, they want me to hold them blameless for negotiating in bad faith (if they chose to do so).
I’ve heard that the better insurance companies will just settle for reasonable amounts and make it easy for me to replace my stuff as needed, instead of rushing to meet arbitrary deadlines before my house is even ready to move back into.
You cannot get out of turning in an itemized list to the insurer. In fact, the California Legislature recently turned town a bill that would have forced insurers to just pay policy limits on contents (without an inventory list), if a house was total loss in a catastrophe situation, like wildfire. Some “savy insurers” might waive the inventory requirement, but this would be simply to draw a community into its confidence and deflect the initial onslaught of public adjuster solicitations.
If the contents inventory was your only concern, for $29.95 you could get high quality information on the most efficient and legitimate way to do it in the UClaim.com product report entitled “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP” at http://www.uclaim.com/products.asp . Most insurers will tell you that you won’t get paid for your time to do an inventory because it is one of “your duties”. This UClaim report will even tell you how to legitimately get get around that obstacle.
I have a question about a claim. Can my homeowner’s insurance company deny my claim for a break-in if we did not put our alarm on when we left out, we were only gone for a couple of hoursMy company is ny central mutual.
I have never seen such an exclusion in a homeowners policy. But there is always a first time. I have never seen a NY Central Mutual policy. Look in your policy under exclusions, conditions and provisions, etc. Also look at the endorsements to see if there is an exclusion.
If you don’t want to put the question to your local adjuster, you could place a telephone call to a NY Central Mutual claim office in another city in New York. Ask to speak to a property adjuster. You don’t have to give your real name or policy number if you fear being charged with a loss.
If you would like me to review your policy for free, either mail, fax or email me a copy of the booklet and endorsements. I could use a copy of that policy anyway for the “Free Policy Copy” section of this website. (Your declaration sheet would not be posted). Just let me know and I will send you an email with my contact info.
Our house recently burned about a month ago. We were assigned the claim manager, contents adjuster, and dwelling adjuster. We have replacement on dwelling and contents. Anyhow the contents adjuster has been great, and very informative. He has kept us in the loop about everything on his end. However the dwelling adjuster hasn’t kept in good communication with us and hardly ever returns our phonecalls. Also when we ask him a question he acts like everything is top secret. I feel like we are gettin the run around. Also we never received a proof of loss statement. But yet they are already sending us an estimate not of total loss value. Everyone that has seen our home says its a total loss even the fire investigator. I’m so confused, what constitutes a total loss with a fire? Our home was completely gutted and burned through the floors, ceiling, attic and outer walls. All our contents were total loss and the cleanup alone will cost a 3rd of what they are wanting to do it all for. It took this long to get an estimate when we were told 2-3 weeks and the only way I found out what it is going to be is because we had to speak to a manager. What is going on, and what do we do?
Hi, can an independant adjuster tell you that a claim is accepted, and then the office adjuster say the claim is under investigation? Even though a month prior the insurance company said the investigation was closed? Or would I have any grounds under esstoppel?
(sorry for spelling)
You have a major loss. Before I start answering these questions, let me say that you are going to be having a lot more detailed questions and problems. The answers below are very general. And Cas, just because the contents adjuster has been nice, don’t let your guard down. The “smartest” adjuster is one who gives you 4 items (knowing that your policy covers 10 items), when you only claimed 2 items. Your dwelling adjuster ignoring your communications is one reason why our economy is in trouble today, lax law enforcement by government. But don’t get me going with that
After reading my answers below, take a look at the product description and the table of contents for the UClaim report entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe) at http://www.uclaim.com/products.asp . Its a bargain at $79.95. It will give far more detailed discussions than my answers below. Or you could hire a public adjuster on a contingency fee basis, for example 10% on a $100,00.00 loss ($10,000.00 fee). A good public adjuster will more than cover his fee by an increased claim recovery settlement. See advice on how to hire a public adjuster on the Free Stuff page at UClaim.com. I would NOT recommend an attorney to handle your claim at this point, especially considering most attorneys would charge around 33% (without litigation) and be much less knowledgeable than a good public adjuster.
Although you say your contents claim is going well, if you are not getting your policy limits, this UClaim report will be of immense value as well. Although you have RCV on contents, you don’t get the RCV unless you actually replace the stuff. So they will depreciate your personal property, and as you replace your stuff and submit proof, you will get another payment for the depreciated amount. Depreciation can be very arbitrary. One adjuster may take 30% while another adjuster will take 70% on the same inventory. If you have $100,000.00 coverage on contents, the RCV on your inventory should be well over that, if you want your policy limits without all the hassles.
1. Most states require a written response to communications within 15 days. One way to document your communications is via fax. Act as though you are building your claim file to present in court.
2. In my opinion, don’t worry about a formal “Proof of Loss” if they have not sent you their own POL form or requested that you submit one. Read about POL under “Duties After Loss” in your policy. I have handled numerous major claims where insurers never requested one. The POL only purpose, in my opinion, is to set you up for a denial based on fraud or a huge reduction in your claim. They can also be misused and misrepresented by insurers as being a release. If you really want to shake up a “bad boy” adjuster, provide the “POL” information on a roll of toilet paper
3. “Total Loss” – generally speaking, when the cost to repair exceeds the value of the house, minus the salvage value, then it is not worth repairing, ie. a total loss. The insurer has the right to pay the lower cost, to repair or rebuild. So if they think they can rebuild your house, they have to have a building contractor who can back up their estimate. Some insurers contractors will always “low ball”, knowing that their buddy insurance adjuster will pay them a “supplement” after they get the job. There are ways to “scare off” the insurers contractor. For example, let them know what a picky son of a gun you will be to work for. Tell them you will sue them if one door does not close perfectly. And tell them that YOU will not sign any supplemental payment checks (so they better write an all inclusive estimate now).
So if the fire went through the floor, what is the adjuster going to save, the concrete footing or slab?
4. If they are delaying the investigation, pay attention to the time allowed by your policy to collect your additional living expenses. If the delays are theirs, then you need to have that documented, in case they try to cut you off. Keep in mind that even though an average home can be built in 3 months, most homeowners do not get back into a repaired or rebuilt home for a year or two after a fire. The delays are usually the insurers fault.
If you want to help clean up the insurance claim industry (because government won’t), consider making some ratings in the Consumer Ratings section of this website. You don’t have to post your real name if you don’t want to.
First of all, estoppel will not do you any good if you don’t have evidence, preferably in writing, or a tape recorded from an answering machine or voice mail.
Second, regardless of who said your claim was “closed”, an insurer should reopen a claim file to review it again up to the time for you to sue them has passed (“statute of limitations”). That can be up to 3 or 4 years on property claims. Even though most insurance policies say “you have 12 months to file suit”, what most don’t tell you is that the policy is overridden by the law.
If you think your claim was wrongly denied and they won’t reconsider or “reopen” their claim file, have an attorney or a good public adjuster take a look at your situation. You could also take a look at the UClaim product description entitled “DENIED HOME AND BUSINESS PROPERTY INSURANCE CLAIMS ADVICE AND HELP” and table of contents at http://www.uclaim.com/products.asp#Miscellaneous .
1. When you say “office adjuster”, are you talking about an employee in the independent adjusters office, or the insurer’s office?
2. If the independent adjuster put in writing that your claim was covered, but the insurer who hired him said it was not covered, then you may have a legal action against the independent adjuster and the insurer who hired him under estoppel and agency.
Insurance estoppel law says that once an insurer has made a payment, or even said they would cover a claim, they cannot later change their minds, even if they made a mistake and the claim was clearly not covered in the policy.
The law of agency, “Respondent Superior”, says the superior, or the employer, is responsible for the acts of its agents. An agent can be a direct employee or an independent contractor. If Allstate sends out Service Master to clean your house and Service Master screws up, then both Service Master and Allstate are responsible for the damage.
Consider making some ratings in the Consumer Ratings section of this website. You don’t have to post your real name if you don’t want to.
Thankyou, we have already had a lawyer contact us, but maybe it wont come to that. As far as a public adjuster, we have one in line. He is a friend of my agent and will do it as a favor. However, @ this point I just dont know what to settle for. The Insurance company is the one who insured my house for that much and I tried to get less at the time but that was the minimum they would insure me for. So now they are wanting to give us less! I had about 65,000 worth of stuff so I guess now I will only get half of that in contents. The lawyer is wanting me to send some info. But not sign anything yet. They are wanting to see if it is worth it. Is that adviseable? BTW, thanks for answering my questions in detail.
If they are cutting your $65,000 in contents in half, is it with depreciation or are they just denying payment on some items?
Is what advisable, sending some info.? If so, what info.?
What is “it” in your comment “They are wanting to see if it is worth it” referring to?
Don’t “settle” for anything less than what makes you happy, AND, what is not excluded and/or limited in your policy.
I’m glad you are getting some help from a public adjuster as a favor. If you get a qualified public adjuster to give you full representation (meetings, letters, evaluation, negotiations, etc) for free as a favor, then you are very lucky. Send him some cookies for Christmas
Some insurance companies are amazing. They want it both ways.
We have a house that’s been on the market for over a year. We stop in about once a week to check on it, since our new house is in the same area. A few days ago we found that the heat was off (Minnesota -10 degrees F), and in contacting the gas company learned that the last LP tank fill had been July. They filled it again, the furnace started up on its own, and when we went over to check on it later it was obvious there was pipe damage and water damage over 3 levels on one side of the house. It seems there was miscommunication with the gas company; they have on record that we requested that service stop after July. State Farm claims dept is saying it is denied because we didn’t take proper precautions. Do we have any chance? We are already paying 2 mortgages!
Update to our situation: The claims agent set up a conference call with the gas co., and asked them what evidence they had. They said they have a record in their computer that we called to update our billing address and then a note saying “July fill only”. The agent asked if they sent any notification in writing regarding the understanding about a change in the standing contract, and they said no. The claims agent took the conversation as sufficient evidence for them to deny the claim. He then said we might want to take the gas company to court. Does State Farm ever not find a reason to deny a homeowner’s claim?
Take a good look at your own policy wording under Section 1-Loses Not Insured (If you want to fax, mail or email us a copy of your policy for review, send an email to info@insuranceclaimhelp.org). Most home and rental policies say damage resulting from a broken pipe due to freezing is not covered if the house was “vacant, unoccupied or being constructed.”
If you have a “special form” policy, the burden of proof is on the insurer to disprove your claim.
My opinion is this:
1. Unless the gas company has something in writing signed by you, or a tape recording requesting no more gas, a note on the gas company computer could have been a clerical error.
2. There was no motive to shut off the heat. No reasonable person would shut off the heat.
3. The definition of “vacant” is open to interpretation and the entire clause is ambiguous, when compared to the exclusion for vandalism, further on down the list of excluded losses. Note it says that “a dwelling being constructed” is not considered “vacant”. That clause also gives 30 days as a definition of the time period of “vacancy.” You could argue that “under construction” implies new construction, not remodeling or maintenance, and if you did any remodeling or maintenance on the house, no matter how small, once every 30 days, then the house would not be vacant.
It would also look better if you had a good reason for not shutting off the water to the house. (I myself am so paranoid about broken water pipes, for any reason, that I will shut off the water valve to my house even if I am gone for the night. I leave the lawn sprinklers on with a separate valve.)
This is a tough claim to fight, even for professionals, and usually requires threat of litigation and multiple letters, sometimes up to the CEO for the insurer. You will be lucky if you get it covered.
And yes, suing the gas company is a possibility, if it can be shown that they were negligent. Also take a look at your contract with the gas company. And also talk to a lawyer who knows Minnesota law regarding negligence, etc.
Thank you for your helpful comments. What a great service this website provides.
Our policy states that loss resulting from freezing pipes is excluded from coverage if the house is vacant, etc, unless the homeowner takes reasonable care to:
a)maintain heat in the house, or
b)shut off the water to the house and drain the system.
We didn’t have the water shut off because we’ve had trouble with the line to the septic tank freezing, requiring a service call that costs about $100. The first time we had this trouble we still lived there, but were on a week’s vacation in January. The condensation from the furnace drains out to the septic, and if there is no water usage in the house the flow is too slow and it freezes. So to prevent this we stop over in the winter every 4-5 days and flush a toilet. Maybe in the future we’ll have to shut off the water and just take a few gallon jugs over to pour down the drain to the septic.
Regardless, given the “or” statement in the policy we were not required to shut off the water. It seems to me we did take reasonable care to maintain heat in the house–I don’t understand why the claims agent can deny our claim when all conditions were met. The fact that the gas company did not take reasonable care does not seem relevant.
I guess we need to get a lawyer to find out if we have a better chance suing the insurance company or the gas company.
If your policy says “reasonable care” then that’s what you hang your hat on. Most policies don’t say that. Fax a letter to the adjusters supervisor with your story. If he denies your claim, then the next letter should be faxed to the CEO of the insurer. Don’t waste time climbing the chain of command. If the home office denies your claim, then go to small claims court if its under the limit or close. If its over the small claims court dollar amount, then see if a lawyer thinks its worth his time to handle on contingency. Of course any lawyer will work for an hourly fee. If a lawyer can shake them up with a couple of threat letters, it may be worth it.
Talk to a plumber and see what they do in your area. Maybe pour antifreeze in the drain once, but don’t flush? Or blow the water out of the drains with a leaf blower (or compressed air). The septic lines won’t be damaged from freezing water if there is no water in them. And I did not know that a partly full drain line would freeze enough to break a drain pipe. I can see if a p-trap would freeze, or a water line full of water???
For some in depth easy to understand help, take a look at the Table of Contents for the UClaim report entitled “DENIED HOME AND BUSINESS PROPERTY INSURANCE CLAIMS ADVICE AND HELP DELUXE VERSION (W/APPENDIX) at: http://www.uclaim.com/products.asp. Scroll to the Miscellaneous report section.
It would be appreciated if you could take a few moments to give a quick rating on your insurer and/or adjuster and/or other insurer’s vendors on the Consumer Ratings page of this website. You don’t have to show your real or full name if you don’t want to.
regarding the question for a mobile home in CA which was burned by the policy holder and since found incompetent..can Foremost Ins deny the claim “intentional act” if the person did not realize what they were doing at the time?
Let me do a little research on this and make a post in a couple days.
Off hand, I would say that the insurer should retract the denial after the homeowner is declared legally or medically or “reasonably” incompetent. I would think this would fall into the same category as a child or “mentally retarded” person intentionally starting a “play fire” that got out of control.
Another important consideration would be “intent”. Did the insured intend to burn the place down, or was it an accident.
Also, once the police drop their investigation for arson, then the insurer should pay up. The insurer’s own private investigator should not be allowed to take a month longer than the fire departments investigator.
Have you read the exact Foremost policy wording? You can download a copy for free at http://www.uclaim.com/products.asp . Look under Policy Conditions “Concealment and Fraud”. Note that it does not list “Arson”. It lists “fraudulent conduct.”
So, lets say an insured intentionally burned his house out of anger against a spouse for whatever reason, revenge maybe. Now while the police may be able to charge and prosecute him and send him to jail, the insurer could not deny the claim, since the arson was not with the intent to collect insurance money or to cheat the insurer.
And then there is also the concept of the “innocent co-insured”. While this Foremost policy says “any of you”, some policies say fraud by “the named insured”. So any “unnamed insureds” like a wife or kids or relative residents can be covered.
And Beth, look at the legal definition of “Arson.” Someone who wants to burn their own house down, without some criminal intent, is not an arsonist.
January 9th, 2009 at 10:14 am #Jane Pytel Insurance Expert
Just taking a moment to review some of the problems encountered by visitors to your site. Claim denial and claim delay are two of the most serious and common problems encountered by consumers. I know because I was in insurance investigator for 12 years.
Since my departure from insurance, I have taken a very proactive approach to assisting people who suffer from insurance company tactics.
I write a series of articles, the most recent dealing with unfair settlement negotiation tactics. Check this out, it may be of help. http://ezinearticles.com/?id=1856390
Or you can contact me through my website, http://solutionsforyourinsuranceclaim.com/
I’ll be checking with this site, insuranceclaimhelp.org on a regular basis. Nice job.
I posed your question to a group of public adjusters and attorneys and no one had any case law off hand, but there has to be some on it. You can ask an attorney to research it for you. You can also go to http://www.findlaw.com to search for it.
The policy does have an exclusion for “any intentional act” under Exclusions in the policy.
If I get any good responses on this, I will advise.
My brother has insurance from State Farm ins. and has a policy that says loss of rents. ( Actual loss) He would like to know if that covers tenets that do not pay the rent and we have to evict them through the courts that takes around 4 months..can we make a claim
This is a little more elaboration to my post on January 9, 2009. Since the policy does state that intentional acts are not covered under the Exclusions section, arson would indeed be excluded, if it was “intentional”. If it was not intentional, since the policy holder was incompetent, then it may not meet the definition of arson. Also check to see whose opinion of incompetent is necessary, a doctor and or a court.
Let us know the outcome and keep us posted on your progress. This is interesting.
I would say no, I have never seen such a claim payment in my 28 years experience.
The State Farm Rental Dwelling policy available for free download at http://www.uclaim.com/products.asp says the loss of rents is only for the time to repair during a covered loss, for example fire, wind. Note, thanks to your post, I discovered that the loss of rents pages were missing from that sample policy. UClaim has been notified and should have the file fixed within an hour.
Now, if after the tenants are evicted, there is damage to the house from them intentionally, from anger at being evicted, then you have a covered loss called vandalism. All you have to do is make a police report. You or your representative will have to meet with the adjuster at the loss site and argue each item of damage line by line. If the damage is from them living like pigs, it’s not vandalism. Much of it is gray and will depend on how liberal your adjuster is. Is kids writing on the wall vandalism? Is allowing a dog to urinate on the carpets vandalism? A broken counter top ceramic tile is vandalism, in my view. Be willing to give in on some items just to make the adjuster feel better. For the items your adjuster does not cover, sue the tenant in small claims court and see how a judge rules on each item. Take pictures to show him. Whatever the judge deems to be vandalism, the insurer has to pay. Although you may get a small claims court judgment against the tenant, you will probably never collect the money from the tenant. But you will collect from the insurer. I suppose you could even try to name both the tenant and the insurer. But the insurer should pay up even if they are not named.
Our house on the Gulf Coast was severely damaged by Hurrican Ike. When roofers went to replace wind damaged shingles, they found damage that we didn’t know about that had been present for years. This damage involved the roof flashing and dormers and may have resulted from prior wind or improper installation.
The home was covered by a State Farm policy(s) for 25 years, including the time when the damage occured. But State Farmd dropped the policy about a year before this damage was discovered, as it did its policies on other properties on the Gulf Coast.
So, if the damage occured during the time the property was covered by State Farm, but was not and could not have reasonably been discoverd until and the coverage ended, do we have a claim under the State farm policy?
The sample policy “State Farm Homeowners FP-7955 CA 6-96.pdf” for free download at http://www.uclaim/products.asp only says you will give immediate notice after the loss. But it is overridden by the law.
The law in most states will state something to the effect “as soon as you become reasonably aware of the loss.” If there is no law on the books, then the judge makes up his own mind, and a competent judge is supposed to use what is “reasonable” in his decision.
Also, any lack of clarity or ambiguity in the policy should favor the insured, not the insurer.
For purposes of the legal statute to file a lawsuit against the insurer, some states have case law that says the “date of loss” is the date that you become aware of the loss and/or the date that the insurer denies payment.
Most states also give 3 or 4 years to file suit against the insurer (this overrides the 12 months stated in most policies). The law overrides policy provisions, which amazingly, are often contrary to prevailing law.
Thanks for the info on the home destroyed by fire. If I find out more, I will post the outcome. As far as I know the owner of the home was charged with arson and is awaiting trial..looks like also an intentional act setting the home on fire..we shall see…thanks for the info!
I have two questions. A tree feel through our roof and we were advised to hire a public adjuster which we did. The insurance co sent a small claims adjuster, large claims adjuster and structural engineer and then cut a small check to get us started. A few months later they cut another check to the mortgage company, public adjuster and us.
1) Our public adjuster told us that the insurance co. would pay for the roof, really 2 roofs, so that we would be whole, i.e., the roofs would match. The house looks terrible with a new roof and old roof and would probably affect the value of the home. Should I expect that the insurance company should cover this or will I have to take this out of my pocket to fix it?
2) How does payment work? We received checks but found a contractor that could perform the work for less than the check amount. The public adjustor is asking for receipts that add up to the check amounts but we don’t have that. Do we return the difference to the insurance company?
1. I don’t know what state you are in, but California law states:
“When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace all items in the damaged area so as to conform to a reasonably uniform appearance.”
But even if your state has no specific law on this, you are still entitled to be put back where you were before, in your case you had a roof that was matching. It does not matter how old or in what condition, it matched. You may have to litigate since most insurers will disagree.
Send a pic of your roof as it looks with the old and new to info@insuranceclaimhelp.org if you like, for me to see.
2. First of all, you don’t have to return any money the insurer sent you, even if they discover a clerk added an extra zero to the check by mistake. That’s called estoppel. Second, I would assume the insurer wants proof of what you spent so that you can claim the “RCV holdback”, the amount of depreciation they took from the repair estimate. Either your public adjuster failed to educate you on this, or you guys have a communication problem. This kind of question should not be coming from someone with a public adjuster. It makes me sad.
Your public adjuster should have prepared you for how to legally not only keep the money already paid (the depreciated value, the ACV), but how to claim the RCV holdback (and more!), even if you got the job done for less than what the insurer estimated it at.
If your insurer is attempting to collect back based on a policy settlement provision that says “We pay the lesser of the following amounts … the amount actually spent …”, that is really sad, and its even more sad that this could happen to someone with a public adjuster. If your public adjuster can’t get you out of this mess, I suggest you get the consumer guide entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” at http://www.uclaim.com/products.asp and read the detailed discussion on this.
Thanks so much for your quick response. We are in the state of Pennsylvania and our insurer is Allstate. Our public adjuster said he thinks we should “sue” which made me nervous. If we sue, I am afraid our rates will go up (we already lost the claim-free discount) or we would have problems getting insurance from another company if we needed to.
You’re right about getting the holdback but I am confused as to why the public adjuster is telling us that the receipts need to equal the amount of the checks. I don’t think he’s a bad public adjuster but he is definitely not a good communicator.
The weather is not good here but I’ll try to get a picture to send you.
Great website, something that is surely needed to deal with the ever growing greed of big insurers. One topic worth mentioning to the sites visitors seeking assistance, is the Public Adjuster. In my opinion, this profession is the single best weapon the consumer can use. Just make sure you find a reputable one.
With many years of Ins experence, I did not read close enough until I lost my home by fire. My husband handled the policy when we built our new Log Home a few years ago. He was killed in an auto accident in 2005. My home was totally destoried by fire 10/2008. I was in another state with my mother while she was having hip replacing surg. so I lost everything since I am in a rual area, it was very dry, no rain in weeks, so it was gone before anyone even saw it and called fire dept. I had replacement cost on my homeowners, but do not intend to rebuild a large 3 story home when I live alone. The small clause I missed was A.C.V. decovery depreciation on home and contents both. In this very rual area, I paid a very high premium for the replacement cost. I’ve spent weeks researching to refresh my memory and changes in laws since I had been out of business. Im still going to submit All of my work and agruements to them, but I think that one clause has got me. Even though I probably won’t recovery the 60,000.00 I still believe Im right. How can they sell me that policy for such a high price but then dictate that I have ti rebuild to receive what I paid for. And what does my not rebuilding have to do with my contents. I guess I want you to tell me that I have overlooked something. They may do it, but it is not right. Everyone better watch out, replacement cost can be taken a lot of different ways in different states. One hundred people could read my policy and 50% would see it my way and 50% would see it their way. Im sorry this is so long, but if I don’t get any help from this, someone else may. Thank You
Sorry to bother you again, when you haven;t even had time to answer my first. Im on brain overload so I would like to ask the questions that I didnot before. 1. can I submit a second inventory list after already being paid A.C.V. -recovery depreciation with 180 days to recovery. I worked for a solid week on the inventory, but out of three stories (including basement) I could not begain to remember everything, besides so much had been moved around and boxed since my husband died. I had 96,500 on contents, but finally quite at 83,000, and they really knocked that down. they took it down to 70,000 with excluding items, then dep. to 50,000. 2. My ins. co. used an independant adjuster, He was very nice, even though I never saw him. When he called to ask for directions(had never been in this area before) and told me when he would come, I assumed he would contact me to go with him. He didnot. There is nothing there, except a crumbling basement wall, and part of the big roc chimney to the fireplace. When I got a copy of his broke down estimate to rebuild, It would not even cover half. He arrived at this using Xactimate estimating software, which I had never heard of. I did a lot of research on that. Im no computer whiz, but I got the concept, but you have to know what was there. He scoped it, I don’t understand that. This is a very small town, he didnot gt anything from tax acesseroffice, or contractors, or a copy of our floor plan. Ive made a lot of mistakes with this, just a very bad 3 yrs. and when I hav refered to my policy, I spoke that wrong. It burned. I have been working with last 4 yrs. declarition pages. I also requested investigator, I though they could tell almost anything. Adjuster said nothing for him to check. I kept thinking I would need to give some kind of statement, was never ask a question. Thanks, FOR WHAT EVER HELP YOU CAN GIVE ME.
I agree completely. There is some free advice on how to get a good public adjuster and how to retain one without risking losing part of your settlement offer to the public adjuster’s fee (if he fails to increase the settlement) at http://www.uclaim.com/aboutadj.asp .
Your rates should not go up just because you sue on the same claim, IMO. And on homeowners insurance, it’s usually not the dollar amount of the claim, but the frequency of claims that triggers a higher deductible or outright non-renewal. So a theft of a $150.00 bicycle would be the same as your house burning down. However, if you made an adjuster angry at you, he could send a “risk advice” to the underwriting department and cite something as trivial as “poor housekeeping” to get your policy non-renewed.
If you had a major loss, you should be looking for another insurer anyway. Many insurers will non-renew you, but not notify you until 30 days before the renewal date. That’s not much time to find another insurer. Also, if you find another insurer and switch before your policy is up for renewal, then you don’t have to worry about retaliation if you do sue. The adjuster could care less if you non-renew, and a smart agent will not put up a fuss if he hopes to get your business back in the future. Also, if you switch before your policy cancels, it looks better on the new application that you “are looking for a better premium” instead of “my insurance got canceled”. And Teresa, there are plenty of companies better than Allstate, and for a better premium.
Unless you are providing receipts to show you spent more than the ACV, in order to claim additional RCV dollars that were held back pending replacement or completion of repairs, then NEVER provide receipts. That’s an open invitation for the insurer to demand some of their money back. I repeat what I said in an earlier post, you should never be in a position of having to pay back any money already paid by an insurer. And I have never heard of any company, especially Allstate, overpaying a claim and saying “just give us back the money you don’t use.”
Don’t tell me your public adjuster’s name or company if you don’t want to, but tell me how many years he has been a public adjuster. And was he ever employed as an adjuster by an insurance company before becoming a public adjuster? Send me a copy of his resume if you like, black out his name and and company name if you like. And Teresa, go online to your state department of insurance and enter his license number or name to see if there are complaints on him. It sounds like this guy is hurting yo more than helping. Pennsylvania is a big state for public adjusters. Call some other PA’s and tell them what you have told us.
In answer to your first recent post, generally speaking, insurers pay the ACV (depreciated cost of repair, or market value) on contents and structure first. You don’t get the “RCV holdback” until after the items are replaced. On contents you send in receipts to prove replacement. The same is usually true for structure, although some adjusters will just make an inspection to verify the house was rebuilt without asking for receipts or a contractors invoice copy.
In answer to your second post, you have way too many details and problems for a free website like this to address. A post as lengthy as yours would not even get a response on most forums. Our best advice is to either get a good public adjuster and pay him a percentage of your claim (eg. 10% on a $100,000.00 loss is typical) or if you are going to handle it yourself, take a look at the table of contents for “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe) Subtitle: HOW TO PLAY THE GAME – DELUXE VERSION (W/APPENDIX) at http://www.uclaim.com/products.asp . At $79.95, it’s a huge bargain.
If the adjuster and or company are giving you a hard time, take the time to give them a rating on this website so you can help your fellow consumer. You don’t have to leave your real name.
Saw the pics. If you can see from the ground from any perspective where there is new roof and old roof, then I think everything “in view” should be replaced. In California they call it “the line of sight rule”. If one side of the ridge is new and the other side is old, then I don’t think you will get a whole new roof. The only way to see it not matching would be from the air, and a judge would not go for it.
January 19th, 2009 at 9:24 am #Jane Pytel Insurance Expert
I couldn’t disagree more. Speaking as a former insurance professional, I can assure you that the single most effective means to defeat the tactics of the insurance companies is simple – knowledge. Consumers must take control of their own claims. To share a percentage of your settlement with a public adjuster is ill advised. Additionally, I can assure you that in my experience, insurance companies fight much harder when a public adjuster appears. No, not the solution.
Since my departure from the insurance industry, I have made it my mission to assist insurance consumers from insurance companies. Sorry, but I just couldn’t let the previous comments pass withour comment.
Its soldiers like you and I who fight the battles so that Joe consumer can watch his favorite TV show in comfort thinking he is in good hands with his good neighbor Allstate.
Thanks much for your spirited comments. I have to say, IMO, that it can go both ways with public adjusters. That’s why David qualified his comment saying “find a reputable one.”
It also depends on the individual insurer and the individual insurance company adjuster. Some insurers will do anything to fight a claim with a public adjuster. Some adjusters (mostly newbies) see burying a public adjuster as putting a feather in their cap (however that can also come back to haunt them if they step over the line of fair claims handling law).
I might also add that I have seen insurers pay a claim more quickly and fairly when they discovered that they would be dealing with the same “son of a gun” PA they fought a battle with on a prior claim.
If the consumer handles their own claim and hires a public adjuster AFTER the consumer has gotten their best settlement, and the public adjuster fee applies only to “new money” recovered, the consumer would have nothing to lose (fee wise), even if the public adjuster was incompetent (and sadly, there are a lot of “PA’s” who got their license “under the table”. But that is another sad story). The downside to this is that most consumers will have made some mistakes that not even the best public adjuster can correct. If a consumer is going to hire a public adjuster, especially right after the loss, they have to compare and choose carefully.
If hired from the start of a claim, some public adjusters can be just like accident attorneys who get the consumer “signed up”, then sit back and do nothing and take what ever settlement the insurer offers and collect their percentage. Now that’s “carpetbagging”, IMO.
The position that most states’ legislatures have taken is that, in order to level the playing field, any quality of licensed public adjuster is better than no public adjuster. Until it becomes “socially acceptable” for insurance company adjusters to pursue a career as a public adjuster, there is always going to be a shortage of good public adjusters.
To the consumer I say: If a PA won’t work for a percentage of the “new money” 6 months or even 2 years after a loss, show him the front door
Barry Harman, a public adjuster and owner of Spectrum, posted this comment. He procured an illegal contract with the client of the attorney he complained about and lost a lawsuit in banruptcy court — after Harman filed for bankruptcy — based on the illegal contract. So he decided to file a phoney complaint. He’s not being truthful.
My auto was stolen in Mexico, within 25 miles of the border. Farmers Insurance has denied my claim.
My policy reads : MEXICO COVERAGE – LIMITED ]
Read This Warning Carefully ]
Auto accidents in Mexico are subject to the laws of Mexico only-NOT the laws of the United States of America. Unlike the United States, the Republic of Mexico considers an auto accident a CRIMINAL OFFENSE as well as a civil matter. In some cases, the coverage under this policy may NOT be recognized by Mexican authorities and the Company may not be allowed to implement this coverage at all in Mexico. You should consider purchasing auto coverage from a licensed Mexican Insurance Company before driving into Mexico. This coverage does not apply to trips into Mexico that exceed 25 miles from the boundary of the United States of America.
The coverages for your covered auto provided by this policy are extended to accidents occurring in Mexico within 25 miles of the United States border. This extension only applies for infrequent trips into Mexico that do not exceed ten days at any one time.
Additional Exclusions
We do not provide any coverage:
1. if your covered auto is not principally garaged and used in the United States; and
2. to any covered person who does not live in the United States.
The claims office obtained a copy of my crossings using the license plate reader from the port of entry. My auto had crossed 15 times in the past 30 days. Farmers has determined that I am a frequent crosser. Why are they allowed to deny a claim if the definition of infrequent is not defined in the policy?
?
Thanks for your comments Scott. There are always two sides to every story. Since this went to court, is this public information? Can you share with us what exactly what was illegal in his contract? Every public adjuster is supposed to have his contract pre-approved by the DOI in California. Any custom changes should be initialed by all parties, and as you already know, must be of a legal purpose.
Incidentally, you are welcome to start a rating thread on Mr. Harman under “Add An Adjuster” on the Consumer Ratings page.
Scott, you may also want to copy your reply to Harman’s comments by clicking on “rate-it!” to the right of Tepper and Garfield. Give yourself a 3 star rating, which is a neutral rating. I believe the star rating field is currently required, so I will ask our programmer to change it to “un-required” ASAP. Once he fixes this, then you can leave the star rating box blank when making any replies to comments. Thanks
Scott,
You are also welcome to have any of your clients who have used your help on an insurance claim give you a rating. This will bring up your average star rating score.
If the policy does not define “infrequent”, then they cannot deny your claim. Insurance policies are “contracts of adhesion”. This means you can’t line stuff out or change stuff when you buy the policy. It’s a “take it or leave it” deal. Therefore the law says that any ambiguities or unclear language in the policy must be ruled in favor of the party who did not draft the policy contract, (that’s you).
Fax a letter to the adjusters supervisor. If he denies it, then fax a letter to Farmers CEO at their home office. If he denies it, then sue them either in small claims court yourself or in Superior Court (if you can find a lawyer to take it).
You can compare your Farmers Mexican policy to a sample Mexican Auto policy for free download at http://www.uclaim.com/products.asp . You can also get much more detailed information on how to pursue a denied claim with the report entitled “DENIED AUTO AND MARINE PROPERTY INSURANCE CLAIMS ADVICE AND HELP Subtitle: STANDARD VERSION (W/O APPENDIX)” for $29.95 also at http://www.uclaim.com/products.asp
Admin – I have sent you by e-mail a copy of the final judgment against Harman and his company, Spectrum Builders, from the bankruptcy court, as well as the court’s ruling on the motion for summary judgment. These documents speak for themselves.
How do I file a claim against an auto dealer’s “Garage Keeper’s” policy for damages caused to my vehicle when they were doing service work when the dealer refuses to give me the policy information or make good on the repairs? Basically they blew the engine and the repairs will cost more than the vehicle’s worth.
I only asked what was “illegal” in his contract. If it was not something easy for our visitors to understand when they themselves look at a public adjuster contract, such as a missing cancellation clause, then all you need tell us is something like “it’s too complicated to describe in a paragraph or two, but the final judgment discussion can be seen at XYZ County Court.” You could also cut and paste short excerpts from your documents if you wanted to. But I believe there is a limit of either 500 or 1000 characters in these comment boxes.
I’m sorry, but your email and attachments were deleted without being read. Unless we ask for an email or give prior approval, all comments should be made in this public forum.
Your participation in this website is greatly appreciated and we encourage your comments on any post in this website.
If the car dealer is unwilling to report your claim to his insurance carrier, your only alternative is to sue him. Your car dealer is gambling that you will just give up and go away. And his insurer cannot open a claim file without the consent of their policy holder.
Now here is your leverage, once he gets the notice that he is being sued, he has to report the suit to his insurance carrier. If he does not, then the insurer may not defend him or even pay the judgment if he loses in court.
Although the liability part of his policy covers him for acts for which he is legally liable, and one is not “legally” liable until there is a court judgment, most insurers will attempt to settle without going to court, since going to court costs everyone more money in the long haul.
I have retained an attorney on this, and your advice is well received. I was hoping that there was a way to find this information without filing, but this is a principle thing now more than a $$ issue. Thanks for your suggestions and advice.
I purchased an extended warrantyon a used automobile from American Guardian Warranty in 2007 from a dealer located in SLC Utah. In Oct. 2008 I reported a heater/ AC “Non-operative bi-level switch malfunction”. American approved the claim for $480. The dealer attempted to repair the defect. The technician discovered the bi-level switch was integrated into the GPS system and the cost of the repair escalated to $5000. American denied the claim. Then they sent out an appraiser who determined the switch did not work due to a missing switch cover. American concluded the cause of the malfunction was neglect and abuse. (The missing switch cover was removed by the technician who attempted the repair and was in the possession of the dealer.) In addition they stated the GPS and the heater control head are not covered. I say you cannot change the rules of the ballgame at the end of the game in order to make it appear you won.
This kind of reminds me of our mission statement on the home page of this website. People who say “oh, my insurance company is great, they paid my claim”, I say it was probably a small automobile claim or something easy to see with you own two eyes. Start talking more dollars and the claws come out.
But to get to your question. Automobile warranty policies are notoriously full of hidden loopholes. If you want us to review yours for you, email a scanned copy to info@insuranceclaimhelp.org. You can also email a copy of the denial denial letter and pics if you like.
As you might expect, neglect and abuse, is not covered, so that’s what they are looking to hand their hat on. Is the heater control head the same as the heater switch cover?
Whatever their technical reason for denial, you have to get an expert with a different opinion. For example, if your mechanic puts in writing that the switch was defective from the factory, then that contradicts the insurance appraiser. That will force the insurer to hire an engineer to look at the part. If he lies, then its your expert against theirs. Be sure to save the part and get close up pictures to show the judge if it goes to small claims court. Expert opinions that “win” are usually the ones that don’t leave everyone scratching their head, the common sense opinions.
Feel free to rate your adjuster and insurer on the Consumer Ratings page of this website.
My husband is a self employed painting contractor and we have had water damage and tree damage from a recent ice storm. Our adjuster told us to get a painting estimate. Can my husband provide the estimate for the repair and painting or do we have to provide a 3rd party estimate.
Waiting for an answer from the web developer on this. If anyone else wants to comment on this, please speak up.
I may be wrong, but try this. If using firefox, look in the address bar to the right side for the little red box with the waves and click on that and go from there?
If using internet explorer, look for the little red box with waves in the task bar (or anywhere you see it)?
or,
look just above the comments on any page in this website for the little icons starting with “ASK” and find the RSS that you use?
You may be able to submit our homepage at your RSS Feed site and add it to your favorites there?
Get an estimate from a 3rd party and use that to negotiate your claim with the adjuster.
Don’t tell the adjuster you are going to do your own repairs or that your husband is a contractor. Some ignorant adjusters will deduct 20% from your estimate for “contractors profit and overhead”, saying you don’t have a right to “profit” from your loss. While their argument is not legal, they think it is, and their supervisors and insurers keep them ignorant of the law.
The other trap many adjusters set for you is not telling you until the repairs are done, when you are expecting to get the “depreciation hold-back” that they only owe “the amount actually spent”. So if you got the job done for less than their estimate, or did it yourself, you got trapped!
If you have already fallen victim to the adjuster on this and want to know how to get out of it, or you want some real detailed information on how to avoid these type traps, go to http://www.uclaim.com/products.asp and consider the Homeowners Loss Standard or Deluxe guide. You will learn the tricks that public adjusters use.
As a fellow Consumer Advocate, with a Similar Web Site, our Feed Back from Consumers throughout the country has been uniformly favorable for ONE lesser-known insurer … AMICA.
Would be interested in knowing about your experience when dealing with AMICA.
Thanks for the nice comments J.D. . Note that your website is listed in our Other Claims Resource Sites. We would appreciate a mention and/or link to our website from somewhere within your site. Mutual links help us “real advocates” to get ahead of those pretending to offer help, but really just selling insurance. Thanks again.
Thanks J.D. for the heads up. What does AMICA stand for? Do they write all lines of insurance or specialize in auto or home, etc? Are they in certain regions or target certain demographics, like seniors or government employees?
If you have time, please click on our “Consumer Ratings” link at the top, go to Add an Insurer, and add AMICA with a text and star rating.
I have never heard of them. They must not be big in Central California. But on the other hand, the best insurers are the quiet ones, with no complaints and little advertising, IMO.
Here’s my dilemma, I refinaced 3-4 yrs. in a row, to take advantage of droppinng interest rates. I was persuaded to purchase insurance by my mortgage loan officer at the time of signing to make sure that my mom’s interest was covered since she was taking this equity loan (Refi) out for me. I didn’t know that I could purchase the identitical insurance coverage through my home owners at 90% of the cost that my mortgage loan officier charged me. Here comes the topper! Each time I refianced this insurance should have been pro-rated & the difference either taken off the loan or given back to me, it never happened & the total comes to around $20/25,000 big ones, plus the two loan officiers that handled my 3 refi’s were busted for emblezzing money from clients(me in perticular).
Normally when a policy cancels during “mid term” the insured gets a prorated refund. If you request the cancellation, you get less back than if the insurer initiates the cancellation. Read the Conditions applying to “Section 1 and 2″ (the entire policy) in your homeowners policy. You can look at the wording within different company’s homeowners policies. There are 75 free policy copies from different insurers in the Products page of UClaim.com.
What were your annual premiums if you don’t mind my asking? They must have been huge if 20-25K was the refund amount for 3-4 years. While 20-25k is not nearly enough to attract an attorney on contingency, you may be able to pay an attorney to write a few letters threatening litigation against the loan companies. Find out if the other victims have an attorney. There may already be a class action lawsuit you can join into. Also, do a Google search for example “class action Wells Fargo Dallas” to see if there are already any class actions in your local area.
My wife and I were married 6 months ago,and she has kept her house and I have kept mine. There was an accidental kitchen fire (faulty burner) at her house while we were out of the U.S. recently, the day before we returned. Her insurance is Allstate, and I am not on the policy. She has lived there for about 6 years, and her daughter continues to live there and is now in college. My wife lives at my house, but still has all of her belongings (except some clothes) at her house, pays all the bills and doesn’t charge her daughter rent. The personal property adjuster couldn’t identify my wife’s room because of not being able to find her closet. We told the adjuster most of her clothes were over at my house, and we are in a transition until we decide to continue to let her daughter stay there, rent it, sell it or we decide to move there. The risk profile hasn’t changed since last summer, yet it ssounds like we may have claim denial exposure, both to fix it and to cover personal property damage. What is your take? Thanks! Rick
I think you are ok. There is a vacancy exclusion for structure vandalism if the property is vacant over 30 days, but the daughter is there. I looked at an Allstate Homeowners policy at http://www.uclaim.com/products.asp, and found no limitation there. And I think you are ok on the contents too. Let us know if something is denied and why.
My question revolves around exclusions. I manage a large roofing company and we handle aprox. 1000 roofs damaged by hail each year. An issue that is coming up alot lately is if the insurance company owes the insured for roof decking when the old decking no longer functional due to age delamanation etc…. I know that all policies exclude losses wet or dry rot, bulging cracking of roofs walls etc… and defects, weakness in materials used in construction… However my argument is two pronged. 1. Since it is not possible to install the new roof over the old decking. The insurance company cannot fullfill thier contract of restoring the insured to thier pre event postion without paying for the cost to redeck the roof. My understnading of replacement cost is to pay for “equivalent construction for similar use” If we were to install the new roof over the old decking it would not adhere to code or manufature’s requirements. Thus the insured has lost because prior to the hail they had a roof covering that met code and manufactuer’s requirements. 2. Most of these policies have an endorsement for code upgrades which states that if an undamaged portion of the structure is required by code to be replaced the inurance company would then pay that cost to repair or replace. We have had building departments visit the job sites and put it in writing that it must be replaced and we still get denials based on the exclusions. By definition a roof assembly includes the decking and therefore if needed would be a part of the damaged loss as you can’t complete the roof covering without replacing it as well. The response I get most often is “what caused the decking to need to be replaced” and I say it is the hail that destroyed the roof. Insurance companies of course don’t agree. What are your thoughts.
You are absolutely right in all you say. And guess what, even without a code endorsement on the policy, they still owe for the decking if the shingles can’t be removed and replaced without further damaging the decking. You can’t get the new nails exactly back into the old nail holes, right? So right there you have more holes, more weakness in the decking.
Yes, these insurers are still denying, even with the code endorsement. They do it either out of ignorance or intentionally, knowing you can’t afford to sue and no lawyer will take it because punitive damages on property cases are now restricted to 3 times the hard damage part (a “Bushenomics” supreme court legacy we will be stuck with for years).
How to deal with it? I just had a fire loss in Bakersfield, the building department said the non fire damaged crumbling foundation had to be replaced or the house could not be rebuilt. State Farm’s adjuster denied the foundation replacement, even though there was a code endorsement with clear language. His manager told me they had not paid on any code edorsement claim since 1991. I faxed a well written letter to Ed Rust, CEO for State Farm asking if State Farm had collected premiums for this endorsement since 1991 in Kern County, or California or the USA for that matter. In a couple days I got a letter from the local manager saying they would now cover this claim. I also got a letter from the head of State Farm Claims in California THANKING ME for bringing this to their attention. Now this is what I do like about State Farm. State Farm may be rotten, but it’s not “rotten to the core”. A lot of companies are rotten to the core.
Tell your clients to make ratings at the Consumer Ratings page on this website. This is what its for. I don’t believe the government can stop corporate abuse. Its got to be us, unselfish people. When you buy something on Ebay, do you check out the Sellers rating first? It’s got to be the same here if we want to get control of the bad boys.
My husband and 6 of his band members were injured in an automobile accident when a cow was standing in the middle of the road at night. The cow owner had insurance and his landowners insurance has accepted responsibility for it. They say that there is a $500,000.00 cap on the policy to be split between the 6 men. But my husband has numerous injuries and still has 3 surgeries that we know of to go. They are asking us to submit a “demand” for the amount that we would like to receive from them on an individual basis. Even though they say that they only have 500,000. to work with we need to know if they can go above that if they need to in order to cover everyone costs. They have missed time at work and still have many outstanding medical bills to cover. We just need some advice before we give them an answer. Thank you
First of all, I’m no expert on liability insurance claims. And I suggest you check with an attorney. If you can’t get 10 minutes of free advice on this question from an attorney after calling around, give them $75.00 for a few minutes of their time. Be careful about hiring an attorney on contingency who will get 1/3 as soon as you sign the contract. He can sit back and do nothing other than collect his money. It sounds like the damages are well over the $500,000.00 and the insurer is willing to pay. If the insurer agrees to pay the full 500,000, look for an attorney who is willing to take his fee from the amount “over” the insurance offer. 50% of the amount over is fair, in my opinion.
Now here is my advice, go ahead and make a demand for an amount for each of the 6 members. List each members claim on a separate sheet of paper. Medical bills, lost work, etc. and describe why the injury will affect future earnings or appearance. A damaged throat on lead singer may be worth more than a similar injury on a drummer who does not sing.
Now, DON’T sign any release from the insurer if it releases the policy holder (the landowner) also. Only release the insurer. And ask to see a certified copy of the policy. Don’t just take their word for it. Adjusters can lie. Also, you don’t want to give up your right to sue the landowner, since he may have assets over and above the insurance limit of $500,000.00 and or an “umbrella” policy.
And find out what the statute of limitations (time to file a lawsuit) is. Its usually 1 or 2 years from the date of the accident. Some insurers will delay the negotiations just so you accidentally forget, and then they won’t pay one dime. Pay a lawyer for an hour of his time to fill out a pre-printed complaint form to file at your local court, to “protect the statute”.
Hi:
I am having trouble getting my insurance disbursments from my bank. I lost my home in a fire 9/07. It has taken me over 2 years to finish the claim, redesign the house (w/addition) and work my way through the Los Angeles building and safety for a permit (I am on a hillside. In that time my original lender (World Savings) was bought my Wachovia. I been received two different processes (on paper) for getting my disbursments, one was for three draws of 1/3 of total claim with the first disbursment upon reciept of required paperwork, the 2nd at 40% and the last @90%.
I received a second letter 29 days later stating the the following disbursments: 20% to begin repairs,20% after 50% completionand the balance after upon approvals of completion of all repairs. Any help is much appreciated….
After receiving one disbursment, I requested my 20% draw at 50% completion. I was then told that I needed only 40% for the next draw. When I called for follow-up on the inspection, I was told that I had been switched to a total loss claim and the requirement for 60%. When the inspection company called for inspection, I was told that they would be looking for 40%. This was confirmed by the inspector. When I called for follow-up from the inspection, I was told everything was fine, I was at 50% and a check would be disbursed by the end of the week. After waiting a week, I called for update and was told that I needed to be at 60% and since I was not there would be no disbursement. I have yet to receive any paperwork outlining a process requirinng 60%. In the meantime, I am out of funds, frustrated and do not know how to rectify this situation. Though I have followed the procedure led out by them, submitted receipts that exceed the current disbursed funds, I was told today that my account was being switch (again) from escrow to loss managment. This feels like a shell game inwhich I will never get out of. What are my rights in this situation.
Well, I’m about half confused myself. Regardless of what their stupid rules are, if you are a certain percentage done, then you are entitled to that percentage of the money they are holding. You could hire a lawyer just to send a letter or two to shake them up, maybe. If you can’t get a loan to use to finish the house, then try this: in California the small claims limit is $7,500.00. Sue them for the full 7,500.00. It does not mean you give up your claim to the rest of the money they are holding, but it does pressure them and makes you a squeaky wheel. And it only costs you 20-30 dollars. If that gets them to pay, then drop the case and file another claim later if you have to do it again. One thing is for sure, when the house is 100% done, they have to give you all the money they are holding. And you don’t have to give them receipts showing what you spent.
And beware of giving receipts to your insurer. The homeowners policy says the insurer owes the least of the following: policy limit, replacement cost, or AMOUNT ACTUALLY SPENT. So if they are still holding depreciation money, “RCV holdback” pending completion of repairs, and you spent less than the amount they estimated for the repairs, ask for a visual inspection to confirm the job is done. Don’t supply receipts for a lower amount, or they will cut your claim.
It would be appreciated if you could take a few moments to give a quick rating on your insurer and/or adjuster and/or other insurer’s vendors on the Consumer Ratings page of this website. You don’t have to show your real or full name if you don’t want to.
You are SO RIGHT about the uselessness of California Capital Insurance for property claims. It has been nearly three months since a fire in my house and I am still fighting for every single penny, every single repair and replacement. CCI chose their own contractor, with good reason–they must have saved a hell of a lot of money. Cabinets that burned were replaced with cheap crap–doors that don’t meet or align, warped wood, and believe it or not, smaller cabinets than the original. The wrong color paint was used twice in one room, I had to ask for any number of jobs to be redone–and on and on. One cabinet is “attached” to the floor with caulking. Nearly three months after the fire, the shower is still coated with dried ash and black smoke. The oven and the stove exhaust fan don’t work. Worst of all, absolutely no one will take responsibilty. The “charming” adjustor at San Jose has called me “you stud” (I am an older professional woman) and “Madam.” Stay as far away as you can from CIG/California Capital for property claims.
February 26th, 2009 at 8:32 pm #Valeria Christiansen
My son, a California resident with a California-registered and -insured 1993 Saturn SL1 with approximately 177,000 miles on it, is attending graduate school in Denver, Colorado, and has had his car with him there.
Last Saturday morning, in snow-and-ice conditions, his car, legally parked curbside across the street from his apartment building, took an ugly hit to its left-rear door and fender panel in a multi-vehicle incident.
Since the Saturn was not insured under our policy for collision, a claim is being pursued against the driver of the vehicle that struck it. That insurance carrier has accepted responsibility and sent an “appraiser” to inspect the Saturn and the body shop reported to my son that the pronouncement that the cost of repair to “restore” the vehicle was $2,400. This appraiser has not contacted my son directly at any point.
At the same time, the body shop, to which my son was referred by a Saturn dealership in the area, has told him that they could do a repair that would make his car once again presentable and drivable (but not “restored”) for approximately $1,000.
We understand that my son may very likely be informed by the insurance company (again, it’s the other guy’s carrier) that they will want to “total” his car. The consensus in our family is if we can get the car back in presentable, drivable condition that would be desirable as my son is scheduled to graduate in June and sometime over the following months transition into employment, and having to deal with getting a replacement car right now is untimely and very inconvenient.
The way we see it, getting a late-model used car would be a hit to his finances, because we know the insurer’s payment will nowhere near cover that cost. And the alternative of taking the insurance money which we anticipate will be low to go buy a “cheap” used car, which would likely be as old as the Saturn, but with a completely unknown background and who knows what issues and problems, doesn’t make sense if that same money would allow my son to keep the Saturn, a great little car that has served him beautifully for 6 years already.
What would we have to do to keep the Saturn without it being transformed into “salvage” and/or having insurability problems going forward?
Have you ever heard of foundation cracks being covered under a property policy, such as a Homeowners or a Dwelling policy? I have a client who was cleaning a sewer leak and discovered foundation cracks. The carrier declined using an engineer’s report stating there was evidence of long-term settlement, prior cracks repaired, and no way that cracks were sudden & accidental based on location of sewer pipe. The insured contends that the leak happened so suddenly that the property sunk to the degree that a lower level exterior door could open one day and not the next!
Is your client the plumber or roto-rooter guy? Is it a plastic or metal drain pipe?
The cracks should be covered if the foundation settled due the the ground settling from water from the cracked sewer pipe, as long as the ground saturation was “sudden and accidental”.
What made the sewer pipe crack? Tree roots? Tree roots can bend a plastic pipe underground and when it finally breaks, it splits big. Unless there were “hair roots” inside the pipe to indicate a long term crack, then I would say sudden and accidental loss.
I would be interested to see the “old repaired crack” photos and what the cause was. Remember, if its an all risk policy, special form, the burden of proof is on the insurer to disprove the claim.
It’s like a broken pipe in a bathroom, long term leaking is indicated by rot. Plywood delamination and discoloration is not “long term”, even though some adjusters say it is.
You have to get your plumber to put in writing that it was a sudden loss and state the reasons. Then the insurer will have to get their own plumber or engineer to look at it. Be aware that many insurance engineers are really prostitutes, they will say and even lie about anything. If that happens, then get your own engineer, or go to small claims court with good photos, your plumber and a good common sense argument. And you will never win in appraisal or arbitration. If you sue in superior court, be aware that judges can be bought off with a password to an offshore numbered bank account, or some other favor (I’m obviously quite Jaded).
Consider a letter to the insurer CEO before going to court. But have it well documented.
It’s your car and no one can take it from you or put a salvage title on it. Let the insurer take a deduction for salvage value from their settlement to you. That salvage value is negotiable. If the car has no collision or comp coverage, you should have no “insurability” problem. A dented fender does not make the driver more likely to have an accident.
If you are trying to save money on the repair, consider “doing it yourself. Saturn is the only car that has “bolt on” quarter panels (just like fenders on regular cars). And the Saturn parts come pre-painted from the factory so you don’t have to pay a body shop to paint it. I imagine the doors are the same. Your car will have a paint code label somewhere. Ask the dealer where it is. Give the paint code to the dealer parts guy and get a price on the parts. You can also shop for used parts, but it the color does not match, then you have to paint it.
C, its great you make a rating here, but how come you didn’t go to the “Consumer Ratings” page and rate them? Start a new entry on them. If you want to really get the word out so “the whole world” can easily find them, do it there. You can rate the adjuster, the insurer and their lousy contractor. Please do it! Its why we built that page.
Now, as to your claim, the best advice I can give you is to go to UClaim.com at the products page, look at the first product “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe). Look at the table of contents. Do you want to rip CCI a new a____ ? That eBook will show you how a veteran public adjuster does it.
After the November 15th, 2008 wildfires, our home was deemed a partial loss. We had little fire damage, but because 5 homes next to us, our backyard slope, front yard slope, and side yard landscaping were on fire, we are noticing a lot of “structural” damage.
Things like warped vinyl window frames as windows are not closing, aluminum windows aren’t closing, cracks in drywall, fine cracks in concrete, discoloration of concrete and rust stains. Is a contractor enough to document these losses for our insurance company, or do we need to get an engineer involved?
Don’t spend money on an engineer unless your claim is denied. Let the insurer estimate the damage and see if they pay enough to meet your satisfaction. If not, then get your own estimates and submit them to the insurer. Insurers don’t normally hire engineers unless they want to deny your claim. If they use an engineer to deny your claim, then you can hire an engineer to refute their engineer. Most insurance company engineers are usually like prostitutes now days, they will say whatever the insurer wants them to say for a buck.
Your claim sounds easy. But if it gets difficult, consider the eBook at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”.
Home damged by fire 1 year ago…insurance company finally agreed on amount to give for rebuilding home. My question is… If I do most of the work myself, and do not use all the money the insurance company gives me can I pocket the remainder, or does the insurance company takes it back…
ex. Insurance claims pays 100,000. I spend 70,000 to rebuild my house. Can I legally keep the remainding 30,000. Or do I return this money back to the insurance company.
Some people tells me I have to use all the building money, if not its considered fraud…Is it fraud?
The clause in most homeowner policies under settlement conditions says we (the insurer) owe the lesser of the following amounts: the policy limit, or the replacement cost of repairs, or the amount actually spent. If you tell them “you” did the repairs and only spent 70k, then they could ask for the money back. Is it fraud if you don’t use all the money? I don’t think so. You have to argue that you are entitled to the left over money for your labor. Most adjusters will say you are not entitled since you can’t “profit” from a loss.
Typically, for example, an insurer figures 100k to repair the house. They give you 70k, the depreciated cost of repair, the ACV cost. And they say “when the repairs are done we will give you the 30k we held back”. What they don’t tell you is that if you spent less than the 100k, then you only get back what you spent over the 70k. And if you can’t supply receipts for the amount over the 70k, then you get nothing. I have never seen anyone dumb enough to tell an adjuster they spent less than the 70k. So why open that can of worms?
You can recover all that 30k money that was held back, “if you work it right”. You can also get yourself in trouble if you don’t work it exactly right. There is a detailed discussion on this topic in the eBook product at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe or standard version)”.
If you would like us to look at your policy free of charge, you can mail or email a scanned copy.
Hello! Thank you for your help! I have a very small seasonal business, handknitting and selling accesiries (hats, scarves, etc.) I had a stall at Reading Terminal Market last Christmas season and stored my stuff at the Market overnight. On October 29th most of my inventory got stolen. I had filed a claim with my insurance company (Ohio Casualty Ins. – part of Liberty Mutual Group) We have been going back and forth with the insurer as to how much I had lost in business as a result if the theft. They have referred me to their audit department and I have been very cooperative and provided them with every record I had. It has been 4.5 months since I filed the claim and they still have not settled it. I am falling back on my business loan payments and unable to go ahead with my business plan before I get the money from settlement. I contacted superwisors at both departments that are handling the case (the officer and the audit department), they say they will do their best but they are still not letting me know what exactly do they need to process it and how long will it take to complete. I am wondering if I should sue for time and business lost as a result of their actions (or, rather, inaction) with it. I have a small claim so I am not sure if a lawyer would be interested and what other options do I have to make them speed it up. Thank you! Anastasia
They are on the Products page at UClaim.com. I just did a test download. It’s possible they were temporarily unavailable during recent server maintenance there.
Most Homeowner policies cover damage from “falling objects” to personal property. However the “falling object” must damage the roof or wall in order for the inside damage to be covered. So if a tree branch or something fell on your roof and damaged a shingle/s, and the impact knocked the chandelier loose and it fell, then it should be covered. Obviously this argument is stretching it, but its all I can think of right now.
Read “Coverage C” in your homeowners policy, or get a sample policy from UClaim.com Products section to read.
Your “small claim” is either not so small or it has some big problems for them to be delaying like this for 4.5 months. You need a lot more help than I could possible give you here. Consider the http://www.UClaim.com eBook entitled “BUSINESS OWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS, Subtitle: HOW TO PLAY THE GAME – DELUXE VERSION (W/APPENDIX)” on the products page, business section. Look at the table of contents. It will help you with the inventory as well the loss of income, “extra expenses” and teach you how to communicate and get attention when you are getting nowhere with the adjuster and his manager. The cost of $89.95 is a drop in the bucket compared to what your claim is worth and what you would pay a lawyer or public adjuster.
If you want us to look at your policy for no charge, you can email a scanned copy to info@insuranceclaimhelp.org. However, any questions or discussions we have will need to be via this blog so everyone can learn from your experience.
I had a rather rare item destroyed in a house fire. It was a carbon fiber race car tub (the part the driver sits in). Erie insurance provides me with replacement cost and has done so with every other item destroyed. This tub was worth around $15,000 but they say I need to buy one in order to get the insurance money for it. I guess this is a way of proving the value of the tub but couldn’t I do that by showing examples of other people purchasing the same thing? Can they make me buy a replacement in order to get the money for it? Thanks for your help!
You don’t have to buy a piece of property to prove what the lost one was worth.
What I think they should be telling you is this “you get the depreciated value of the car tub now. If you replace it, then we give you the amount we previously held back for depreciation.” Either there is more to the story, or they are jacking you around because they don’t to pay out that $15,000.00.
And if that car part was “off” of the car then they cannot deny it as being a motor vehicle. This car tub is no different than a chair that burned up in your house. If the adjusters supervisor backs him up, fax a letter to the CEO of the insurance company. Be a pest.
I have lived in my home and paid my insurance for 12 years. I recently had someone come to the door offering free roof inspection. They said I had hail damage and should file a claim. My insurance claim representative came by and assessed.After meeting with his manager, they decided that the roof should be totalled but rather than paying in full for the roof replacement they are offering a cash settlement due to depreciation. They indicated that the damaged occurred in August 2004 and the cash settlement would represent a reduced amount that is substantially less than the full coverage. What are my options?
By the way, my insurance company is State Farm.
Try to get them to issue the money without your signing any release. Once you have the money, then you have nothing to lose if you get “under their skin”. If they make the payment without writing something like “your claim is not covered because it was not reported on time, but this money is paid as a compromise or a courtesy” then go for the full cost of replacing your roof (if you have replacement cost coverage).
If indeed the damage was in 2004, then you are lucky they are even covering your claim and paying anything. Most policies give 12 months to turn in the claim from the accident date. And most states override that by giving 3 or 4 years to sue your insurer for property damage. Check with a local attorney what the “statute of limitations” is to sue for property damage. They should not charge for a simple question like that.
Also find out if the “date of loss” in your state is the actual date of the physical damage, or when you discovered the damage (the idea being that you have no loss until you become aware of a loss). That is a question that most adjusters and even attorneys will not know the answer to. You could pay an attorney for 1 hour to research the answer.
If you can spare the time and “give back” a little something to this website, make a rating on State Farm and or their adjuster on the Consumer Ratings page of this website. You could also do a rating on the contractor who alerted you to your roof.
My house was burglarized and item were stolen and damaged. My claim rep at State Farm keep stating a depreciated value will apply in my claim, when I have a policy that should cover the replacement.
I got loss as to how can I value my collection when I didn’t have time to have it priced. They also – stated that coin collection is considered as cash – which will subject to cash limitation. Is that true. I talk to my agent and she stated the same. I need help -
I recently found that I had a broken drain line in my house. The drain line for my washing machine and kitchen sink runs under the concrete slabs which covers a good part of the house. When the lines began to back up and we discovered water coming out of the floor in one of the rooms, we called a plumber. The plummer ran a camera through the pipe and discovered the broken pipe. We immediately called the insurance company and they would not tell us anything other then they would send an adjuster the following week. We needed to get the damage pipe fixed, so the plumber ripped up the floor and slab and repaired the pipe. The adjuster finally came out and from the time he walked through the door, told my wife (unfortunately I could not be home) that is was unlikely that any portion of the work to fix the pipe or the floor that needed to be ripped up would be covered. He stated that insurance does not cover worn /damaged drain pipes and since the floors were not damaged by the drain they would not be covered as well. This was an expensive repair (over $8,000) and we have not even looked into the cost to replace the floor. I have Allstate insurance – is this true that insurance companies do not cover drain pipe repairs? Thanks for your help!
The 1996 State Farm Homeowners policy at UClaim.com says the limit of $200.00 on money includes money that is “part of a collection”, in the Personal Property “Special Limits” section.
Look on the declarations page, the cover sheet with your name on it, and see if there is an endorsement for contents replacement cost. If you do have replacement cost on contents, then most insurers will take depreciation, then refund the held back depreciation after you prove replacement of the property. The UClaim.com eBook “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP” will show you how to maximize your claim and not get trapped.
Insurance covers “sudden and accidental” losses. If this was your case:
1. Get your plumber to put in writing what caused the pipe to break.
If your plumber does not know the cause, then let the insurer hire an engineer or whoever to find out the cause. Most homeowner policies say “we cover everything except” … . This means the burden to disprove your claim is on them.
2. If you get them to cover the pipe, then they should cover the damaged floor. They don’t owe the cost to fix the cause of the loss. But they do owe the cost to get access to do the repair, in your case, the concrete floor damage.
Some low quality insurers will say that since “the cause of loss is never covered”, the plumbers bill is not covered. If you argue that the $2.00 piece of broken pipe is the cause, then the plumbers labor should be covered on all but the 2 minutes to insert and glue the pipe.
March 20th, 2009 at 5:48 am #f. michael conte,CPIA
maggie,
the coin part i agree is the correct method of settlement, only becuase i assume it was not a scheduled or itemized class.
the other colletions part would also have had to be separately insured.
this all should have been explain when you purchased the contract.
read your contract all slmnt methods are outlined there.
hope this help
fmc ny,ny
March 20th, 2009 at 6:13 am #f. michael conte,CPIA
to mike gaspar,
typically pipes under the foundation are not covered.
however read your contract or ask your agent to read the contrat.
I recently got some settlement checks for my fire claim. If we decide to do the work ourselves, ie: sprinkler system replacement, painting, etc, how can we go about making sure we can still claim the recoverable depreciation? What would we have to do, as far as the paper trail goes?
Also, we claimed some ALE expenses for two weeks, while we stayed with my parents. They are retired so my wife paid them $1200 cash for using three rooms and a bathroom in their home, food, and utilities ($100 a day). The cash came from our emergency pretty cash, which we keep with our passports, etc, which was all evacuated from the home when we left the day of the fire. What would I need to provide for my insurance company, as the cash wasn’t taken out from our bank account anytime recently, or at any one time… its more of an accumulation of extra cash over the year. I know I need a receipt from my parents, which is fine, anything else in this case?
Additionally, I have a copy of the Farmer’s Next Gen insurance policy in PDF which might be helpful to your site…
Thank you for this site! Never having had to file a claim before, I’m feeling quite lost. I really appreciate the link to the different insurance policies, since if I ever HAD a full copy of my State Farm policy it’s long since gone.
I was burglarized last week, and given what’s been said so far I feel like I’m already being set up for the insurance company to deny my claim. I called the police immediately. The front door was unlocked but closed; the back door was wide open and there were no broken windows or pry marks. The officer who responded kept saying things like “You left the door unlocked, didn’t you?” I DON’T remember leaving the door unlocked, certainly not open, and said so repeatedly. He seemed determined to make me say I had. Would it matter if I had? Wouldn’t it still be theft? Would the insurance company refuse to cover me if I accidentally left the door unlocked?
I called my State Farm office the next day, and gave them the police report #. The insurance adjuster called me the following day. HE kept trying to get me to give him a dollar amount of the loss. I kept telling him I didn’t know; I was still discovering things missing, didn’t have receipts for everything, still looking for receipts and hadn’t added up the ones I’d found, but I’d spent at least $4500 on a TV and camcorder that I DID have receipts for.
I have Homeowners Policy FP-7955.CA with Loss Settlement Provisions A1 (Replacement Cost – Similar Construction) with Deductibles Section I All Losses $1000. Plus B1 (Limited Replacement Cost – Coverage B) plus OPT JF (Jewelry and Furs $1500/$2500)
Of course I didn’t have an inventory of my property before the theft. I lost almost every piece of jewelry I’ve bought or been given since I was a child, and I’ve only been able to find about $1000 in receipts for recently purchased jewelry. I’ve been making a list with as much description as I can remember, along with sketches and looking for pictures of similar items on line. Any advice here? I was SOLD the OPT JF because I had quite a bit, some inherited from my grandparents and some I’d purchased on trips starting when I was a child. Does State Farm pay out for receipt-less jewelry or am I wasting my time making an inventory?
Also, I’d set up a very nice system involving my (stolen) LCD HDTV with a beautiful picture, a LOT of connections that spanned RCA plugs through s-video to firelink and PC connections so I could use it with my older VCR and my newer DVD/VCR and my new HD camcorder, eventually adding a computer to the mix.
The company I bought the TV from doesn’t make LCD TV’s any more. They have some huge laser TV now. The size that fits into my entertainment system is almost impossible to find; prices have collapsed, so a much bigger screen costs less than what I used to have but the TVs with the good pictures don’t have all the connections I used to use. THAT means I’ll probably have to replace components that weren’t stolen and furniture as well, just to be able to do what I used to do.
There’s also a missing 35mm camera that worked FINE the last time I used it. I’m not sure they even MAKE them anymore. I’d buy a digital camera with the same features, but I don’t know if insurance covers that.
Only my camcorder has a comparable model from the same company. I paid about$1300 for it; the new comparable model is only about $800.
How do insurance companies deal with things like that? Do they refuse to pay anything saying it ‘cannot be replaced with other of like kind and quality on the current retail market’? Do they pay the replacement for as close as I can get? Would I be allowed to take whatever $$ they’ll give me and add my OWN money to get something I’ll really be happy with, or not?
I’d really rather have an idea of what to expect before I call the claims adjuster or spend any more time on my jewelry inventory, or wander through any more electronics stores trying to figure out what my beloved TV’s repair/replacement/amount of loss today (without tax) is!
Unfortunately, my car was stolen last week. I had all my car paperwork inside my car and I’m filling out the equipment form and frankly, I don’t know all the details about my car. Is there somewhere I can pull a report on my car or can I call the dealership to figure out all the specs on my car?
In answer to your first paragraph, how to do your own repairs without “getting burned”. It’s too detailed and tricky to explain here. You will get a very detailed explanation in the UClaim.com eBook “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (standard)”. If this and the ALE are your only problems, then you don’t need the appendix that comes with the Deluxe version.
Regarding the ALE, you don’t have to prove where your petty cash comes from. You only have to give the insurance company receipts or evidence if you have it, and within reason. For example, you don’t have to go back to a store and ask them to reproduce a receipt. Let the insurer hire an investigator to do that.
Yes check with the dealer or whoever you bought the car from to help you with the details.
Go to your local library or to your dealer to look at a copy of a Kelley Book, or NADA book to see all the options that could have been on your car. The vin number will have some basic information, and your insurer will have that.
You can also go to the Kelley book and NADA book websites to see what options came with the car. If yo don’t know the mileage, you will jsut have to make a best guess and put in writing it is only a guess.
You may contact Carfax.com to see if their reports give detailed descriptions. They have records from prior insurance claims and repairs from prior owners.
And if you get cheated on the value of your car, consider one of the eBooks on total loss vehicles in the automobile section at UClaim.com.
I will take your questions one at a time and see how far I get . This blog is for short questions. So please consider one of the comprehensive eBooks at UClaim.com to answer most of your questions in great detail.
Unless your policy has a clause that says there must be evidence of “forced entry”, then they cannot deny the claim. The cop sounds over zealous.
You know what Val, upon reading he rest of your questions, you definitely need the eBook at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”. Your claim is way too big and complex not to have professional help. you could hire a public adjuster for 10% of your claim, or a lawyer for 33% of your claim. Again you do need more help than I can give here. Sorry.
March 26th, 2009 at 8:50 pm #New pipe dammage guy...
Just had a 5 room food, carpets, walls, ceilings…and an espostos tile floor.
In regards to a new claim, are relo-costs covered, adjuster said “just save receipts” How long can I stay away? Full time of deconstruction and reconstruction?
Does adjuster actually check on every item on my list? She did a breif walk around…but had Service Master take pics…..not of Personal property from what I saw…just damage areas they were to demolish.
If your Homeowners policy covers ALE Additional Living Expense, then it is covered until you git back into the house up to the policy time or dollar limits, and “within reason” (You can’t stay at the Disneyland Hotel for example). You can ask the adjuster to send you a letter saying this if you can’t find your policy. You can get sample policies at UClaim.com.
The adjuster has a right to check out everything on your list. Most make random checks for larger items. But if they catch you “intentionally” inflating something, they can deny the entire claim, so be careful.
Get your own pictures also.
March 30th, 2009 at 7:07 am #f. michael conte,CPIA
to new pipe guy,
thought i would chime in on the last reply i read. here in NY they will only pay for your additional cost to live. the amount they pay is the amount of time for the work to resonably done. so if the job is projected to take two weeks thats what you get. so be careful and have the conversation with the adjuster before you make arraingements. ( you might also ask what he or she reasonables asks you to spend per night)
I have a 2007 Chevy Aveo that I am making payments on to the bank. I let my boyfriend drive the car to pick up lunch for us the other day. While he was out, he rear ended another car.
The other car has no damage. My car had about $4,000.00 worth of damange. I called in the claim to Met Life. The car was not drivable and was towed away. The company who towed the car stated the if I had the work done there, I would not have to pay the storage fee’s. The adjuster went out, wrote up the paperwork and the shop started the work. The car is now complete, but Met Life is not sure if they will cover the cost.
They are claming that my boyfriend is a regular driver. When I talked to the woman from met life she made me give her a montly estimate of how often he drives it, I told her maybe 1 or twice a month if that… I honestly don’t know how often it is, but i’m guessing its less than that.
He is not listed on my policy or any other policy. She said if he was listed on another policy this wouldn’t be an issue, but because he does not have his own insurance he is a liability??
I called Met Life (just the generic number) and ask how often does some one need to drive my car before I should put them on the policy. They said 4-5 times a month. If they drive it 4-5 times a month I should add them as a driver.
Can you forsee any reason this would be denied? I live in Massachusetts and my boyfriend does not live with me.
I am freaking out, if they do not cover it, I don’t know how I will pay this huge bill.
Also, They called both me and my boyfriend for recorded statements about how often he drives. They said the matter will go in front of a board who will decide. Do you know who this “board” is? also if they do deny it, do I have any kind of appeal I can do?
I HAVE BEEN HAVING MAJOR PROBLEMS WITH MY 2003 HONDA CRV. THE DEALER HAS REPLACED THE TRANSMISSION AND SEVERAL OTHER THINGS SUCH AS BOTH FRONT AXELS, BUT THAT HAS NOT COMPLETLY SOLVED THE PROBLEM. MY CAR STILL SHAKES WHEN IT TAKES OFF. THAT’S BAD ENOUGH ON IT’S OWN BUT IT GET’S WORSE. I HAVE HAD IT IN THE SHOP SEVERAL TIMES SINCE OCTOBER AND MY WARRANTY IS RUNNING OUT. IN FACT I ONLY HAVE 20 MORE MILES ON IT. ANOTHER TRIP TO THE DEALERSHIP WILL TAKE UP THOSE 20 MILES. WHAT CAN I DO?
You will have to read your policy to see if it defines who is covered. I don’t have a Met Life policy to look at. If you want to email a scanned copy to info@insuranceclaimhelp.org I will look at it for you.
In looking at the ISO auto policy (generic) at UClaim.com product page, I don’t see any definitions of who is an insured in the physical damage section of the policy.
If Met Life denies the claim, make them put it in writing and make them quote the policy language where the definition or exclusion is. If they cover it, but underpay the value of the claim, consider one of the automobile loss eBooks at UClaim.com.
If the Met Life adjuster said the claim was covered and you started repairs, then he can’t come back later and say its not covered, even if the policy says its not covered. This is what lawyers call “estoppel”.
Hello,
I recently let my friend borrow my car to pick up her kids from school and to pick up a friend from the hospital. While on her way to the hospital, she was rear ended by a driver that caused her to spin into another car. My car was a 2005 Saturn Ion 2 Four Door Sedan and fortunately Saturn makes quality cars because the trunk just folded up and her 7 yr old son was unhurt. My car is completely totalled now. The guy who hit my car (I didn’t have insurance at the time of the accident) had insurance through Preferred Auto Insurance so I called in the claim myself once I got the police report. He was deemed at fault on the report for following too closely. On Monday, 3-16-09, No one had called in a claim and the adjuster had no idea about the accident which had happened 3-13-09. My friend was taken to the Emergency Room with neck and back pain due to the impact of the hit snapping the driver’s seat back. I received a phone call from Preferred Auto Insurance saying that this was a non covered loss and that the details couldn’t be discussed due to their privacy policy. A letter was sent in the mail without anymore detail than what I was told on the phone. I proceeded to contact two lawyers so far who are telling me they can’t take the case but no one will tell me why. The Kelly Blue Book Value of my car is $7915 and my friend is now in physical therapy and I need to know what to do because this man has insurance and neither I nor my friend contributed to this accident in any way. Also now the person whom my friend hit is suing my friend when she would not have hit her if it were not for this guy rear ending her. My car and his vehicle sustained the most damage in this six car pile up.
Heres my question on january 29th 2008 i came home from work to find water leaking from my kitchen ceiling. there was water coming down the walls and dripping through my window frames. my pergo floor was soaked to the point if u stepped on it water came out. i filed a claim that day and had a contractor come the next day. the report was an ice damn. this ice damn ruined my upstaris bathroom wall all the way to the kitchen walls, ceiling and floor. two seperate estimates where done by seperate contractors each around 12,000. this includes the siding wich was damaged from the ice. adjuster came and questioned wether the walls where STILL wet. he then said he didnt think the walls where still wet and that he had to have them tested. meanwhile my bathroom walls are open with the planks exposed and no insulation and so is my kitchen ceiling. The ice has all melted and the siding doesnt look to bad. pictures where sent the dayafter the incident showing all damage. the adjuster had chemdry come to my house 3 days ago to measure if walls where wet. we just recieved there estimate for the whole damage at 2,555, thats a big difference. i dont understand why such a difference and what should i do. i really dont think that will cover it when the other estimates where so much higher. its almost a 10,000 difference… please advise.. very confused
also forgot to mention the walls where opened for 2 months before chem dry came to see if they where wet.. of course there dry now theres no snow or ice and they have been open for a couple months.. please help
My mother in law’s house caught on fire a few weeks ago and she is staying with us in the meantime until her house can be repaired. (maybe up to 6 months) Her policy has Additional Living Expenses included in it. My wife and I are not trying to get money out of the Insurance Company but all of our bills will be going up not to mention we are saving them money by not putting her up in a hotel. My question is would we be allowed to charge her rent to recoup some of the cost of her living with us? Or would she have to actually be staying in a hotel for that part of the policy to kick in? I just wanted to check before I asked the adjuster.
It may be that Preferred Auto is denying the claim because your state does not allow victims to sue if they have no insurance themselves, regardless of who was at fault. It’s a way that some states penalize drivers without insurance. This may also be why the two lawyers would not take your case.
You may also be a risk of being sued by your friend who you loaned the car to.
Please let us know what state you are in, and if this is indeed the reason so that others may learn from your very unfortunate experience.
I live in the state of Tennessee and I’ve been in an accident in which someone hit me and I didn’t have Insurance then either and they paid for all the repairs through their Insurance. I was laid off Recently and that’s why I haven’t had Insurance.
Well the good news is that at least its covered and all you are arguing is damages.
Is the $2,555.00 the repair cost “after depreciation” and deductible, etc.? Make sure you know the repair cost that includes no deductions. Most home policies pay replacement cost, “after” the repairs are completed.
Try to get the adjuster to “reach an agreed cost” with the contractor of your choice. And try to get your contractor to call the adjuster also. If your contractor thinks he has a chance of doing the work, he will be motivated to help with this part of the insurance claim.
I don’t recommend going to appraisal. You are better off in small claims court in front of a judge.
For that amount of money, $10,000.00, you won’t find a lawyer or public adjuster to help you. But if you want to know how a good public adjuster would handle your situation, consider the eBook at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe).
You could also have a mold situation. Consider asking the adjuster for a mold test.
For ALE, the policy will say you have to “incur the expense”. Some policies give you a choice of ALE or FRV (fair rental value). So check that first. With FRV, you don’t have to incur the expense.
Bill your mother in law for what it would cost for a rental house or what a motel would charge and submit that bill to the adjuster. The expense is “incurred”, even if your mother in law has not been able to pay the bill yet.
For a detailed answer to this question and all the other issues you will encounter, consider the UClaim.com product “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”.
Check to make sure the law has not changed. Laws get changed all the time and often the public never hears about it.
If indeed you can legally file suit and the situation is as you said, then there has to be dozens of lawyers who would love your case. Feel free to email a copy of the insurer’s denial letter to info@insuranceclaimhelp.org if you want better advice.
My 14 yr old son collided with a car while riding his bicycle. Both he and the driver where approaching a blind corner and didn’t see each other. He collided with the drivers door creating several small dents and scratches. The insurance adjusted for the driver determined that it is my sons fault and is billing me for $1400.00 in repairs. The driver is suing me for $1000.00 in small claims court (her deductible). I don’t feel that it is 100% my sons fault, and that I should have to pay the driver and the insurance company twice. When I ask them for 3 estimates of the damage, the adjuster tells me that they used a reparable repair shop to get their estimate. I feel like I’m being bullied by the Insurance company. What can I do?
bhoffa24,
this is an acceptable alternative and you should not have a problem getting the adjuster to agree to help offset the expenses.
go for it. good luck.
fmc
Adding to Michael’s suggestion, you can rate your insurer and any of their representatives in the Consumer Ratings page of this website. You can leave your name as “anonymous” if you fear making a rating, but at least it will help all of us, as Michael says.
1. If you have auto insurance, you may have coverage for your son on the bicycle (I’m no expert on auto damage liability). Check your own auto policy and consider making a claim. Check with your agent. I believe the definition of “occupying” a motor vehicle in most policies includes “upon” a vehicle, which includes you as a pedestrian or bicycle rider. Perhaps a visitor to this website can comment on this?
2. Regarding who is at fault and percentages, look at the police report first (if there is one). Then get witness statements (if any). See who your own insurer’s adjuster says is at fault, (if you turned it in). Then look in the phone book or google “accident reconstruction” in your area. If the cost of an expert is too high, he may give a little free phone advice. Ask a traffic cop his opinion. And in the end, it may be the small claims judge who decides the fault issue.
Common sense would say that if the car was in its lane of travel and your son hit the side of the car, as opposed to the front, it was your son’s fault. Make a diagram of the street and the positions of the car and bicycle before, during and after impact. A number of factors should be considered, like speed, obstructions to vision, etc. One key to who is at fault is “negligence”, ie “was your son negligent?”.
3. You should not have to pay twice and I believe the law in most states would support that. If the damage is $1400.00 and the deductible is $1000.00, then the insurer should not be looking for over $400.00 from you (assuming you are 100% at fault).
4. If they want you to pay the cost of repair, I would think you would have a right to see the car. At the very least, they should give you a copy of their estimate and some photos, so you can show them to another shop for an opinion. You only owe the “reasonable” cost of repairs. Obviously they cannot charge you 1,000,000.00 for a broken headlamp.
Thank you guys – your information kept me sane in my claim processing. State Farm (SF) finanly settled my claim, however, I still noticing item was missing since my initial police report. I still forward lost item to the detective – but I am not sure if SF will considered them since they already settled them.
Another question I have – if 1 item on the settlement I strongly desagree in there settlement amount could I decline that 1 item eventhough it was included in original settlement checks.
As long as you did not sign a “release” paper with State Farm, you can turn in additional items for the next couple of years as you remember stuff. It’s illegal in most states for your own insurer to make you sign a release, unless it’s a “compromise settlement” and you both agree to the release.
Even if SF paid you what they estimated the one item was worth, you can still request more money on that item (or the entire list of items for that matter). If they “closed” the file, then they have to “reopen” it. For the best detailed information on how to increase your contents claim settlement consider the UClaim eBook entitled “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP” in the Homeowner’s section at http://www.uclaim.com/products.asp .
I am the recent victim of an extremly large and very old oak tree which fell on my house. According to the guys hired to remove the tree it would seem that it was about 125-150 years old. I have never filed a homeowners claim with my insurer before but i am already not getting a good vibe about this already. i had the adjustor arrive at my home and he did his intial inspection during this intial inspection he told me “this is the largest claim i have ever done” because my one entire side of my home was pretty much obliterated. After a couple of days passed i got a call from another adjustor to let me know that he had been put on this case because the inital adjustor did not have the experince to handle this claim. Well after a that he gave a check to cover some of my internal goods (which was an advance) within my home so i could buy some basic items to move into an apartment. well after all this i have only seen adjustors but i have concerns about the structual integrity of the home being comprimised and i don’t think the insurance company has any intentions of hiring an engineer to inspect it. from what i gather they are dead set on fixing it. Can i request that an engineer look at the house before they start telling me what there gonna do? and will i have to pay for that myself to get a truly honest opinion of weather the house will ever be the same again. i know that the insurance company will want to bid it as low as they can but how can they say lets start fixing it now after a tree that was 8ft wide and 15ft in diameter lands on the house and not even have a enginner look at it to say weather or not the foundation is good and it would be worth rebuilding. My fear is that with this economy the way it is and the fact that housing contractors are not in high demand right now due to the housing market. That a contractor will “low ball” the bid to get the job and then after the insurance company has put 40 or 50 grand into rebuliding it they will discover more problems and the insurance company will keep paying out more because they have too much invested not to fix it at that point when it should have been written off as a total loss to begin with and i get stuck with house that will never be right. i feel like my concern of the structual viability will not be addressed properly as i feel like it should. any advice you could offer me would be great
I will try to answer your questions in order, then give you the best advice at the end of this reply
If the adjuster refuses to hire an engineer to inspect the house before a repair estimate is made, fax a letter to the adjuster and whatever contractor who writes an estimate to repair the house that if he does not hire an engineer and architect to review the plans prior to doing the repairs, that you will sue him if any problems develop because of not using an engineer and architect. Also notify your local building inspector. The building inspector can insist that that the plans have engineering and architect approval.
Will their engineer be biased? Probably yes. Unless you want to hire your own engineer, then you are stuck with theirs. But do the same thing with their engineer if you think he “cut corners”. Fax him a letter saying you will sue him if problems develop while you own the house or if you sell the house and the new owner sues you.
If you fear they will waste your insurance money trying to repair the house, then run out of money after they discover it should have been totalled out, then do this, NOW: fax the adjuster a letter stating you prefer the house totaled out, but if the adjuster insists on repairing it, that your policy limits will be increased by the amount the adjuster wasted trying to repair your house. Now you have a record you can use later in court, if necessary. You also put pressure on the adjuster to total out the house. And if you really want the house totaled out, Cc the letter to the CEO of the insurance company.
Now my best advice. For the money you are talking about, you need more than a couple of paragraphs of advice from this website. You need professional help. You could pay an attorney who knows nothing about property insurance claims 30% of your entire settlement. You could pay a “public adjuster” 10% of your entire settlement and maybe get an unknown result, or pay him 50% of anything he gets over what you got on your own (as a “guarantee” of no unearned fees). Get advice at UClaim.com on how to hire a good public adjuster.
Or you could get all the information and techniques that a good public adjuster would use in an eBook in the Products page at http://www.uclaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” .
PS, if the house has not been covered temporarily while the negotiations proceed, get it done (and at their expense). Good luck.
Hello,
We had a flexible spending account in 2007 which we used to pay for approved medical expenses. We provided the fsa company with receipts which they say they did not recieve. They did not notify us about this denial until August 2008, at which time they asked for receipts again, which we provided again. In March 2009, they demanded money, claiming that they never recieved our receipts. We sent them proof (a dated fax receipt) that we did indeed send the receipts to them when requested.
The fsa company is not denying the viability of the medical claims. They are denying recieving the receipts.
After several conversations with the company’s service reps, who agree that we provided the company with everything they asked for, their “review board” still denies our appeal and is asking for money. I spent much of last week on the phone with this company and am at a loss as to how to proceed. What now?
It’s an ongoing process for each form. The latest editions I have seen are 2002 on some dwelling and commercial policies. And there are later “ISO” custom made forms for some insurers.
I normally suggest faxing documents to insurers (as you have already done) in order to get the “transaction report” as proof of delivery. And you can still use this in court if you have to. But in your case, I think I would scan the receipts and save as PDF’s, attach them to an email sent to whoever you are talking to at the insurer and Cc the email to several other addresses and get the insurance rep on the phone and ask him to open the email and attachment while you are on the phone. If you don’t have a scanner, have Office Depot or a friend do it.
And the fun part, Cc the email to your state department of insurance, 60 minutes and whoever you want to add.
And do this too, fax a copy of the receipts to the CEO’s office for the insurer.
i was out of town for ester break, friday through sunday night and when i took off i guess my garage didn’t close, the sensor must have triggered it back up.
now i work out of my garage which i am not really suppose to do but its the only space i have left to work in. i buy computers from apple and upgrade them and i had over $30k in units on the shelf in there that are now gone!
when i got home it was very late and i just drove 8 hours and the last thing i wanted to deal with was the cops there so i waited till the next day to deal with it. i live right by the manager and wanted to go into the police station to do the report because i didn’t want them making a major scene at my apartment. i didn’t want the appt. manager coming over and seeing whats going on and see that i have been working in my garage which i could get evicted for!
also i didn’t want my neighbors coming over or asking whats going on because then everyone will know what i do and keep in there. that would put me at risk even more with everyone knowing whats in there.
i got all the documents needed, the receipts, and went to the police station and waited to do the report and when the officer came out, a young rookie, he stated that i should have called them out when it happened and there is nothing he can do. i told him it was late and it didn’t just happen since i was out of town the whole weekend. i also explained my situation with the fact i am not suppose to be working in there and didn’t want to get in trouble with my complex manager who lives right by me!
his response to that was, well whats more important you place or your things? i said BOTH ! i dont want to get evicted and i also want to be covered for my things so yea
i said he can come out to investigate it as long as he can keep it quiet so i don’t get in trouble with the manager and draw attention to my garage. he said that is not possible and would talk to the manager and knock on my neighbors doors and make a scene.
now without a report and them not caring i have to deal with my insurance company who wants a report to file my claim. i might be screwed now since i can’t provide a report….
can the police do that and say no to making a report for me?
can my insurance company deny my claim if i CAN’T get a report for them because the police department wont make one?
if i try to get a report and can’t because the police wont do it then i think the insurance company should still cover me because its out of my hands and not my fault they won’t take the report…
any ideas or thoughts on the subject or help for me here
Well, your story sounds “reasonable” to me. And that is a very important word in insurance law and in your insurance policy.
1. No, the insurer can’t deny your claim based on your story. But they may try like crazy to delay their “decision” for a couple of years until you just give up. Maybe they will deny it for “failure to cooperate.”
2. Nothing in most policies says you have to make a police report. Your policy says you have a “duty to cooperate”, “within reason”.
3. If the police refuse to make a report, then try to get that in writing, and sent that to your insurer. In fact, you should make your request for the report in writing and fax it. Any failure on their part to respond can in itself be an admission.
4. The insurer may make a false issue of this since they know you want to keep a low profile.
5. But consider this before you spend a lot of time pursuing a claim, unless you have a “business” policy, or an endorsement on your renters or homeowners policy to cover, or increase a small limit on “business property”, your renters or homeowners policy may not cover business property.
If you decide to pursue the claim, consider the eBooks “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP” and “INSURANCE CLAIM PRACTICES LAWS WITH UCLAIM COMMENTARY, ADVICE AND HELP” on the product page at http://www.uclaim.com/ .
they tried to give me the lower business coverage which is only 2500 leaving me screwed on the 40k plus worth of lost equipment!
i told them that its not technically a business since i haven’t sold anything yet, don’t have a business name or license or web site. the lady who was not even in California said it doesn’t matter and told me that since i mentioned a business that there is nothing i can do about it.
i told her that we haven’t even done the recorded interview and that i will not state its a business because its not one yet and may never be one. i told her that its all mine and that i was thinking of selling some of the units or all of them but they are mine. same as buying a lot of furniture and turning around and selling it all for newer pieces.
she also said that i can’t get anything or continue with my claim unless i get a police report. so i am up sh#t creek here and very very upset!
so i have no idea what to do now and feel very taken advantage of by this insurance company being esurance
they wont even return my 266 dollars i paid 5 months ago for a year up front of coverage. i demanded it back since i am not getting the coverage i am paying for and they refuse to do it. they said i would get 160 back and thats all…
i really want to sue them but i don’t want to deal with it really but its a lot of money i am loosing that they aren’t covering!!!
1. I still don’t think they can insist on a police report.
2. If their claim denial is valid, then I don’t think they owe you a full refund.
2. Read the definition of “Business Property” in the definitions section of your policy. If it does not exactly fit your situation, then they can’t deny the claim. If there is no definition, then look up the legal definition in Blacks Law Dictionary. Short of a clear definition, I think a judge could consider what the property was “intended” for. On the other hand, if the property was never offered for sale and you filed no business papers, then maybe technically it was not a business.
3. If the policy definition is not clear, then the benefit of unclarity goes to your favor.
4. If you want us to review your policy for no charge, scan it or have Office Depot scan it and email it to info@insuranceclaimhelp.org .
Our house was in NYS. We were renting it out while away on temporary, long-term assignment. Due to the tenant’s negligence, the house was destroyed by fire. We hired a public adjuster due to our locale and the extent of damage (total loss). We are wondering if we can go after the tenant’s liability insurance to recoup the PA fees, which are in the area of $25,000-30,000.
Also, the tenant’s liability insurance was shy the required $500,000 by $200,000. We are hoping the fees can come out of that, or from the property management company that did not ensure proper coverage per the lease.
1. The public adjuster will probably not be able to pursue the liability claim since in most states PAs are limited to handling property damage claims. But, he can “work for free” on this, if you get my drift.
2. To cover myself, I will first say consult with a lawyer on this. In my opinion, the tenants liability insurance will not extend coverage, unless as you say there was negligence, and to meet the New York definitions of negligence.
3. As to the property management company, you or your lawyer need to see if there is case law in New York on their responsibility in this matter. And the language of the lease itself is also very important. Have a lawyer look at it. You can also email us a copy of the lease language on the insurance, or cut and paste it here. Our email is info@insuranceclaimhelp.org .
April 24th, 2009 at 10:30 am #f. michael conte,CPIA
pjean,
also keep in mind that the carrier who paid the claim may be persuing the tenant through subrogation. if you go to an attorney he should attempt to coordinate with the carrier. i would also review the fire report to see what the cause and origin of the fire was. the will give a better clue as to who caused it. if it was something apparent like using an outdoor grill inside(we had such a loss) you may attempt to contact the carrier directly to see what their humor is on this topic. be carefull though you cannot collet on the same loss twice.
fmc
I just had a slab leak in my home. Some of the areas effected by this slab leak overlap with some damage we had incurred with a wildfire a few months back. Now the wildfire damage has not been replaced or repaired because the claim on that was just settled a few days ago.
Now with this new water damage claim, I was wondering if the overlapping items will be covered by the water damage claim? Some of these items have already been covered for replacement from the fire claim, but this (water damage) claim is a separate incident.
While you may technically and legally be able to claim water damage to a fire damaged carpet that was not replaced, I suspect the adjuster will resist your efforts. But hey, give it a shot. it’s what you pay premiums for.
Now had the carpet been damaged from fire and water on the same day, during the same loss event, I don’t think you could collect twice.
fmc,
Thanks for the input. Interestingly, the same insurance company represents both us and the tenant. Not so sure how hard they will try to recoup our fees for us, since they would be taking their own money…except that I believe his liability insurance was exhausted through subrogation for both our claim and neighbors’ claims who sustained damage to property and vehicles due to debris.
On another note, the property management company failed to ensure that the tenant obtain a set amount of liability insurance. They were shy by $200,000 per the lease terms. If this amounts to gross negligence on the part of the property management company, I think we could sue them for the fees if the tenant’s insurance is shy.
We would not be collecting twice….the fees of the adjuster go above what we have settled for. Thanks for that tip though.
Finally, the cause of origin indicates cause to be unattended candle or smoking, both a liability on the tenant’s part. Our fees are in excess of $25,000, so we will be looking to work with a lawyer to recoup. I just did not know if it is standard practice to pay out on someone’s public adjustor fees, since it was our choice to hire him. Only problem was that we are not local to where the fire occurred and were geographically disadvantaged to pursue the insurance process on our own. It necessitated our hiring of the adjuster (esp since we were both covered by one in the same carrier). I just hate to pay a lawyer $200/hour to potentially lose. Ouch…
Thanks for your comments.
April 29th, 2009 at 5:11 am #f. michael conte,CPIA
PJEAN
seems like the managing agent dropped the ball, i would go that route surely they have proffesional liability coverage.
good luck
fmc
ps i trust deductible was waived?
Have a question? After reading all these problems with the insurance companys, rebuilding (or trying), pay, not pay, brings us to the question whether all this is really worth the effort.
Our house burned down a few months ago, and we are experiencing the same problems that others are facing with the insurance company’s. The lender called last week and asked what was going on with the insurance company and I explained where we were at. By the time the insurance company gets around to settling the claim, our home may be in foreclosure. I told them we plan on rebuilding, but now that is in question.
Neither of us really want to even rebuild if we are to face the problems like we are reading, and the insurance company at max. will only pay out barely enough to rebuild. (We lowered our coverages, last year due to our resources at the time). Big Mistake!
Here is the question. Our lender knows of the fire, and is telling us if the insurance does not act soon that the LETTER (foreclosure) will be generated. Im now unemployed, have spent all monies towards getting resettled, and being told we would be compensated accordingly by the ins. company. Now they are not paying.
If we just drop the claim, let the house go to the lender, and move on…..
Will we somehow be held liable to the lender for the house if they foreclose? Or will it haunt us later?
At max our contents would pay 60K and we have the depreciated value.
Sure we lose our contents, and alot of hurt, but is it really worth fighting the insurance company to the points of total loss of self, being angered, frustrated, humiliated,………..among a whole lot more? Listen to what they are doing! Its absolutely Insane. Yet, they ask for more money and percentage increases……………..
Hi,
I was involved in an accident that occured in a parking lot. I was driving in a designated driving lane and was struck on the driver’s side, front quarter panel. The damage is on the side front. The police accident report clearly states that the other driver failed to yield right of way. Now, after several attempts to reach the other driver’s insurance adjustor, she returns my calls, and claims that her company has ruled that the accident was contributory because their insured, claimed that I had reasonable ability to stop and avoid the accident. We were at a slow speed and the other driver hit me in the side of my car. The accident report claims the other driver failed to yield right of way. I argued this to no avail. By the way, I filed the claim with my insurance and the other driver’s insurance. What should I do? Should I file small claims on both the driver and their insurance company, or get tough with the other driver’s adjustor and threaten to sue, since I have the proof of failure to yield in the accident report. Thank you for your time and attention to this matter.
We had parked our brand new Lexus in a commuter rail parking lot from 930AM to 905PM. When we returned the rear side of the car had been hit. We took it the next day to the body shop that the Lexus dealership uses and the insurance adjuster viewed the car I believe a day later. There was over $4000 of damage, being a new Lexus it is expensive to repair. The insurance company is trying to deny the claim, saying that the car was moving when hit. The car was in perfect shape when we parked it in the morning and damaged when we returned. Can you give me any help in what to do next.
1. Get yourself the ebook at UClaim entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” for $79.95. It currently has a 30 day money back guarantee. Look at the table of contents online there http://www.uclaim.com/products.asp .
2. If your house burned and you have not at least been paid the ACV (depreciated value) upfront, then either they think you burned the house or they are one of those “low quality insurers”. In either case, you can’t handle this on your own. You either need the direction in the ebook recommended above, if you want to “do it yourself”, or you need a good public adjuster. The Free Stuff page at UClaim will give advice on how to get a good public adjuster. Get a public adjuster who will let you keep what you were offered and apply his percentage fee to any additional recovery. If a PA can’t help you, then seek out a lawyer. Lawyers are more expensive.
3. As to whether you should “walk away”, definitely consult with a lawyer who handles foreclosures and bankruptcies. Pay the lawyer for an hour of his time.
You don’t want to be penny wise and pound foolish here. It could haunt you for years to come, even if you declare bankruptcy.
I would say turn it in to your own insurer, pay your deductible and let your insurer settle up with the other insurer and get back all or part of your deductible for you.
If you are determined not at fault by your own insurer, then your premiums should not go up.
I don’t know what difference it would make if your car was moving or not. Most auto policies cover collision damage to the car whether it was moving or parked. And if you have comprehensive coverage, most insurers require collision coverage as well. I would also think that you have uninsured motorist coverage with a Lexus?
Ask the adjuster to put the denial in writing and to quote the policy language that says collision to a moving vehicle is not covered. If they have more reasons for the denial, then it should state why.
If you don’t have your policy form copy, you can get a sample at UClaim.com.
dc,
not sure what state you are in i would suggest contacting the insurance department for that state. also i am not sure that the bank can move to forclosure in your situation. i would ask the bank to have their attorney get involved and i would also list the name of the carrier you are dealing with so people learn who not to do business with…….
i would not walk away from this it will haunt you for a while.
you might also ask you agent or broker to get involved afterall this is exactly why we earn a commision.
i purchased a 2006 toyota tacoma brand new. recently i had my truck stolen. i had done a lot of upgrades to the vehicle, but i feel they are undervaluing it. heres the details.
truck only had 14,000 miles on it from me
i purchased an extended factory 100,000 mile bumper bumper warranty. ($1900)
car was in mint condition inside out (seat covers, floor ,mats, wax jobs)
added the following…
premium tires, upgraded rims, grill, brush guard, toyota seat covers, top of the line sound system that didnt alter the vehicle. everything was mounted and made for this specific truck. ($4500)
now i know these are accessories, but they were specificaly for this truck and it did make my truck the best. of course if i were to sell my truck, it would be worth more than the same one stock with zero upgrades or warranty.
so they are valuing my truck like an average joe vehicle. i have AAA.
does any of this ad value? does the warranty ad value? is there anything i can do?
thank you.
1. In my opinion, if you take a cash settlement instead of replacing the truck, I don’t think the insurer will add for the warranty. However if you tell AAA to replace the truck with exactly what you had and use the same dealer you got the warranty from, you would have a better chance of keeping that warranty? Read your warranty agreement to see what it says “in the event of theft or total loss” to the vehicle.
2. As to the other options/accessories, unless the AAA policy says it will only pay for a “stock” vehicle, then they should add to the value.
3. All this aside, the chances of you still being lowballed are pretty high, especially if AAA used CCC or ADP to value your truck. I suggest you consider the eBook “TOTAL LOSS AUTOMOBILE INSURANCE CLAIM ADVICE AND HELP – FOR INSUREDS” at http://www.uclaim.com/products.asp .
I have recently filed a Home Owner’s Insurance Claim. The insurance company has cut me a check to cover the estimated value of the items damaged. I went to replace the items and was able to replace them at a cost less than estimated. My insurance company is requesting that I fax over the receipts to prove that I have replaced the items. My question is, if I did not spend the total amount alloted for the item, is the insurance company going to require that I give them back the money I did not spend? I have heard that I would have to and that I would not. Any help would be appreciated…
When you say “estimated value”, I assume you mean the depreciated value, not the replacement value. The only reason to turn in receipts is to prove you paid more than the depreciated value, so you can get the difference back (assuming you have replacement cost coverage). If you don’t turn in the receipts, then they don’t know how much to “collect back”. This is not something that adjusters waste their time on investigating or pursuing.
One option to increase your contents settlement in your situation would be to renegotiate the depreciation taken on your contents.
We have a standard homeowners policy with a company that has an exclusion for “collapse”. A while back, we noticed damage to our well, and immediately contacted the insurance company with a claim. They denied it outright without sending out an inspector, and because the well was within 5 feet of our home (and a safety risk), we filled the well in. After contacting the State Department of Insurance, we learned that common practice is for a company to send out an adjuster/inspector before denying a claim – in our case it is possible that the well did not collapse – nobody really knows what happens because the only damage was the subsidence of a few cubic feet of soil and very dirty water in the pipes.
Now it sounds like they want to deny it based on several other factors, primarily that it “probably was a collapse”, “flooding”, and inferior construction because the well was brick-lined, not cased in modern concrete tiles. The brick-lining was state of the art before WWII when the well was probably built, and I just can’t see that “inferior construction” applies just because technology got better over the next 75 years.
My argument is that the company did not exercise due-care in investigating the claim, and that they should have either sent out an inspector before denying, or recommended that we have the well professionally inspected before we began to fill it in. What kind of responsibility to exercise due-care in the investigation of a claim does a company have?
Lots to consider here. Was the denial in writing? Was there a tape recorded statement? Is the well a “structure” below the casing or bricked in part? Or is that lower part just a hole in the dirt or clay or rock below the casing? Is this a wide well that you drop a bucket down?
The insurer has a duty to do what is “reasonable” in deciding how much investigating to do. And that depends on what information you gave the adjuster on the phone to describe your well and what questions you were asked. Well construction may vary considerably. At first I assumed you had a submersible type well with a steel pipe casing at the top. But when you said “brick lined”, then I started to wonder if it was a well like you drop a bucket down.
A collapsed well is a very unusual insurance claim, and in my 30 years living in a farming area, I have never has such a claim.
Most adjusters know nothing about how wells are constructed in different parts of the country. And if they do have knowledge, it is probably about how wells are built in their own area.
Even though you filled the well in, it may be possible to “exhume” enough of it to determine the cause and origin by an engineer.
As to denial for “inferior construction”, that sounds like an over zealous wishful thinking adjuster. Most policies exclude “negligent construction”. That’s not the same as “inferior construction”. If “inferior construction” was not covered, then there would be no coverage for old homes, right?
Read your policy wording and check it against the denial letter wording.
I think you could also say the well was an “appurtenant structure”, if part of the denial is that the well is not a structure or that the well is a hole in the land and land is not covered.
You can learn the basics of dealing with denied claims in the eBook entitled “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP – STANDARD VERSION (W/O APPENDIX)” at UClaim.com http://www.uclaim.com/products.asp .
The well is a ground-water well, very common in older rural homes in the Midwest. My research on this tells me that today’s common drilled wells (diameter 12” or less) didn’t become common until the late 1940’s, and hand-dug tiled wells like mine were still being put in up to the early 1970’s. Concrete ring-cased wells become common to line the wide, dug wells like mine once truck-mounted dolleys and cranes were available.
The well was larger than 36 inches wide, and I bet you could drop a bucket down it. But mine had a submersible “push-pump” resting on the bottom – similar to a sump pump in a home, but designed for this kind of wide but shallow well.
I personally did not tape record the claim denial, but when I bypassed the claim adjuster and spoke with the claim manager, I heard the tell-tale pauses and clicking of a recorded conversation. I’ve documented that I was informed of the denial on day 1 to the company and the State Insurance Commissioner as well. What I do have is that the letter notifying me that they intend to investigate the claim is dated almost a week after I first contacted the company.
The entire well casing from top to bottom was “clay tile”, similar to field tillage tiles, but squared off and made for use in a well. The top 6 inches was a poured concrete cap. I believe the bottom of the well was sand, because it tapped into a subterranean mineral water spring. Putting concrete over this would stop the spring water flow.
It would be difficult to exhume the well, as it was within a few feet of my home’s foundation. One of the key problems right now is that what caused the well to malfunction is “unknowable”. It’s kind of like having your house bulldozed before the claim adjuster arrives to evaluate the fire damage. Maybe it was a total loss, maybe a partial loss, maybe the fire was not accidental, now that the house is gone – it’s impossible to be certain what happened.
If it was “legal” (admissible in court) tape recording, they would have to have asked your permission.
1. What would it cost to replace the well:
A. exactly as it was built?
B. With current replacement to code?
2. What was the current “market value” of the well?
3. What was the demo cost?
Feel free to post the exact denial wording from the letter here if you like, or email a copy of the denial letter to info@insuranceclaimhelp.org for our review. Black out any id info. if you like.
One more thing. Check out the wording on collapse exclusions in your policy. Some policies don’t clearly exclude “eminent collapse” (a sagging, leaning, slumping, cracked, etc. structure).
I recently had hail damage to my roof. Well we just found out that our home loan was put in our bankruptcy so we aren’t going to be keeping the house. My question is can we keep all the money and not fix the roof or can we just do minimum repairs and keep the rest?
There are 5 editions of the ISO HO3 listed above from 1988 to 2000 (latest HO3). They are available for download at http://www.uclaim.com/products.asp .
If the check is only in your name, then keep the money. Now as to your bankruptcy, you have to find out if the court requires you to report insurance claim proceeds as “income”. FYI, The IRS does not consider property insurance claim proceeds to be income. Check with your bankruptcy lawyer.
If the insurance claim payment check includes the mortgagee, your bank, named on the check with you, then you will have to do the repairs. If you get the repairs done for less or do it yourself, then the bank may sign off on the check.
If it’s a two party check, do not sign the check and mail it to the bank. Hold onto the check. Do the repairs first, then call the bank to have their inspector verify the repairs were done, then, mail the unsigned check to the bank for them to sign and return it to you so you can now cash or deposit the check.
I have a truck that is a couple years old. It received minor damage from my garage door to the front bumper. I received 2 estimates in the $700 to $800 range. My deductible is $250.
What are the implications if I file a claim? Increase in premium? For how long?
I have multiple vehicles, and this one is for “recreational” use, < 5000 miles per year. I have not had a claim in 15 years.
I was in an auto accident about a year ago, and my vehicle was totaled. We had gap insurance to cover the cost of the difference between the value and the loan amount; however, the gap insurance company, did not pay the entire amount. They claimed that the vehicle was worth a different amoun than our primary insurance company. We have been trying to resolve this issue for over a year. I believe one of the two companies is trying to rip us off. The gap insurance company said they used a different “book” to get the value than the primary insurance company did. This doesn’t seem right to me…Have you ever heard of this type of discrepancy?
HI We had a House fire on March 13, 2008 on brand new property. The fire started in the garage went into the roof and we lost half the house and 3 cars any everything in the garage. We were completly hounded by public claims adjusters even while the fire was still burning. We signed with one and that has been a night mare. They have been worthless there only concern is to get there 15%. The items that were saved need to be cleaned before they go back into the house. We had to contact Departmetn of Insurance for the State of California to get beds cleaned. Right now my sons mattresses havent been cleaned. Do you know of stories of public claims adjuster that have really help consumers? We havent been payed yet for the contents and the builders has place a len on property for the extras that werent on the scope by the insurance company. We had to get a attorney
Of course. Insurance companies and government tax assessors use whichever guide book suits their purpose whether its to lowball or to highball a valuation. Anyway, your first goal is to deal with the underlying insurer first, and the gap insurer later. You usually have 3 years to file suit on property damage, in spite of what the policy says.
Get yourself the eBook entitled “TOTAL LOSS AUTOMOBILE INSURANCE CLAIM ADVICE AND HELP – FOR INSUREDS” at UClaim.com http://www.uclaim.com in the Products section. Use the techniques in that eBook to discredit the insurers valuation. And use the gap insurers valuation also. (But if the gap insurer used a book, and not CCC or ADP, then the primary insurer will not likely be influenced).
Win or lose with the primary insurer, you can use your new valuation against the gap insurer. If that fails, you will have plenty of evidence for small claims court (no lawyers).
If your story is even half true, then it makes my stomach turn. I feel shame for the PA profession in California.
We all know there’s good and bad in every profession. Unfortunately there are more bad PAs in California because the biggest player years ago thought he could wipe out the competition by forcing the “solicitors” to become licensed as public adjusters. Well, it backfired, because now you have people with PA licenses whose experience “working for insurance companies” consisted of sucking water out of carpets from toilet overflows. (And in fairness to the PA profession, there are excellant PAs who have never worked as insurance company employees, but they are few.)
Now if you want to know how to hire a competent public adjuster (or any professional for that matter), go to the “Free Stuff” page at UClaim.com http://www.uclaim.com and click on the line entitled “About Public Adjusters”. Scroll half way down to the yellow highlighted part and read those two paragraphs.
And if you and your lawyer want to know specifically if your PA followed reasonable PA procedures, get the PA’s “Bible” entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” at UClaim.com, top of the Product page. It was written in layman’s terms, for the common man. It will teach you how to pick up the pieces and do a better job than the guy you hired.
Good luck to you.
If the PA you hired was at your house as it burned of after hours, you may have a legal way out of the contract. Also, go to section 15006 of the California insurance code for a list of illegal PA practices. Go to Findlaw.com to access the codes for free.
This is a better question for an agent. Find out if it will increase the premium, and if so, how much and for how long. If you don’t want to alert your own agent, call one in another town, but for your same company.
If you are not at fault in an accident, then your premium should not increase. Was there some negligence or fault by you or your family in this little mishap?
Yes,
I failed to back the truck in far enough and when I closed the garage door it scratched the front bumper. So yes, I suppose I was negligent.
I’ve put in an inquiry w/ my insurance company but have not received a response yet.
My personal opinion is that it would be a travesty if the insurance company increases my premium for a single non-driving incident after 15 years. They’ve made a ton of money from me over the years.
If person seeking health coverage is family member of active duty military personnel, Uniformed Family Health Plan (USFHP) is the best choice for him/her with best coverage and very competitive rates.
On March 14th 2009 my home burned. About half of the house was completely destroyed, and the other half was severely smoke and water damaged. The insurance co. started off by playing nice. They put us up in a rental house, got us rental furniture and housewares, and even got us a couple thousand dollars for incidentals.
But lately, the adjuster has become impossible to deal with. He takes days to return an e-mail, a week or more to return a phone call, and he is condescending. He gave us the contents forms to fill out to start processing our contents claim, then after about 20 hours of labor on my part to fill it all out, he sends me a 5pm on Friday email saying that it wasn’t done correctly and quoting sections of my policy. This A: doesn’t help me correct it and B: is a slap in the face considering all the work I have already put into it.
Should I get a public adjuster to deal with this? or maybe a lawyer? or just ride it out?
I was involved in an auto accident. I was on my bicycle at the time.
Question:
Can I get my bike replaced? It is a high end bike – $ 3,000 msrp, $2400 paid. It is an 2006.
I was traveling along the side of the road and the driver hit me. It is basicly totaled in my eyes. The carbon frame is not visibly cracked or damaged. BUT I feel that the frame has been hit hard enough that I do not trust it to give me the longevity that I expected when I bought it.
The repair estimate is $2000. New bike is $3300.
Now will the evaluate it at the $2400 or the msrp of $3000. Or will they replace it.
The insurer owes the least amount, to repair or replace.
You need some expert opinion on your side, and you need it in writing. If you can get a bicycle dealer to say that the frame will not last as long because of the accident, then that is where you start. Hopefully the insurer won’t hire their own engineer to refute your expert. This will give you a clue as to whether this is a low or high quality insurer.
Oh, and if they do pay to replace the bike, then they have a right to the salvage. So keep that in mind. Also, if it’s some one else’s insurer you are dealing with, if they do agree to total it out, they owe the used market value, not the replacement cost. If its your own insurer and you have Replacement Cost on contents, then you get RCV, if you replace it.
Hey Chris, the best website to find a good PA is http://www.napia.com. It is the self governing organization for PA’s. They mandate continuing education and heavily scrutinize new and existing members to ensure they conduct themselves in a professional manner. Just my two cents. Good luck.
Sounds like your adjuster did what many are trained to do now days – be super nice in the beginning to keep you from hiring a public adjuster or attorney. And actually that’s not so bad, because it does help to discourage some of the lower quality PA’s using hard sell tactics.
I suggest hiring a PA (a good PA) before you hire a lawyer. Don’t shop for a lawyer unless the PA can’t get a fair settlement for you. For advice on how to find a good PA, look on the Free Stuff page at UClaim.com http://www.uclaim.com for the link “About Public Adjusters”, scroll down to the yellow highlighted area and read those 2 paragraphs. To find PAs in your area, look in the Yellow Pages and check http://www.napia.com. You can pay the PA a percentage of the entire settlement (10-15% is typical), or a percentage of the amount over and above what you were already offered (not over 50%). And read the post of 5-14-09 by Chris about public adjusters on the home page here.
If you are inclined to continue to handle it yourself longer, consider the eBook entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” on the Products page at UClaim.com . You can also use that eBook as a guide to see what your PA or lawyer should be doing for you.
Great advice and thanks for your “two cents”, which is most welcome here!
I might add for the visitors here that if one is looking at the Napia website for a PA, give preference to the ones with the designation “SPPA”, which means that PA has passed a number of college level type classes and exams in claim adjusting. While this is no “guarantee” that they will do a good job, it raises the odds that they will. And don’t necessarily rule out non SPPA members, or non Napia PAs. You have to take a good look anyone you are considering contracting with.
I live in Wisconsin. My name is on a mortgage with my ex-husband who recently set fire to the home and is being charged with arson. The insurance company has agreed to pay the mortgagae comany for partial losses but has not yet due to lengthy investigation. Meanwhile the home is being foreclosed on and I am being told that I will be sued by the mortgage company’s private mortgage insurance. I am completely innocent. Is this even possible? Thanks.
While I am traveling for business, my wife discovered a lot of water on the basement floor. The entire floor was soaking wet. There was some evidence of water on the drop ceiling. The 1st floor floor right above the basement (hardwood) got buckled up. She immediately contact our handyman to find out what’s going on. Upon inspection the house, he raised two possibility: (1) rain water could have come through the wall or (2) there is some type of plumbing failure. He was leaning toward plumbing failure as there was no sign of water coming through drywall, and the buckling seem to become more severe. It also smelled really bad. Furthermore, he suggested the amount of water is too much for rain water coming. (For your information, our basement was never wet.) He suggested that we should get professional mitigation company to restore the basement and ask their opinion. The guy came and immediately suggested that it is some type of plumbing failure, based on the smell. He also pointed out the buckling. He suspect that it cannot happen because of water coming to the basement. Again, he did not see any sign of wetness or water stain on our drywall in the basement. He said we should get a plumber and claim to our insurance.
Later a plumber came and looked. But, he could not find any plumbing problem, saying that everything is dry. He said, that water must have come from outside. He was not able pinpoint where it came from. But, he said our plumbing is fine.
We called the insurance to make a claim. Insurance guy told us that they would not cover the damage if the water came from outside. But, he also agreed that it is strange to have severe damage on the first floor and no sign of water on the wall, given the amount of water we had on the floor. So, he said, “we will cover it if you show us plumbing problem. Hire a plumber and show us what he fixed. Then, we will cover it”.
The mitigation came back yesterday. After hearing the opinion of the plumber and the insurance, he still believed that water must have come from inside. So, he tracked the damage area and found wet area in our basement ceiling which is connected to the vent from 2nd floor bathroom. The vent is on the floor. So, now he suggested that some water might have come from that vent. However, my wife did not see any overflow in the bathroom. But, he said, he is going to put it as a statement that we can submit to the insurance company to show as evidence of water coming from inside. However, we don’t have a broken pipe.
What we now have is two theories, without any positive proof for either of them. We don’t have clear evidence of outside water coming (our sump pump is fine) – no stained wall, water mark or wetness of the wall. At the same time, we haven’t been able to locate the broken pipe. Yet, we have clear damage of water on the 1st floor and the basement. How should we present our case to the adjuster? Is this kind of case that we should get public adjuster?
I’m in California. My husband was riding down the freeway on his motorcycle when a pickup one lane over ran over a large piece of metal (about 3 feet by 2 feet) and launched it. It slammed into the side of my husband’s motorcycle, causing some extensive damage. When I went through all of my insurance paperwork I realized that the company had never sent me the full policy. My question is, how should this be covered? Under comprehensive or collision? Thank you.
Check with an attorney in your state. Most states have laws protecting innocent spouses. Look at your policy to see if it says the claim will be void if there is fraud by “the insured” or “any insured”. “The insured” is the “named insured” on the declarations page, and may not include “non named insureds” like other relatives in the house. So “the insured” would assume that there would have to be fraud by all the insureds.
Educate your bank foreclosure officer. Advise them that they will be in a better financial position to have a repaired house as collateral than just the amount of their loan. Also advise them that the insurer owes “replacement cost” to the homeowner, but only ACV (depreciated value) or loan value whichever is less to a mortgagee. Most policies don’t give RCV to the mortgagee.
If they won’t give you the policy or delay it, see if its listed on the Policy From Copies page of this website.
I would think collision. And most insurers don’t write comprehensive without collision already being covered. Most policies also define comprehensive as “non collision”, except for specific listed things, like impact with an animal in the road.
If they deny it, get the denial in writing stating the specific reasons and policy language.
I assume the pickup truck got away. If not go after them or your own UM coverage, as long as you can identify the truck.
It sounds like a small claim and I’m not sure a PA would be interested, but you can try. Definitely hire a PA if the claim is denied, and consider hiring a PA before a denial. Read “About Public Adjusters” on the Free Stuff page at UClaim.com http://www.uclaim.com .
You probably have an “all risk” policy on structure. It says “we cover everything except …” with named exclusions. That means the “burden to disprove” your claim is on the insurer. That means they, not you, have to disprove the cause of loss if they want to deny the claim. That means they, not you, have to hire an engineer or leak detection service or whoever to find the water source.
Has anyone cut a hole in the ceiling or opened the vent to look for water stains etc?
wow what a nightmare, get an attorney, i do not think they will persue you for arson, however i think they will be looking for their money as i assume you are a co-signer on the loan. fmc
young,
you mentioned you were away on business how long were you away?
also was their waste in the water or was io t clean? finally a buckled floor is not a surprise, as wood acts like a sponge so in a condition of high humidity wood will absorbe the water in the air and then buckle.
ideally you must pinpoint the problem. is it possible that some left a faucet on?
finally keep in mind that overflow from a plumbing system may be an exclusion as well.
Insurance company says it is a comprehensive claim and will have no affect on my premium. They said it is no different than having a tree fall on the truck. It’s outside my control and doesn’t make me any higher risk to insure.
BTW, I found out you can request your A-PLUS and CLUE reports under the Fair Credit Reporting Act here in California. I’ll be doing this in the near future to see what the insurance company puts on it. These are the insurance equivalent to your credit report.
may 19th our beach house had a pipe burst and flooded, the neighbors realized there was something wrong and used their key to enter. Upon entering the house they realized the mess, falling ceilings, mold up the walls and bucked hardwood floors just to name few. Currently the insurance company has a company serv-pro removing everything down to the studs, we do not have a mortgage and with current home values we might be better with a total loss. Can we suggest that? The mold is everywhere and they are saying that it may take days just to get the mold to an accessible range. I also have asthma and severe allergies and the thoughts of a home possibly having mold in the walls freaks me out. What should we do.
Please let us all know exactly how you access CLUE and A-PLUS. I wonder if you can get them for free if you were denied coverage or something adverse, as in getting free copies of credit reports?
This is one reason why I shut off the water valve to my house anytime I plan on being gone, even if for 1 night.
1. Consider that your policy may have a limit for mold coverage, possibly as low as $5,000.00. Insurers got tired of trying to deny mold claims, so they found it easier to cover it, but put a dollar limit on it. Make sure that any agreements you signed with Servpro don’t leave YOU with the bill if they run over cost.
2. Get as much covered or replaced using “non mold” coverage. For example, if wall paper is stained and molded, claim it as stain damaged, not mold damaged.
3. If you prefer the house be “totaled out”, then put that in writing to the adjuster. Tell him the house is a total, in your opinion, and you don’t want your insurance money wasted on Servpro or others. And fax that in writing also to Servpro. This will force the adjuster to be the one to authorize Servpro to attempt remediation (and it is his right to do so). In other words, any failed attempts to repair or “remediate” your house will now not be applied to your policy limits.
4. If Servpro screws up the remediation, now you have a liability claim against both Servpro and your insurer. And such a claim would not be subject to your policy limits.
5. Is Servpro using blowers AND dehumidifiers? Most insurers are too cheap to cover dehumidifiers. So if they did not use the dehumidifiers, then you may have a liability claim against both Servpro and your insurer for negligence if your coverage on mold depletes.
I suggest you run this strategy by an attorney, as the final decision will be yours. Insurance claims are often like a chess game and you may want to consider a “good” public adjuster and or attorney. See “About Public Adjusters” on the Free Stuff page at UClaim.com.
A great reference for handling this claim is the eBook entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” at UClaim.com http://www.uclaim.com/products.asp .
I found this article which makes it seem you can get your CLUE and/or A-PLUS under the same circumstances as your credit report. Denial of coverage and/or once per year in California.
My insurance company denied my claim by saying my loss is due to long term leakage at the water heater which is not true. I hired a plumber and the hot water heater is not leaking it is the pipe and valve that started to leak. At the first sign of water on my floor I contacted the insurance company they sent out an adjuster who just took pictures and didnot even check so see where the leak was. The hot water heater is in the wall in the bedroom so how am I to know something is wrong until I see water on the floor?
Unfortunately it does not matter if the damage was hidden from view. And it does not matter if the water leaks from a pipe, valve, or the heater itself. They are all “appliances”. But all is not lost.
Adjusters often mistake a black wood floor or buckled floor for “long term” damage. The key is whether you can push your finger or a dull butter knife through the “damaged” floor. If you can’t push your finger through the “rotted” wood, then it is not “long term” damage. A plywood floor can buckle over night and can turn black in a couple days. That’s sudden and accidental, not long term.
What is definition of vacancy under a DP3 policy. The dwelling was being repaired after tenants damaged it. insured was doing repairs himself but not living there. Water loss occurred but was discovered and mitigated within 48hours.
Florida
i was t boned by a taxi driver who ran a stop sign; there insurance in nationwide in ny. they wont pay claims as person was using car as a taxi and only had personal insurance on it, isnt there a way to get some payment for my car. i cant work as i use it for work
The ISO Homeowners Insurance Special Form Policy DP3 7-88 (available at UClaim.com product section) does not define the word “vacant” in the Definition part of the policy, but it does say “a dwelling being constructed is not considered vacant” in the Perils Insured Against section of the policy. I would argue that this includes repairs and remodeling.
Most personal auto policies exclude liability coverage if the vehicle was used as a taxi. Did the “taxi” have any passengers during the accident? If not, there may be coverage if the taxi driver argues the accident occurred during personal use of the vehicle.
And of course, you are still free to sue the driver and taxi owner, regardless of whether his insurance covers him or not. That could motivate the taxi driver to pressure his insurer to cover your claim.
In order to collect the balance of a claim which ins. adjuster referred to as “applicable depreciation balance” withheld by my insurance co., my insurance company is asking for receipts for the restoration & cleaning work completed by the contractor after a fire in my home. I have a final invoice from the contractor, however the contractor is refusing to provide receipts, says he does not have to and claims their demand is redundant and that the itemization for everything is in his estimate that the ins. company has already sent payment for (less depreciation). He says it is evident that ins. co. is attempting to get out of paying remainder & that they are acting in bad faith. Now the contractor has threatened to put a lien on my home for non-payment. If I am unable to provide these receipts the insurer is refusing to release the final monies of which I need to pay the final invoice. The work is complete and I am very happy with the work and my mortgage company is happy as well and have released the balance of the money in escrow for payment to contractor. I still owe the contractor money which I thought I would be getting from the ins. co. after contractor completed job. What is my recourse here?
We had a storm come through our town on June 4, 2008. I immediatley called the insurance company who sent an adjuster out. I received a check from the insurance co on June 26th for the amount of $3676.00. I contacted a couple of contractors to replace the roof, however, there were so many roofs in town needing repair that they were all busy. They told me it would be a couple of months until anyone could look at my roof. Finally in September, a contractor did look at the roof and asked if I had any leakage. I told him no, I did not. He advised that because it was getting late in the season, that the roof would probably be ok through the winter. He told me that shingle prices would probably be lower in the spring and said since I had no leakage that I should probably wait until then to have the work done. That is exactly what I did. The contractor contacted me last week with an estimate of the repairs…$5865.00 to be exact. I still have the original $3676.00 that the insurance paid me. This is a difference of $2189.00. My question is, can I send the estimate to the insurance company and see if they will pay more on the claim, or will I have to eat the cost myself since the claim is now a year old? I understand that I will be responsible for my $500.00 deductible and depreciation costs, but those together only equal $1365.69. Am I responsible for the difference because I waited until spring to have the repair work done? Also, my insurance policy says the depreciation costs are not recoverable…is this right?
Your contractor is right, and since “he” is not “the insured”, he does not have to cooperate with your insurer. And if all you have is one general invoice from your contractor, then that’s all you can give them, and you have fulfilled “your” duty to cooperate with your insurer.
Your insurer is really looking for a back door to cut down or completely eliminate the “hold back amount”. There are ways to verify the job is complete without looking at the contractors invoices, etc.. Have the contractor give you one piece of paper that states “Job complete, amount due $xxx.” Then if the adjuster wants to verify repairs were done, let him do his own inspection. How to handle this “safely” and all your possible questions is included in the eBook entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (standard)” at UClaim.com http://www.uclaim.com/products.asp .
1. If the original check was for 3676.00 and your deductible was 500.00 and your policy does not pay Replacement Cost, how much did your original adjuster figure for RCV of repairs, before depreciation? If that’s over 5865.00, then the only thing you can argue about is the depreciation, if you think that was too high.
2. As to the time limit, most policies say you have “12 months to sue”, but the question is from when, the date of loss or the date payment was made? Also, most states laws override the policy language anyway and give you up to 3 or 4 years to file property damage claims (you can check that with your local small claims court or a lawyer).
In my experience, you should not have a problem reopening the claim, unless you are with a “low quality” insurer.
I have HO insurance in Florida. I experienced a flood due to a crack in my home’s concrete slab. Since I am new at being a landlord, as soon as my tenant told me about the flood, I had it fixed. I sent out a licensed and insured handyman to fix the crack, and later had a flooring company to repair the flooring. I did not call the insurance carrier prior to having the repairs done, nor did I make the workers take pictures. Like I said, I’m new at this.
So I called my insurer and told them what happened. They wanted to send our an adjuster. But I told them the work was already done, so I wasn’t sure if they needed to send out an adjuster. Next thing I don’t I have my insurer calling me, asking me to fax them my invoices. I did so. Right afterward, they called me to tell me they were going to pay my claim minus my deductible, since it was a “small claim amount”. So they faxed me a “release to sign” that has to be notarized, which basically say that they will pay my claim, but I waive my right to future claims directly related to this claim/incident.
Now, I might just be naive or too skeptical, but I feel this was too easy. I feel that there is an underlying reason they are so quick to pay my claim without ever having seen the property. Are they afraid of something? What do they gain from this? They have more experience than me, and I almost feel they have an feeling there will be more to this ordeal. Why???? Mold claim maybe???
We have a Foremost Policy in Calif. We had lightning hit a tree near our house, which also transferred the energy into the house. We are contemplating putting in a claim, but are trying to assess if it is worth it. We would like an estimate on how much our insurance will go up without the claim free discount. Is there any scenario that can just give us an idea? ie, if our damage is only $5000, our insurance will go up approx $xx this much per year for 5 years?
We are also concerned about putting in a claim because we are in a high fire area and are wondering if they could drop us. Many ins. companies are dropping people like crazy in our area (zip 92382). They are able to do this by stating any brush and trees need to be removed anywhere near the home by so many feet – but most peoples lots aren’t even that large and they can’t cut their neighbors trees. So they are able to do it with their exclusion that they invented after the last round of fires. Fire season is coming and we don’t want to lose our insurance for something like this lightning damage which is something we would struggle with, but could deal with – unlike fire damage or something more extreme.
Another concern: will they cover removal of the tree that has been damaged and weakened from the lightning (it is 10′ away from the house and did not fall on the house)? The tree did transfer the energy to the house through another tree, which then touched the roof and went from there. It is a danger (broken branches are still hung up in the top of it) and could break off at the weakened point.
Just trying to be educated in our decision and appreciate any help and incite. $1000 deductible and losing the discount- is it worth it?
I had a significant amount of items taken from my auto after our daughter was in an accident in January. Because of the amount of items stolen or missing the insurance company conducted an under oath investigation of me verifying my loss. No problem with that at all I realize that is within their rights. I was just wondering under Pennsylvania law how long can they take to make a decision? Also do I have the right to suggest or force them to investigate others under oath? Thank you for any info..
Most states have laws stating how long the insurer has to accept or deny a claim, usually 30 to 60 days. The problem is that the time can be extended for years if the insurer simply advises the DOI that they are still investigating and suspect fraud. So the law is worthless here. Your only way to fight on that ground is to show “unreasonable delay in investigation”.
I don’t know Pennsylvania law, but you can see the California laws in the Miscellaneous Product section at UClaim.com. Pennsylvania is relatively consumer oriented and likely to be like California on these laws.
You can’t “force” your insurer to take someone else’s EUO or do investigation. But you can suggest, in writing, that they do this or that, and if they fail to do it and it adversely affects your claim, you can sue your insurer for bad faith breach of contract.
Not enough info. to answer. Water source? Dollar amount of damages?
1. Where did the water come from? If from a broken pipe under the slab, then its covered. If from ground water seeping through the cracked slab, its not covered. This is how most policies read.
2. Unless there was a broken pipe, you are lucky your insurer is covering the claim, so sign the “release” and be happy you slipped through the cracks.
3. If there was a broken pipe, don’t sign a “release”. Only sign a Proof of Loss, but safely. How to do it safely is outlined in the Homeowner Loss eBooks at UClaim.com.
You will have to ask your agent about what would happen to the premium if you make a claim. We are claim adjusters here and adjusters are not trained in this regard. Get your answer in writing from your agent or Foremost, because I doubt they will “guarantee” what they tell you.
When I worked claims for Farmers (who owns Foremost) in the 1980’s, they would not cancel a policy if you had 1 claim, but they might raise the deductible if you had 2 claims. If you had a third claim, then they would non renew the policy.
They cannot cancel the policy if you have had it for so much time. But they can “non renew” it. So that gives you time to get insurance with another company before Foremost gives you notice of non renewal, 2 weeks before it comes time to renew. So if you do turn in the claim, consider shopping for another insurer in the meantime.
Regarding the tree. Insurers will only pay to remove a tree that has fallen on a building in order to access the repairs. They will only cover fire damage to trees, and even then only to a stated amount, like $500.00 each, up to 5 or 10% of building structure limits. You have to remove the potential hazardous tree, the insurer won’t do that. And furthermore they could use your failure to remove the hazard as reason to deny the claim if it does fall on the house.
I got a claim check for hail damage over a year ago and never repaired the car. The check was made out to me and the lien holder. I assume that because the check is more than a year old it is now stale and a new one has to be issued. However, the car was returned to the leasing company about three months ago. Will the insurer issue a new check to just myself?
Some lady rear ended me last month. I own my car. Insurance adjuster came out inspected the obvious damage and a week later sent me a $500 check. Bent sides, A trunk that wont open, The whole bumper is messed up, and The paint is messed up. An $500 is suppose to cover that? Um nooo, I don’t think so. So I took it to the body shop today and called the adjustor to let him know they are going to “tear the car down”. In a few days the adjustor will come out to inspect and negotiate with my body shop. He is making is sound like, after he inspects the other damage, he won’t right a new check to me, ONLY to the body shop. He is making it sound like I HAVE to get it repaired. What if I don’t want to get it repaired? what if I want the check written to me? It is my money after all! How do I get around this? I have a feeling he is going to be pushy on the issue.
You would have been better off to get the car repaired cheap, then the lien holder would have had no choice but to sign the check and return it to you for you to deposit.
Look on the claim check for words that say if it expires in so much time.
Good question about who the insurer will issue the check to, now that you have returned the car, but I suspect that they will issue the check to the lien holder, since you currently have no insurable interest, unless … the lien holder charged you a penalty for the hail damage to the car?
You have nothing to lose by asking the insurer to send you another check. And if it has both names on it, don’t sign it. Mail it to the lien holder to try and get them to sign it and return it to you. And call them first to see if they will do that. And don’t volunteer what the check is for if you don’t have to.
And read your lease agreement provisions regarding loss to the vehicle.
You may want to get a few estimates, before the car is torn down.
If there is no lien holder on the car, then he has to send you the check, in your name. I doubt that there is any clause in your policy saying the shop gets the payment. But play nice for now and DON’T sign any authoriztion for the shop to start repairs (except teardown). But you will have to pay the shop for their tear down time if you decide to repair it elsewhere or not to do any repairs. If you reveal your intention not to repair, the shop and adjuster may conspire to lowball the estimate.
If the shop and adjuster are “good friends”, they could low ball the estimate, so you don’t take it elsewhere, and then do a “supplement” for more money if the shop does the repairs. So be nice until you have a check or satisfactory estimate in your hand.
My question is regarding health insurance, I have a claim that was denied stating that a procedure was “investigational”. My doctor did not inform me that the procedure was investigation and would not be covered by my insurance, if he had, I would not have had the procedure done. Shouldn’t the doctor assume the risk on any “investigational” procedures, or at least have the procedure pre-approved by the insurance company?
I have been in Insurance for 30 yrs and I have been an adjuster/Claims processer, Underwriter and Agent and the bottom line is…they will tell you anything to not cover a claim…The biggest one is “the damage is not bad and under your deductible”…I just had my first claim after being a homeowner for 30 yrs. The first adjuster came when I was out of town and he said my roof did not have much damage and under my $500 ded (surprise)…well I then had him come back out and he admitted it was bad storm damage and for me to get 2 estimates. A week later w/estimates in hand…I called him but he was no longer w/the company and my claim was closed…”how sneaky”…Got new adjuster and my claim now is up to him paying $5200…is that not a big difference…but I still am not accepting that…its a low ball estimate because my 3 estimates were range $5800 to $6600 so where did he get $5200 less my $500 ded he plans on giving me check for $4700. My two friends accepted their adjuster saying under $500 and they are sick now…Please NEVER accept the adjuster’s estimate if you feel you have a true claim…If you have wear and tear and not a direct physical loss from storm like me…thats a different story…wear & tear is not and should not be a covered claim.
In my opinion, common sense and decency would say that the doctor should have pre approved the procedure with your insurer, even if you did not ask them to pre approve it. They should know better because they do this every day. While you probably had no choice but to sign a paper that says you will be responsible for the doctors bill if the insurance company denies the claim, I say that a patient should have a “reasonable expectation” that the service provider will pre approve whatever their service is. “Reasonable expectation” is a legal concept that can be used to override an unreasonable or deceptively written contract.
Considering the unfriendly nature of explanations of medical procedures, coverages and billings, policy holders should not have to jump through a thousand time consuming hoops that no reasonable person can understand anyway, and therefore should get the benefit of the doubt if litigation ensues.
We all know that most medical providers grossly over bill for their services and “suck us in”, giving us as little information as possible when we are at our most vulnerable, when we have a health problem. When they engage in negligence and deception for the purpose of sticking you with the bill, they should be fined and have their license to practice revoked. Period! But the system is broken when our legislators are getting “contributions” and free game tickets from the medical lobbyists.
Want a little satisfaction? Go to http://www.RateMDs.com and rip your doctor up so everyone can see who not to go to. Medical providers hate this website, but it gives consumers power that failed government and the media lack.
Thanks for your bold comments and please give your comments on any posted questions on this website. And please consider making ratings in the “Consumer’s Ratings” page of this website to help do what government and the media fail to do. You can always give your name as “Anonymous” if you are not comfortable identifying yourself there.
Bristol West admits their client is at fault and offers me $800 For my old car despite my having over $2000 into it. They call all that engine rebuilding “routine maintenance.” I have proof of the work done. Does anyone know howthey value cars?
ok here it is…..HELP!!! 2 months ago my 2007 toyota highlander was stolen. it was completely a show car. very expensive accessories. i had upgrade coverage put on the car. specifically i had custom rims and tires. i had no receipts but i did have a bill of sale and specifically asked when i insured my vehichle that if anything happened was that good enough. i was told yes. after 2 months of inquires and the standard “the investigation is ongoing” my car was recovered. of course it was in bad shape and whoever took it put some junkyard tires and rims on that didnt even fit.. to top it all off it doesnt start. ive exhausted myself with phone calls and inquires to no avail of a satisfactory answer on whats happening with my claim. im coming up on a third car payment with no car, and recently the car mechanic who is friendly told me that it got it from the insurance guy that they are trying to just throw factory tires and wheels on there. i got 8000 worth of extra coverage not to mention the storage and towing fees i incurred after it was recovered. thinking about getting a lawyer. what are my options????? my insurance is unitrin direct.. ok everybody laugh at once…..HELP
Sorry to tell you that in most areas, the value of a vehicle is based on the ACV (Actual Cash Value) or Market Value (what it would sell for), not what you put into it. And the Market is defined by “the average buyer”, not that one in a thousand buyers that matches your likes and dislikes.
Usually putting a new motor that costs $2000.00 in a 20 year old car will not raise the resale value by more than 200 to 300 dollars. That is what a used car dealer will tell you. And that is why used car dealers don’t put new or rebuilt motors in used cars for sale. Don’t put $2,000 into an old car unless you plan keeping it for yourself for a long time. And money spent on maintenance like new brakes or alternator will not raise the market value at all. Valuation guide books like Kelly Book and NADA Book will tell you the same thing.
Now if you want to see if the $800.00 was a lowball appraisal (and it probably is) check out the Total Loss Auto for Insureds on the product page at UClaim.com.
Ok I’m assuming they are repairing your vehicle instead of totaling it out. If you got special insurance or endorsement for the tires and rims, then they owe you for that, less depreciation. Read your policy and endorsement and see if you can find out who has the burden of proof. I think in your case, the insurer has the burden to disprove you owned those tires and rims, not you giving them the proof. You can check that with a lawyer in your area.
If you got an endorsement for 8k extra, and you have a bill copy, I think that’s proof enough. You can also get affidavits from people who saw the car before it was stolen. Consider small claims court. Note that the insurer owes the used value of the tires and rims, not new value.
Two weeks ago my wife was rear-ended in an auto accident. The other ins co accepted fault. We subrogated for repairs. The car was deemed totaled and settled with our insurance co. As part of the accident, my wife’s shoulder was injuried by the seatbelt restraint due to the impact. She also had some lower back and leg pain. A week later bruises showed on her arms and legs. We sent photos to the insureds ins co. Unfortunately she did not seek medical care. She has had over two weeks of sleepless night because she keep replaying the accident in her mind to the point of hearing the impact of the crash. Because of sleep deprivation, she has missed 20 hours of work (used her paid leave). She also has the fear on being rear-ended again. I was a passenger with her the other day and she ended up going through a red light because of this fear. As a matter of fact, the other ins co has never really contact us to see how thing are. Without medical bills, what recourse do we had? Will we get any settlement from the insureds co.?”
Could you please give me your input, I had a claim for flood insurance, we had a bad storm and did bad damage to a rental property, the claim adjuster did a good job, was very professional and sent all the documentation to my ins. co. right away, now my insurance company, all they say when I ask them for an update, when I am going to get the funds, they say: “each claim is different, we got the final report, it is being reviewed, we don’t have a specific date to give you an answer when you will hear from us”, the tenants had to move out, it got 5 to 6 inches of water inside, it’s being two months, I had to pay the mortgage May and June out of my pocket because the tenants had to leave, this affected my bills, I am behind, overdrafted, you name it,
Do you know if the insurance company has to pay me for these 2 months of rent that these tenants could not pay because they had to leave?
I will call my ins. co. tomorrow to ask them, but still I would appreciate your comments.
Have you ever heard of anyone prevailing in getting reimbursed Public Adjuster fees? We are temporarily living 6 hours from our family home which was being rented out. Tenant burned the house down by leaving a candle unattended. Tenant did not have the $500,000 liability insurance that was required by lease, but that was also not verified by the property management company listed as the “Landlord” on the lease. Such verification was to take place within 7 days of lease signing. Anyhow, we have been told that we will never get the fees refunded b/c we chose to hire a P.A. Is this true? If so, we are out $27000. Yes, we probably got a better settlement by having hired the P.A…just hurts to have the loss. Would suing the tenant get us that fee back (provided they have the cash)? Would a court award us the P.A. fees if we sue the property management company that was negligent in its review of lease requirements? How about out-of-pocket expenses? We have made 5 trips to follow-up on rebuild and such for a total of almost $1500. We anticipate another 5 trips, at least. Anyway to recoup those losses? Our property is in NYS.
Thanks!
My laundry room floor caved in. Farmers sent an agent who said it was due to a leak from the A/C unit which was in the room. I received a check for partial repairs, but when the A/C was removed we discovered the floor was a 3 1/2 inch slab of concrete on a pier foundation in the laundry room (house is 65 years old) As my agent asked me to do I sent him a copy of the new proposal as the cost increased for the repairs due to the concrete and the size of the area to be fixed. No word…call…no word..call… agent on vacaton for 2 weeks. Meanwhile we have no A/C and in south Louisiana it is in the 90’s, the room is half way torn down, and the floor is tilting more each day. I called Farmers who sent another agent and he was a total jerk with an attitude. Told me if they had seen it I wouldn’t have gotten anything due to decay, and that I was lucky to have gotten what I did. In my policy under the collaspe cause it mentions hidden decay, water damage, weight of object. Now they say there was a change in the policy that I should have recieved due to some H114 endorsement which will not cover repairs for any decay no matter what the cause, and are refusing to cover the additional 5000.00 to fix it. What recourse do I have? It seems to me that since collaspe is a covered loss, that maybe the cost to repair the A/C that cause the damage would not be covered, but the damage to the floor should be. Should I file a complaint with the insurance commissioners office, or is the insurance company right?
I had a house fire almost four months ago. I met with state farm a week after the five and answered a lot of questions. I then received a letter from a law firm asking me to provide a great deal of information such as bank statements and tax records to them on the insurance companies behalf. I had to meet with them in person and under oath answer more questions. My lawyer told me to provide everything that was asked for. I know that this is normal in a case with a suspicious fire. However I do not understand why they never verified any where I was yet have questioned me about it several times. I know from the insurance investigator that me and my exhusband are suspects he told me that himself yet is this a normal tactic. I do not know what to expect next. Are they trying to find a loop whole in the contract and why so long. The house is now in foreclosure yet they still have not made a decision one way or another. I could use any advice that lets me know what they are doing or is going to happen?
That being said, if the other drivers insurer is ignoring you, then its time to get a lawyer (on contingency fee) or file suit against the other driver and car owner. Pay attention the the “statute of limitations” in your state to file suit. It is often only 12 months from the accident date.
If you have no medical bills as proof of your wife’s new injuries, get some pictures. In fact get pictures anyway. A good accident lawyer will send you to doctors he works with.
To insure you got a fair settlement for your totaled car, consider the product entitled “Total Loss Auto for Claimants” at UClaim.com.
Questions like this should be posted on the Home Insurance Claims page.
Most rental policies cover loss of rents if your claim is covered. It pays for the time to do the repairs as well as the time it takes to reach an agreed cost on the repairs. So if your insurer wants to delay their investigation and drag their feet, then they owe you for that time (as long as they don’t deny the underlying flood claim). Read your policy or get a copy at UClaim.com.
If your insurer is dragging its feet, you need to start building your own file. Your word against the adjusters word will be of no help 6 months later when you discover that some adjusters tell lies and mislead. You should consider the eBook entitled “LANDLORD RENTAL PROPERTY INSURANCE CLAIM ADVICE AND HELP, HOW TO PLAY THE GAME – DELUXE VERSION” at UClaim.com. Read it’s table of contents.
I think you may have a chance of getting the PA fees in a liability claim against the property manager, but not from your own insurer. You have nothing to lose by including the PA fees in the claim (and litigation if it goes that far). I don’t personally know of any case law on that, but your attorney could check that. Most PAs would not know, since they only handle 1st party claims.
And yes, include all your expenses. You are not limited by any policy provisions in a “3rd party liability claim”, as you would be in a claim against your own insurer.
I have no idea what a court would award. Judges and jurys are unpredictable. It sounds like you need to hunt for an attorney to take your case on contingency. That can be a chore.
When you said the AC was leaking, I thought you were going to say the claim was denied. But you said they covered it. The policy covers “sudden and accidental” not long term damage over time. And policies cover collapse, but there are more limitations and endorsements being attached to that kind of claim every day. The policy and endorsements that apply are the ones in effect on the date of loss, not after the DOL.
Without arguing over that issue, your best argument is that Farmers waived their right to deny any supplemental claim since they already decided to cover the claim and issued payment and told you to proceed with repairs. You relied on their actions and instructions. In insurance law this is called “estoppel”. An insurer can’t take back what it already paid, even if in error. And an insurer can “change its mind” after it already said it would take a course of action. I assume you have documents to prove that the insurer initially covered your claim, for example a check, cover letter, adjusters estimate, etc.
Go to the UClaim.com Products page under Miscellaneous and consider the eBooks entitled “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP” and “EXAMINATION UNDER OATH (EUO) INSURANCE CLAIM ADVICE AND HELP”. If things get dirty, you may also consider the eBook “INSURANCE CLAIM PRACTICES LAWS WITH UCLAIM COMMENTARY, ADVICE AND HELP”.
Note, most attorneys know nothing about the differences between an EUO and a deposition. Most will handle your EUO as if it were a deposition. But even so, an attorney with you during EUO is far better than none at all. And the insurer can recall you for more EUO’s. So don’t assume its all over with.
If after all this “stuff” they put you through they put in writing that they will cover your claim, then you will need the eBook “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”.
If they deny your claim, you need to have an attorney and or good public adjuster take a look at your claim. In fact it’s a good idea to get them working for you now. The UClaim eBooks will also show you what your PA and or attorney should be doing. You can also get advice on hiring a PA on the Free Stuff page at UClaim.com.
Thanks for all the advice. To clarify, would we ask the property management company who insures them, and then contact their insurance company to file a third party claim? We are confused right now, since our insurance company (and the liable tenant’s insurance company–one in the same) wants us to sign a joint prosecution agreeement for the subrogation. They have said that there are anti-subrogation rules in NYS that preclude them from doing this, but no one has caught on yet, so they hope to prevail. We are afraid to do that, since we will only get pro-rata after the atty’s fees are paid, which at best would be $5000, when we are out of pocket close to $40,000 including the PA fees. If we go that route, we will surely get something, but if we file a third party claim with the property management insurance company, we may get denied. We are not gambling folks…we want to minimize our risk due to all we have been through thus far and for our childrens’ sakes. We are unsure how misleading our insurance company is being by saying the more they get for us, the less loss is showing for our policy and therefore, the less affect it will have on our future premiums. In other words, if we help them, it will help us. They have all the info they need to go ahead and subrogate on their own, while we take our own route. Note: the property management company, as “Landlord” failed to make sure the tenant secured the $500,000 liability insurance required by the lease. The $300,000 they did acquire will be exhausted by neighbors’ damage and the cost paid to us already. We are left with uninsured loss of $7500, personal out-of-pocket travel expenses…($1200 so far with anticipated $1200 more) and the PA fees of $28,000. We are afraid to file the third party on our own, get denied and then have to sue with the risk that the lawsuit could cost more than we could potentially recoup. Does any of this make sense? And we had to pay the deductible since the tenant’s policy limits were exhausted. We are living in another country, and had to retain the PA services, since the property management company could not answer any of our questions immediately after the loss. We had no other choice. We could not be present for the insurance process, claim, etc… due to our residence abroad. Many have said it was our choice to hire the PA, while we see it as having had no legitimate choice based upon the circumstances.
Confused, angry, frustrated and ready to be done with all of this…
Thanks for your site…and all of the great advice thus far.
Hi,
I relocated to the DC area from the SouthWest. I hired a moving company to move my things. The truck carrying my things got in an accident. Much of my major furniture was damaged and/or demolished.
The moving companies insurance company (Progressive) contacted me to begin the claims process. I am in the process of filling out their form. The form asks for items damaged, date of purchase, amount paid, etc…
My questions are:
1. for items that I don’t have a receipt for, how do I go about putting a price on them?
2. Because my furniture is demolished, I’ve needed to store it elsewhere. I had to rent a truck to move the furniture. Can I include the cost of the truck rental in my claim?
3. One of the pieces of furniture that was damaged was a living room couch. I’ve already purchased a new couch so that I have something to sit on in my living room. How (if at all) will that affect my claim?
4. One of the items that was demolished was a high end bedroom dresser that was part of a set (bedframe and dresser). The set is no longer available, so to make my furniture match, I’d need to buy a new bedframe/dresser combination. Can I add the cost of a new bedframe to my claim?
5. any other words of advice?
If someone else out there wants to take the torch and give PJean some advice, please jump in.
If no one jumps in here, PJean, you probably need to consult with an attorney and or a good PA in your area. Our admin time on this website is really intended for short questions and answers since it is all volunteer time. Thanks for your nice compliments.
I could write an book on this, but it’s already been done. The eBook entitled “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP
Subtitle: How to Maximize Your Contents Claim Settlement” at UClaim.com will answer most of your questions in great detail and provide sample inventories. And it has a money back guarantee.
While the EBook was intended for claimants making claims against their own insurer with a policy contract, most of the information and techniques in there will also apply to you as a 3rd party (if they consider this as a liability claim which is governed by the law in the absence of a policy contract). If they treat you as “an insured” and start quoting policy language, for example a “pairs and sets” limitation clause, then be sure to insist on a complete copy of the policy. Whatever denial they make, insist that they put it in writing and that they quote the policy wording or the law that they rely on.
Any help/advice appreciated.
I rented a truck from Penske with the cargo insurance. In the truck was my motorcycle which was attached to the cargo “ribs” in the truck via very secure ties. (Drove from VA to RI). When I opened the back the “ribs” were broken and the bike was down with a very dented gas tank. After going through Penske I was eventually sent to Zurich (Empire Fire and Marine) who told me this wasn’t covered for 2 reasons:
1) Section A. Coverage – “We will pay for all direct and accidental loss or damage if caused by cyclone, ….upset or overturn of “truck”". I told them the truck was upset and resulted in the damage, they say NO.
2) Section E: Exclusions – We will not pay for damage sustained by 4-wheel, licensed vehicles to include motor vehicles, motorcycles…
– My issue here is that the contract says “Damage done by”, in my case it was damage done to…my motorcycle. They told me I didn’t know legal definition of “to” and “by”. My response was “If a crime is done BY domeone they are a criminal, if it is done TO someone they are a victim”. Am I wrong? Any advice is appreciated as I feel I am getting the once over. Thanks in advance.
In 2004 rear ended at stop sign, the police office at scene and in the E.R advised the other driver was insured and presented a valid insurance card.
Attempted to file claim the next day and was required to leave VM in the claims office and my call would be return asap. After several days I recieved a call advising this claim is being reviewed for validity and I would be informed of the decision asap. Concerned and hurt I retained attorney, formal request for coverage status was sent by attorney and the reply was uninsured. Attorney persued UIM claim with my auto insurance. Several issues surrounding the at fault drive did not add up, when my concerns were ignored by attorney, I personally requested a formal investigation by the Colorado Division of Insurance to insure the denied claim was valid. Early in 2007 the denial was reversed and the UIM claim was dropped and case was sent to drivers insurance and settlement for personal injury awarded.
The question concerns “consortium”. My UIM policy allows for “bodily injury” only so “consortium” was not allowed. When the liability changed my right under “consortium” was valid? Yes. If so how do you calculate the time limit for filing claim – the accident was 2004 but reveral of claim was 2007.
We had a house fire Christmas eve 2008 and luckily we we at church.
The fire started in the basement and was contained there except for all of the smoke damage throughout the entire house. I will spare you with some of the details and get rigt to the point. Our insurance company has paid us for
the dryer ( the fire source) washer, and water heater . The heater is what I have been denied on. Our heater stopped working when the water heater did
and they paid for that and the heater is next to the dryer.
1. Find out the definition of “upset”. If it is not defined in the “Definitions” part of the policy, then look in a Websters Dictionary, and look in a Blacks Law Dictionary (at your local county free law library, usually at the court house). Look for the legal definition before the common man definition, because that will carry more weight with a small claims court judge. If you want to see how court cases define “upset” either get the law librarian to help you search, or go to Findlaw.com “professional section” and search for case law in your state first. If none, check other states. To learn how to research the law for insurance claims consider the UClaim.com product entitled “INSURANCE CLAIM PRACTICES LAWS WITH UCLAIM COMMENTARY, ADVICE AND HELP Subtitle: Save HOURS of Research Time”. View the table of contents.
2. Your thinking about “damage to” and “damage by” is logical and reasonable. Theirs is what I call “brainwash brainlock” or intentional stonewalling (gambling you won’t sue them). In either case you will get nowhere with the individual who denied the claim. Advance to the supervisor, if no luck advance straight to the CEO. If no luck, then small claims court. You can learn the techniques in detail in the “standard” versions of UClaim home and auto eBooks.
(And we can thank George Bush and his supreme court for effectively getting rid of punitive damages against insurance companies.)
Look at the policy requirement. If it says report the claim as soon as reasonable or possible, then you have already done that long ago.
2. If you are talking about time limit to file suit:
Most states have “statutes” defining the time to file suit, eg. 1 year for injury, 3 years for property damage. However these limits are extended usually by case law in your state which will say something like “1 year from the date of loss, where “date of loss” is not the date of the accident, but the date from which your claim was finally approved or denied. There is “no loss” until the insurer refuses or accepts liability.
You better find out the statute of limitations on bodily injury ASAP. Call your local small claims court for a quick free answer. California just raised theirs from 1 year to 2 years.
1. Most policies are “All risk” on structure, stating “we cover all perils except …”. This means the insurer has the burden to disprove your claim. So let “them” hire the engineer to find out why your heater failed. And they are supposed to give you a copy of the report. And the heater is part of the structure, not “contents”, like the washer and dryer.
2. Get a written statement from an HVAC person that the heater could have been damaged from the heat and or smoke.
3. If the insurer still denies it, go to small claims court for around $25.00 and no attorneys allowed in.
I my jeep had an engine failure, the shop i had it inspect did not want to touch it and informed me to take it to the dealer incase there was a warrantee that exist for 2002 jeep liberty. I took it to the dealer and only way to find the proble was disassemble the engine which cost me 600 bucks. I the engien was completely destroyed due to coolant fluids was getting inside the engine. All in all my jeep is dead and i’m in need of another transportation. I call an insurance agent told my situation and asked for MBI (mechanial breakdown) claim, which i was denied due to i do not have collision insurance. I was told to get back with the dealer and perform a “f14 function” chrysler extended “Home for the holiday” warrantee, that was effective back in 2001 – 2002. Dealer mechanic had informed me that he had run my jeep’s vin# and had performed F14 function. The jeep was not covered due to first owner was a company, not a private owner. I did my reseach on chrysler’s extended warrantee where, it stated first buyer gets 100k miles 7yrs extended warr.
Q. how could i definitely be sure that my jeep is really not covered for such extended warr.?
Q. I wasn’t any collision, its a complete engine break down, is there any claim i can make for these type of loss?
I have a question. I was driving to get something to eat and a car came in to my lane to avoid something in their lane or because they were not focusing. I don’t know. It caused me to go on the side walk and damage my under carriage. I did not realize anything was wrong. As I gathered my senses and started to drive the oil light came on. I turned the car around to start to head back home. It was in the middle of the night in a not so populated part of town. As I started to head back the car lost power and I was able to park it off the street. Will the insurance company pay to have the engine replaced? My friend told me the engine was locked. Will they replace with a used engine or will they just try and total the car out. The KB value is about $2800. Car has just about that much left to pay off.
Thanks,
Seriously Sad!
I have home owners insurance with two questions.
1-I have a patio door that had leaked about a year ago, fixed the leak with minimal damage to the carpet and subflooring, recently began leaking again ad carpet has started to mold and leak still countinuing. Is this a valid claim.
2-Believe televison was hit by lighting during a storm was a pop and burning smell. Would this be covered and how would Iprove that was the case?
Turn it in and see what they say. Most auto policies have “collision” coverage and “other than collision” coverage (which is called Comprehensive). A low quality insurer may say that YOU caused the engine to lock or seize by driving with low oil pressure. A good company might say it was a consequential loss to the collision and cover it under collision. I don’t think any insurer would cover it under comprehensive coverage.
If they cover it, they will either pay the full cost for a used motor or rebuilt motor, or pay for a new motor less depreciation. If they total the car out, make sure you get a fair settlement with one of the auto total loss eBooks at UClaim.com. It will also tell you how to keep the salvage without getting short changed.
Assuming you are talking about making an insurance claim, most policies say you should report the claim as soon as possible. Some say as soon as “reasonably” possible. If there is no time limit stated, then I think the law or a judge would insert the word “reasonably”.
If you are talking about filing a lawsuit, then the statutes of limitations for filing different kinds of complaints, like for injury and property damage, will have different time periods.
If they deny your claim, get it in writing with the specific reasons stated, and go from there.
1. If the water is from a broken pipe or plumbing fixture, then it should be covered. But if it is from rain or flood or sprinkler water, that’s called “surface water” and excluded in most policies.
2. Most policies cover electrical surge, but not to appliances (so what good is it right?). And lightening damage is covered, but I suspect the adjuster will say it must be a “direct hit”.
Ask an electrician to read that part of your policy to see if he can come up with a creative explanation for the lightening damage that is not electrical surge.
I have a serious situation. My 16 year old daughter took my brand new car without permission and proceded to wrap it around a light pole totaling the vehical. AAA is saying that because she was excluded from my policy the car is not covered, but because she took it without permission I feel it should be, do I have any recourse?
Our home was a complete loss on October 27, 2008. We were out of town, thankfully. Our insurance company, State Farm, had an engineer sent out to determine cause of fire and we were informed that he could not determine the cause because there was not enough left of the home. We rec’d a couple small checks early on for neccessaties but that has been all. We hired a PA early on and we also have an attorney (due to issues with the structure claim….our mortgage company foreclosed on house 6 weeks after fire and sold it for amount owed. When SF cut the structure check to us and mortgage co., the mortgage co said we did not owe them anything so SF did stop pay on check and are now saying they just don’t know who to pay for that portion of the claim.) My question is more on content portion. We did the EUO, content lists, and every other thing asked of us. The ins. company attorney stated he could see no grounds for not paying the claim but all we get from insurance co. is “we are still investigating”. What could they possibly still be investigating? We are getting close to being 3 months shy of 1 year and they have not denied but they are not letting us know anything either. Is there anything we can do to light a fire and get them to do something? anything? this life of limbo is getting to be almost too much to bear.
2 weeks back my retaining wall (which retains my pool) collapsed. On the day of and the previous day there was severe rain and hail. The Insurance company(Nationwide – which is NOT on my side!) sent in a structural Enggineer to check it out and ultimately today I received a letter of denial. The reason being, no earth movement, faulty construction, etc is covered. The retaining wall has taken down a whole chunk of the fence, concrete patio, landscaping, irrigation system and landed on my basket ball court. The engineers report also mentions that it is not clear whether there was a leak in the irrigation system that might have caused it.(in which case, I think, the insurance should cover the peril). Since they are not sure of the reason, shouldn’t I reply back with the above said points and ask them to reconsider. Please let me know what you think. Thanks for your time.
We are not experts on auto coverage, just total auto loss valuations.
Turn in the claim and insist that they put their denial in writing. It must state specifically where your claim is excluded in the policy or the law. If the policy or endorsement says “excluded” but does not specify “with or without” your permission, then you may have a claim. If they persist in the denial, check with an accident lawyer. There may be statute or case law on this issue in your state.
Consider turning it in as a theft claim under comprehensive coverage? If the insurer insists on a police report, ask the police if you can report your daughter as the thief (for insurance claim purposes), then later drop charges after the claim is paid? And it may be good for your daughter to get arrested and spend a night in jail if she does not want to buy you a new car.
Now if the car was brand new and you had a loan on it, then the insurer would probably have to pay the lender’s interest. Just an idea.
Well Mary, on the structure part, State Farm should issue the check in both your’s and the mortgagee’s name. You send the check to the mortgagee (without your signature), the mortgagee signs off and mails it back to you. Any competent public adjuster or attorney should be able to handle that for you, unless there is more to the story here. State Farm’s excuse is no good.
I think the mortgagee may have screwed up by foreclosing too soon not allowing you to claim full RCV benefits, if SF only paid the ACV (depreciated cost). But then, State Farm is the only company I know of that normally pays full RCV up front without requiring replacement.
Regarding the contents, if they put you through an EUO, and all is as you said, you have too many issues to address in a paragraph or two here. I suggest you consider one or more of the eBooks (currently on sale) at UClaim.com and learn how a competent public adjuster plays the game. They will also help you find out if your PA and lawyer are doing their job or just looking for an easy buck.
Yes of course reply, and put it in writing. You have to build your own file so if you have to sue, you have good evidence, not just your word against theirs.
Get your own expert to state the cause in writing. Start with a plumber, or pool tech and if you can afford it, get your own engineer. Sadly, many experts will conclude whatever you want them to and make the facts fit their conclusion.
Your policy probably says “we cover everything except …” on structure items. That means the burden of proof is on the insurer. So if their engineer can’t rule out a plumbing leak, then the insurer has to pay you. Consider one or more of the products (currently on sale) at UClaim.com to teach you how handle this situation.
Is your insurer really Nationwide or “Allied in disguise”. Nationwide is normally generous. They bought Allied, a low quality insurer, for their claims infrastructure (see Recommended Insurers link on this website).
Got to say it “like a good neighbor” guess who’s not there…….
This story make my blood pressure go to 1000. I would consider filing a complaint with the Ins Dept of your state, Insurance carrier’s pay attention to these complaints you might include thm names of the comapny reps you have been talking to, i promise they will make this get resolved quicker than you can imagine. In my mind this has been mishandle from day one. This claim should have been closed about 7 months ago. Has your agent offered help? He is your first advocate in matter like this.
fmc
I’m not sure what agent you are asking about? If you are talking about our insurance agent….then the answer is a BIG NO. We cannot get any one at state farm to even return a call. We sent a letter to them via fax on the 8th stating we expected payment immediately, and just today, we rec’d one back from the attorney for state farm stating it was “still under investigation” and we would be notified when a decision has been made. (whatever that may mean). They also informed us in this letter that no more payments of any kind will be made until a decision has been decided upon. The ONLY payments they have been making are our additional living expenses for the home we rent and the furniture we are using. Are they honestly trying to inform us they are not paying these anymore? What grounds would they have to stop paying additional living expenses when they have not settled nor denied the claim? I am so stressed at this point, I just want to sit in the floor and cry…(but I guess that is exactly what they are hoping to cause.) Is there anything else I can do besides filing a complaint with the ins dept? We live in TN & I’m not sure how that works. Thank you so much for your help.
My daughters house was damaged by a neighbors fire. My daughter filed a claim with her insurance company and they told her that she would have to pay the $1000 deductible. The insurance company told her that they would not subbrogate against the neighbors insurance because the cause of fire was ruled an accident. This does not seem fair. Why should my daughter be out money because of a neighbors accidental fire.
Your insurer could only subrogate against the neighbor if there were “negligence” by the neighbor. Negligence is the requirement in most states for “legal liability” (something you can sue for).
But here is a possible tidbit for you. Ask the neighbor if she would mind asking her homeowners insurance company to pay your daughter under “fire non legal liability” coverage. Most homeowners policies pay a small amount $500 or $1,000 under the liability part of the policy for “non legal liability” for fire damages to neighbors, such as in your daughter’s case. But note, the neighbor does not “have to” turn it in. He or she, the neighbor, should confirm with their agent that it will not increase her premiums.
We have a 2009 GMC Sierra Crew Cab with 8,000 miles that was hit on the passager side, at first the damage looked cosmetic. But once we had it towed to a AAA certified body shop, we were advised the frame was bent(front end). The body shop manager and AAA adjuster say the vehicle can be fixed by cutting the front end and welding back…we have refused their fix and now we are being told they will replace the entire frame.
The AAA Adjuster will not total it because it only has 8,000 miles and the cost to repair is less than the value per KB.
Do we have to accept their solution in replacing the entire frame? Wouldn’t this fix have to be disclosed should we trade in?
Will replacing the entire frame reduce the value?
As a claim adjuster, I have no idea. This would be a better question for an sales agent or an underwriter. However I can tell you that claim adjusters usually estimate 20% for contractors P&O when they are writing a repair estimate on a homeowners insurance claim. Hope that helps a little.
First of all, you are right that the market value of the vehicle would be diminished, perhaps 10%, if you disclosed to a buyer these repairs. Check to see if that is required in your state. Getting compensation for that from an insurance company is not likely, in my opinion. But try anyway since you seem to be a good negotiator.
You should be happy that you got them to replace the entire frame. I have never seen an insurer agree to replace an entire frame when they could weld on a new piece. In fact frames are often straightened and the wrinkly part is often covered up with trim parts so the owner never sees it.
My wife and I purchased our home in July 2006. Our home was destroyed by fire as a result of Hurricane Ike on Sept 14, 2008. We were not at home at the time to save anything. Our home and contents was a total loss. Scott county was declared a federal disaster area. Ten months later we are still living in our RV. Is it ethical and legal for Cincinnati Insurance to file two claims for the same occurrence then cancel or “not renew” my policy, preventing me from acquiring insurance, making it impossible for me to rebuild my home at replacement cost and forcing me to take their “fair market value”?
Hi, don’t know if anyone can help or if this is the right place…but to make a long story short…. I hit an uninsured motorist(his fault)… He had just purchased a used vehicle from a dealer, is it possible to sue the dealer for not “Verifying” proof of insurance on that vehicle??? Thanks Rick
If the fire is directly connected to the hurricane, for example the wind blew a tree into a transformer that fell on your house and fire ensued, then that should be one loss and one deductible. Or if the wind knocked a tree into the house smashing the roof and cutting wires that later shorted and fire started, I would call that one loss, one chain of events.
In most states, insurers need no reason to “non renew”. But they can cancel midterm for example due to fraud or change in risk of loss.
I personally advise my clients to start looking for insurance after a major loss since its easier to get insurance while you have insurance than after cancellation. Insurers often cancel policies after major losses. And its not too ethical, IMO, for an insurer to only give 15 or 30 days notice of non renewal.
If your house was a total loss and you are handling this on your own, consider the eBook on that at UClaim.com, currently 75% off on sale and guaranteed!
HEY BILL,
DID YOU HAVE A REPLACEMENT COST POLICY, WAS THE LIMIT ADEQUATE TO REBUILD, DID THEY PAY THE POLICY FACE AMOUNT?
THE ONE CALIM TWO CLAIM ISSUES SEEMS IMMATERIAL, THE CANCELLATION PART, IS TO BE EXPECTED. HAVE TO ASK WHAT DOES YOUR AGENT OR BROKER SAY ABOUT ALL THIS?
MIKE
I just received my check and my property damage estimate for a claim that I filed about 3 yrs ago. My house was burglarized and a great deal of tools and electronics were stolen. The total value they came up with was a couple thousand off and I intend to fight that. My question is on recoverable depreciation. Is there any way to fight this since this over 34% of my claim. I have replaced some of the stuff in the last 3 years but was only recently told of this and have not really kept my receipts? Or would it be possible to move or combine the depreciation on tools onto only select tools? Any help on this would be great. A lot of the stuff I had, I rarely used and do not necessarily need it all now that my life has changed some and I would like to get back most of the money I had to pay out on this. Also, would it be wrong to buy something and then return it for the receipt? An example would be movies, I lost a lot in movies and they are giving me only about %25 for the dvd’s I owned. i know do netflix, so I do not buy them anymore. Thank you for your help.
The high winds blew trees down on the power lines. Before power was fully restored, it reportedly came on and went back off several times. The fire marshalls suggested that this may have caused an electrical item in the home to overheat and eventually catch on fire. After posting this complaint, I was contacted yesterday by the Indiana Department of Insurance and informed that they were investigating why there were two claims filed.The independent adjuster has not made us an offer for the contents loss, but wants us to say what we are willing to accept, so that they can come back with a lower offer, i’m sure. Our last meeting with he and our attourney seemed more like a mediation, because he wanted us in a different room.
My niece had an accident involving her car and a tree. Anyway, when they reported it to the insurance company they were told that she had not been added to the policy. My sister and brother-in-law spoke with the agent to add the car and my niece to the policy over a year ago. They were even advised by the agent to list the teen as the primary drive of another vehicle in the household to get a better rate. Anyway, it seems that the agent dropped the ball and didn’t notify the company to add the driver but did add the car. If the claim is denied is there a course of action for my sister to take.
I would say Indiana could save some tax dollars by trimming their Department of Insurance if they are wasting time on simple stuff like this. Glad to hear you have a lawyer helping you. I hope he is doing good for you.
1. I don’t know of any of any policy clause that says you cannot return an item you purchased.
2. Since they did not tell you about supplying receipts to prove replacement, let them physically inspect the replaced items, and let them track down the receipts from vendors if they want receipts.
3. For items not replaced, you can negotiate that 34% depreciation.
Detailed information on how to properly do all this is included in one of the eBooks on Homeowner’s losses at UClaim.com.
If the agent denies he was asked to add the daughter, try to find some proof that the newly added car was used mostly by the daughter. This would be circumstantial evidence that a car was added for the daughter and the agent was probably aware of it and either forgot or doesn’t want to look bad to his company.
If the insurer still denies the claim, sue the agent and the insurer.
And I guess now everyone knows from your sisters experience to look at their declarations page (with the bill) to see who is a named insured.
On the contrary, we don’t believe our lawyer is very skilled in this area, and it’s too late to hire a new one. That’s why i’m posting here, trying to get some straight answers. She had to call up the isn agent to ask what A.C.V and R.C. meant? If we have replacement insurance and the dollar figure on the declarations page for contents is $216,000, is that the maximum that they will pay even if the cost of replacing the contents excedes that? Also, if the dollar figure on the declarations page for structure is $288,000, the builders bid to replace the home is $316,000 and the insurance co’s estimated “fair market value” is $164,000, what is the maximum amount they have to pay to rebuild.
Also, can you give me an example for normal depriciation of contents of different ages and types.
Hello Michael
Thanks for your curteous response.
Yes, we have carried replacement insurance with them for 18 years.
They are not wanting to pay us the face amount of $288,000, they want to pay us their “estimated fair market value” of $164,000.
Thanks
please bill green, tell me who this inusrer is? are you saying that they are telling you they can pay the fair market value regardless of the rebuilding cost? if that is so it must be said in you contract. there must be an endorsement that gives them the right to do so. if that is the road they choose then i think it would be fair for you to ask for your premium back that was paid over the years for the replacement cost option. also did you use and agent or broker? if so have they excersised any influence here?
i understand the state ins dept is now involved, put all these issues on the table and use the term”unfair claim practices” thats a buzz world that everybody is afarid of. do you have the policy and did you give it to your attorney? the question she had would have been explained in that document ask her if she read it, it is afterall a legal contract. finally here in NY we have a tv guy that does an spot called “shame on you” maybe you have a similar tv guy out there if so get him on the phone this sounds like a story for the six o’clock news. it is not supposed to be like this, unfortunatly my peers forget that we are in a business to help people when they need us most. good luck!
A covered building experience a theft loss of several items one of which is a set of keys that fit 13 locks. The keys of course are covered subject to the deductible but would the cost of re-keying the locks be covered under a standard ISO commercial property form?
Great question! Just my opinion, at first thought I would have to say no, since the policy is basically a “property” policy. Unless there are “additional coverages” or “extensions of coverage” type clauses in the policy, or endorsements adding re-keying, I would again say no.
However I suppose an argument could be made that if the locks came with keys, the locks are now not working because part of “the assembly” or “package” was stolen and so the insured would be entitled to completely new locks with keys and the insurer would get the salvage? So perhaps the insurer would be wise to pay for the coding ($20-$30 per lock normally, but perhaps a discount could be given by the lock smith for 13 locks?) instead of replacing the locks and keys.
The only reason insurers cover re-coding door locks in automobile policies is because the entire lock is being replaced on one door, for example, and the vehicle owner should have a reasonable expectation that all the door locks should match without having two sets of keys.
My roommate called me while I was in school and told me he just got home and noticed the apt was broken into.I left school came home and called the cops and filed a claim.Allstate took 5 months to investigate my claim,including giving me a EUO with their big Attorney ,Looking at my bank statements for the last two years,incomtax records for the last two years,cell phone records,Renters history of 5 years,credit reports,loan history,school grades and attendance,and everything inbetween.After five months of finding nothing to discredit me….they still deny my claim stating….1.On the police report the officer said”The porch balcony door had pry marks on the outside but appaired to be in random places” and “the door jam was broken outward apairing as if it was kicked outward.”…2.My policy canceled in January and was reinstated less than 48 hours before the burgulary..3.Most of the items that were stolen from apt were bought with cash from local sellers on craigslist.org and I have no receipts so they say I didnt prove I owned the items(even though I have a video tape inventory of my entire apt specificly incase something like this was to happen)When the police was at my apt taking the report they couldnt conclude as to how the perps got into myapt….they say it could have been my roommate,maintnance,or anyone else but they couldnt conclude who or how.But Allstate concludes from reading the report.Allstate never came out tomy apt to see the door or anything.Early in the investigation,Allstate asked for my roommates phone number and they called him and asked him whatever…then coming to the end of the investigation they when I keep asking for a status on the claim,they start telling me that they need to talk to my roommate again and they been trying for over a month and he never answers the phone or reply back.Its very clear that Allstate simply doesnt want to pay.I plan on sueing them for handling my claim in bad faith.
As a claim adjuster, and possible homeowner/policyholder, it seems it would be important and beneficial for you to know the core indemnified values of a structure that ones are paying premiums for, so that claim settlement values will be “adjusted” truly appropriately.
No matter what various carriers instructions are to adjusters, the daily and historical fact exists that structures contain first and foremost, general contractors business overhead and profit costs, coupled with all of their specialty trade subcontractors’ business overhead and profit costs.
Since general contractor + subcontractors’ costs are customarily woven into every component of a residential and/or commercial structure that is built by a G.C., insurance agents need to account for those costs for the anticipated future replacement costs of a structure.
When a hail/wind storm creates a insurance covered loss, the roofing system, like every other component on the structure, has prospective general contractor replacement costs values to account for, fairly and equitably.
A general contractor using a roofing contractor is the fair market construction value/actual cash value of the roofing component “loss”
that a policyholder needs a insurance adjuster to understand.
The same is historically true for all other components of a structure, from the roof to the foundation, inside and out.
A insurer that only wants adjusters to pay for the roofing contractor business overhead and profit value of a roofing system is involving adjusters in their undervaluation / underpayment practices.
They also place adjusters at real (litigation) risk of defending unfair and unjust construction market manipulation conduct against general contractors in a given area.
So, now you and other adjusters, and consumers/claimants, have an idea why, when insurers want adjusters to support their contrived construction market myths that claim a structure needs a certain damage “complexity” or requires “three or more trades work” to qualify for general contractor overhead and profit costs/involvement, you should separate yourself from such unfair claim settlement practices.
You also can also help others with the question…
How exactly is general contractor overhead and profit values calculated into limits-of-liability/homeowners insurance premiums?
And for further verification regarding adjusting roofing “loss” values, ask any general contractor if their roofing system on their projects customarily contains roofing contractor business overhead and profit only.
Also, as you drive by a structure, or are responsible for assessing/
adjusting the intrinsic loss value of one, remember the general contractor + specialty subcontractor overhead and profit value that is built into every component of the structure.
With those points in mind, claims can be settled for their actual and fair financial loss.
I had a fire with total loss of dwelling and contents. There is no house to insure, and I find companies reluctant to offer liability, etc coverage that I would expect would satisfy the mortgage company during the long period that it is taking the old company to settle. Am I correct that “liability, etc” is the kind that I am likely to need, and that the mortgage company will require such, or is there a name for the kind of insurance needed after a loss and before rebuilding while property is in limbo during settlement? If it will be required, is there any ‘insurer of last resort’ that would offer such insurance. The property is in Massachusetts.
Yes you would need liability insurance only, in case some kid, for example, gets hurt on the property. A good insurer would leave the liability coverage on and take off the fire property coverage. A low quality insurer would leave you in the cold. Talk to an independent agent to see if he can find liability only.
Also note that most insurers will add “liability only” for a second property location, at no charge, if you have a homeowners policy. But you have to advise your agent that you want that and the property location. Its not automatic.
For the best information on maximizing your rental or home structure insurance claim, consider one of the eBooks at UClaim.com. They are guaranteed and currently 75% off. You can also view their tables of contents before purchasing.
FYI, on a contents loss, the burden of proof is on the policy holder, whereas on a structure loss, usually the burden is on the insurer to disprove your claim. But Allstate has gone too far, IMO.
A court may have to decide whether your videotape is reasonable proof of ownership. I think it is. You could also get affidavits, written statements from people saying they saw the property in your home. If Allstate still denies your claim, it’s that much more angry it will make a court.
Hi I need help and some advised. I was hit the other day on the on the back door of my vehicle the person who hit me has progressive when i call them and started the claim they told me they will do an investigation and call me back within two weeks. To make the story short I waited and the adjuster never call me I call him 20 times, left him messages and he never return my call , finally I was so frustrated and fed up that I call the progresive customer care and told them i wanted to check the status on a claim, the csr from progresive told me that my claim was denied b/c their insurer said that he did not hit me and that my claim was a word against word claim so basically it was his word against mind and they believe their insurer. I told my husband and gave him the number of the adjuster that determine the denial of my claim, since the adjuster did not have my husband number on the list he answer right away when my husband told him taht he was calling about my claim and start to complain about the decison he told him there was not enough proof and when my husband told him well if my wife hit your insurer car why he gave her his information and he never ask for hers and the adjuster from progressive started to evade my husband question and told him that my insurance will have to call them and dispute the claim. What should I do???? what if my insurance does not help me?? can i get progressive to pay for my damages? or should i sued the guy that hit me?
Turn it in to your own insurer. They have to pay your claim regardless of fault. You may have to pay a deductible, but your insurer will attempt to collect all or part of that back for you. It could take them a year or two. If you get tired waiting for your insurer, you can sue the other driver in court and see what the judge says. But it will be binding, so your insurer will have to accept whatever the judge says. What does the police report say about fault?
Hi, a few months ago our house in Colorado suffered severe hail damage to the roof and siding. We at the time where filling for a home loan modification, and was told to sign our insurance check for the repairs and send it in along with three bids on the repairs. Since then we have worked out the modifications however never sent the check in. I was concerned because some of the repairs I would be able to do myself however without the funds from that check I could not afford to do so. Once I asked Litton Loans( the Mortgage company) on what funds I would get in return they stated they would keep them until I submitted receipts on the work plus labor. It’s a catch 22 on this so someone told me don’t sign the check, and just contact the insurance company tell them I can’t get the work done because the mortgage company will not release the funds. How do I handle this is there some sort of law I can send in with the check or should I just contact my insurance company and return the check to them? Thanks Danny
My truck was stolen, when trying to file the claim the adjuster states that my rims are not covered by the insurence, she also said that they do not go by the blue book value. I do not undestand how can she said that when we purchase that truck the rims came with it and at the same time we purchase the full coverage for it is there anything that I can do?
Are the rims original or aftermarket? Have the adjuster quote the policy language which says aftermarket stuff is not covered.
As to the value of the truck, if it was low balled, get the UClaim.com eBook “Total Loss Auto for Insureds”. Its guaranteed and currently on a 75% off sale at around $6.00.
You and the mortgagee have to treat this as 2 separate business transactions. The insurance claim damage and repair should be separate from the remodel and corresponding loan. The mortgagee should have a “loss draft” department that holds your insurance check until the repairs are done. It does not matter if you got the repairs done for half the amount of the insurance payment, the mortgagee has to send you all that money when the job is done. They can send their inspector to verify the repairs were done. You don’t have to supply receipts or a contract for repairs. Go ahead and get this in writing from your lender “before” you sign over the insurance check.
I own a 4 unit apartment building in Arizona. A parked tow truck rolled down the hill and hit the building. The building is about 35 years old. Because it is 4 units the local city inspectors consider it commercial. Being a commercial building all work done is required to have architectural plans, permits and a structural engineer. The tow truck companies insurance carrier is tell me that because the building is so old, the new code requirements (that were not in place when it was built but now are required) are not covered by them. They say they are only responsible for the depreciated value of the building repairs not the actual value. Do I have a leg to stand on? And to extent is their liability?
Hello hope that you may be able to help me. I have a Hail claim with Safeco ,called in the claim Aug. 6th shortly after the storm stopped and was advised that a adjustor would contact us on Friday the following week a adjustor came and was at my home approximately 45 min. he was from out of state and mentioned that he was headed to Yellowstone Park for the weekend to at least get to see some of Montana. He did not take the time to go over any of the claim, my home has number 1 hand cut cedar on the roof, and number 1 clear cedar siding (lap) my home is insured for over $350,000 we have replacement . My siding on one side of the home was ripped off and on another side plummetted with hail the size of lemons. We lost 5 windows, damage to a cedar deck with dents the size of a golf ball,a Barn metal roof, it put holes in the seats of our boat,busted a truck windshield , destroyed hot tub cover and almost all yard ornaments, a contractor came out directly after the storm and said you have at least $63,000 in damages that I can see. The roof has 46 squares of cedar. After calling almost each day to the point of almost exploding the 2nd claims department said oh we are send out a payment today(this was Friday at 5pm) for $29,000. The adjustor that was here said that he thought the roof needed replaced and one side of home, and a few boards here and there and they would pay to have it stained. Cedar does not match up after stained and new. Oh and all gutters were destroyed with holes the size of a softball. Also we have a natural pond that has canadian geese, well they were about 30 in the pond when the storm hit and now we have two with broken wings, this will tell you how bad our storm was. I need so advise on what to do, Help Thank You Barb
Hello Amber,
Yes, they are right, because they only owe you what is required by the law, not an insurance policy. You are better off to turn in the claim to your own insurance. Most insurance policies pay full replacement cost without depreciation. And many policies now days have “code upgrade” endorsements. Your insurer will try to collect back from the other insurer and get all or part of your deductible back.
The tow truck owner is only liable if there was negligence on his part. For example non maintained brakes, but not for example if some vandals pushed it down the hill.
You need way more help than I can give in a few paragraphs. You probably won’t get a public adjuster in your area. But if you do, take the advice offered at UClaim.com on how to hire one on the Free Stuff page. You could hire a lawyer as a last resort, but most lawyers will not know how to make the insurer pay more without litigation.
My best advice is to get the eBook at UClaim.com entitled “Homeowners loss Deluxe” currently on sale for $20.00, 75% off, with a money back guarantee. Read the description and view the table of contents.
Not sure if this makes sense but this is our timeline for what has happen with Foremost since our house was destroyed by fire.
ON THE AFTERNOON OF SATURDAY NOVEMBER 10, 2007 KAY AND COLTEN WERE AT HOME WHILE MARTY WAS HUNTING IN SCREVEN COUNTY. KAY HAD SPENT THE DAY WATCHING CARTOONS AND PLAYING WITH THE COLT.
AROUND TWO THAT AFTERNOON KAY STARTED WORKING ON CHRISTMAS ORNAMENTS IN THE KITCHEN. COLT WAS WATCHING TV IN THE LIVING ROOM. KAY HEARD A NOICE AND LOOK TO SEE WHAT IT WAS, SHE WALKED IN TO THE LIVING ROOM WHERE SHE SAW COLT STILL SITTING ON THE FLOOR WATCHING TV. AS SHE TURNED AROUND SHE SAW WHAT APPEARED TO BE SMOKE.
ENTERING THE BEDROOM, SHE CONTINUED INTO THE MASTER BATHROOM WHERE SHE SAW THE CLOSET ENGULFED IN FLAMES. SHE DOES NOT RECALL FEELING HIT FROM FIRE.
KAY TURNED BACK AND RAN TO LIVINGROOM PICKING UP SON SHE STARTED BACK INTO THE KITCHEN WHERE AT THIS TIME IT WAS FULL OF THICK BLACK SMOKE. THE SMOKE ALARMS WENT OFF.
SHE COVERED COLTEN’S MOUTH AND NOSE WITH HER HAND AND RAN THROUGH SMOKE OUT BACKDOOR.
RUNNING TO NEAREST NEIGHBORS HOUSE SHE SAT COLT DOWN AND ASK NEIGHBOR TO CALL 911.
SUNDAY NOVEMBER 11, 2007
ARRIVING BACK TO HOUSE KAY PLACED CALL TO FOREMOST INSURANCE LETTING THEM KNOW OF FIRE. SHE WAS ASKED IF THE HOME WAS LIVEABLE SHE ANSWERED NO. WAS TOLD ADJUSTER WOULD CONTACT HER WITHIN A FEW DAYS.
TUESDAY NOV 13, 2007
MET DEBRA CARRAHAN ADJUSTER FOREMOST INSURANCE AT HOUSE. SHE WALKED THROUGH HOME TAKING NOTES AND ASKING QUESTIONS. MARTY, KAY & MS CARRAHAN WALK TO BACK POARCH WHERE MARTY’S GUNS WERE LAID OUT ON TABLE.(PICTURE 1 & 2). SPOKE BRIEFLY OF HOW HOT FIRE WAS TO HAVE DONE THAT MUCH DAMAMGE TO GUNS.
WENT TO SIDE ENTRANCE OF HOUSE WHERE MS CARRAHAN EXPLAINED TO MARTY & KAY THAT THEIR HOME WAS A TOTAL LOST. TOLD CLIENTS TO NOT WORRY ABOUT SERIAL OR MODEL NUMBMERS BECAUSE OF THE AMOUNT OF DAMMAGE TO PERSONAL PROPERTY.
GAVE MARTY & KAY CHECK FOR $3,000 AND SAID SHE WAS GOING ON A FOUR WEEK VACATION.
RENTED HOUSE FROM JOE RICHARDSON FOR $600.00 A MONTH.
NOVEMBER 13 – DECEMBER 12 UNABLE TO GET IN CONTACT WITH MS. CARAHHAN OR HAVE ANYONE FROM FOREMOST RETURN CALLS.
DECEMBER 12, 2007
RECEIVED CALL FROM CUNNINGHAM INVESTAGATIONS ASKING FOR DIRECTIONS TO HOUSE. STATED HE WOULD BE OUT THE NEXT DAY AND IT WAS NOT NECESSARY FOR US TO BE THERE.
WENT TO HOUSE THAT AFTERNOON AND SAW THAT SOMEONE HAD BEEN IN HOUSE, CALLED THE INVESTIGATOR TO TELL HIM ABOUT DOG IN HOUSE. HE INFORMED KAY HE HAD MET THE DOG THAT DAY. KAY ASKED HIM WHAT HE FOUND. HE STATED THERE WAS NO SIGNS OF ACCELLERATE IN HOUSE.
KAY ASKED HIM IS THIS WHY FOREMOST WOULD NOT RETURN OUR CALLS, HE SAID “NO, THEY ARE NOT GOING TO TALK TO YOU BECAUSE YOU HIRED AN ATTORNEY”
KAY STATED THAT WAS NOT TRUE, MR DOZIER IS OUR BANKRUPTCY ATTORNEY AND WE HAD TO LET HIM KNOW.
INVESTAGATOR SAID “SOMEBODY TOLD THEM, YOU NEED TO CALL AND GET THIS STRAIGHTEN OUT” I WISH YOU THE BEST OF LUCK MRS. JENKINS
JANUARY 4, 2008
DEWITT INSURANCE FAXED 32 PAGES OF RECEIPTS TO MS. CARRAHAN
TOTAL $ 7,313.00
JANUARY 22 2008
CALLED TO GIVE DEPOSITION TO MS CARRANAH AT MR DOZIERS OFFICE.
KAY ASKED “IS THE INVESTIGATION OVER” WAS TOLD THEY SHOULD HAVE IT TODAY AND WOULD CALL THIS AFTERNOON OR IN THE MORNING”
(LETTER TO INSURANCE COMM. STATES FOREMOST RECEIVED REPORT JANUARY 23, 2008.)
KAY ASKED “WHEN ARE WE GOING TO GET OUR ADDITIONAL LIVING EXPENSES” MS. CARRAHAN REPLIED “MY BOSS SAID YOU WOULD NOT RECEIVE ANYTHING UNTIL INVESTIGATION WAS OVER”
(LETTER TO INSURANCE COMM. STATES FOREMOST RECEIVED REPORT JANUARY 23, 2008.)
GAVE MS. CARAHANN RECEIPTS FOR ADDITIONAL LIVING EXPENSES.
NOV – JAN
DID NOT HEAR FROM MS.CARAHAN UNTIL FEB 2008 SHE NEEDED SERIAL NUMBERS FROM GUNS AND ITEMIZATION OF FOOD LOST.(REFER TO NOVEMBER 13, 2007, ADJUSTER STATED HOME AND ITEMS WERE DESTROYED
RECEIVED CALL FROM MS CARRAHAN:WAIITNG ON BOSS TO SIGN OFF
RECEIVED CALL FROM MS CARRAHAN:STATING SHE WOULD FINISH CASE BY WEDNESDAY AND OVERNIGHT CHECKS.
MARCH 10, 2008
RECEIVED CALL FROM MS. CARRAHAN STATING WAIITNG FOR BOSS TO SIGN OFF AND WOULD CALL WHEN CHECKS WERE OVERNIGHTED THAT I HAD NOT UNDERSTOOD WHAT SHE SAID IN PREVIUOS CALLS
MARCH 11, 2008
FILED COMPLAINT WITH INSURANCE COMM.
RECEIVED LETTTER FROM INSURANCE COMM.
MARCH 25, 2008
FOREMOST CLAIMS CHECK FOR 83,905 ISSUED MARCH 14, 2008
AND CHECK FOR 4,195.27.
PERSONAL PROPERTY CHECK DATED MARCH 26, 2008
ADDITIONAL LIVING EXPENSE CHECK DATED APRIL 3, 2000
NOVEMBER 2007-FEBRUARY 2008
LETTER FROM ADJUSTER, APRIL 10, 2008
STATING FOREMOST WAS STILL WORKING ON CLAIM
LETTER FROM US BANK STATING NON RENEWAL OF POLICY 02/26/2009
LETTER FROM DAVID HARRIS, ATTORNEY FOR FOREMOST DATED APRIL 1, 2008 STATING FOREMOST WAS CANCELING INSURANCE. REQUIRED THAT WE DISMIISS ACTION WITH PREJUDICE,SIGN A POLICY HOLDERS RELEASE AND CANCEL POLICY IN SIXTY DAYS. (LETTER FROM US BANK STATING NON RENEWAL OF POLICY 02/26/2009)
Letter March 14, 2008
Debra Carrahan
$83,905
Additional 2% 2,095.00
Replacement Insurance is 20% $16,781.00
Letter Dated March 26, 2008
Personal Property Total:
62,585.00
tax 4380.95
Total: 66,965.95
$45,037.12 Policy
Depreciation 16,781.00
Is it not strange both amounts are $16,781?
Is there bad faith involved?
I’m going to make this as short as possible, but detailed.
Two vehicles in my own driveway were wrecked into by drunk driver w/ no insurance.
Both paid-off, but I kept full coverage on both under advisement from my agent.
Simply put she asked “If I was able to easily replace these vehicles if anything was to happen to them, then yes take off full coverage.” So I kept it.
Car 1 = Totalled / Car 2 = Minor damage.
Car 2 is undergoing repairs
Car 1 is again totalled
My insurance is giving my only 1400 after ded. for car1. My issue is that I don’t need the money, I need the car. If money was the issue I would have sold the car a long time ago and got more for it then. I dont expect a spanking new car but I would expect a car guaranteed to give me what I know car1 would have continued to give me and I cant afford to buy another car payment. Adjustor will not budge. Do I need an attorney? What can I do?
State of Texas / American First Ins (Liberty Mutual)
You can hire an attorney who has no experience on this subject for 150-250/hour who will waste your money or you can spend $6.00 (current sale price) on the eBook at UClaim.com entitled “Total Loss Auto for Insureds” that will teach you how to get most or all of your money in dispute simply, the way a good public adjuster would do it.
I have a 2nd story outside deck (attached to the house) which has two drains at deck level. One of the drains drained into the supporting column and developed wood rot. This also spread to the entire deck under the concrete and tiles so that it was not noticed. It also spread to the other column and horizontal wood beam. The entire deck needs to be replaced. There was no way to know there was a leak. The way I found out was the one supporting column suddenly one day showed a sign of compression in the stucco. Should State Farm cover this and to what extent if so?
Thank you.
Most insurers don’t cover rot, even if it was hidden from view. First try the sympathy route. If that fails, try to find a “concurrent cause”, another covered cause of loss that could have contributed to the loss. Be creative if you have to. Most home policies say they cover “everything except”, so this puts the burden and cost to disprove your claim on the insurer. If it cost more to hire an engineer to disprove your claim, it may be cheaper for your insurer to just pay you for your damages if you sign a release. Its called a “compromise settlement”.
I have a rental property in Pittsburgh where the tenants destroyed my home. From allowing their dogs to urinate and crap all over the floor, kitchen cabinets ripped off, carpeting torn off, superglue to put on walls, holes in doors, ect. And my insurance company denied my claim based on normal wear and tear, deterioration and maintenance. Maybe for a zoo but this is my home. What should and can I do?
OK. Here’s a question! My husband and I had filed a chapter 13 banckruptcy April 08. By August 08, we had a mtg with the trustee due to unexpected circumstance we were unable to pay the monthly payment. The trustee assured us due to circumstances, we should refile when the circumstances were resolved, and she would approve for us to be re-entered into the chapter 13. Our bankruptcy attorney advised us when doing our personal property inventory to only list major items in the home (ie. living room furniture, bedroom furniture, jewelry, & clothes as a whole) and to list them at a price we would get if we put the items in a yard sale. Before being able to refile the bankruptcy, our house burned and was a total loss. We jumped through all the hoops and got all the paperwork. The insurance company paid nearly 10 months of additional living expenses and even paid the policy limit on the structure but did a stop pay soon after. Now 1 month short of a year they have denied the claim due to misrepresentation on the contents inventory because of the difference with the bankruptcy. I understand the difference but honestly with the bankruptcy, we were only following our attorney’s advice, and to my understanding they don’t require you to list everything down to curtains, food, etc. Is there any case law where this has been overturned in court? We are sueing the insurance company because we feel this is ludacris. But I am not naive to how all this must look but do honest people really suffer because so many try manipulation the system. We had every intention of keeping our home and no fear of loosing it because of the trustee mtg. This was a terrible thing….is there really nothing we can do now?
I was parallel parked about 10 feet away from an intersection where only 2 of the directions were required to stop.
I signaled, checked my mirrors, and did the once-over my shoulder and proceeded since it was clear. As I was pulling away, a man hit me. Now I believe he must have been coming around the corner (on my right side) and floored it.
when we got out of the vehicles, he was apologizing up and down saying “I’m so sorry, I wasn’t paying attention, I was looking at the light up ahead and couldn’t slow down in time.” He then proceeded to sway me to not call insurance/police. I thought this was fishy so I called my boyfriend. When he arrived, the man began telling my boyfriend his car was fixable (By a buffer) but he suggested a friend of his who would only charge me $150. I thought that was strange as well.
Now my insurance won’t cover my damages, is it reasonable to go after his since he hit me? I feel he was negligent in not paying attention and possibly speeding around the corner in a residential neighborhood.
Hello Trish,
You have to approach this as a vandalism. Make a police report, even if only by phone. You will have to argue each and every item claimed with the adjuster, preferably on site. Be prepared to give in on some items. For more details on how to handle this kind of claim, consider the eBooks at UClaim.com Homeowners Loss Deluxe and possibly Denied Claims. Look at the tables of contents for each product.
If you are saying the insurer is denying the claim saying you misrepresented the inventory because you listed more stuff than was on the inventory for the bankruptcy, then I think the insurer is wrong (and I would gladly give expert testimony to that effect). Make sure you get their denial in writing stating the exact reasons. In addition to suing the insurer, consider one of the eBooks on handling denied claims at UClaim.com. They are on a 50% off sale with money back guarantee.
You and or your attorney could easily resolve this claim before a trial if you play it right. If the facts are indeed as you say, any insurer would be crazy to let this go to trial. But hey, there are some low quality insurers who will run up your legal costs and play you up to the morning of the first day of trial, just to see if you will go away.
I don’t know why your insurer won’t cover your damages, unless its under the deductible. You may have to sue the other driver in small claims court and see who the judge believes. If the other driver wants to lie to a judge after swearing to tell the truth, then he will have to live with himself. Do a diagram of the accident scene showing where the cars came from and where they impacted. And get witness statements if there were any. And see if the police will take a “late report.”
I am getting a new roof from a Hail Storm. I don’t really need a full new roof, but they don’t make the same roof so I get a full new one. What If I want to use the money for other home improvements instead? Can I do that or would I get in trouble?
You can use the money they gave you to go to Hawaii if you like. But keep in mind, that if they deducted depreciation from your settlement, and if you have replacement cost coverage, you can’t later recover that depreciated amount if you don’t do the repairs, and there is usually a time limit like 180 days to do the repairs.
Now for you other readers, sometimes you can “shift” money around if there are several trades in the repairs, and you get the adjuster to agree in writing before doing that. But in the case of a single item, like a roof, most adjusters won’t agree to it. Of course it won’t hurt to ask the adjuster, but make sure you have the money in hand before asking, because the adjuster could “change his mind” on the depreciation if he thinks you will “cash out.”
Hi. I’m a Restoration contractor in NY and I have a question as to how a denied claim affects “mitigation”.
We performed the mitigation on a water damaged home for a customer that has Insurance. The cause was determined to be a frozen/ruptured pipe in the bathroom sink. (water supply line)
Anyway, the claim has been denied due to lack of due diligence on the insureds part for not insuring his LP tank was full. (He was staying at his relatives due to being temporarily disabled from a previous car accident)
Now I believe that on most policies it is required for the insureds to “mitigate” their damages. If they do not, than the claim is likely to be denied. If they do, but the claim is then denied after mitigation has been performed by a contractor, wouldn’t the “mitigation” portion of the claim still be covered being that the insureds did what their policy (and an insurance rep)directed them to do?
I mean, if the insured did not mitigate, and the claim was valid and not deniable, then once the insurance company discovered all the additional damage from the insureds failure to mitigate, than I’m sure the insurance company would be very quick to now deny the claim. So, am I crazy to think that Mitigation would still be covered on claims that are later denied?
I can see the build back/restoration/repairs being denied, but the mitigation?
What say you?
Please allow me to thank you ahead of time…
Thank You……….
Darek
Well first of all, to simplify communication, you should not refer to restoration services or mold remediation as “mitigation”, because that word has different meanings. In insurance policies, the word mitigation means the insured must do what they can to reduce their damages or chance of damage, for example, cover a roof if it has a hole in it and it’s about to rain. So if the homeowner in your case had a good reason (that a court judge would agree with also) for not keeping the heat on, or the propane tank full, then his claim cannot be denied. While insurance policies say “mitigation”, they are overridden by the law, which says “mitigation, within reason”. But it sounds to me like your client (and his relatives) just forgot, unless he was in a coma or mentally incapacitated from the accident.
I see no difference in “build back” and “mold remediation” (if that’s what you mean by mediation) when it comes to denying a claim for mitigation. Consider the UClaim.com eBook on denied homeowner claims if you need to play hardball with the insurer.
Thank you. Insurance companies have specifically divided “restoration” from “mitigation” and we are directed to refer to our services as either “restoration” or “mitigation” when either calling the claims center/dept to update the adjusters on the status of the job or to ask the adjuster questions,or even when submitting our emergency service estimates.
On most of our jobs in Florida, when we performed the “initial emergency services” ie: water extraction, contents manipulation, initial structural drying, etc, we were for lack of a better term, “protected” on performing those services even if the claim was later denied. It is those services that we refer to as “performing the emergency mitigation”. ie:stopping the damage from getting worse when it is above and beyond what most homeowners could perform themselves.
I guess the key here is when you stated “While insurance policies say “mitigation”, they are overridden by the law, which says “mitigation, within reason”. That, I think, answers my question..
Thanks again…
Someone ran into the front of our house and broke a gas line.To fix the line we had to call a plumber when he gave us the estimate he said he had to bring it up to code the codes have changed in our area and he said it would not pass city inspection. who is responsible for the repairs the estimate was for 4700.00 the insurance offered 100.00 to replace the piece of pipe? What should I do?
Well first check the endorsements to your policy to see if you have a “code upgrade or improvement endorsement” that covers replacement of “undamaged” parts of your home required by building departments. That would make it easy. You could argue that the insurance company bases its premiums on current construction, which includes bringing structures up to code, but it will be a fight.
Now one option is to make the claim to the drivers insurance, which would not limit you to “policy exclusions” like your own insurance would.
What negotiating power does one have to push for a salvage settlement? I have a 2005 Dodge Magnum with a market value prior to the accident of approx. $10,000. The two quotes to fix the damage are around $7,000. Even though the car is driveable, it does have some ambiguous suspension problems that I am not convinced will get covered under a repair as part of the settlement. Most of the questions on this forum are on how to keep from having your car totaled but mine is how to force a salvage settlement?
The wood rot on the decks was caused be a breakage in the “hot-mop” which was per code in 1989 when the house was built. With the tile flooring over the hot-mop, one cannot see the damage. I would therefore think that the insurer would be responsible for all wood rot and water damage since it was caused by this breakage. What do you think?
It sounds like the question you mean to ask is how do you force the insurer to total your car out? Because you can’t “force a salvage settlement”. If your car is totaled out and you keep the salvage, then they deduct the salvage value from your settlement. If they take the car, then there is no deduction.
The insurer’s rule of thumb is that if the cost to repair gets close to 80-90% of the repair cost, then better to total the car out since supplemental repairs could end up costing more than that 10-20% margin.
If you want your car totaled out, then insist that they check out the suspension at a suspension shop before any body repairs. They have to. Now some body shops may be reluctant to do that first, because they could lose a repair job. If you have to, get the car to a suspension shop yourself and pay them to check it out and give you an estimate. The insurer has to reimburse you for that estimate cost.
And if they still fail to total it out, then take the repair money and sell the car.
Larry, go ahead and make the argument and hope for the best. If they deny the rotted wood, ask them to cover what it would have cost to access the repairs (which could include replacing the tile floor, etc.) and what would have been “non rot” damage at the time of the break. What could have caused the hot mop to break, something other than “wear and tear”, like a 400 pound guy walking on the deck?
And make sure the hop mop break occurred within your State Farm policy period. If not, go to the prior insurer.
The air handler in my house was somehow tilted the wrong way and ended up leaking out in my attic and down my walls rather than down the condensate line. I have no idea how long it was going on for, but I first noticed damaged when the carpet in my hallway was completely soaked. I called a contractor to come look at the damage. He saw the water damage in my walls and immediately recommended I open a claim with my insurance company. I called the same day and opened a claim. The adjuster wasn’t able to make it to my house until 8 days after I opened my claim. I tried to escalate the issue with my claims handler, stating that due to the closed-in environment and extreme amount of moisture, the water damage and mold would exacerbate. They were only able to send the adjuster a day sooner so it took a week for him to arrive.
By the time the adjuster arrived, my walls were covered in mold (it was a lot worse than at the time I opened the claim) and it had spread to the vanity cabinet in my bathroom. The adjuster concluded that due to the mold damage, the water must have been a constant seepage and must have occurred over a period of weeks, months or years. His verbiage was direct verbatim from the policy under “Losses we do not cover.”
I have filed a complaint with my state’s department of insurance and am in the process of appealing to my insurance company. The department of insurance has reviewed all documentation of my claim was not able to assist me.
I had an air quality expert inspect my house and state that there is no possible way to determine the genesis of the event and confirmed my suspicions that the issue was exacerbated due to the adjuster’s unwillingness to change his schedule and arrive sooner.
I am getting a written letter from the contractor and air quality expert that should help contravene the insurance company’s results, however, from conversations over the phone, I have a strong suspicion that it will still not be covered.
My question to you is, will this be worth pursuing in court as a bad faith claim? My arguments would be that the insurance company took no action (via hiring professionals) to prove that the damage has occurred over a period of weeks, months or years. The policy is also a contract of adhesion and the ambiguity of the policy should be refuted in court. The damage to my home is only about $5,000, so would it be worth the money to get a lawyer? I’ve gotten a quote from a lawyer already and he stated that $5,000 is usually the minimum for court fees, lawyer fees, etc.
I appreciate any assistance you can provide. Thanks.
You may want to condense this question. Way too many details for most contributors to take the time to read. You may also want to post it in our Discussion Forum and change a few words to avoid Google penalties to this website. And take a look at the “Denied Claim” eBook at UClaim.com.
Hi,
My son was hit going through a green light. The officer did not interview all the witnesses, and cited my son for failure to yield. Both cars were totaled. We both have liability only. They have 2 witnesses that say it was red. We have 2 witnesses that say it was green and their is another witness that said both lights where red and only the turn single light was green. Both insurance co. have denied all claims. We have not gone to trial for the ticket yet. If the other party takes my son to court and wins will our insurance co. pay that? Does it seem likely anyone would sue? The insurance companies win.
Thanks for asking. It does not matter. Make one word or grammar change for every 10-20 words. It could be a spelling change (like a misspelling), adding a comma or parenthesis, capitalizing a letter, changing a “the” to an “a”, etc.
It’s all a matter of which witnesses are more believable as to whether who wins in court, imo.
1. If the other party wins in court, your insurer has to pay.
2. If you get served with notice of a lawsuit, you must report that to your own insurer, so they can defend you. That’s part of your liability coverage. If you don’t advise your insurer of the lawsuit, they may not pay if you lose.
3. In the end, one or both insurers will pay. IMO, if the witnesses are equally believable, I would say the insurers should just pay half of each others damages.
4. “Will anyone sue?” That depends on the amount of their damages, their chance of success in court, and your assets.
Not worth hiring a lawyer. Go to small claims court if suing. And no lawyer is going to take such a small case, even if it has bad faith. Punitive damages in property claims in recent years are now limited 3 to 10 times special damages, in all states. So those days are over, thanks to the George Bush supreme court legacy. Big business can do whatever the hell it pleases.
If you policy does not cover mold up to a stated amount, usually 5 or 10 thousand, then your only option is to sue the insurer for negligence, ie. their delay caused more damage. The eBook at UClaim.com on denied homeowner claims will coach you on how to build a liability claim against your own insurer on denied water damage claims.
I have farmers renters insurance. My apt had a fire accident some days ago and the insurance company is saying they cancelled my policy in Aug 10. I didnt know this change because i didnt think i had any problem with them as i had sent out a check for my premium for additional 6months way back in May. They are sying they didnt get the check hence the cancellation. What should i do in this situation because i have property damage.
Thanks
Well the easiest first step is to see if the check cleared. Look at your bank statements. If it cleared, then there is your proof.
If it did not clear, then there are other ways to show how the insurer screwed up. You can get details on how to pursue this kind of denial in the eBook at UClaim.com entitled “DENIED AUTO AND MARINE INSURANCE CLAIM ADVICE AND HELP”. Check out the table of contents. The eBooks are 50% off and have a money back guarantee.
I was recently hit by another driver in CA while riding my 1987 Yamaha motorcycle. I only have liability coverage on my policy. The other drivers insurance is probably going to total the vehicle for $1000 or so. This is my primary vehicle and I will not be able to purchase another reliable vehicle for that amount. Do I have any other options to get the vehicle replaced or a more appropriate sum of $ to get a replacement?
I live in PA. Got cold out and clicked on thermostat for heat ( oil furnace, steam heat regularly serviced) I heard a, I guess i’ll call it a small explosion, in the basement approx. 15 to 20 minutes after turning heat on. Went in basement , felt furnace unusally hot, and noticed no water in water tube. Opened lever to fill and water gushed out from under furnace. Immediately hit cut off electric switch and called a furnace technician. He diagnosed low water cut off malfunction, burner “dry fired” , water tank ruptured ( no water in tank) and deemed furnace NON repairable.Need new furnace. Put in claim to my homeowners insurance State Farm, was denied, told not covered. Explanation was told to me like this ” well you have car insurance right? if the motor goes we don’t replace the motor?” I said we are not talking about a car we are talking about the heating system of my home !! Said i’ll recieve denial letter in mail. Does this sound right to anyone? I thought homeowners insurance, especially in a winter state, that would be a covered item> Is there any law in PA. that would say that the heating system is one of the basic items that would be covered, i’m confused on State Farms denial, considering the heating system is an intregal and necessary part of the home to be able to live in.
They have to pay you for something comparable to what you had. If the check has a release on it, line it out. And don’t sign a release. The same principals for settling a car total loss claim apply to motorcycles. You can get an eBook at UClaim.com entitled Total Loss Auto for Claimants currently on sale for around $12.00, 50% off and money back guarantee.
If the furnace was damaged by a covered peril like fire, then it would be covered without question. They will probably deny the claim saying the thing broke down due to inherent defect or malfunction.
Another angle for denial is this, in property insurance, the cause of the loss is never covered. So if a television malfunctions and catches fire and the house burns down, the house is covered, but not the television.
The UClaim.com eBook on denied home and business claims has a detailed discussion on how to get around this “cause of loss and inherent defect not covered” issue. It’s currently on sale with a money back guarantee.
September 29th, 2009 at 5:42 am #f. michael conte,CPIA
Larry,
if it is ok with moderatorr of this board i would like to review your policy, the last time i read a home owners policy the boiler portion was pretty broad, i would be looking for exclusions pertaining to the boiler itself. i agree with the moderators comments however, i am preety sure we have had similar claims paid. You might ask your agent to do some reasearch, to find out how the other carriers he represents would handle such a situation.
f micheal conte
ny,ny
My son was hit by a drunk driver in Los Angeles California, he was sitting at a red light and a drunk driver hit him from behind, it has been a 1 1/2 and the
case has not settle yet, the driver was convicted and arrested that night at the scene of the but the insurance company is trying to find all types of
clauses to not pay for my son pental damages he has a spinal tissue damage and a football player in college he was on his way back to college when this
accident happen, the clause know after they want to reach an agreement to settle the insurance company say’s no they want to back out of the settlement
small statement because he was not coveraged on the policy. my understanding if you have insurance or not that he was hit from behind and the driver was arrested that night and taking to jail for being under the influence and now the insurance company does not want to pay for damages, what law is this I need to know the law that defensive drunk drivers so I can bring to MADD to investigate this more and we shall look into this matter. Help my son was the victim.
If you guys use the Discussion Board on this website, you can communicate with each other without displaying your email addresses to everyone. Larry should make a post there, from which you Michael can PM to him. Otherwise Michael you could post your email address on this blog and hope that Larry is following it.
I can’t understand your English grammar enough to answer your question. Unless another visitor wants to try to answer your question, you may have to get someone to rewrite your post. Sorry …
Hello and thank you for taking time to answer so many questions. Recently my car was hit by a drunk driver and thankfully minimal damage was done. I had an estimate done at the auto body shop my insurance appointed, and the other parties insurance had an appraiser come out to do an estimate as well. Since the damage is minimal- no one at work even realized my car was in an accident- I would like the insurance company to write me the check instead of taking it in to this auto body shop for repairs. How do I go about requesting this from the other parties insurance company?
I recently had some issues with water damage in the downstairs of my bi-level home. I have hardwood floors and (rain) water seemed to have come through the door frame (underneath) and went under my floor and rotted a section of it. I had an estimate done and was told initially by the State Farm that if it was storm related, then it will be covered. I submitted my claim to State Farm (pennsylvania) and they are stating this is considered flood damage, since the water sat under the wood floor and rotted it. I do not have flood insurance.
From what I can tell, our gutters overflowed from heavy rains and splashed down on our deck and made its way to the door frame.
Anything I can do to get this resolved without having to pay for a new floor myself?
If you read the policy for yourself, under exclusions where it talks about rotted wood not being covered, it does not specify the cause. Most policies just say rot is never covered regardless of the cause. So it does not matter if it was from flood (surface water) or from rain leaking from the roof or window or door.
Now where most adjusters confuse themselves and the policy holder is in what they deem to be rot. If you can push your finger through the “rotted” wood, then it is rot that occurred over time and therefore not covered. However if the wood is just black or discolored and or delaminated, but it is still too hard to push a butter knife through, then it is not rot, even though it may look gross. And if the water that caused that came from a source above ground or a leaking pipe, then it should be covered.
It takes a lot of water over a long period of time to rot a hardwood floor, unlike pine framing. Hardwood floors usually buckle before they rot. And buckling is covered damage.
I have a question about a mother-in-law unit and landlord policy. I currently live in a single family home in Seattle, WA with a legal mother-in-law appartment/accessory dwelling unit in my basement. I put the unit into the house in 2001 with full permits with the city of Seattle.
Now I’ve purchased another home and want to rent out the upstairs part of my old house along with the MIL unit. The issue is that the City of Seattle requires at least one of the units to be owner-occupied for the MIL unit to remain legal. Once we move out and have not lived in the house for 6 months in a given year, the certificate of owner occupancy is invalid and the MIL is an illegal unit.
My question is about a landlord homeowner’s insurance policy as it relates to an illegal unit. I’m not concerned about the City of Seattle comming to fine me for renting an illegal unit, but the risk of my landlord policy being invalidated because of the illegal unit is not a reasonable risk to assume. Am I at risk of invalidating a landlord policy if I move out and rent both the upstairs unit and the MIL?
don,
this is a topic that i have preached on for many years, and i am happy that i have not had first hand experiance. i believe that any carrier in their right mind would deny a claim for any situation that was a result of an illegal occupacy. the exclsuion in the contract clearly excludes illegal activity, it also has wording about prior knowledge of a situation…. i would not take such a risk and i have held this opinion for years .the situation that i have seen more often is a legal two that is then turned into an illegal three. in the event of a wrongful death claim i cannot imagine how the carrier could offer a defense for an illegal occupancy, and as a result would be better served simply offering a denial.
i have waited a long time to answer this question, and i thank you. excellent question!
Just so a potential claim is not denied for misrepresentation, fax a note to your agents office advising you are moving to another location, and add that your mother in law is staying in the mil apartment. Or if you get insurance for your new location with the same agent, then he is now aware of the change in risk.
I would try to help translate Roberta’s post as it seems I am in a similar position, though there are some bits that I can’t quite figure.
However my problem – my dad was injured over 2 yrs ago by an uninsured driver speeding at 2.5x the limit of our residential street. He was since convicted, did his three months in a cosy cell and is apparently back home beating his wife (:/ nice system we have.)
my dad has been left with severe cognitive difficulties that most of the medical experts have been able to identify, although some do acknowledge some form of brain injury. We’ve actually just found out that his doctors have actually been making somewhat derogatory remarks in his notes suggesting he’s been making it all up anyway, and as a result of this, he has not received the treatment he needed to get back on his feet, to date. It is only now that some specialists are disputing these comments, and through them, we found out what had been said.
meanwhile the insurance process is turning out to be a nightmare – the accident claim, in the UK is handled by the MIB as the other driver was uninsured. To date, their policy with our lawyer has been to avoid communication as much as possible. The 2 are now trying to establish some middle ground on treatment and possible interim compensation, but the brick wall is relentless. It has been 2 years of struggle, both medically and financially, and we need to get this resolved!
My dad also had insurance claims to cover illness and accident – however these guys are now playing up too, as they keep trying to draw out the process by asking for information over and over again.
There is also another (non)issue that they keep using as an obstacle – a yr previous to his accident my dad used to be a company director, which I then took over. He remained as an employee as he had other commitments. However because of this history, his insurers are insisting on seeing all the company’s records, although I have been advised repeatedly by business legal reps that as the current director, they have NO RIGHT or NEEd to this information, and are using it as a tactic. They are essentially asking my dad to take confidential information “under the table” as it were.
When trying to communicate with them about any of this, they fob us off with a lot of jargon, ultimately saying, “we can’t really say what info we need as we don’t know yet – just give us evrthing we ask for and we’ll figure it out”.
none of this is acceptable – the mess my dad has been put in should not be happening were it not for a system riddled with incompetency and greed.
Please, if you have any advice at all, it would be much appreciated.
Travelers: be warned not to use Access America for travel insurance. After my bad experience with them- I then found the pages and pages of negative reviews from dissatisfied customers who were victimized by their “reverse insurance fraud”. They do not pay claims. I purchased travel insurance with them through US Air. My aunt died two days before I was scheduled to leave for a vacation. I called Access America and was assured that this would be no problem-just fill out the claim forms. In addition to the claim forms, I also mailed a copy of the death certificate as well as a letter from the funeral home. They are now saying that if there was a pre-existing condition that they will not pay. Travel insurance is meant for unplanned, unforeseen events that cause a consumer to have to cancel travel plans…and that’s exactly what happened. My aunt’s death was unplanned and unforeseen. Be warned…. I have read hundreds of other complaints made by victims raped by Access America Travel Insurance and Assistance. Someone needs to stop them!
I was in an auto accident in Florida. I went to the hospital and am now in physical therapy. The other car caused the accident and was cited for it. Their insurance carrier has now send me a letter that they will be denying all claims for this accident because their insured has not assisted in the investigation (which they say is required by their policy). What can I do? Is this allowed?
Well then you will have to pursue your damages directly from the other driver, and sue him if necessary. And if he looses in court, then his insurer may not reimburse him. Its his loss. If you have insurance, then you should make your claim with them and let them chase the other driver. I’m not sure if your uninsured/under-insured coverage would kick in on this. Maybe someone else here knows.
All I can say is document your communications and find out what the unfair claims practices laws are in your area. Sometimes, regardless of the merits of a claim, you can get coverage if the insurer screwed up with a negligent investigation.
The most common unfair practice is “delay”, so find out what the time limits are for answering letters and to deny or accept coverage. You can view typical claim practice laws in the UClaim.com publication “Claims Practices Laws With UCLAIM Commentary 2007″.
I have Homeowners Policy H03 with endorsement H04 32. Rain water most likely enters my home where roof meets the side of the house and in a 2nd location where the deck meets the side of the house. Water runs down inside the walls of the house and rots the siding, sheathing, studs, sub-floor, joists, etc. The rot dammage most likely occurred over some time and was hidden until a rotted window was discovered. The highest estimate I have received from a Contractor is $44K. Insurance adjuster and insurance company indicate that this loss is subject to the $10K limit of the H04 32 endorsement which provides “Additional Coverage” for Fungi, Wet or Dry Rot or Bacteria.
The endorsement adds paragraph 2.e.(9) to Section 1 – Perils Insured against, which basically states that Constant or repeated seepage or leakage of water… over a period of weeks, months or years… and the resulting damage is “covered” if unknown to the insured, i.e. hidden within walls or cielings, etc.
That would indicate to me that my dwelling is covered for such a Peril under section 1 – Property Coverages. However because the “resulting damage” is indeed Rot, am I limited to the maximum of $10K as indicated in the Additional Coverages, which would appear to be “coverage ” in addition to the “Main Coverages” for the property? If this is the case, how can a home owner insure against the full extent of damage from hidden Rot? Also because of the limit, the adjuster indicates that my loss is $10K when it is actually significantly more and perhaps not eligible to be referred to a three member board of referees. Please help this is really bugging me!
Insurers have wised up in recent years and found it cheaper to just pay a stated nominal amount on what used to me non covered claims instead of fighting and risking an adverse court judgment and costs of litigation.
You have to be creative to get coverage with these type claims, and you write like a “creative guy.” Keep us posted, and email a copy of that endorsement to info@insuranceclaimhelp.org and Cc to info@uclaim.com, if you want a more “creative” answer
My townhome was recently damaged due to my nextdoor neighbor’s fire. I was not home when the fire took place. In attempt to rescue the neighbors who were trapped on the third floor, the fire fighters smashed through my windows on the 3rd floor to get to the neighbor’s unit and sledgehammered a hole in the wall to get through to the next unit. As a result, there is a huge hole in the drywall, 2 windows gutted out, smoke damage, and debris left behind by the fire fighters/rescuers.
I have made a claim using my insurance (All State) already and they have assured us of standard coverage including construction, accommodations(as I cannot stay in my townhome due to strong smoke residue), food, and cleaning. Are we entitled to any other claims? Should the firefighters /police be contacted for the damage done in my home and are they responsible for any or part of the damages? Any advice would be appreciated. Thanks.
As far as FLOOD INSURANCE goes, the adjuster does not have control over the process. He is provided as a courtesy – read the policy. Actually, it is not even a typical policy – it is written into the US code 42. All flood insurance goes back to the federal goverment and there is no coverage for such things as loss of use, even for commercial properties. In fact, with a rental property, you will get Actual Cash Value, not replacement cost. It is the way the feds wrote the policy. There is no additional living expenses, no loss of use, no replacement cost for commercial properties, second homes, or rental properties.
It is a “bar bones” “policy”, but it is the only one available, and they are all the same. Additionally, the feds give the crrier/insurance company/WYO 60 days from the day they receive the Proof of Loss/Final Report to send the check.
In the case you sent and quoted from, rot was not excluded in that USAA policy. Most policies do exclude it and or limit it specifically. But in your case, you are right, your endorsement gives you coverage.
I don’t see much room for creativity after reviewing your info. The only way to get past the dollar amount of the limit would be to show your insurer was negligent in its investigation by delay or other unreasonable handling that would have “added” to your damages. This would be looking for coverage via negligence, which is not covered in the policy, but does give you recourse against your insurer in the courts.
And as I said in an earlier post on this website, make sure what you have is indeed “rot”. If any part of the wood “looks” like rot, but you can’t push your finger through it, it’s not “rot.” It’s sudden and accidental damage, and you can claim that under the main policy.
Don’t waste time or money on “policy appraisal” (the referees you referred to) unless you get the insurer to agree to go over the 10k limit. Policy appraisal is not for coverage disputes. It’s for dollar amount of damages. don’t feel cheated, the 10K you got is way better than what most people have been getting for the last 50 years or rotted wood claims.
I don’t know of any claim you can make under your insurance policy against the fire/police. If they were negligent in what they did, then you can sue them.
As to your claim with Allstate, I can’t tell you what you are entitled to in a paragraph. You not only are entitled to a lot more items than you mentioned, but you are entitled to a fair dollar amount for those items mentioned. I suggest you get the eBook “Homeowners Loss Deluxe” from UClaim.com, currently on sale with a money back guarantee. You can view the table of contents online to see a bit of what you are in store for. And “Goodneighbor”, you are going to need help since you are in the “good hands” of Allstate
Yes, we are so spoiled today, living off the fruits of the labor of “The Great Generation”. But its coming home, as our roads, bridges and infrastructure crumble around us. We may all soon have those bare bones policies if our government and economy can’t get back to the basics and stop trying to save the rest of the world and every freeloader and corporate swindler here at home.
October 13th, 2009 at 6:51 pm #f. michael conte,CPIA
here is one for me…. i recieved a denial of coverage for a toilet back up. the adjuster cited exclsuion for back up of sewer and drain. any thoughts.
uclaim charges about $10 for each policy document. I have 9 policy documents listed in the Declarations Page = $90. That is really shady of them to charge for docs they’ve pilfered from others.
We are planing to file insurance claim for the inventory we have lost either from our customer and/ or by our yard/ trucking partner.
Can you please help me with the procedure indetail for both instance…
What caused the toilet to back up? Tree roots, stopped up toilet, backup from a septic tank on your property or backup from the city sewer? If from the toilet, call it a “toilet malfunction”, not backup. That’s always a tough one.
It’s MISLEADING the way you explain it, and that’s why UClaim has a disclaimer for customers purchasing those policies. Most policyholders have ONE policy per Declatations page and “endorsements” added to that.
UClaim does charge $9.95 for the main policy booklets, and they charge 3.95 extra if the buyer wants the endorsements, and that is for ALL of the endorsements UClaim has available for that policy, not “each”. The typical buyer purchases one policy form copy, without endorsements. Why? Because something is better than nothing, and most buyers are “penny wise, pound foolish” when it comes to insurance claims (that’s why this free website is so popular).
If you have a Declarations page with 10 policy forms (not endorsements) we would very much like to see that. You can email a copy to info@insuranceclaimhelp.org and Cc to info@ulaim.com.
As to whether its is a ripoff, most visitors know full well that they can’t even get a copy of “their own policy” from “their own insurer” after a loss, at least not when they need it. They may get it weeks or months after a loss, too late to help the policy holder.
And John, “pilfering” is not a wise choice of words. Sorry if I sound harsh, but UClaim.com is a gift to the insurance claim consumer by a semi retired public adjuster, Ron Cercone. And as the saying goes “you are looking at a gift horse in the mouth”.
If you have a full business policy, it should pay you for what you paid (wholesale) for your inventory and retail for your business personal property (eg. tools, furniture, fixtures, etc. Your customers should get the “market value” (used value) of their property lost. I suggest the UClaim.com eBook Businessowners Loss Deluxe to guide you through it. Its on sale 50% off with a money back guarantee.
My wife was in an accident. We tried to file a claim with the other party’s Progressive insurance company. They had to conduct investigation because the other party denied it was their fault. The insurance company came back saying it was my wife’s fault due to a security camera footage. I have asked my wife many times to make sure that she was 100% not at fault. I know it is in human nature to not accept our own faults and to place the blame on others. My wife really believed she didn’t do anything wrong. In any case, we really want to dispute their finding. They are saying it is 100% our fault. I don’t believe the video showed that. I have not seen it though. What do I do next? There was a police officer involved but I have not seen the report, if there’s any. Please help. My wife and I are very distraught. I wish people would just admit when they made a mistake.
First, get a copy of the police report and see what it says. Then ask for a copy of the video tape and if they decline, then ask to view the video tape. Put your request in writing and fax it. It would cost them more money to sue you in court than to simply show you the video tape. And if they won in court, I doubt the judge would award them costs since they withheld the evidence.
If they still decline to show you the tape, then they are either lying or misrepresenting the evidence. You might also make a complaint to the state department of insurance and let them get the tape.
You could also turn in the claim to your own insurer and let the two insurers fight it out.
You could also ask to speak to a supervisor at the other insurer since the adjuster may be out of line.
Thanks for your suggestions. After talking to my agent, it looks like the insurance companies will duke it out. But we have to put up the $500 deductible in order for State Farm to have a reason to go after Progressive. Another fishy thing they did was to have their own adjuster give me a quote, instead of the car shop give me a quote. Is that illegal? I found out my insurance company got a statement from the other driver admitted to fault.
Should I still tried to contact their insurance company to scare them a little bit so they would give in? or do I leave it to the insurance companies?
We don’t have $500 to put it up but if I have to, I will.
You could continue to press the other insurer, but keep in mind that your insurer will get all or part of the $500.00 back for you after they collect back from the other insurer. But it could take 6-12 months. If the other driver was only 90% at fault, then you would get 90% of the $500.00 back.
The adjusters estimate is ok, as long as the shop agrees with it.
I have only had my Geico insurance and truck for a few months before it was broken into on the street. I had a touch screen Navigation unit in the truck. The agent told me he could only compensate $400. I am not sure if it was aftermarket or not. He told me that if it was aftermarket the policy does not cover it, that you have to pay more for that coverage. I didn’t know that was an option as it didnt ask when i signed up online. What options do i have here?
My dads house just burned down and the adjuster is trying to settle quickly. The maximum limit on the building is $343,580.00 and they are willing to settle at 335,000.00. However, there are endorsements and riders I am not familiar with such as OPT. OL, Debris Removal, Opt ID.
I am going to look for the policy however it may have been destroed in the fire. Have the Dec. Page and requested full docs but not expecting quick response.
Suggestions?
1. Get the UClaim.com eBook Homeowners Loss Deluxe (half price with money back guarantee). Look at the table of contents online free to get an idea of what you don’t know.
2. Get the policy copy and endorsements at UClaim.com, now. The longer you go without information, the harder it is to get “unscrewed”.
3. Consider hiring a good public adjuster either now or later. Read the UClaim.com advice on how to hire a good public adjuster to work on a percentage on the recovery amount for “over” what you got on your own.
Most auto policies don’t cover aftermarket items. But they should cover “factory” options. Is the insurer obligated to point this out when you buy your policy? Not in America.
You could argue in small claims court that the agent or company was negligent in not pointing this out, and hope that the judge agrees with you?
Yes, there ought to be a notification of this when you buy your policy, but that might “kill the sale.” This is one of those “buyer beware” things in our unregulated economy that allows big businesses to screw the little guy.
Next time around, fax your agent or company a letter with a complete description of your vehicle and advise that you want it fully covered. If they ignore it and if you later have a claim, they won’t be able to deny it.
This post is to Dennis Bran regarding house burning down. First you are doing right by trying to get the policy forms to see what is covered and what is excluded. See if your father had a “Homeowner” policy or a “Fire policy”. Homeowner could have the Replacement Cost and a Fire policy is usually ACV (actual cash value, less depreciation) which is what it looks like the adjuster is doing. You possibly could have loss of use which is 20% of your Cov A amount which could pay for expenses while you or father could not be in house while repairing fire damage or loss or rents if its a fire policy. The policy makes all the difference. Also, remember you could have separate contents coverage. Be sure to look at type of policy, then coverage and forms for exclusions. Let us know what you find out. Also the State makes a difference as coverage could be different in another state. Good Luck!
Can anyone help me…. I have h/o with additional collapse coverage. I have had the policy 8 years the house was built in 1977 and the family room adition in1984… I purchased in 1997 and the h/o company has been out 2 times in the 8 years to inspect and it was fine… My family room collapsed with 24 teenagers and sits in a state of collapse since 2/20/2009.. My claim was denied due to faulty construction… The company agrees it is a collapse and I am covered for weight, decay, insect…. I did not own the home when it was built and the building code says it only needed to be fastened??? I have had to get an attorney and now they have increased my policy by $1631.00
I have put complaints in and called my senators office…. I am wondering if a new insurance company would insure nme while this is going on?? and How can a insurnace company deny a collapse claim…when you have collapse coverage.
The homeowners expectation is they are covered… It is time the insurance companied are made to disclose and review entire policies to consumers before just handing a policy and taking a check….It is a total injustice and something needs to be done…… Can anyone help me….
Both are RCV and all risk with named exclusions on structure, and ACV and “named perils” with named exclusions on contents. DP3 is usually purchased by landlords and HO3 by homeowners. HO3 includes liability coverage, DP3 does not have to have liability? HO3 has more bells and whistles, fufu stuff.
How about some of you visitors elaborate more for Tammy …
IMO, the insurer wrongly denied the claim. Collapse like yours is covered, and the insurer can try to subrogate (collect back) from the builder for negligent construction. And your claim is for “collapse”, not negligent construction, so the claim can’t be denied for “faulty construction”, unless there is a specific clause in the policy saying collapse is excluded if faulty construction contributed to the loss.
Your claim was “sudden and accidental” which is what insurance is intended for. The intent of the collapse exclusion is to exclude coverage for dilapidated and rotting structures. If you have an attorney working on a contingency, he should be on top of it and perhaps should have filed a complaint in court? Ask the attorney for copies of EVERYTHING he has done, letters, pleadings etc. and show it to another attorney if you think your attorney has been doing nothing. And pay attention to the statute of limitations to file suit. Don’t let your attorney blow that.
I live in Northern CA and have Farmers Ins for my structure and interior contents insurance. While away on vacation back east,the supply line on my toilet in the master bath broke and leaked water into the room. This caused major floor and wall damage along with mold issues. Farmers said they won’t cover the damage as it was a leak and not catistrofic failure of the line. The agent then told me that even if they were to pay for the damage, that as I live in CA, there would be a 30% increase of my premium due for the next 3 years because I made a claim. He informed me that this was for all insurance companies in CA as it is a CA law. What is this and when did this go into effect? Not only would I have to pay the deductable, but this incease in premium, all for making a claim.
Just my opinion, but it sounds like your Farmers agent is more interested in protecting his “loss ratio” than helping you. Ask your agent to cite the California law that he mentions. I have never heard of such a law and would be very interested to know of such a law.
As to the “leak”, your adjuster is just dead wrong. Your loss was “sudden and accidental”. Now if they want to deny or apply a small policy limit for resulting mold, that’s ok. But cover all the other stuff, like buckled floors, swollen drywall, stained stuff, etc. Consider the UClaim.com eBook on denied homeowner claims to pursue the claim on your own and properly document the claim for possible litigation. If you get nowhere, then start hunting for an attorney to sue them.
Oh, and FYI, every time I’m away from my home for more than one night, I shut off the water valve to the house, just in case … I’ve seen too many stories like yours.
October 30th, 2009 at 5:49 am #f. michael conte,CPIA
richard,
i agree broken pipe is a standard coverage. please review your policy form for perils, i am sure you will find this in the coverage portion. Better yet ask your agent to read the section on coverd perils sounds like this will be his first time reading it……….
My vehicle had minor rear bumper damage done to it in a mall parking lot. I filed a claim with a quote from a local body shop. My insurance company approved the quote. However, the body shop has now called me and stated that they have received everything necessary to repair my vehicle. I don’t plan on taking my vehicle to this specific body shop, I was planning on taking it to the actual dealer. My question is can I go somewhere else? I haven’t received the check from the insurance company would they have sent it directly to the body shop?
What is the protocol an insurance company is to follow for an accident claim? We’re in NJ and Twin Lights is the insurance company. My daughter reported her accident and the insurance company sent all of her correspondence to her finance company not her. Though the typing of the letters make it appear to be sent to my daughter by the address information etc.. This completely took her out of the loop and gave her no opportunity to dispute the ‘total loss’ of her vehicle. Phone calls from the insurance company were only to confiscate the vehicle, which we did not release due to the lack of information. Phone calls made to the insurance company were answered with one lie after another seemingly to keep my daughter and us in the dark. To cut to the chase, we finally got the insurance company to agree to sell back the title, but they couldn’t find it (the title) until I handed them the tracking info I worked to get from the finance co. Now that they have the title in hand they say it will be a ’salvage title’!!! Is the finance company allowed to send the title to the insurance company w/o any consent from my daughter? Is the insurance co. required to retitle the vehicle as ’salvage’? My daughter would like to repair it as the only reason it is ‘totaled’ is financial not mechanical or safety. My daughter has very limited options due to poor credit, so she needs this car.
I live in a manufactured home and my agent had our policy wrote up as frame built. I recently filed a claim and was wondering if this will cause us problems. i asked my agent and he said not to worry about it and he will just make some changes to the policy. I cant hardly sleep at night though. Should I be worried?
You can take the car to any shop of your choice, as long as your policy does not say you can’t. By the same token, the body shop can’t just charge anything they like either. The insurer owes the “reasonable” cost. And you don’t have to get it fixed if no lienholder is named on the check. Yes, they could have sent it to the shop. Call the insurer and tell them to stop the check and mail it to you. If you did not authorize the shop in writing to order the parts, then they can return the parts.
Can Farmers Ins Group charge me a “surcharge” for filing a claim? This is the “law” that the agent refered to when he told me that Farmers would charge me 30% of my premium for 3 years for filing a claim. I was told that it probably would be in my best interest not to claim this damage and “save” the surcharge for a larger claim, if and when that happens. I have found nothing that relates to a fixed or sliding charge for filing of any claims in my paperwork. What can I do? Any thoughts?
Hello and thank you for taking the time to read this. I was involved in an accident about a week ago. I was turning left onto my home street and a 16 year old girl was turning left onto the street I was leaving. She had a stop sign and was determined to be at fault for the accident. She hit me on the side of my car on the drivers side back door. She ran for 4 blocks and pulled over after realizing I wasn’t going to stop following her. She told the police that she was trying to find a non-busy street to pull over at, she didn’t have her drivers license on her but was licensed she said. They were insured and was at fault for the accident. She was not issued a ticket. The mother doesn’t want to go through the insurance company but after being told that I want the money from the $840 estimate of damage, she decided that she would. The insurance company called me and told me that they would not issue me a check but would only issue it to the repair place. I do not want to have the work done at this time, what should I do? I own the car outright, no liens are on it. Is it not my choice on where/when I get the work done and shouldn’t the insurance company be required to pay me?
BJ,
You need to read your loan agreement papers with the finance company to see if it takes you out of the decision process if there is an insurance claim. If there is no “insurance clause/s”, then I would think it unreasonable that you have no say or rights in the claim.
And you have a right to letters that are addressed to you. That also indicates to me that the insurer should be dealing with you, not the lienholder. Yes, sounds like they are trying to keep you in the dark.
Does this “law” have a statute number? I think it is probably just Farmer’s own policy, not the law, to charge the 30% extra for 3 years. Check with some other insurers to see how their premium compares to Farmers. If the accident was not your fault, you should not be surcharged anyway.
Fax your insurer telling them to mail you the check. If they want to put in writing that they only send the check to the body shop, make a complaint to your state department of motor vehicles/consumer affairs and or department of insurance. Maybe the adjuster is getting kickbacks from the shop? You can make a complaint to the president of the insurer. And you can sue in court.
For those with lienholders, the insurer should still send the check to you, even if they put the lienholder on the check. Once you get the car repaired, the lienholder has to sign the check. Read your loan papers to see conditions about an insurance claim.
Hey folks, there’s some good people with claim problems needing your input in the Discussion Forum. Please jump in.
November 6th, 2009 at 6:02 am #f. michael conte,CPIA
richard,
first lets do the math, what will the claim pay out?
what will a 30% surcharge do to your premium?
finally, go to your states ins dept web site and ask them the question, i think the whole comment is balony, as many agents use this type of scare tactics for some strange reason. the state will have a filing on the carriers practices that they should be able to review and explain.
Thanks! The adjuster came out this morning and it didnt appear that it would be a problem that our home had the incorrect rating. I have Allstate. He said that they will pay me a depreciated value and then after the items are repaired and replaced they will cut me a check for the actual cash value. Will I have to show them the costs of the repairs? I plan to try to get it done cheaper than they estimate to help cover my $1000 deductible.
My car was hit in the school parking lot. I took the estimate to their insurance and i want to know if they will write me a check with my name on it and not the auto repair shops or if they will pay the shop directly? What if i don’t want to get it repaired, can i still get the estimate check for compensation? How can i get them to give me the money?
I am actually writing for my 78 year old mother who recently had a renter’s claim denied. The living arrangements there sound like something out of a bad soap opera, but need to be explained. My mother lives with my sister (her daughter) and her 3 kids as well as my sister’s ex-husband (yes, ex-) and his new wife and 6 year old son. My mother has her own renter’s policy. My sister has her own and the ex-husband’s family has their own (3 separate policies, 2 different companies). Told you it was weird. Anyway, my mother started her policy in January 2009 and it was in good standing in July when a fire destroyed the house they were renting while they were all away over the July 4 weekend. Although arson is suspected (and, IMO, probable), there is no evidence any of the residents are still considered suspects or had any involvement (residents are frequently the initial suspects). The apparent reason for the denial (she hasn’t received a written explanation yet) is inconsistencies in her “testimony” as to the location of various objects within the house. She claimed an item was in one room when it was apparently in another, for example. My questions: can an insurance company deny a claim based on an elderly client’s faulty memory? Can they deny based on lack of knowledge regarding an item’s value? How about lack of knowledge on the insurance company’s part. When told there were at least 2,000 DVDs in the house, one interrogator claimed “there aren’t 2,000 DVD titles available” (despite the fact that Netflix claims over 100,000 titles are available on their site). As an outside party, I realize my information on the case may be incomplete, but I have tried to give you what I have been told. Is there any info you can give me (or more you need) that I can pass along to her/them. P.S. the other 2 claims, which are both with the same company (but a different one from my mother’s) are still open.
About six months ago, my wife and her side of her family were on vacation in Florida. Her mom pulled out of a parking space after a White SUV passed and the coast was clear.
While she was pulling out, the White SUV stopped and reversed direction, hitting my wife’s car, which was only about two to three feet out of the parking space (we have the pictures to prove it).
There were multiple witnesses and the police report indicated that the driver of the White SUV was at fault. No citations were given since it was on private property.
A claims agent was working with us on the claim and we did get an estimate done at the shop of USAA’s choice, for around $650. USAA’s claims person indicated that the other driver was at fault at some point during the multiple conversations we had.
Since then, the claim was transferred to another claims agent who says the file did not show any history or claim that the other driver was at fault. They then indicated that they were working with the other driver’s insurance company and would contact us soon.
USAA claims that the liability is 50% our fault and 50% the other driver’s fault since my mother-in-law was supposed to wait until there was ‘reasonable’ safety to exit the parking space. It is quite reasonable to believe that the driver of the white SUV would not throw it in to reverse and go in the wrong direction in the wrong lane without looking, which is exactly what happened – as evidenced by the testimony of the passengers of the white SUV.
Since when is it ok for an insurance company to contradict a police report that states the other driver is at fault?
We have pushed this for months now and are at our last resort, and are considering arbitration. However, USAA says that they only offer 0%, 50% or 100% liability. In other words, if the arbitrators say that it is 51% our fault, then it rounds to 100% our fault and then our rates hike and it stays on our records for a few years. With the 50%/50% option, that would not happen.
However, if we take the 50%/50% option, we must pay our entire deductible and wait for USAA to obtain the other driver’s half of his deductible prior to us then getting a refund of half our deductible. Is this common insurance practice?
Is it even legal for them to contradict a police report?
That was the easy part. Now if you want to come out of this with money in your pocket and not get outsmarted by your adjuster, and hate your adjuster for it, and stay within the law, I can’t tell you how to handle all the possible moves to make in a couple paragraphs. It’s like a chess game and the moves change with every new letter and call from your adjuster. If you want to learn how to play the game, get the eBook at UClaim.com Homeowners Loss Deluxe.
You can also try the Discussion Forum in this website for ongoing help from other visitors.
If any of you visitors want to give Jennifer some advice here, please join in.
Way too complex for a couple of paragraphs of answers. You either need a lawyer (if you can find one or afford one) or get two of the publications at UClaim.com: Homeowners Loss Deluxe (it covers renter claims) and Denied Home and Business Claims. If the insurer is going to do an EUO (Examination Under Oath) then you need the eBook on that as well. The insurer will slaughter your mom in a EUO, so don’t go through it without a lawyer or the UClaim eBook on that.
Any visitors to this website are welcome to counsel Tony on this, either here or in the Discussion Forum, if Tony wants to post without delays.
Andy,
I don’t know the liability laws in Florida, but that is possibly correct, on the 51% part. Call one to those big yellow page ad accident attorneys in Florida or the Florida DOI.
If it was me, I would just go into small claims court with my evidence and tell your insurer to drop the claim so you don’t risk the premium increase.
I guess my main question is about the deductible. Is it normal to pay an entire deductible to the insurer, then wait on them to obtain the funds from the other insurer before giving half of it back to us?
I have travelers home insurance. My home had a fire. I hired a contractor. The contractor did not evaluate the plumbing in the whole house. The contrator drywalled over problems and installed new flooring. Well now there is leaking and damage. The contractor ask me to open another claim. I do not want to open another new claim. My premium went up $600 annual for the first came. I have only made 2 or 3 payments to the contractor. I have contacted the insurance company and told them I hold the contractor responsible for not checking the plumbing. No sure what to do if I have to open a new claim my deductible is 2500.
Andy, yes, that’s normal. And it can take months to get it back from the other drivers insurer or years or never to get it from a driver without insurance. That right of “subrogation” to your insurer is in your policy contract. Now if you can find a way to “encourage” the other driver or his insurer to pay up sooner, then go for it.
So take some kids with drippy ice cream cones into their plush claim office and let em run wild while they “find an adjuster” or manager to find your file and discuss it with you. You may not have to wait very long
Or sit outside their claim office, or their best agents office on the “public” sidewalk with a sign saying you got screwed by xyz insurance company Oh, and you may as well put a hat out there for donations while you are at it ))
These “Guerrilla tactics” are one kind of minimal effort “last resort” strategy, short of litigation, you will find in the eBooks at UClaim.com.
Unless they have evidence it was YOU who set the fire, they can’t deny the claim. All they can do is drag out the investigation in hopes that you will just fade away. Short of hiring a lawyer and or public adjuster, get the eBook from UClaim.com on denied auto claims. And if they demand an EUO (examination under oath) both you and your attorney should get the eBook on that subject. You can view the tables of contents online free. The eBooks are on sale with a money back guarantee.
If the contractor was one you chose, your insurer will probably deny your additional claim if the damage was due to his negligence. But it if the damage was part of the original loss and just overlooked, then it should be covered as a supplement to the original fire claim with no more deductible or premium increase.
The sooner you turn it in the better, before the water causes “rot”, which is not covered.
The insurance adjuster, who recommended them, stated I needed to open a new claim. I taked to his supervisor who said she would look into this further. This is the original statements from contractor when asked why they did not inspect plumbing prior to drywalling. “We would not normally check the whole house plumbing for a fire this size. We did inspect the plumbing that is in proximity of the fire. It appears the leak from the third floor might have been ready to leak for some time. We are assuming this due to discoloration around the pipe. The leak on the second floor looks like a problem from the original construction.” my home showed no visible signs of leaking prior to the fire. After the fire by house leaked water for days. How two unrelated leaks started at the same time is beyond me, both causing damage to newly installed floors.
I have not heard from anyone in a week. I asked contractor to update check list questions on the status of the original work to be done including Electric, AC, Sprinkler system etc inspections. They have not answered me. Any suggestions of what I should do at this point? I don’t plan on giving them any more money until I am back in my home with everything completed to my satisfaction.
Alison,
IMO, unless you can get another contractor, plumber and or engineer’s opinion contrary to your contractor’s opinion, then you are in a tough spot.
Our home sustained some damage due to a water leak. The insurance company quickly settled the claim and sent us a check to cover the repair work. The amount was based on an estimate from the contractor. However, the actual costs turned out to be lower than the estimate. Do I need to notify the insurance company and return the difference?
i receive a insurance claim check for storm damage it had my name mortgage company, and the contractor. I sent it to the mortgage company to see if they would endorse it first can they hold the check if they refuse to endorse the check if so for how long.
Admin,
Thanks for all the great info, you are very helpful to us poor accident victims. I am currently negotiating a total loss settlement, I had casually notified them I had a rental car on my credit card that I was expecting them to pay for. They took 7 weeks to make an initial offer for the loss and I have prepared my desired settlement over the past 2 weeks. I reminded them I have the rental car and they said I should be turning that in since they made an offer. Today I received a call from the rental company saying that the last day the insurance would pay for it was 4 days ago. I will be sending my request to them tomorrow, but since we haven’t settled I am in need of the rental still. Are they just trying to push me to accept or do they have the right to cut the rental as soon as they have offered me something? Thanks again.
They can end the rental if their offer on the vlaue of your car is reasonable. But the offer will probably be lowballed, so if you fight it and get them to pay more, then they owe the rental during the negotiation. Consider one of the eBooks on Total Loss Automobile at UClaim.com to get a fair settlement on the car. They are on sale with money back guarantee.
Well, even though the policy says the insurer owes the lowest amount actually spent, I have never heard of an adjuster checking back to see what you actually spent, unless you were claiming held back depreciation. There is nothing in the policy that says you have to return any unused money. But if it makes you feel good, go ahead and return it.
I don’t think they are allowed to hold onto the check, but its worthless to them if you have not signed it. Once the repairs are done, tell the mortgagee the job is done. After they send their own inspector out to confirm the repairs were done, THEN, legally they have to sign the check and return it to you.
My motorcycle was stolen and recovered. The police called me on Thursday and told me I could pick it up. I didnt want to pick it up without an adjustor looking at it first. I tried to call Progressive on Friday and Saturday but I couldnt reach my insurance agent and no one else would help me. I finally spoke with my agent on on Monday. He sent someone out to the impound lot on Tuesday. Today (WED), they called me and told me to pick it up and I owe the Police Department for towing and storage. I owe $34
August 17th, 2008 at 4:18 am #Alex
Your blog is interesting!
Keep up the good work!
August 17th, 2008 at 5:44 pm #admin
Glad you like it. Please refer anyone you know with an insurance claim question.
August 25th, 2008 at 12:54 am #Ben
Thanks. Good news. I’ll become your regular visitor.
August 25th, 2008 at 3:51 pm #Nick
Hello,
Is engine non flood damage covered under insurance?
August 27th, 2008 at 1:29 pm #admin
Thanks Ben
August 27th, 2008 at 1:59 pm #admin
Yes, depending on the circumstances and what kind of damage and what kind of policy. Wear and tear is not covered. Under most auto policies with collision coverage, if you are in an accident and the motor gets smashed, or an engine part like an alternator is smashed, its covered. As far as comprehensive coverage for a motor, vandalism is covered and theft is covered.
If you are talking about “warranty coverage” insurance, thats another story.
Can you tell me exactly what the damage is to the engine and the cause as well as what kind of policy (auto, warranty, rental) you are talking about? If you give me the insurance company name, I may have one of their policies I can look at.
While most auto policies are very similar, there can be slight differences, like who pays for your appraiser if your claim “goes to appraisal”, and whether or not you have to accept aftermarket parts if your car is repaired. If you want to compare auto policies from different companies, you can download them for free at http://www.uclaim.com.
In my opinion, if you are shopping for auto insurance and short on time, don’t compare the wording in the policies. Compare how generous they are when it comes time to pay a claim.
September 5th, 2008 at 10:17 am #nick
An insurance adjuster sent us a claim payment check payable to us and the auto body shop that did the estimate (a dual party check). We asked the aduster to reissue the check with just our name on it as we are unable to get the repairs done any time soon and wish to bank the check. The adjuster reply is they will issue the check to the lean holder of the vehicle. How come they wont just write us a check? If they do write the check to the lean holder will this money go twards principle owed?
Talking to the adjuster is like talking to an angry rock.
September 8th, 2008 at 5:59 pm #admin
Hello Nick,
Yes, an “angry rock” is an excellent description on many adjusters. If there is a loan on the car, the insurer has to protect the lien holder as well as you, or the lien holder could sue the insurer. Actually they should name you and the lien holder, if not you and the body shop. And no, if they do send the check to the lien holder anyway, the lien holder cannot apply it to your payments, unless there is a clause in your loan contract that allows it. This would be highly unusual. They must set the money aside.
Now if you do your own repairs, or find a shop to do the repairs for less than what the insurer paid, then you should be entitled to the left over money.
Of course if you pay off the car, then the money has to go to you.
September 11th, 2008 at 8:29 pm #admin
And Nick, you should give this “angry rock” adjuster a rating on our “Rate Your Adjuster” page. You can also give a rating to your insurance company there.
September 15th, 2008 at 9:39 am #gerry
Need to know If Debri from wind is covered under the Allstate HO-3 policy.
Part of tree on house.
September 17th, 2008 at 12:37 am #admin
The damage to the house from the falling tree should be covered. And the cost to get the tree off the house to access repairs should be covered. A “generous insurer” or adjuster will cover the cost to haul away the tree debris after the tree is cut up and removed from the roof. A “tight wad insurer” will leave the debris on the ground. If your lucky and your contractor makes a lump sum estimate for “tree removal” without separating the cost for cutting up the tree and hauling away the debris, the adjuster may pay it all without question. If the adjuster asks your contractor to break the costs apart, or “itemize it”, you will know what he is setting you up for – a partial denial of payment.
Most insurers HO-3 policies don’t cover wind damage to the tree itself and I’m sure Allstate is the same. An HO-3 policy “covers everything” unless there is a named exclusion, so look at the exclusions in the policy booklet and the endorsements. Read about trees and landcaping coverage under “additional coverages” in the HO-3 policy booklet itself.
September 17th, 2008 at 4:07 pm #Lynn
My sister and I have spent many hours working on an insurance claim for our Mother who was injured in a house fire. Is there any reimbursement for time spent preparing and researching items for a fire loss? The insurance company paid for the inventory to be done, but would they pay anything to a 3rd party for the services mentioned above?
September 19th, 2008 at 1:26 pm #admin
Yes they should pay you as a 3rd party, unless you were “an insured” yourself (that is, a relative who was living in the house with your mother, the named insured, at the time of the fire), they should pay for your time “preparing and researching items for the fire loss” just as they would have paid the inventory company to do this. If they are denying to pay your time, then turn in a bill for your friend’s time who helped you do the research.
Insurers routinely refuse to reimburse “an insured” for the time it takes to inventory a loss, which includes time to get pricing, do research, make phone calls, etc. They cite the policy language in “Your Duties After Loss” that says “you (the insured) will inventory and present the loss”. And sneaky adjusters often don’t make the denial until after the insured or “relative resident” has turned in the inventory.
To get around this, I usually tell policy holders to get a friend or relative not living with them to perform the “duties after loss” like inventory, board-up, security fence, etc.
If they do pay for these “your duty” items, the check should be in the insured’s name, unless the insured signed an assignment of payment form.
You should help your fellow consumers and give a rating on the adjuster and the insurer on the “Peoples Choice” page at http://www.uclaim.com when you are ready. You don’t have to post information that identifies you or your mom personally.
September 23rd, 2008 at 9:57 am #marian hamilton
I would like to know if your car is in a flood and water get into your car and starter andother place . Should your car be total
September 24th, 2008 at 9:49 am #nick
thank you for the guidance.
September 24th, 2008 at 2:07 pm #admin
Hello Marian,
Yes, it should be a total, in my opinion. There are two arguments: mold concern and mechanical and electrical concern. The insurers “restoration company” cannot get inside the inner sheet metal panels of your car to clean them since they are spot welded together. And they will not guarantee in writing that electrical components will not fail prematurely. If the engine had water in it for over 24 hours, most mechanics will tell you that the crankshaft main bearings will fail prematurely.
You should take five minutes and give the adjuster, insurer and their body shop or cleaning company ratings on our “Rate Your Adjuster” page.
September 28th, 2008 at 3:20 pm #nancy
What about travel insurance? My foster son has been having horrible sensory problems and is in a study at the University and would not be able to tolorate flying in a plane. We have cancelled our trip ( other family memeber going has to have hip replacement) and we got all these forms and confused by it all. With Dr. sign off will we get some of our money back or will they fight this all the way?
September 29th, 2008 at 1:44 am #admin
Hello Nancy,
Are you saying you had to cancel a flight because of a medical emergency and you are making a claim to the airline to refund the ticket cost? If so, all I know about this is that I have heard that some airlines will give a discount or a free flight to go to a funeral if you provide a copy of a death certificate.
Normally “travel insurance” is something you pay extra for when you buy a travel ticket, and it does refund the ticket money if you have a medical problem. Did you buy travel insurance?
I’d also think that if they sent you claim forms to fill out that maybe you do have the insurance. That’s good. Let your doctor fill in the form and see what happens.
September 30th, 2008 at 1:20 pm #Charles P Harrington
After the storm the adjuster came out to my house an assest the property. the insurance company sent me the check which now has to be signed by the bank which holds my mortgage account. What happes to the rest of the money after repairs are made and finalized.
Please write back this question is killing me. Niether the bank of the insurance company will give me a straight answer.
September 30th, 2008 at 9:43 pm #admin
Hello Charles,
Unless the mortgage company can show you a specific clause in your loan agreement that lets them keep left over insurance money, the mortgage company (mortgagee) has to give any left over money to you. They cannot apply it to the balance on your loan. The mortgagee has a right to send their inspector out to verify the repairs were done. And it does not matter if you or a contractor did the repairs, you are entitled to the same money as a contractor.
You should take five minutes to help your fellow man and give the adjuster and insurance company a rating on our “Rate Your Adjuster” page.
October 2nd, 2008 at 8:41 am #JOE
IF MY CAR WAS PARKED IN A PARKING LOT AND LOCKED AND IT GOT STOLIN AND THERE WAS A KEY LOCKED IN IT ,HIDDEN OF COURSE WOULD THE INSURANCE CO TRY TO DENY MY CLAIM.
October 4th, 2008 at 2:56 pm #admin
I have not heard of that being a reason for denial, but there is always a first, and some adjusters will try anything to deny a claim.
It depends on who the insurer is and their auto policy. I may have one of their policies that I can read for you if you let me know who the insurer is. If I don’t have their policy, you can fax or email me a copy if you like.
I can tell you that the ISO (Insurance Services Office) generic personal auto policy sold by many independent insurance agents has no such exclusion. But most insurers take the ISO policy and edit it to suit their own needs.
If they are a “fair” company and there is no policy exclusion for this circumstance, then they should pay the claim without question. First read your policy exclusions.
Please help yourself and other consumers. Take 60 seconds to give a quick rating on your insurer and/or adjuster on our “Rate Your Adjuster” page.
October 10th, 2008 at 6:54 pm #Jolie
Hello,
I was wondering if you can clarify what the endorsements are on the State farm mobile home policies for Texas. I have the endorsement codes but don’t know what they cover.
Thank you!
Jolie
October 11th, 2008 at 7:56 am #admin
Hello Jolie,
Sorry for the delay. I don’t have any Texas State Farm Mobile home endorsements on hand so I could not answer even if you gave the numbers. You could post those endorsement numbers and their titles (if available) in a a reply on this thread and maybe someone will have them.
Your agent and or adjuster must not only tell you what those endorsement numbers are for, they must give you a copy if you request them. If they are being difficult, fax a letter to your adjuster. If no response, fax a letter to Edward Rust ceo for State Farm. Now you have documented your file in case they don’t comply.
Don’t forget to make a rating on your adjuster and insurer on this website at some point and help build our new database for others to reference.
October 11th, 2008 at 2:11 pm #Jolie
Hello,
Does anyone know about State Farm’s Texas mobile homeowners policies? They are written through their general Ins co. I am looking for the meaning of the following endorsement codes; FGP-4926, FGE-4886, FP-4978, FE-4669, FE4564 and FE-4706. Anyone with any information would be helpful! Thank you!
Jolie
October 13th, 2008 at 9:50 am #Suzanne
we had a hotwater heater burst on vacation damaged our wood flooring,was denied, and we are pursuing the claim further but we just received interregotorie questions that need answering is this legal to ask for 15yrs of questions also list all receipt’s and contractors name address
that did work on the house when we have only had the policy with them for 2yrs.
October 16th, 2008 at 5:07 pm #admin
Hello Jolie,
If you don’t want to ask your agent for those endorsements (for whatever reason), try calling a SF agent/s in another town/s in Texas. You don’t have to give your policy number or full name, just tell them you are not happy with your current agent and are looking for another agent. Who knows, maybe they will even fax or mail you a copy of the actual endorsements. You may have to call several agents before you find one hungry enough to help you.
If your agent refused to give you copies of the endorsements and you don’t care whether he likes you are not, call the SF home office in Bloomington, Illinois and ask them. I’m sure they will want your policy number to confirm you are their policy holder first. You can even ask for a complete certified copy of the policy be mailed to you.
If you have an open claim, ask the adjuster for copies of those endorsements. If he refuses or refers you back to the agent, ask for the claim manager. If he refuses, then go straight to the SF CEO in Bloomington.
Also, try asking the other mobile homeowners who they are insured with. If its in a mobile home park, I’m sure there will be others in the neighborhood insured with SF. Ask to see their policies.
October 16th, 2008 at 5:42 pm #admin
Hello Suzanne,
Wow, thats a lot of stuff. When you use the word “interrogatories” that implies your claim is in litigation. Has a lawsuit been filed? Whether or not a lawsuit was filed, the 2 key legal words to focus on are “Reasonable” and “Relevant.” Most insurance policies themselves in “Your Duties After Loss” say you (the policy holder) will provide the necessary information “that we (the insurer) ‘reasonably’ require.” The law is the same in most states. If it’s in litigation, you or your attorney have to file an objection to each question or request for information on the grounds that it is unreasonable, irrelevant, over broad, vexatious, annoying and whatever fancy legal words attorneys like to use. If its not in litigation, just state your objection and reasons in a reply letter. Give them only what you think is reasonable and relevant. If the adjuster, claim manager, attorney persist in an unreasonable, invalid or illegal denial, fax a letter to the CEO of the insurer. Now the insurer will be facing punitive damages if your claim was unreasonably denied.
As to the water damage from the hot water heater, I assume the insurer is saying the damage occurred over a long period of time resulting in rotted wood. If the floor is not rotted, but just delaminated or swollen, that does not constitute “a long period of time”. Adjusters also often call black or stained wood “rot”. If you can’t push a butter knife through the wood, its not rotted. A reasonable insurer should cover the claim.
Don’t forget to make a rating on your adjuster and insurer in the Consumer Ratings section of this website when the time is right.
October 22nd, 2008 at 2:31 pm #Dale Whipple
My car was damanaged beyond repair and insursance company of the person that hit me denied the caim saying he didn’t have insurance at the time of the accident. I’d like to know how much to ask for. The blue book value of the car is approximately $3500 but just prior to the accident (less than a month) I had just under $2000 worth of repair. I’ve been told I can add that to the total I want by some and others say no. So I’d like to know from if I can or not.
thanks
October 23rd, 2008 at 4:47 pm #admin
Hello Dale,
Its a tough situation you are in, but go for it if you have the time. Yes repairs do add some value, but to most buyers (and courts), not much value.
You can’t take the book blue and add the cost of repairs or maintenance. Look at a Kelly or Nada book at your local law library or car dealer and read the introduction pages. No insurer would ever pay it either. But hey, you may be dealing with just the other driver or a judge in small claims court. Dealers will tell you that a vehicle with a newly rebuilt motor that cost $3,000.00 will only raise “the market value” a couple hundred dollars. Call a dealer and ask him how much he would add to a selling price for your new repairs.
The book value should be adjustable based on condition and miles. Getting the book value up is the approach to take. Also getting local dealer quotes, in writing, may get the book value up or down. Also there are different books eg. Kelley, Nada, which can sometimes vary by 25%!
If you are going to small claims court, go ahead and claim the book value and your $2,000 worth of repair receipts. Who knows, the judge may allow a good chunk of that. What have you got to lose? And take some written dealer quotes to show the judge. And pictures too, if you have any showing your car looks above average.
October 24th, 2008 at 4:01 pm #An Adjuster
As an Independent adjuster and having to work for many carriers I chose Texas Farm Bureau for my home, truck, 4-wheeler, horse trailer, health, life and my E&O / Liability coverage.
October 25th, 2008 at 9:47 pm #admin
Thanks for your valuable comments!
So is it safe to assume that since you are an independent adjuster, you chose Texas Farm Bureau because they pay their claims fairly?
You should give them a star and text rating in our Consumer Ratings section and add that you are an adjuster.
November 7th, 2008 at 3:08 pm #Kelly
If you have a home inventory done with digital photos, video along a list of electronics, appliances and computers with their make, model and serial numbers, would this suffice to a claims adjuster as “Your duties after loss” in the event of total loss due to fire?
What about in the event of total damage due to flood?
If you do not have a complete record of your belongings and you suffer total loss, does the insurance company pay the full limit of personal property under coverage B?
November 9th, 2008 at 8:16 pm #admin
Hello Kelly,
In an over simple answer to the “Your Duties After Loss” question, No, not unless your adjuster really likes you. Most policies say that you, the insured, will supply the ACV, the actual cash value of the loss, building and contents. Actual Cash Value on contents is the replacement cost less depreciation (in most states). Most insurers will give you an inventory sheet to fill out and you enter the replacement prices and age of items claimed (A “low quality” insurer will tell you to enter original costs and depreciate from that figure). While you have the right to enter the deprecation yourself, most insurance adjusters will steer you to let them do it. There are many ways that a low quality insurer’s adjuster can outsmart you in a contents claim. For the best help in a contents claim, consider the UClaim.com product “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS” $29.95 at http://www.uclaim.com/products.asp .
If you don’t want to be troubled with doing your own inventory, give the job to a friend or relative and bill the insurer for their time. Note, most insurers will not reimburse you, the insured, for “your” time to do an inventory, but they will reimburse for your cost to hire someone else to do it. A few old fashioned insurers will even do the inventory for you (for obvious reasons).
The photos, videos and list are good to help “document” and “prove ownership”. If you don’t want to be troubled with an inventory sheet, try just adding today’s replacement cost prices to the items on your list. If your fire loss was due to arson and the insurer suspects you, they may still do an EUO (Examination Under Oath).
These same general guidelines apply to flood damage, as long as the flood is covered. However, while most homeowners policies cover water damage, they don’t cover flood. That requires a flood endorsement or federal flood insurance.
In answer to the last part of your question: Assuming you have the most common homeowners all risk policy, the “special form”, while the legal burden to “disprove” your claim is on the insurer for the structure portion of your claim, when it comes to contents, the burden to prove ownership is on the insured, you. So if you can’t prove you had something, legally they don’t have to pay it. This is where it pays to have a “quality” insurer.
November 10th, 2008 at 2:47 pm #Chase
You should know, Progressive sucks too. I’ve been involved with heavy equipment for years and a friend of mine’s son was hired on by them and got horrible treatment by his employer.
November 10th, 2008 at 3:55 pm #admin
I could not agree more with you on Progressive.
Thanks for your comments.
November 11th, 2008 at 1:54 pm #YahooBot
Nice site, thanks for information!
November 11th, 2008 at 7:42 pm #HairyMan
Not bad… Not bad.
November 12th, 2008 at 2:38 pm #admin
Thanks for your comments. And any suggestions for improvement are welcome!
November 17th, 2008 at 12:29 pm #Jane Pytel
You mission is noble. As a 12 year insurance investigation veteran, I regret to say that “low quality insurers” are the norm, not the exception.
November 17th, 2008 at 6:57 pm #admin
Hello Jane,
Thanks for the nice comments. Your comments “delay, deny, defend” bring to mind a comment by a former California insurance commissioner (one of the few California commissioners who really cared about the consumer). He said most insurers usual practice is “to pay as little, as late as possible.”
You are very welcome to add your comments to any posts on this website and you should add a signature to your posts something like “Jane, contributor and former insurance claim investigator” (or however you want to word it.
Thanks
November 17th, 2008 at 7:00 pm #admin
Jane, forgot to mention the commissioner’s name: John Garamendi. I think he is currently the Leutennant General.
December 9th, 2008 at 7:44 pm #LC
Hello,
My house burned in the recent California wildfires. The insurance company would like me to sign a “White waiver” before they will discuss settlements of any kind. Is this a smart move? It would appear on its face that this removes any recourse if they negotiate in bad faith (which after looking around the web, I expect them to do). Is this a tricky way to dissuade me from entering into a negotiation with them or is this pretty standard stuff?
Thanks,
LC in CA
December 9th, 2008 at 9:11 pm #admin
Hello LC,
A White Waiver is serious, not “standard stuff”. Don’t sign it! It does not stop you from negotiating with them.
A White Waiver basically says that if the insurer makes an offer to cover your claim, or to settle your claim for x dollars, you cannot come back later and tell anyone, including a court, that the insurer previously offered you x dollars. A White Waiver is usually accompanied by a confidentially agreement.
Insurers don’t normally ask you to sign a White Waiver unless they want to deny your claim or seriously cut it down based on a suspicion of fraud or arson. Insurers usually hire a lawyer to do it, and only after they have conducted an EUO (Examination Under Oath) with a court reporter present, or during litigation (after a lawsuit is filed). It usually comes just before they make their decision to deny the claim or “compromise” (seriously cut) the claim.
Nothing in your policy says you have to sign such a document. I have been in insurance claims 28 years and it never ceases to amaze me the new stuff some of these insurers try to pull. Insurers usually try new abusive techniques like this in rural areas (like the San Joaquin Valley) before they try it in Metropolitan areas. Sounds like something Farmers Insurance would do.
The only document you have to submit is a “Proof of Loss”. Which is outlined in your policy. (A “Proof of Loss” can also come with hidden “traps”.)
If you have an insurer asking you to sign a White Waiver, you are probably in serious need of professional help. I would suggest that you consider hiring a “good” public adjuster for a percentage fee. You can read about how to find a good one at this link http://www.uclaim.com/free.asp. Click on the link entitled “About Public Adjusters”. You could also hire a lawyer to help you on an hourly basis for selected issues in your claim, like this White Waiver thing, or even to negotiate for you. If the claim gets denied, then I would suggest you seek a lawyer to work on a percentage (contingency).
Please keep us posted on this.
December 9th, 2008 at 9:32 pm #LC
Thanks for the heads up. I’ll contact a lawyer. For the record, the insurance company is Fidelity National Insurance Company. I doubt very much they suspect foul play since my house when up with most of the houses in my neighborhood. I’ve been resisting itemizing the thousands of things in my home because it seemed unreasonable for me to remember every hair clip and every roll of toilet paper, just to get reimbursed. Before they will discuss a settlement that would preclude me from needing to create this list and providing receipts for everything, they want me to hold them blameless for negotiating in bad faith (if they chose to do so).
I’ve heard that the better insurance companies will just settle for reasonable amounts and make it easy for me to replace my stuff as needed, instead of rushing to meet arbitrary deadlines before my house is even ready to move back into.
Thanks again,
LC
December 9th, 2008 at 10:04 pm #admin
LC,
You cannot get out of turning in an itemized list to the insurer. In fact, the California Legislature recently turned town a bill that would have forced insurers to just pay policy limits on contents (without an inventory list), if a house was total loss in a catastrophe situation, like wildfire. Some “savy insurers” might waive the inventory requirement, but this would be simply to draw a community into its confidence and deflect the initial onslaught of public adjuster solicitations.
If the contents inventory was your only concern, for $29.95 you could get high quality information on the most efficient and legitimate way to do it in the UClaim.com product report entitled “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP” at http://www.uclaim.com/products.asp . Most insurers will tell you that you won’t get paid for your time to do an inventory because it is one of “your duties”. This UClaim report will even tell you how to legitimately get get around that obstacle.
December 14th, 2008 at 9:47 pm #Paula
I have a question about a claim. Can my homeowner’s insurance company deny my claim for a break-in if we did not put our alarm on when we left out, we were only gone for a couple of hoursMy company is ny central mutual.
December 14th, 2008 at 10:45 pm #admin
Hello Paula,
I have never seen such an exclusion in a homeowners policy. But there is always a first time. I have never seen a NY Central Mutual policy. Look in your policy under exclusions, conditions and provisions, etc. Also look at the endorsements to see if there is an exclusion.
If you don’t want to put the question to your local adjuster, you could place a telephone call to a NY Central Mutual claim office in another city in New York. Ask to speak to a property adjuster. You don’t have to give your real name or policy number if you fear being charged with a loss.
If you would like me to review your policy for free, either mail, fax or email me a copy of the booklet and endorsements. I could use a copy of that policy anyway for the “Free Policy Copy” section of this website. (Your declaration sheet would not be posted). Just let me know and I will send you an email with my contact info.
December 15th, 2008 at 2:00 pm #cas
Hello,
Our house recently burned about a month ago. We were assigned the claim manager, contents adjuster, and dwelling adjuster. We have replacement on dwelling and contents. Anyhow the contents adjuster has been great, and very informative. He has kept us in the loop about everything on his end. However the dwelling adjuster hasn’t kept in good communication with us and hardly ever returns our phonecalls. Also when we ask him a question he acts like everything is top secret. I feel like we are gettin the run around. Also we never received a proof of loss statement. But yet they are already sending us an estimate not of total loss value. Everyone that has seen our home says its a total loss even the fire investigator. I’m so confused, what constitutes a total loss with a fire? Our home was completely gutted and burned through the floors, ceiling, attic and outer walls. All our contents were total loss and the cleanup alone will cost a 3rd of what they are wanting to do it all for. It took this long to get an estimate when we were told 2-3 weeks and the only way I found out what it is going to be is because we had to speak to a manager. What is going on, and what do we do?
December 16th, 2008 at 12:13 pm #kara
Hi, can an independant adjuster tell you that a claim is accepted, and then the office adjuster say the claim is under investigation? Even though a month prior the insurance company said the investigation was closed? Or would I have any grounds under esstoppel?
(sorry for spelling)
December 16th, 2008 at 3:32 pm #admin
Hello Cas,
You have a major loss. Before I start answering these questions, let me say that you are going to be having a lot more detailed questions and problems. The answers below are very general. And Cas, just because the contents adjuster has been nice, don’t let your guard down. The “smartest” adjuster is one who gives you 4 items (knowing that your policy covers 10 items), when you only claimed 2 items. Your dwelling adjuster ignoring your communications is one reason why our economy is in trouble today, lax law enforcement by government. But don’t get me going with that
After reading my answers below, take a look at the product description and the table of contents for the UClaim report entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe) at http://www.uclaim.com/products.asp . Its a bargain at $79.95. It will give far more detailed discussions than my answers below. Or you could hire a public adjuster on a contingency fee basis, for example 10% on a $100,00.00 loss ($10,000.00 fee). A good public adjuster will more than cover his fee by an increased claim recovery settlement. See advice on how to hire a public adjuster on the Free Stuff page at UClaim.com. I would NOT recommend an attorney to handle your claim at this point, especially considering most attorneys would charge around 33% (without litigation) and be much less knowledgeable than a good public adjuster.
Although you say your contents claim is going well, if you are not getting your policy limits, this UClaim report will be of immense value as well. Although you have RCV on contents, you don’t get the RCV unless you actually replace the stuff. So they will depreciate your personal property, and as you replace your stuff and submit proof, you will get another payment for the depreciated amount. Depreciation can be very arbitrary. One adjuster may take 30% while another adjuster will take 70% on the same inventory. If you have $100,000.00 coverage on contents, the RCV on your inventory should be well over that, if you want your policy limits without all the hassles.
1. Most states require a written response to communications within 15 days. One way to document your communications is via fax. Act as though you are building your claim file to present in court.
2. In my opinion, don’t worry about a formal “Proof of Loss” if they have not sent you their own POL form or requested that you submit one. Read about POL under “Duties After Loss” in your policy. I have handled numerous major claims where insurers never requested one. The POL only purpose, in my opinion, is to set you up for a denial based on fraud or a huge reduction in your claim. They can also be misused and misrepresented by insurers as being a release. If you really want to shake up a “bad boy” adjuster, provide the “POL” information on a roll of toilet paper
3. “Total Loss” – generally speaking, when the cost to repair exceeds the value of the house, minus the salvage value, then it is not worth repairing, ie. a total loss. The insurer has the right to pay the lower cost, to repair or rebuild. So if they think they can rebuild your house, they have to have a building contractor who can back up their estimate. Some insurers contractors will always “low ball”, knowing that their buddy insurance adjuster will pay them a “supplement” after they get the job. There are ways to “scare off” the insurers contractor. For example, let them know what a picky son of a gun you will be to work for. Tell them you will sue them if one door does not close perfectly. And tell them that YOU will not sign any supplemental payment checks (so they better write an all inclusive estimate now).
So if the fire went through the floor, what is the adjuster going to save, the concrete footing or slab?
4. If they are delaying the investigation, pay attention to the time allowed by your policy to collect your additional living expenses. If the delays are theirs, then you need to have that documented, in case they try to cut you off. Keep in mind that even though an average home can be built in 3 months, most homeowners do not get back into a repaired or rebuilt home for a year or two after a fire. The delays are usually the insurers fault.
If you want to help clean up the insurance claim industry (because government won’t), consider making some ratings in the Consumer Ratings section of this website. You don’t have to post your real name if you don’t want to.
Keep us posted and good luck.
December 16th, 2008 at 4:12 pm #admin
Hello Kara,
First of all, estoppel will not do you any good if you don’t have evidence, preferably in writing, or a tape recorded from an answering machine or voice mail.
Second, regardless of who said your claim was “closed”, an insurer should reopen a claim file to review it again up to the time for you to sue them has passed (“statute of limitations”). That can be up to 3 or 4 years on property claims. Even though most insurance policies say “you have 12 months to file suit”, what most don’t tell you is that the policy is overridden by the law.
If you think your claim was wrongly denied and they won’t reconsider or “reopen” their claim file, have an attorney or a good public adjuster take a look at your situation. You could also take a look at the UClaim product description entitled “DENIED HOME AND BUSINESS PROPERTY INSURANCE CLAIMS ADVICE AND HELP” and table of contents at http://www.uclaim.com/products.asp#Miscellaneous .
1. When you say “office adjuster”, are you talking about an employee in the independent adjusters office, or the insurer’s office?
2. If the independent adjuster put in writing that your claim was covered, but the insurer who hired him said it was not covered, then you may have a legal action against the independent adjuster and the insurer who hired him under estoppel and agency.
Insurance estoppel law says that once an insurer has made a payment, or even said they would cover a claim, they cannot later change their minds, even if they made a mistake and the claim was clearly not covered in the policy.
The law of agency, “Respondent Superior”, says the superior, or the employer, is responsible for the acts of its agents. An agent can be a direct employee or an independent contractor. If Allstate sends out Service Master to clean your house and Service Master screws up, then both Service Master and Allstate are responsible for the damage.
Consider making some ratings in the Consumer Ratings section of this website. You don’t have to post your real name if you don’t want to.
December 17th, 2008 at 5:55 pm #cas
Thankyou, we have already had a lawyer contact us, but maybe it wont come to that. As far as a public adjuster, we have one in line. He is a friend of my agent and will do it as a favor. However, @ this point I just dont know what to settle for. The Insurance company is the one who insured my house for that much and I tried to get less at the time but that was the minimum they would insure me for. So now they are wanting to give us less! I had about 65,000 worth of stuff so I guess now I will only get half of that in contents. The lawyer is wanting me to send some info. But not sign anything yet. They are wanting to see if it is worth it. Is that adviseable? BTW, thanks for answering my questions in detail.
December 19th, 2008 at 3:20 pm #admin
Hello Cas,
If they are cutting your $65,000 in contents in half, is it with depreciation or are they just denying payment on some items?
Is what advisable, sending some info.? If so, what info.?
What is “it” in your comment “They are wanting to see if it is worth it” referring to?
Don’t “settle” for anything less than what makes you happy, AND, what is not excluded and/or limited in your policy.
I’m glad you are getting some help from a public adjuster as a favor. If you get a qualified public adjuster to give you full representation (meetings, letters, evaluation, negotiations, etc) for free as a favor, then you are very lucky. Send him some cookies for Christmas
Some insurance companies are amazing. They want it both ways.
December 26th, 2008 at 8:32 am #Karen
We have a house that’s been on the market for over a year. We stop in about once a week to check on it, since our new house is in the same area. A few days ago we found that the heat was off (Minnesota -10 degrees F), and in contacting the gas company learned that the last LP tank fill had been July. They filled it again, the furnace started up on its own, and when we went over to check on it later it was obvious there was pipe damage and water damage over 3 levels on one side of the house. It seems there was miscommunication with the gas company; they have on record that we requested that service stop after July. State Farm claims dept is saying it is denied because we didn’t take proper precautions. Do we have any chance? We are already paying 2 mortgages!
December 26th, 2008 at 2:59 pm #Karen
Update to our situation: The claims agent set up a conference call with the gas co., and asked them what evidence they had. They said they have a record in their computer that we called to update our billing address and then a note saying “July fill only”. The agent asked if they sent any notification in writing regarding the understanding about a change in the standing contract, and they said no. The claims agent took the conversation as sufficient evidence for them to deny the claim. He then said we might want to take the gas company to court. Does State Farm ever not find a reason to deny a homeowner’s claim?
December 27th, 2008 at 2:13 am #admin
Hello Karen,
Take a good look at your own policy wording under Section 1-Loses Not Insured (If you want to fax, mail or email us a copy of your policy for review, send an email to info@insuranceclaimhelp.org). Most home and rental policies say damage resulting from a broken pipe due to freezing is not covered if the house was “vacant, unoccupied or being constructed.”
If you have a “special form” policy, the burden of proof is on the insurer to disprove your claim.
My opinion is this:
1. Unless the gas company has something in writing signed by you, or a tape recording requesting no more gas, a note on the gas company computer could have been a clerical error.
2. There was no motive to shut off the heat. No reasonable person would shut off the heat.
3. The definition of “vacant” is open to interpretation and the entire clause is ambiguous, when compared to the exclusion for vandalism, further on down the list of excluded losses. Note it says that “a dwelling being constructed” is not considered “vacant”. That clause also gives 30 days as a definition of the time period of “vacancy.” You could argue that “under construction” implies new construction, not remodeling or maintenance, and if you did any remodeling or maintenance on the house, no matter how small, once every 30 days, then the house would not be vacant.
It would also look better if you had a good reason for not shutting off the water to the house. (I myself am so paranoid about broken water pipes, for any reason, that I will shut off the water valve to my house even if I am gone for the night. I leave the lawn sprinklers on with a separate valve.)
This is a tough claim to fight, even for professionals, and usually requires threat of litigation and multiple letters, sometimes up to the CEO for the insurer. You will be lucky if you get it covered.
And yes, suing the gas company is a possibility, if it can be shown that they were negligent. Also take a look at your contract with the gas company. And also talk to a lawyer who knows Minnesota law regarding negligence, etc.
December 27th, 2008 at 9:03 pm #Karen
Thank you for your helpful comments. What a great service this website provides.
Our policy states that loss resulting from freezing pipes is excluded from coverage if the house is vacant, etc, unless the homeowner takes reasonable care to:
a)maintain heat in the house, or
b)shut off the water to the house and drain the system.
We didn’t have the water shut off because we’ve had trouble with the line to the septic tank freezing, requiring a service call that costs about $100. The first time we had this trouble we still lived there, but were on a week’s vacation in January. The condensation from the furnace drains out to the septic, and if there is no water usage in the house the flow is too slow and it freezes. So to prevent this we stop over in the winter every 4-5 days and flush a toilet. Maybe in the future we’ll have to shut off the water and just take a few gallon jugs over to pour down the drain to the septic.
Regardless, given the “or” statement in the policy we were not required to shut off the water. It seems to me we did take reasonable care to maintain heat in the house–I don’t understand why the claims agent can deny our claim when all conditions were met. The fact that the gas company did not take reasonable care does not seem relevant.
I guess we need to get a lawyer to find out if we have a better chance suing the insurance company or the gas company.
January 1st, 2009 at 4:55 pm #admin
Hello Karen,
If your policy says “reasonable care” then that’s what you hang your hat on. Most policies don’t say that. Fax a letter to the adjusters supervisor with your story. If he denies your claim, then the next letter should be faxed to the CEO of the insurer. Don’t waste time climbing the chain of command. If the home office denies your claim, then go to small claims court if its under the limit or close. If its over the small claims court dollar amount, then see if a lawyer thinks its worth his time to handle on contingency. Of course any lawyer will work for an hourly fee. If a lawyer can shake them up with a couple of threat letters, it may be worth it.
Talk to a plumber and see what they do in your area. Maybe pour antifreeze in the drain once, but don’t flush? Or blow the water out of the drains with a leaf blower (or compressed air). The septic lines won’t be damaged from freezing water if there is no water in them. And I did not know that a partly full drain line would freeze enough to break a drain pipe. I can see if a p-trap would freeze, or a water line full of water???
January 5th, 2009 at 1:12 am #admin
Karen,
For some in depth easy to understand help, take a look at the Table of Contents for the UClaim report entitled “DENIED HOME AND BUSINESS PROPERTY INSURANCE CLAIMS ADVICE AND HELP DELUXE VERSION (W/APPENDIX) at: http://www.uclaim.com/products.asp. Scroll to the Miscellaneous report section.
It would be appreciated if you could take a few moments to give a quick rating on your insurer and/or adjuster and/or other insurer’s vendors on the Consumer Ratings page of this website. You don’t have to show your real or full name if you don’t want to.
January 5th, 2009 at 7:46 pm #beth
In a Foremost CA mobile home policy, can a claim be denied as an intentional act if the homeowner is not competent and is being charged with arson?
January 5th, 2009 at 7:49 pm #beth
regarding the question for a mobile home in CA which was burned by the policy holder and since found incompetent..can Foremost Ins deny the claim “intentional act” if the person did not realize what they were doing at the time?
January 9th, 2009 at 1:47 am #admin
Hello Beth,
Let me do a little research on this and make a post in a couple days.
Off hand, I would say that the insurer should retract the denial after the homeowner is declared legally or medically or “reasonably” incompetent. I would think this would fall into the same category as a child or “mentally retarded” person intentionally starting a “play fire” that got out of control.
Another important consideration would be “intent”. Did the insured intend to burn the place down, or was it an accident.
Also, once the police drop their investigation for arson, then the insurer should pay up. The insurer’s own private investigator should not be allowed to take a month longer than the fire departments investigator.
January 9th, 2009 at 2:13 am #admin
Beth,
Have you read the exact Foremost policy wording? You can download a copy for free at http://www.uclaim.com/products.asp . Look under Policy Conditions “Concealment and Fraud”. Note that it does not list “Arson”. It lists “fraudulent conduct.”
So, lets say an insured intentionally burned his house out of anger against a spouse for whatever reason, revenge maybe. Now while the police may be able to charge and prosecute him and send him to jail, the insurer could not deny the claim, since the arson was not with the intent to collect insurance money or to cheat the insurer.
And then there is also the concept of the “innocent co-insured”. While this Foremost policy says “any of you”, some policies say fraud by “the named insured”. So any “unnamed insureds” like a wife or kids or relative residents can be covered.
January 9th, 2009 at 2:17 am #admin
And Beth, look at the legal definition of “Arson.” Someone who wants to burn their own house down, without some criminal intent, is not an arsonist.
January 9th, 2009 at 10:14 am #Jane Pytel Insurance Expert
Just taking a moment to review some of the problems encountered by visitors to your site. Claim denial and claim delay are two of the most serious and common problems encountered by consumers. I know because I was in insurance investigator for 12 years.
Since my departure from insurance, I have taken a very proactive approach to assisting people who suffer from insurance company tactics.
I write a series of articles, the most recent dealing with unfair settlement negotiation tactics. Check this out, it may be of help. http://ezinearticles.com/?id=1856390
Or you can contact me through my website, http://solutionsforyourinsuranceclaim.com/
I’ll be checking with this site, insuranceclaimhelp.org on a regular basis. Nice job.
January 9th, 2009 at 3:31 pm #admin
Hello Jane,
Thank you for your nice comments and spread the word.
January 9th, 2009 at 4:34 pm #admin
Beth,
I posed your question to a group of public adjusters and attorneys and no one had any case law off hand, but there has to be some on it. You can ask an attorney to research it for you. You can also go to http://www.findlaw.com to search for it.
The policy does have an exclusion for “any intentional act” under Exclusions in the policy.
If I get any good responses on this, I will advise.
January 9th, 2009 at 6:57 pm #Rube
My brother has insurance from State Farm ins. and has a policy that says loss of rents. ( Actual loss) He would like to know if that covers tenets that do not pay the rent and we have to evict them through the courts that takes around 4 months..can we make a claim
January 10th, 2009 at 12:59 pm #admin
Beth,
This is a little more elaboration to my post on January 9, 2009. Since the policy does state that intentional acts are not covered under the Exclusions section, arson would indeed be excluded, if it was “intentional”. If it was not intentional, since the policy holder was incompetent, then it may not meet the definition of arson. Also check to see whose opinion of incompetent is necessary, a doctor and or a court.
Let us know the outcome and keep us posted on your progress. This is interesting.
January 10th, 2009 at 5:37 pm #admin
Hello Rube,
I would say no, I have never seen such a claim payment in my 28 years experience.
The State Farm Rental Dwelling policy available for free download at http://www.uclaim.com/products.asp says the loss of rents is only for the time to repair during a covered loss, for example fire, wind. Note, thanks to your post, I discovered that the loss of rents pages were missing from that sample policy. UClaim has been notified and should have the file fixed within an hour.
Now, if after the tenants are evicted, there is damage to the house from them intentionally, from anger at being evicted, then you have a covered loss called vandalism. All you have to do is make a police report. You or your representative will have to meet with the adjuster at the loss site and argue each item of damage line by line. If the damage is from them living like pigs, it’s not vandalism. Much of it is gray and will depend on how liberal your adjuster is. Is kids writing on the wall vandalism? Is allowing a dog to urinate on the carpets vandalism? A broken counter top ceramic tile is vandalism, in my view. Be willing to give in on some items just to make the adjuster feel better. For the items your adjuster does not cover, sue the tenant in small claims court and see how a judge rules on each item. Take pictures to show him. Whatever the judge deems to be vandalism, the insurer has to pay. Although you may get a small claims court judgment against the tenant, you will probably never collect the money from the tenant. But you will collect from the insurer. I suppose you could even try to name both the tenant and the insurer. But the insurer should pay up even if they are not named.
January 11th, 2009 at 12:55 am #Scott
Our house on the Gulf Coast was severely damaged by Hurrican Ike. When roofers went to replace wind damaged shingles, they found damage that we didn’t know about that had been present for years. This damage involved the roof flashing and dormers and may have resulted from prior wind or improper installation.
The home was covered by a State Farm policy(s) for 25 years, including the time when the damage occured. But State Farmd dropped the policy about a year before this damage was discovered, as it did its policies on other properties on the Gulf Coast.
So, if the damage occured during the time the property was covered by State Farm, but was not and could not have reasonably been discoverd until and the coverage ended, do we have a claim under the State farm policy?
Thanks!
January 11th, 2009 at 4:16 pm #admin
I would say yes.
The sample policy “State Farm Homeowners FP-7955 CA 6-96.pdf” for free download at http://www.uclaim/products.asp only says you will give immediate notice after the loss. But it is overridden by the law.
The law in most states will state something to the effect “as soon as you become reasonably aware of the loss.” If there is no law on the books, then the judge makes up his own mind, and a competent judge is supposed to use what is “reasonable” in his decision.
Also, any lack of clarity or ambiguity in the policy should favor the insured, not the insurer.
For purposes of the legal statute to file a lawsuit against the insurer, some states have case law that says the “date of loss” is the date that you become aware of the loss and/or the date that the insurer denies payment.
Most states also give 3 or 4 years to file suit against the insurer (this overrides the 12 months stated in most policies). The law overrides policy provisions, which amazingly, are often contrary to prevailing law.
January 12th, 2009 at 7:27 pm #beth
Thanks for the info on the home destroyed by fire. If I find out more, I will post the outcome. As far as I know the owner of the home was charged with arson and is awaiting trial..looks like also an intentional act setting the home on fire..we shall see…thanks for the info!
January 14th, 2009 at 2:27 pm #Teresa
I have two questions. A tree feel through our roof and we were advised to hire a public adjuster which we did. The insurance co sent a small claims adjuster, large claims adjuster and structural engineer and then cut a small check to get us started. A few months later they cut another check to the mortgage company, public adjuster and us.
1) Our public adjuster told us that the insurance co. would pay for the roof, really 2 roofs, so that we would be whole, i.e., the roofs would match. The house looks terrible with a new roof and old roof and would probably affect the value of the home. Should I expect that the insurance company should cover this or will I have to take this out of my pocket to fix it?
2) How does payment work? We received checks but found a contractor that could perform the work for less than the check amount. The public adjustor is asking for receipts that add up to the check amounts but we don’t have that. Do we return the difference to the insurance company?
January 14th, 2009 at 5:16 pm #admin
Hello Teresa,
1. I don’t know what state you are in, but California law states:
“When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace all items in the damaged area so as to conform to a reasonably uniform appearance.”
But even if your state has no specific law on this, you are still entitled to be put back where you were before, in your case you had a roof that was matching. It does not matter how old or in what condition, it matched. You may have to litigate since most insurers will disagree.
Send a pic of your roof as it looks with the old and new to info@insuranceclaimhelp.org if you like, for me to see.
2. First of all, you don’t have to return any money the insurer sent you, even if they discover a clerk added an extra zero to the check by mistake. That’s called estoppel. Second, I would assume the insurer wants proof of what you spent so that you can claim the “RCV holdback”, the amount of depreciation they took from the repair estimate. Either your public adjuster failed to educate you on this, or you guys have a communication problem. This kind of question should not be coming from someone with a public adjuster. It makes me sad.
Your public adjuster should have prepared you for how to legally not only keep the money already paid (the depreciated value, the ACV), but how to claim the RCV holdback (and more!), even if you got the job done for less than what the insurer estimated it at.
If your insurer is attempting to collect back based on a policy settlement provision that says “We pay the lesser of the following amounts … the amount actually spent …”, that is really sad, and its even more sad that this could happen to someone with a public adjuster. If your public adjuster can’t get you out of this mess, I suggest you get the consumer guide entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” at http://www.uclaim.com/products.asp and read the detailed discussion on this.
January 15th, 2009 at 6:32 am #Teresa
Admin,
Thanks so much for your quick response. We are in the state of Pennsylvania and our insurer is Allstate. Our public adjuster said he thinks we should “sue” which made me nervous. If we sue, I am afraid our rates will go up (we already lost the claim-free discount) or we would have problems getting insurance from another company if we needed to.
You’re right about getting the holdback but I am confused as to why the public adjuster is telling us that the receipts need to equal the amount of the checks. I don’t think he’s a bad public adjuster but he is definitely not a good communicator.
The weather is not good here but I’ll try to get a picture to send you.
Thanks again.
January 15th, 2009 at 12:46 pm #David L.
Great website, something that is surely needed to deal with the ever growing greed of big insurers. One topic worth mentioning to the sites visitors seeking assistance, is the Public Adjuster. In my opinion, this profession is the single best weapon the consumer can use. Just make sure you find a reputable one.
January 17th, 2009 at 3:55 am #Kuykendall
With many years of Ins experence, I did not read close enough until I lost my home by fire. My husband handled the policy when we built our new Log Home a few years ago. He was killed in an auto accident in 2005. My home was totally destoried by fire 10/2008. I was in another state with my mother while she was having hip replacing surg. so I lost everything since I am in a rual area, it was very dry, no rain in weeks, so it was gone before anyone even saw it and called fire dept. I had replacement cost on my homeowners, but do not intend to rebuild a large 3 story home when I live alone. The small clause I missed was A.C.V. decovery depreciation on home and contents both. In this very rual area, I paid a very high premium for the replacement cost. I’ve spent weeks researching to refresh my memory and changes in laws since I had been out of business. Im still going to submit All of my work and agruements to them, but I think that one clause has got me. Even though I probably won’t recovery the 60,000.00 I still believe Im right. How can they sell me that policy for such a high price but then dictate that I have ti rebuild to receive what I paid for. And what does my not rebuilding have to do with my contents. I guess I want you to tell me that I have overlooked something. They may do it, but it is not right. Everyone better watch out, replacement cost can be taken a lot of different ways in different states. One hundred people could read my policy and 50% would see it my way and 50% would see it their way. Im sorry this is so long, but if I don’t get any help from this, someone else may. Thank You
January 17th, 2009 at 11:32 am #Kuykendall
Sorry to bother you again, when you haven;t even had time to answer my first. Im on brain overload so I would like to ask the questions that I didnot before. 1. can I submit a second inventory list after already being paid A.C.V. -recovery depreciation with 180 days to recovery. I worked for a solid week on the inventory, but out of three stories (including basement) I could not begain to remember everything, besides so much had been moved around and boxed since my husband died. I had 96,500 on contents, but finally quite at 83,000, and they really knocked that down. they took it down to 70,000 with excluding items, then dep. to 50,000. 2. My ins. co. used an independant adjuster, He was very nice, even though I never saw him. When he called to ask for directions(had never been in this area before) and told me when he would come, I assumed he would contact me to go with him. He didnot. There is nothing there, except a crumbling basement wall, and part of the big roc chimney to the fireplace. When I got a copy of his broke down estimate to rebuild, It would not even cover half. He arrived at this using Xactimate estimating software, which I had never heard of. I did a lot of research on that. Im no computer whiz, but I got the concept, but you have to know what was there. He scoped it, I don’t understand that. This is a very small town, he didnot gt anything from tax acesseroffice, or contractors, or a copy of our floor plan. Ive made a lot of mistakes with this, just a very bad 3 yrs. and when I hav refered to my policy, I spoke that wrong. It burned. I have been working with last 4 yrs. declarition pages. I also requested investigator, I though they could tell almost anything. Adjuster said nothing for him to check. I kept thinking I would need to give some kind of statement, was never ask a question. Thanks, FOR WHAT EVER HELP YOU CAN GIVE ME.
January 19th, 2009 at 1:12 am #admin
Welcome David,
I agree completely. There is some free advice on how to get a good public adjuster and how to retain one without risking losing part of your settlement offer to the public adjuster’s fee (if he fails to increase the settlement) at http://www.uclaim.com/aboutadj.asp .
January 19th, 2009 at 1:52 am #admin
Teresa,
Your rates should not go up just because you sue on the same claim, IMO. And on homeowners insurance, it’s usually not the dollar amount of the claim, but the frequency of claims that triggers a higher deductible or outright non-renewal. So a theft of a $150.00 bicycle would be the same as your house burning down. However, if you made an adjuster angry at you, he could send a “risk advice” to the underwriting department and cite something as trivial as “poor housekeeping” to get your policy non-renewed.
If you had a major loss, you should be looking for another insurer anyway. Many insurers will non-renew you, but not notify you until 30 days before the renewal date. That’s not much time to find another insurer. Also, if you find another insurer and switch before your policy is up for renewal, then you don’t have to worry about retaliation if you do sue. The adjuster could care less if you non-renew, and a smart agent will not put up a fuss if he hopes to get your business back in the future. Also, if you switch before your policy cancels, it looks better on the new application that you “are looking for a better premium” instead of “my insurance got canceled”. And Teresa, there are plenty of companies better than Allstate, and for a better premium.
Unless you are providing receipts to show you spent more than the ACV, in order to claim additional RCV dollars that were held back pending replacement or completion of repairs, then NEVER provide receipts. That’s an open invitation for the insurer to demand some of their money back. I repeat what I said in an earlier post, you should never be in a position of having to pay back any money already paid by an insurer. And I have never heard of any company, especially Allstate, overpaying a claim and saying “just give us back the money you don’t use.”
Don’t tell me your public adjuster’s name or company if you don’t want to, but tell me how many years he has been a public adjuster. And was he ever employed as an adjuster by an insurance company before becoming a public adjuster? Send me a copy of his resume if you like, black out his name and and company name if you like. And Teresa, go online to your state department of insurance and enter his license number or name to see if there are complaints on him. It sounds like this guy is hurting yo more than helping. Pennsylvania is a big state for public adjusters. Call some other PA’s and tell them what you have told us.
January 19th, 2009 at 2:31 am #admin
Hello Kuykendall,
In answer to your first recent post, generally speaking, insurers pay the ACV (depreciated cost of repair, or market value) on contents and structure first. You don’t get the “RCV holdback” until after the items are replaced. On contents you send in receipts to prove replacement. The same is usually true for structure, although some adjusters will just make an inspection to verify the house was rebuilt without asking for receipts or a contractors invoice copy.
In answer to your second post, you have way too many details and problems for a free website like this to address. A post as lengthy as yours would not even get a response on most forums. Our best advice is to either get a good public adjuster and pay him a percentage of your claim (eg. 10% on a $100,000.00 loss is typical) or if you are going to handle it yourself, take a look at the table of contents for “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe) Subtitle: HOW TO PLAY THE GAME – DELUXE VERSION (W/APPENDIX) at http://www.uclaim.com/products.asp . At $79.95, it’s a huge bargain.
If the adjuster and or company are giving you a hard time, take the time to give them a rating on this website so you can help your fellow consumer. You don’t have to leave your real name.
January 19th, 2009 at 3:24 am #admin
Teresa,
Saw the pics. If you can see from the ground from any perspective where there is new roof and old roof, then I think everything “in view” should be replaced. In California they call it “the line of sight rule”. If one side of the ridge is new and the other side is old, then I don’t think you will get a whole new roof. The only way to see it not matching would be from the air, and a judge would not go for it.
January 19th, 2009 at 9:24 am #Jane Pytel Insurance Expert
I couldn’t disagree more. Speaking as a former insurance professional, I can assure you that the single most effective means to defeat the tactics of the insurance companies is simple – knowledge. Consumers must take control of their own claims. To share a percentage of your settlement with a public adjuster is ill advised. Additionally, I can assure you that in my experience, insurance companies fight much harder when a public adjuster appears. No, not the solution.
Since my departure from the insurance industry, I have made it my mission to assist insurance consumers from insurance companies. Sorry, but I just couldn’t let the previous comments pass withour comment.
January 19th, 2009 at 3:59 pm #Kelly
Kuykendall,
Would your insurance allow you to rebuild on a different piece of real estate?
January 20th, 2009 at 5:03 pm #admin
Hello Jane,
Its soldiers like you and I who fight the battles so that Joe consumer can watch his favorite TV show in comfort thinking he is in good hands with his good neighbor Allstate.
Thanks much for your spirited comments. I have to say, IMO, that it can go both ways with public adjusters. That’s why David qualified his comment saying “find a reputable one.”
It also depends on the individual insurer and the individual insurance company adjuster. Some insurers will do anything to fight a claim with a public adjuster. Some adjusters (mostly newbies) see burying a public adjuster as putting a feather in their cap (however that can also come back to haunt them if they step over the line of fair claims handling law).
I might also add that I have seen insurers pay a claim more quickly and fairly when they discovered that they would be dealing with the same “son of a gun” PA they fought a battle with on a prior claim.
If the consumer handles their own claim and hires a public adjuster AFTER the consumer has gotten their best settlement, and the public adjuster fee applies only to “new money” recovered, the consumer would have nothing to lose (fee wise), even if the public adjuster was incompetent (and sadly, there are a lot of “PA’s” who got their license “under the table”. But that is another sad story). The downside to this is that most consumers will have made some mistakes that not even the best public adjuster can correct. If a consumer is going to hire a public adjuster, especially right after the loss, they have to compare and choose carefully.
If hired from the start of a claim, some public adjusters can be just like accident attorneys who get the consumer “signed up”, then sit back and do nothing and take what ever settlement the insurer offers and collect their percentage. Now that’s “carpetbagging”, IMO.
The position that most states’ legislatures have taken is that, in order to level the playing field, any quality of licensed public adjuster is better than no public adjuster. Until it becomes “socially acceptable” for insurance company adjusters to pursue a career as a public adjuster, there is always going to be a shortage of good public adjusters.
To the consumer I say: If a PA won’t work for a percentage of the “new money” 6 months or even 2 years after a loss, show him the front door
January 20th, 2009 at 9:00 pm #Scott J. Tepper
Barry Harman, a public adjuster and owner of Spectrum, posted this comment. He procured an illegal contract with the client of the attorney he complained about and lost a lawsuit in banruptcy court — after Harman filed for bankruptcy — based on the illegal contract. So he decided to file a phoney complaint. He’s not being truthful.
January 21st, 2009 at 9:26 am #john angelo
Hi Jane please call me I have been trying to get in touch with you
561-338-5577
908-358-9311
hope you are well need to ask you some questions
thanks
John/ Mr. Billy
January 23rd, 2009 at 9:18 pm #Maricela
My auto was stolen in Mexico, within 25 miles of the border. Farmers Insurance has denied my claim.
My policy reads : MEXICO COVERAGE – LIMITED ]
Read This Warning Carefully ]
Auto accidents in Mexico are subject to the laws of Mexico only-NOT the laws of the United States of America. Unlike the United States, the Republic of Mexico considers an auto accident a CRIMINAL OFFENSE as well as a civil matter. In some cases, the coverage under this policy may NOT be recognized by Mexican authorities and the Company may not be allowed to implement this coverage at all in Mexico. You should consider purchasing auto coverage from a licensed Mexican Insurance Company before driving into Mexico. This coverage does not apply to trips into Mexico that exceed 25 miles from the boundary of the United States of America.
The coverages for your covered auto provided by this policy are extended to accidents occurring in Mexico within 25 miles of the United States border. This extension only applies for infrequent trips into Mexico that do not exceed ten days at any one time.
Additional Exclusions
We do not provide any coverage:
1. if your covered auto is not principally garaged and used in the United States; and
2. to any covered person who does not live in the United States.
The claims office obtained a copy of my crossings using the license plate reader from the port of entry. My auto had crossed 15 times in the past 30 days. Farmers has determined that I am a frequent crosser. Why are they allowed to deny a claim if the definition of infrequent is not defined in the policy?
?
January 24th, 2009 at 1:31 am #admin
Thanks for your comments Scott. There are always two sides to every story. Since this went to court, is this public information? Can you share with us what exactly what was illegal in his contract? Every public adjuster is supposed to have his contract pre-approved by the DOI in California. Any custom changes should be initialed by all parties, and as you already know, must be of a legal purpose.
Incidentally, you are welcome to start a rating thread on Mr. Harman under “Add An Adjuster” on the Consumer Ratings page.
January 24th, 2009 at 2:15 am #admin
Scott, you may also want to copy your reply to Harman’s comments by clicking on “rate-it!” to the right of Tepper and Garfield. Give yourself a 3 star rating, which is a neutral rating. I believe the star rating field is currently required, so I will ask our programmer to change it to “un-required” ASAP. Once he fixes this, then you can leave the star rating box blank when making any replies to comments. Thanks
January 24th, 2009 at 2:42 am #admin
Scott,
You are also welcome to have any of your clients who have used your help on an insurance claim give you a rating. This will bring up your average star rating score.
January 24th, 2009 at 3:01 am #admin
Maricela,
If the policy does not define “infrequent”, then they cannot deny your claim. Insurance policies are “contracts of adhesion”. This means you can’t line stuff out or change stuff when you buy the policy. It’s a “take it or leave it” deal. Therefore the law says that any ambiguities or unclear language in the policy must be ruled in favor of the party who did not draft the policy contract, (that’s you).
Fax a letter to the adjusters supervisor. If he denies it, then fax a letter to Farmers CEO at their home office. If he denies it, then sue them either in small claims court yourself or in Superior Court (if you can find a lawyer to take it).
You can compare your Farmers Mexican policy to a sample Mexican Auto policy for free download at http://www.uclaim.com/products.asp . You can also get much more detailed information on how to pursue a denied claim with the report entitled “DENIED AUTO AND MARINE PROPERTY INSURANCE CLAIMS ADVICE AND HELP Subtitle: STANDARD VERSION (W/O APPENDIX)” for $29.95 also at http://www.uclaim.com/products.asp
January 24th, 2009 at 9:34 am #Scott J. Tepper
Admin – I have sent you by e-mail a copy of the final judgment against Harman and his company, Spectrum Builders, from the bankruptcy court, as well as the court’s ruling on the motion for summary judgment. These documents speak for themselves.
January 24th, 2009 at 5:05 pm #Thomas Treakle
How do I file a claim against an auto dealer’s “Garage Keeper’s” policy for damages caused to my vehicle when they were doing service work when the dealer refuses to give me the policy information or make good on the repairs? Basically they blew the engine and the repairs will cost more than the vehicle’s worth.
January 26th, 2009 at 2:56 am #admin
Hello Scott,
I only asked what was “illegal” in his contract. If it was not something easy for our visitors to understand when they themselves look at a public adjuster contract, such as a missing cancellation clause, then all you need tell us is something like “it’s too complicated to describe in a paragraph or two, but the final judgment discussion can be seen at XYZ County Court.” You could also cut and paste short excerpts from your documents if you wanted to. But I believe there is a limit of either 500 or 1000 characters in these comment boxes.
I’m sorry, but your email and attachments were deleted without being read. Unless we ask for an email or give prior approval, all comments should be made in this public forum.
Your participation in this website is greatly appreciated and we encourage your comments on any post in this website.
January 26th, 2009 at 3:17 am #admin
Hello Thomas,
If the car dealer is unwilling to report your claim to his insurance carrier, your only alternative is to sue him. Your car dealer is gambling that you will just give up and go away. And his insurer cannot open a claim file without the consent of their policy holder.
Now here is your leverage, once he gets the notice that he is being sued, he has to report the suit to his insurance carrier. If he does not, then the insurer may not defend him or even pay the judgment if he loses in court.
Although the liability part of his policy covers him for acts for which he is legally liable, and one is not “legally” liable until there is a court judgment, most insurers will attempt to settle without going to court, since going to court costs everyone more money in the long haul.
January 26th, 2009 at 5:50 am #Thomas Treakle
I have retained an attorney on this, and your advice is well received. I was hoping that there was a way to find this information without filing, but this is a principle thing now more than a $$ issue. Thanks for your suggestions and advice.
February 2nd, 2009 at 2:08 pm #Bonnie Nack
I purchased an extended warrantyon a used automobile from American Guardian Warranty in 2007 from a dealer located in SLC Utah. In Oct. 2008 I reported a heater/ AC “Non-operative bi-level switch malfunction”. American approved the claim for $480. The dealer attempted to repair the defect. The technician discovered the bi-level switch was integrated into the GPS system and the cost of the repair escalated to $5000. American denied the claim. Then they sent out an appraiser who determined the switch did not work due to a missing switch cover. American concluded the cause of the malfunction was neglect and abuse. (The missing switch cover was removed by the technician who attempted the repair and was in the possession of the dealer.) In addition they stated the GPS and the heater control head are not covered. I say you cannot change the rules of the ballgame at the end of the game in order to make it appear you won.
February 3rd, 2009 at 8:34 pm #admin
Hello Bonnie,
This kind of reminds me of our mission statement on the home page of this website. People who say “oh, my insurance company is great, they paid my claim”, I say it was probably a small automobile claim or something easy to see with you own two eyes. Start talking more dollars and the claws come out.
But to get to your question. Automobile warranty policies are notoriously full of hidden loopholes. If you want us to review yours for you, email a scanned copy to info@insuranceclaimhelp.org. You can also email a copy of the denial denial letter and pics if you like.
As you might expect, neglect and abuse, is not covered, so that’s what they are looking to hand their hat on. Is the heater control head the same as the heater switch cover?
Whatever their technical reason for denial, you have to get an expert with a different opinion. For example, if your mechanic puts in writing that the switch was defective from the factory, then that contradicts the insurance appraiser. That will force the insurer to hire an engineer to look at the part. If he lies, then its your expert against theirs. Be sure to save the part and get close up pictures to show the judge if it goes to small claims court. Expert opinions that “win” are usually the ones that don’t leave everyone scratching their head, the common sense opinions.
Feel free to rate your adjuster and insurer on the Consumer Ratings page of this website.
February 5th, 2009 at 2:45 am #Music_Mp3_Abareexeddile
Hello to all
I can’t understand how to add your site in my rss reader. Help me, please
February 5th, 2009 at 9:21 am #Laura
My husband is a self employed painting contractor and we have had water damage and tree damage from a recent ice storm. Our adjuster told us to get a painting estimate. Can my husband provide the estimate for the repair and painting or do we have to provide a 3rd party estimate.
February 6th, 2009 at 10:40 pm #admin
Music Man,
Waiting for an answer from the web developer on this. If anyone else wants to comment on this, please speak up.
I may be wrong, but try this. If using firefox, look in the address bar to the right side for the little red box with the waves and click on that and go from there?
If using internet explorer, look for the little red box with waves in the task bar (or anywhere you see it)?
or,
look just above the comments on any page in this website for the little icons starting with “ASK” and find the RSS that you use?
You may be able to submit our homepage at your RSS Feed site and add it to your favorites there?
I will get you the right answer eventually.
February 6th, 2009 at 11:00 pm #admin
Hello Laura,
Get an estimate from a 3rd party and use that to negotiate your claim with the adjuster.
Don’t tell the adjuster you are going to do your own repairs or that your husband is a contractor. Some ignorant adjusters will deduct 20% from your estimate for “contractors profit and overhead”, saying you don’t have a right to “profit” from your loss. While their argument is not legal, they think it is, and their supervisors and insurers keep them ignorant of the law.
The other trap many adjusters set for you is not telling you until the repairs are done, when you are expecting to get the “depreciation hold-back” that they only owe “the amount actually spent”. So if you got the job done for less than their estimate, or did it yourself, you got trapped!
If you have already fallen victim to the adjuster on this and want to know how to get out of it, or you want some real detailed information on how to avoid these type traps, go to http://www.uclaim.com/products.asp and consider the Homeowners Loss Standard or Deluxe guide. You will learn the tricks that public adjusters use.
February 11th, 2009 at 4:52 am #J. D. Howard
Good Web Site … Good Information … Am Much Impressed … from One Consumer Advocate to Another – Keep Up the Good Work !
February 11th, 2009 at 5:07 am #J. D. Howard
As a fellow Consumer Advocate, with a Similar Web Site, our Feed Back from Consumers throughout the country has been uniformly favorable for ONE lesser-known insurer … AMICA.
Would be interested in knowing about your experience when dealing with AMICA.
February 13th, 2009 at 1:40 am #admin
Thanks for the nice comments J.D. . Note that your website is listed in our Other Claims Resource Sites. We would appreciate a mention and/or link to our website from somewhere within your site. Mutual links help us “real advocates” to get ahead of those pretending to offer help, but really just selling insurance. Thanks again.
February 13th, 2009 at 1:57 am #admin
Thanks J.D. for the heads up. What does AMICA stand for? Do they write all lines of insurance or specialize in auto or home, etc? Are they in certain regions or target certain demographics, like seniors or government employees?
If you have time, please click on our “Consumer Ratings” link at the top, go to Add an Insurer, and add AMICA with a text and star rating.
I have never heard of them. They must not be big in Central California. But on the other hand, the best insurers are the quiet ones, with no complaints and little advertising, IMO.
February 14th, 2009 at 4:23 am #Russell Heard
Here’s my dilemma, I refinaced 3-4 yrs. in a row, to take advantage of droppinng interest rates. I was persuaded to purchase insurance by my mortgage loan officer at the time of signing to make sure that my mom’s interest was covered since she was taking this equity loan (Refi) out for me. I didn’t know that I could purchase the identitical insurance coverage through my home owners at 90% of the cost that my mortgage loan officier charged me. Here comes the topper! Each time I refianced this insurance should have been pro-rated & the difference either taken off the loan or given back to me, it never happened & the total comes to around $20/25,000 big ones, plus the two loan officiers that handled my 3 refi’s were busted for emblezzing money from clients(me in perticular).
February 15th, 2009 at 12:17 am #admin
Hello Russell,
Normally when a policy cancels during “mid term” the insured gets a prorated refund. If you request the cancellation, you get less back than if the insurer initiates the cancellation. Read the Conditions applying to “Section 1 and 2″ (the entire policy) in your homeowners policy. You can look at the wording within different company’s homeowners policies. There are 75 free policy copies from different insurers in the Products page of UClaim.com.
What were your annual premiums if you don’t mind my asking? They must have been huge if 20-25K was the refund amount for 3-4 years. While 20-25k is not nearly enough to attract an attorney on contingency, you may be able to pay an attorney to write a few letters threatening litigation against the loan companies. Find out if the other victims have an attorney. There may already be a class action lawsuit you can join into. Also, do a Google search for example “class action Wells Fargo Dallas” to see if there are already any class actions in your local area.
February 19th, 2009 at 12:17 am #Rick Osterhout
My wife and I were married 6 months ago,and she has kept her house and I have kept mine. There was an accidental kitchen fire (faulty burner) at her house while we were out of the U.S. recently, the day before we returned. Her insurance is Allstate, and I am not on the policy. She has lived there for about 6 years, and her daughter continues to live there and is now in college. My wife lives at my house, but still has all of her belongings (except some clothes) at her house, pays all the bills and doesn’t charge her daughter rent. The personal property adjuster couldn’t identify my wife’s room because of not being able to find her closet. We told the adjuster most of her clothes were over at my house, and we are in a transition until we decide to continue to let her daughter stay there, rent it, sell it or we decide to move there. The risk profile hasn’t changed since last summer, yet it ssounds like we may have claim denial exposure, both to fix it and to cover personal property damage. What is your take? Thanks! Rick
February 19th, 2009 at 5:18 am #admin
Rick,
I think you are ok. There is a vacancy exclusion for structure vandalism if the property is vacant over 30 days, but the daughter is there. I looked at an Allstate Homeowners policy at http://www.uclaim.com/products.asp, and found no limitation there. And I think you are ok on the contents too. Let us know if something is denied and why.
February 20th, 2009 at 6:41 pm #Kyle Larson
My question revolves around exclusions. I manage a large roofing company and we handle aprox. 1000 roofs damaged by hail each year. An issue that is coming up alot lately is if the insurance company owes the insured for roof decking when the old decking no longer functional due to age delamanation etc…. I know that all policies exclude losses wet or dry rot, bulging cracking of roofs walls etc… and defects, weakness in materials used in construction… However my argument is two pronged. 1. Since it is not possible to install the new roof over the old decking. The insurance company cannot fullfill thier contract of restoring the insured to thier pre event postion without paying for the cost to redeck the roof. My understnading of replacement cost is to pay for “equivalent construction for similar use” If we were to install the new roof over the old decking it would not adhere to code or manufature’s requirements. Thus the insured has lost because prior to the hail they had a roof covering that met code and manufactuer’s requirements. 2. Most of these policies have an endorsement for code upgrades which states that if an undamaged portion of the structure is required by code to be replaced the inurance company would then pay that cost to repair or replace. We have had building departments visit the job sites and put it in writing that it must be replaced and we still get denials based on the exclusions. By definition a roof assembly includes the decking and therefore if needed would be a part of the damaged loss as you can’t complete the roof covering without replacing it as well. The response I get most often is “what caused the decking to need to be replaced” and I say it is the hail that destroyed the roof. Insurance companies of course don’t agree. What are your thoughts.
February 21st, 2009 at 3:36 pm #admin
Kyle,
You are absolutely right in all you say. And guess what, even without a code endorsement on the policy, they still owe for the decking if the shingles can’t be removed and replaced without further damaging the decking. You can’t get the new nails exactly back into the old nail holes, right? So right there you have more holes, more weakness in the decking.
Yes, these insurers are still denying, even with the code endorsement. They do it either out of ignorance or intentionally, knowing you can’t afford to sue and no lawyer will take it because punitive damages on property cases are now restricted to 3 times the hard damage part (a “Bushenomics” supreme court legacy we will be stuck with for years).
How to deal with it? I just had a fire loss in Bakersfield, the building department said the non fire damaged crumbling foundation had to be replaced or the house could not be rebuilt. State Farm’s adjuster denied the foundation replacement, even though there was a code endorsement with clear language. His manager told me they had not paid on any code edorsement claim since 1991. I faxed a well written letter to Ed Rust, CEO for State Farm asking if State Farm had collected premiums for this endorsement since 1991 in Kern County, or California or the USA for that matter. In a couple days I got a letter from the local manager saying they would now cover this claim. I also got a letter from the head of State Farm Claims in California THANKING ME for bringing this to their attention. Now this is what I do like about State Farm. State Farm may be rotten, but it’s not “rotten to the core”. A lot of companies are rotten to the core.
Tell your clients to make ratings at the Consumer Ratings page on this website. This is what its for. I don’t believe the government can stop corporate abuse. Its got to be us, unselfish people. When you buy something on Ebay, do you check out the Sellers rating first? It’s got to be the same here if we want to get control of the bad boys.
February 23rd, 2009 at 6:16 pm #susan
My husband and 6 of his band members were injured in an automobile accident when a cow was standing in the middle of the road at night. The cow owner had insurance and his landowners insurance has accepted responsibility for it. They say that there is a $500,000.00 cap on the policy to be split between the 6 men. But my husband has numerous injuries and still has 3 surgeries that we know of to go. They are asking us to submit a “demand” for the amount that we would like to receive from them on an individual basis. Even though they say that they only have 500,000. to work with we need to know if they can go above that if they need to in order to cover everyone costs. They have missed time at work and still have many outstanding medical bills to cover. We just need some advice before we give them an answer. Thank you
February 24th, 2009 at 10:23 pm #admin
Hello Susan,
First of all, I’m no expert on liability insurance claims. And I suggest you check with an attorney. If you can’t get 10 minutes of free advice on this question from an attorney after calling around, give them $75.00 for a few minutes of their time. Be careful about hiring an attorney on contingency who will get 1/3 as soon as you sign the contract. He can sit back and do nothing other than collect his money. It sounds like the damages are well over the $500,000.00 and the insurer is willing to pay. If the insurer agrees to pay the full 500,000, look for an attorney who is willing to take his fee from the amount “over” the insurance offer. 50% of the amount over is fair, in my opinion.
Now here is my advice, go ahead and make a demand for an amount for each of the 6 members. List each members claim on a separate sheet of paper. Medical bills, lost work, etc. and describe why the injury will affect future earnings or appearance. A damaged throat on lead singer may be worth more than a similar injury on a drummer who does not sing.
Now, DON’T sign any release from the insurer if it releases the policy holder (the landowner) also. Only release the insurer. And ask to see a certified copy of the policy. Don’t just take their word for it. Adjusters can lie. Also, you don’t want to give up your right to sue the landowner, since he may have assets over and above the insurance limit of $500,000.00 and or an “umbrella” policy.
And find out what the statute of limitations (time to file a lawsuit) is. Its usually 1 or 2 years from the date of the accident. Some insurers will delay the negotiations just so you accidentally forget, and then they won’t pay one dime. Pay a lawyer for an hour of his time to fill out a pre-printed complaint form to file at your local court, to “protect the statute”.
Again, get a lawyers advice for 1/2 hour.
February 25th, 2009 at 4:59 pm #Kelly
Hi:
I am having trouble getting my insurance disbursments from my bank. I lost my home in a fire 9/07. It has taken me over 2 years to finish the claim, redesign the house (w/addition) and work my way through the Los Angeles building and safety for a permit (I am on a hillside. In that time my original lender (World Savings) was bought my Wachovia. I been received two different processes (on paper) for getting my disbursments, one was for three draws of 1/3 of total claim with the first disbursment upon reciept of required paperwork, the 2nd at 40% and the last @90%.
I received a second letter 29 days later stating the the following disbursments: 20% to begin repairs,20% after 50% completionand the balance after upon approvals of completion of all repairs. Any help is much appreciated….
After receiving one disbursment, I requested my 20% draw at 50% completion. I was then told that I needed only 40% for the next draw. When I called for follow-up on the inspection, I was told that I had been switched to a total loss claim and the requirement for 60%. When the inspection company called for inspection, I was told that they would be looking for 40%. This was confirmed by the inspector. When I called for follow-up from the inspection, I was told everything was fine, I was at 50% and a check would be disbursed by the end of the week. After waiting a week, I called for update and was told that I needed to be at 60% and since I was not there would be no disbursement. I have yet to receive any paperwork outlining a process requirinng 60%. In the meantime, I am out of funds, frustrated and do not know how to rectify this situation. Though I have followed the procedure led out by them, submitted receipts that exceed the current disbursed funds, I was told today that my account was being switch (again) from escrow to loss managment. This feels like a shell game inwhich I will never get out of. What are my rights in this situation.
February 26th, 2009 at 12:01 am #admin
Hello Kelly,
Well, I’m about half confused myself. Regardless of what their stupid rules are, if you are a certain percentage done, then you are entitled to that percentage of the money they are holding. You could hire a lawyer just to send a letter or two to shake them up, maybe. If you can’t get a loan to use to finish the house, then try this: in California the small claims limit is $7,500.00. Sue them for the full 7,500.00. It does not mean you give up your claim to the rest of the money they are holding, but it does pressure them and makes you a squeaky wheel. And it only costs you 20-30 dollars. If that gets them to pay, then drop the case and file another claim later if you have to do it again. One thing is for sure, when the house is 100% done, they have to give you all the money they are holding. And you don’t have to give them receipts showing what you spent.
And beware of giving receipts to your insurer. The homeowners policy says the insurer owes the least of the following: policy limit, replacement cost, or AMOUNT ACTUALLY SPENT. So if they are still holding depreciation money, “RCV holdback” pending completion of repairs, and you spent less than the amount they estimated for the repairs, ask for a visual inspection to confirm the job is done. Don’t supply receipts for a lower amount, or they will cut your claim.
It would be appreciated if you could take a few moments to give a quick rating on your insurer and/or adjuster and/or other insurer’s vendors on the Consumer Ratings page of this website. You don’t have to show your real or full name if you don’t want to.
February 26th, 2009 at 8:51 am #C. Christians
You are SO RIGHT about the uselessness of California Capital Insurance for property claims. It has been nearly three months since a fire in my house and I am still fighting for every single penny, every single repair and replacement. CCI chose their own contractor, with good reason–they must have saved a hell of a lot of money. Cabinets that burned were replaced with cheap crap–doors that don’t meet or align, warped wood, and believe it or not, smaller cabinets than the original. The wrong color paint was used twice in one room, I had to ask for any number of jobs to be redone–and on and on. One cabinet is “attached” to the floor with caulking. Nearly three months after the fire, the shower is still coated with dried ash and black smoke. The oven and the stove exhaust fan don’t work. Worst of all, absolutely no one will take responsibilty. The “charming” adjustor at San Jose has called me “you stud” (I am an older professional woman) and “Madam.” Stay as far away as you can from CIG/California Capital for property claims.
February 26th, 2009 at 8:32 pm #Valeria Christiansen
My son, a California resident with a California-registered and -insured 1993 Saturn SL1 with approximately 177,000 miles on it, is attending graduate school in Denver, Colorado, and has had his car with him there.
Last Saturday morning, in snow-and-ice conditions, his car, legally parked curbside across the street from his apartment building, took an ugly hit to its left-rear door and fender panel in a multi-vehicle incident.
Since the Saturn was not insured under our policy for collision, a claim is being pursued against the driver of the vehicle that struck it. That insurance carrier has accepted responsibility and sent an “appraiser” to inspect the Saturn and the body shop reported to my son that the pronouncement that the cost of repair to “restore” the vehicle was $2,400. This appraiser has not contacted my son directly at any point.
At the same time, the body shop, to which my son was referred by a Saturn dealership in the area, has told him that they could do a repair that would make his car once again presentable and drivable (but not “restored”) for approximately $1,000.
We understand that my son may very likely be informed by the insurance company (again, it’s the other guy’s carrier) that they will want to “total” his car. The consensus in our family is if we can get the car back in presentable, drivable condition that would be desirable as my son is scheduled to graduate in June and sometime over the following months transition into employment, and having to deal with getting a replacement car right now is untimely and very inconvenient.
The way we see it, getting a late-model used car would be a hit to his finances, because we know the insurer’s payment will nowhere near cover that cost. And the alternative of taking the insurance money which we anticipate will be low to go buy a “cheap” used car, which would likely be as old as the Saturn, but with a completely unknown background and who knows what issues and problems, doesn’t make sense if that same money would allow my son to keep the Saturn, a great little car that has served him beautifully for 6 years already.
What would we have to do to keep the Saturn without it being transformed into “salvage” and/or having insurability problems going forward?
March 1st, 2009 at 4:03 pm #Neil Wesley
Have you ever heard of foundation cracks being covered under a property policy, such as a Homeowners or a Dwelling policy? I have a client who was cleaning a sewer leak and discovered foundation cracks. The carrier declined using an engineer’s report stating there was evidence of long-term settlement, prior cracks repaired, and no way that cracks were sudden & accidental based on location of sewer pipe. The insured contends that the leak happened so suddenly that the property sunk to the degree that a lower level exterior door could open one day and not the next!
March 1st, 2009 at 7:00 pm #admin
Hello Neil,
Is your client the plumber or roto-rooter guy? Is it a plastic or metal drain pipe?
The cracks should be covered if the foundation settled due the the ground settling from water from the cracked sewer pipe, as long as the ground saturation was “sudden and accidental”.
What made the sewer pipe crack? Tree roots? Tree roots can bend a plastic pipe underground and when it finally breaks, it splits big. Unless there were “hair roots” inside the pipe to indicate a long term crack, then I would say sudden and accidental loss.
I would be interested to see the “old repaired crack” photos and what the cause was. Remember, if its an all risk policy, special form, the burden of proof is on the insurer to disprove the claim.
It’s like a broken pipe in a bathroom, long term leaking is indicated by rot. Plywood delamination and discoloration is not “long term”, even though some adjusters say it is.
You have to get your plumber to put in writing that it was a sudden loss and state the reasons. Then the insurer will have to get their own plumber or engineer to look at it. Be aware that many insurance engineers are really prostitutes, they will say and even lie about anything. If that happens, then get your own engineer, or go to small claims court with good photos, your plumber and a good common sense argument. And you will never win in appraisal or arbitration. If you sue in superior court, be aware that judges can be bought off with a password to an offshore numbered bank account, or some other favor (I’m obviously quite Jaded).
Consider a letter to the insurer CEO before going to court. But have it well documented.
March 1st, 2009 at 9:53 pm #admin
Valeria,
It’s your car and no one can take it from you or put a salvage title on it. Let the insurer take a deduction for salvage value from their settlement to you. That salvage value is negotiable. If the car has no collision or comp coverage, you should have no “insurability” problem. A dented fender does not make the driver more likely to have an accident.
If you are trying to save money on the repair, consider “doing it yourself. Saturn is the only car that has “bolt on” quarter panels (just like fenders on regular cars). And the Saturn parts come pre-painted from the factory so you don’t have to pay a body shop to paint it. I imagine the doors are the same. Your car will have a paint code label somewhere. Ask the dealer where it is. Give the paint code to the dealer parts guy and get a price on the parts. You can also shop for used parts, but it the color does not match, then you have to paint it.
March 1st, 2009 at 10:34 pm #admin
Hello “C.”,
C, its great you make a rating here, but how come you didn’t go to the “Consumer Ratings” page and rate them? Start a new entry on them. If you want to really get the word out so “the whole world” can easily find them, do it there. You can rate the adjuster, the insurer and their lousy contractor. Please do it! Its why we built that page.
Now, as to your claim, the best advice I can give you is to go to UClaim.com at the products page, look at the first product “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe). Look at the table of contents. Do you want to rip CCI a new a____ ? That eBook will show you how a veteran public adjuster does it.
March 3rd, 2009 at 2:15 am #Ali
Hi,
After the November 15th, 2008 wildfires, our home was deemed a partial loss. We had little fire damage, but because 5 homes next to us, our backyard slope, front yard slope, and side yard landscaping were on fire, we are noticing a lot of “structural” damage.
Things like warped vinyl window frames as windows are not closing, aluminum windows aren’t closing, cracks in drywall, fine cracks in concrete, discoloration of concrete and rust stains. Is a contractor enough to document these losses for our insurance company, or do we need to get an engineer involved?
Thank you,
Ali
March 4th, 2009 at 12:43 am #admin
Hello Ali,
Don’t spend money on an engineer unless your claim is denied. Let the insurer estimate the damage and see if they pay enough to meet your satisfaction. If not, then get your own estimates and submit them to the insurer. Insurers don’t normally hire engineers unless they want to deny your claim. If they use an engineer to deny your claim, then you can hire an engineer to refute their engineer. Most insurance company engineers are usually like prostitutes now days, they will say whatever the insurer wants them to say for a buck.
Your claim sounds easy. But if it gets difficult, consider the eBook at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”.
March 5th, 2009 at 8:35 am #Vee
Home damged by fire 1 year ago…insurance company finally agreed on amount to give for rebuilding home. My question is… If I do most of the work myself, and do not use all the money the insurance company gives me can I pocket the remainder, or does the insurance company takes it back…
ex. Insurance claims pays 100,000. I spend 70,000 to rebuild my house. Can I legally keep the remainding 30,000. Or do I return this money back to the insurance company.
Some people tells me I have to use all the building money, if not its considered fraud…Is it fraud?
Need help!!! Thanks.
March 5th, 2009 at 8:40 am #Vee
Sorry.. Just adding more info for you…
My insurance company is The Massachusetts Property Insurance Underwriting Association (MPIUA).
March 5th, 2009 at 9:35 pm #admin
Hello Vee,
The clause in most homeowner policies under settlement conditions says we (the insurer) owe the lesser of the following amounts: the policy limit, or the replacement cost of repairs, or the amount actually spent. If you tell them “you” did the repairs and only spent 70k, then they could ask for the money back. Is it fraud if you don’t use all the money? I don’t think so. You have to argue that you are entitled to the left over money for your labor. Most adjusters will say you are not entitled since you can’t “profit” from a loss.
Typically, for example, an insurer figures 100k to repair the house. They give you 70k, the depreciated cost of repair, the ACV cost. And they say “when the repairs are done we will give you the 30k we held back”. What they don’t tell you is that if you spent less than the 100k, then you only get back what you spent over the 70k. And if you can’t supply receipts for the amount over the 70k, then you get nothing. I have never seen anyone dumb enough to tell an adjuster they spent less than the 70k. So why open that can of worms?
You can recover all that 30k money that was held back, “if you work it right”. You can also get yourself in trouble if you don’t work it exactly right. There is a detailed discussion on this topic in the eBook product at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe or standard version)”.
If you would like us to look at your policy free of charge, you can mail or email a scanned copy.
March 8th, 2009 at 7:58 pm #Robert
None of these policy copies are on th Uclaim website.
March 9th, 2009 at 1:14 pm #anastasia
Hello! Thank you for your help! I have a very small seasonal business, handknitting and selling accesiries (hats, scarves, etc.) I had a stall at Reading Terminal Market last Christmas season and stored my stuff at the Market overnight. On October 29th most of my inventory got stolen. I had filed a claim with my insurance company (Ohio Casualty Ins. – part of Liberty Mutual Group) We have been going back and forth with the insurer as to how much I had lost in business as a result if the theft. They have referred me to their audit department and I have been very cooperative and provided them with every record I had. It has been 4.5 months since I filed the claim and they still have not settled it. I am falling back on my business loan payments and unable to go ahead with my business plan before I get the money from settlement. I contacted superwisors at both departments that are handling the case (the officer and the audit department), they say they will do their best but they are still not letting me know what exactly do they need to process it and how long will it take to complete. I am wondering if I should sue for time and business lost as a result of their actions (or, rather, inaction) with it. I have a small claim so I am not sure if a lawyer would be interested and what other options do I have to make them speed it up. Thank you! Anastasia
March 10th, 2009 at 8:49 am #john angelo
jayne lost your phone # please call
John angelo
908-358-9311
561-338-5577
ginacabretti@yahoo.com
03/10/2009
March 10th, 2009 at 9:02 am #f. michael conte
help,
i have a homeowners policy in new jersey my dinning room chandelier fell and destroyed table. am i covered?
March 10th, 2009 at 6:42 pm #admin
Hello Robert,
They are on the Products page at UClaim.com. I just did a test download. It’s possible they were temporarily unavailable during recent server maintenance there.
March 11th, 2009 at 1:05 am #admin
Hello Michael,
Most Homeowner policies cover damage from “falling objects” to personal property. However the “falling object” must damage the roof or wall in order for the inside damage to be covered. So if a tree branch or something fell on your roof and damaged a shingle/s, and the impact knocked the chandelier loose and it fell, then it should be covered. Obviously this argument is stretching it, but its all I can think of right now.
Read “Coverage C” in your homeowners policy, or get a sample policy from UClaim.com Products section to read.
March 11th, 2009 at 1:27 am #admin
Hello Anastasia,
Your “small claim” is either not so small or it has some big problems for them to be delaying like this for 4.5 months. You need a lot more help than I could possible give you here. Consider the http://www.UClaim.com eBook entitled “BUSINESS OWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS, Subtitle: HOW TO PLAY THE GAME – DELUXE VERSION (W/APPENDIX)” on the products page, business section. Look at the table of contents. It will help you with the inventory as well the loss of income, “extra expenses” and teach you how to communicate and get attention when you are getting nowhere with the adjuster and his manager. The cost of $89.95 is a drop in the bucket compared to what your claim is worth and what you would pay a lawyer or public adjuster.
If you want us to look at your policy for no charge, you can email a scanned copy to info@insuranceclaimhelp.org. However, any questions or discussions we have will need to be via this blog so everyone can learn from your experience.
March 13th, 2009 at 4:07 am #Matthew
I had a rather rare item destroyed in a house fire. It was a carbon fiber race car tub (the part the driver sits in). Erie insurance provides me with replacement cost and has done so with every other item destroyed. This tub was worth around $15,000 but they say I need to buy one in order to get the insurance money for it. I guess this is a way of proving the value of the tub but couldn’t I do that by showing examples of other people purchasing the same thing? Can they make me buy a replacement in order to get the money for it? Thanks for your help!
March 14th, 2009 at 12:59 am #admin
Hello Matthew,
You don’t have to buy a piece of property to prove what the lost one was worth.
What I think they should be telling you is this “you get the depreciated value of the car tub now. If you replace it, then we give you the amount we previously held back for depreciation.” Either there is more to the story, or they are jacking you around because they don’t to pay out that $15,000.00.
And if that car part was “off” of the car then they cannot deny it as being a motor vehicle. This car tub is no different than a chair that burned up in your house. If the adjusters supervisor backs him up, fax a letter to the CEO of the insurance company. Be a pest.
March 16th, 2009 at 11:43 am #Joe C
I have lived in my home and paid my insurance for 12 years. I recently had someone come to the door offering free roof inspection. They said I had hail damage and should file a claim. My insurance claim representative came by and assessed.After meeting with his manager, they decided that the roof should be totalled but rather than paying in full for the roof replacement they are offering a cash settlement due to depreciation. They indicated that the damaged occurred in August 2004 and the cash settlement would represent a reduced amount that is substantially less than the full coverage. What are my options?
By the way, my insurance company is State Farm.
March 16th, 2009 at 1:31 pm #admin
Hello Joe,
Try to get them to issue the money without your signing any release. Once you have the money, then you have nothing to lose if you get “under their skin”. If they make the payment without writing something like “your claim is not covered because it was not reported on time, but this money is paid as a compromise or a courtesy” then go for the full cost of replacing your roof (if you have replacement cost coverage).
If indeed the damage was in 2004, then you are lucky they are even covering your claim and paying anything. Most policies give 12 months to turn in the claim from the accident date. And most states override that by giving 3 or 4 years to sue your insurer for property damage. Check with a local attorney what the “statute of limitations” is to sue for property damage. They should not charge for a simple question like that.
Also find out if the “date of loss” in your state is the actual date of the physical damage, or when you discovered the damage (the idea being that you have no loss until you become aware of a loss). That is a question that most adjusters and even attorneys will not know the answer to. You could pay an attorney for 1 hour to research the answer.
If you can spare the time and “give back” a little something to this website, make a rating on State Farm and or their adjuster on the Consumer Ratings page of this website. You could also do a rating on the contractor who alerted you to your roof.
March 18th, 2009 at 8:21 am #Mags
Hello,
My house was burglarized and item were stolen and damaged. My claim rep at State Farm keep stating a depreciated value will apply in my claim, when I have a policy that should cover the replacement.
I got loss as to how can I value my collection when I didn’t have time to have it priced. They also – stated that coin collection is considered as cash – which will subject to cash limitation. Is that true. I talk to my agent and she stated the same. I need help -
Thanks,
Maggie
March 18th, 2009 at 3:14 pm #Mike Gaspar
Hello,
I recently found that I had a broken drain line in my house. The drain line for my washing machine and kitchen sink runs under the concrete slabs which covers a good part of the house. When the lines began to back up and we discovered water coming out of the floor in one of the rooms, we called a plumber. The plummer ran a camera through the pipe and discovered the broken pipe. We immediately called the insurance company and they would not tell us anything other then they would send an adjuster the following week. We needed to get the damage pipe fixed, so the plumber ripped up the floor and slab and repaired the pipe. The adjuster finally came out and from the time he walked through the door, told my wife (unfortunately I could not be home) that is was unlikely that any portion of the work to fix the pipe or the floor that needed to be ripped up would be covered. He stated that insurance does not cover worn /damaged drain pipes and since the floors were not damaged by the drain they would not be covered as well. This was an expensive repair (over $8,000) and we have not even looked into the cost to replace the floor. I have Allstate insurance – is this true that insurance companies do not cover drain pipe repairs? Thanks for your help!
March 20th, 2009 at 12:10 am #admin
Hello Maggie,
The 1996 State Farm Homeowners policy at UClaim.com says the limit of $200.00 on money includes money that is “part of a collection”, in the Personal Property “Special Limits” section.
Look on the declarations page, the cover sheet with your name on it, and see if there is an endorsement for contents replacement cost. If you do have replacement cost on contents, then most insurers will take depreciation, then refund the held back depreciation after you prove replacement of the property. The UClaim.com eBook “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP” will show you how to maximize your claim and not get trapped.
March 20th, 2009 at 12:27 am #admin
Hello Mike,
Insurance covers “sudden and accidental” losses. If this was your case:
1. Get your plumber to put in writing what caused the pipe to break.
If your plumber does not know the cause, then let the insurer hire an engineer or whoever to find out the cause. Most homeowner policies say “we cover everything except” … . This means the burden to disprove your claim is on them.
2. If you get them to cover the pipe, then they should cover the damaged floor. They don’t owe the cost to fix the cause of the loss. But they do owe the cost to get access to do the repair, in your case, the concrete floor damage.
Some low quality insurers will say that since “the cause of loss is never covered”, the plumbers bill is not covered. If you argue that the $2.00 piece of broken pipe is the cause, then the plumbers labor should be covered on all but the 2 minutes to insert and glue the pipe.
March 20th, 2009 at 5:48 am #f. michael conte,CPIA
maggie,
the coin part i agree is the correct method of settlement, only becuase i assume it was not a scheduled or itemized class.
the other colletions part would also have had to be separately insured.
this all should have been explain when you purchased the contract.
read your contract all slmnt methods are outlined there.
hope this help
fmc ny,ny
March 20th, 2009 at 6:13 am #f. michael conte,CPIA
to mike gaspar,
typically pipes under the foundation are not covered.
however read your contract or ask your agent to read the contrat.
fmc,ny,ny
March 25th, 2009 at 8:50 pm #AR
I recently got some settlement checks for my fire claim. If we decide to do the work ourselves, ie: sprinkler system replacement, painting, etc, how can we go about making sure we can still claim the recoverable depreciation? What would we have to do, as far as the paper trail goes?
Also, we claimed some ALE expenses for two weeks, while we stayed with my parents. They are retired so my wife paid them $1200 cash for using three rooms and a bathroom in their home, food, and utilities ($100 a day). The cash came from our emergency pretty cash, which we keep with our passports, etc, which was all evacuated from the home when we left the day of the fire. What would I need to provide for my insurance company, as the cash wasn’t taken out from our bank account anytime recently, or at any one time… its more of an accumulation of extra cash over the year. I know I need a receipt from my parents, which is fine, anything else in this case?
Additionally, I have a copy of the Farmer’s Next Gen insurance policy in PDF which might be helpful to your site…
March 25th, 2009 at 10:24 pm #Val
Thank you for this site! Never having had to file a claim before, I’m feeling quite lost. I really appreciate the link to the different insurance policies, since if I ever HAD a full copy of my State Farm policy it’s long since gone.
I was burglarized last week, and given what’s been said so far I feel like I’m already being set up for the insurance company to deny my claim. I called the police immediately. The front door was unlocked but closed; the back door was wide open and there were no broken windows or pry marks. The officer who responded kept saying things like “You left the door unlocked, didn’t you?” I DON’T remember leaving the door unlocked, certainly not open, and said so repeatedly. He seemed determined to make me say I had. Would it matter if I had? Wouldn’t it still be theft? Would the insurance company refuse to cover me if I accidentally left the door unlocked?
I called my State Farm office the next day, and gave them the police report #. The insurance adjuster called me the following day. HE kept trying to get me to give him a dollar amount of the loss. I kept telling him I didn’t know; I was still discovering things missing, didn’t have receipts for everything, still looking for receipts and hadn’t added up the ones I’d found, but I’d spent at least $4500 on a TV and camcorder that I DID have receipts for.
I have Homeowners Policy FP-7955.CA with Loss Settlement Provisions A1 (Replacement Cost – Similar Construction) with Deductibles Section I All Losses $1000. Plus B1 (Limited Replacement Cost – Coverage B) plus OPT JF (Jewelry and Furs $1500/$2500)
Of course I didn’t have an inventory of my property before the theft. I lost almost every piece of jewelry I’ve bought or been given since I was a child, and I’ve only been able to find about $1000 in receipts for recently purchased jewelry. I’ve been making a list with as much description as I can remember, along with sketches and looking for pictures of similar items on line. Any advice here? I was SOLD the OPT JF because I had quite a bit, some inherited from my grandparents and some I’d purchased on trips starting when I was a child. Does State Farm pay out for receipt-less jewelry or am I wasting my time making an inventory?
Also, I’d set up a very nice system involving my (stolen) LCD HDTV with a beautiful picture, a LOT of connections that spanned RCA plugs through s-video to firelink and PC connections so I could use it with my older VCR and my newer DVD/VCR and my new HD camcorder, eventually adding a computer to the mix.
The company I bought the TV from doesn’t make LCD TV’s any more. They have some huge laser TV now. The size that fits into my entertainment system is almost impossible to find; prices have collapsed, so a much bigger screen costs less than what I used to have but the TVs with the good pictures don’t have all the connections I used to use. THAT means I’ll probably have to replace components that weren’t stolen and furniture as well, just to be able to do what I used to do.
There’s also a missing 35mm camera that worked FINE the last time I used it. I’m not sure they even MAKE them anymore. I’d buy a digital camera with the same features, but I don’t know if insurance covers that.
Only my camcorder has a comparable model from the same company. I paid about$1300 for it; the new comparable model is only about $800.
How do insurance companies deal with things like that? Do they refuse to pay anything saying it ‘cannot be replaced with other of like kind and quality on the current retail market’? Do they pay the replacement for as close as I can get? Would I be allowed to take whatever $$ they’ll give me and add my OWN money to get something I’ll really be happy with, or not?
I’d really rather have an idea of what to expect before I call the claims adjuster or spend any more time on my jewelry inventory, or wander through any more electronics stores trying to figure out what my beloved TV’s repair/replacement/amount of loss today (without tax) is!
Thanks!
Val in sunny CA
March 26th, 2009 at 3:39 pm #Angela
Unfortunately, my car was stolen last week. I had all my car paperwork inside my car and I’m filling out the equipment form and frankly, I don’t know all the details about my car. Is there somewhere I can pull a report on my car or can I call the dealership to figure out all the specs on my car?
Thanks!
March 26th, 2009 at 4:00 pm #admin
Hello AR,
Yes, the policy would be most helpful. Please attach it to an email to info@insuranceclaimhelp.org .
In answer to your first paragraph, how to do your own repairs without “getting burned”. It’s too detailed and tricky to explain here. You will get a very detailed explanation in the UClaim.com eBook “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (standard)”. If this and the ALE are your only problems, then you don’t need the appendix that comes with the Deluxe version.
Regarding the ALE, you don’t have to prove where your petty cash comes from. You only have to give the insurance company receipts or evidence if you have it, and within reason. For example, you don’t have to go back to a store and ask them to reproduce a receipt. Let the insurer hire an investigator to do that.
March 26th, 2009 at 4:08 pm #admin
Hello Angela,
Yes check with the dealer or whoever you bought the car from to help you with the details.
Go to your local library or to your dealer to look at a copy of a Kelley Book, or NADA book to see all the options that could have been on your car. The vin number will have some basic information, and your insurer will have that.
You can also go to the Kelley book and NADA book websites to see what options came with the car. If yo don’t know the mileage, you will jsut have to make a best guess and put in writing it is only a guess.
You may contact Carfax.com to see if their reports give detailed descriptions. They have records from prior insurance claims and repairs from prior owners.
And if you get cheated on the value of your car, consider one of the eBooks on total loss vehicles in the automobile section at UClaim.com.
March 26th, 2009 at 4:21 pm #admin
Hello Val,
I will take your questions one at a time and see how far I get
. This blog is for short questions. So please consider one of the comprehensive eBooks at UClaim.com to answer most of your questions in great detail.
Unless your policy has a clause that says there must be evidence of “forced entry”, then they cannot deny the claim. The cop sounds over zealous.
You know what Val, upon reading he rest of your questions, you definitely need the eBook at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”. Your claim is way too big and complex not to have professional help. you could hire a public adjuster for 10% of your claim, or a lawyer for 33% of your claim. Again you do need more help than I can give here. Sorry.
March 26th, 2009 at 8:50 pm #New pipe dammage guy...
Just had a 5 room food, carpets, walls, ceilings…and an espostos tile floor.
In regards to a new claim, are relo-costs covered, adjuster said “just save receipts” How long can I stay away? Full time of deconstruction and reconstruction?
Does adjuster actually check on every item on my list? She did a breif walk around…but had Service Master take pics…..not of Personal property from what I saw…just damage areas they were to demolish.
March 27th, 2009 at 9:41 pm #admin
New Pipe Guy,
If your Homeowners policy covers ALE Additional Living Expense, then it is covered until you git back into the house up to the policy time or dollar limits, and “within reason” (You can’t stay at the Disneyland Hotel for example). You can ask the adjuster to send you a letter saying this if you can’t find your policy. You can get sample policies at UClaim.com.
The adjuster has a right to check out everything on your list. Most make random checks for larger items. But if they catch you “intentionally” inflating something, they can deny the entire claim, so be careful.
Get your own pictures also.
March 30th, 2009 at 7:07 am #f. michael conte,CPIA
to new pipe guy,
thought i would chime in on the last reply i read. here in NY they will only pay for your additional cost to live. the amount they pay is the amount of time for the work to resonably done. so if the job is projected to take two weeks thats what you get. so be careful and have the conversation with the adjuster before you make arraingements. ( you might also ask what he or she reasonables asks you to spend per night)
March 31st, 2009 at 9:49 am #Candice Morrison
Hello,
I have a 2007 Chevy Aveo that I am making payments on to the bank. I let my boyfriend drive the car to pick up lunch for us the other day. While he was out, he rear ended another car.
The other car has no damage. My car had about $4,000.00 worth of damange. I called in the claim to Met Life. The car was not drivable and was towed away. The company who towed the car stated the if I had the work done there, I would not have to pay the storage fee’s. The adjuster went out, wrote up the paperwork and the shop started the work. The car is now complete, but Met Life is not sure if they will cover the cost.
They are claming that my boyfriend is a regular driver. When I talked to the woman from met life she made me give her a montly estimate of how often he drives it, I told her maybe 1 or twice a month if that… I honestly don’t know how often it is, but i’m guessing its less than that.
He is not listed on my policy or any other policy. She said if he was listed on another policy this wouldn’t be an issue, but because he does not have his own insurance he is a liability??
I called Met Life (just the generic number) and ask how often does some one need to drive my car before I should put them on the policy. They said 4-5 times a month. If they drive it 4-5 times a month I should add them as a driver.
Can you forsee any reason this would be denied? I live in Massachusetts and my boyfriend does not live with me.
I am freaking out, if they do not cover it, I don’t know how I will pay this huge bill.
Also, They called both me and my boyfriend for recorded statements about how often he drives. They said the matter will go in front of a board who will decide. Do you know who this “board” is? also if they do deny it, do I have any kind of appeal I can do?
Thanks for any advice you may have!
March 31st, 2009 at 11:30 am #VADA MILLER
I HAVE BEEN HAVING MAJOR PROBLEMS WITH MY 2003 HONDA CRV. THE DEALER HAS REPLACED THE TRANSMISSION AND SEVERAL OTHER THINGS SUCH AS BOTH FRONT AXELS, BUT THAT HAS NOT COMPLETLY SOLVED THE PROBLEM. MY CAR STILL SHAKES WHEN IT TAKES OFF. THAT’S BAD ENOUGH ON IT’S OWN BUT IT GET’S WORSE. I HAVE HAD IT IN THE SHOP SEVERAL TIMES SINCE OCTOBER AND MY WARRANTY IS RUNNING OUT. IN FACT I ONLY HAVE 20 MORE MILES ON IT. ANOTHER TRIP TO THE DEALERSHIP WILL TAKE UP THOSE 20 MILES. WHAT CAN I DO?
April 1st, 2009 at 1:17 am #admin
Candice,
I don’t know who “the board” is.
You will have to read your policy to see if it defines who is covered. I don’t have a Met Life policy to look at. If you want to email a scanned copy to info@insuranceclaimhelp.org I will look at it for you.
In looking at the ISO auto policy (generic) at UClaim.com product page, I don’t see any definitions of who is an insured in the physical damage section of the policy.
If Met Life denies the claim, make them put it in writing and make them quote the policy language where the definition or exclusion is. If they cover it, but underpay the value of the claim, consider one of the automobile loss eBooks at UClaim.com.
If the Met Life adjuster said the claim was covered and you started repairs, then he can’t come back later and say its not covered, even if the policy says its not covered. This is what lawyers call “estoppel”.
April 1st, 2009 at 1:23 am #admin
Vada,
I guess either get the dealer to put in writing that he will still cover the repairs if the miles go over, or have your car towed to the dealer.
See if you can extend the warranty. Then sell the car
April 2nd, 2009 at 7:11 pm #Evangela
Hello,
I recently let my friend borrow my car to pick up her kids from school and to pick up a friend from the hospital. While on her way to the hospital, she was rear ended by a driver that caused her to spin into another car. My car was a 2005 Saturn Ion 2 Four Door Sedan and fortunately Saturn makes quality cars because the trunk just folded up and her 7 yr old son was unhurt. My car is completely totalled now. The guy who hit my car (I didn’t have insurance at the time of the accident) had insurance through Preferred Auto Insurance so I called in the claim myself once I got the police report. He was deemed at fault on the report for following too closely. On Monday, 3-16-09, No one had called in a claim and the adjuster had no idea about the accident which had happened 3-13-09. My friend was taken to the Emergency Room with neck and back pain due to the impact of the hit snapping the driver’s seat back. I received a phone call from Preferred Auto Insurance saying that this was a non covered loss and that the details couldn’t be discussed due to their privacy policy. A letter was sent in the mail without anymore detail than what I was told on the phone. I proceeded to contact two lawyers so far who are telling me they can’t take the case but no one will tell me why. The Kelly Blue Book Value of my car is $7915 and my friend is now in physical therapy and I need to know what to do because this man has insurance and neither I nor my friend contributed to this accident in any way. Also now the person whom my friend hit is suing my friend when she would not have hit her if it were not for this guy rear ending her. My car and his vehicle sustained the most damage in this six car pile up.
Please Help!!!!!
April 3rd, 2009 at 12:26 pm #yolanda
Heres my question on january 29th 2008 i came home from work to find water leaking from my kitchen ceiling. there was water coming down the walls and dripping through my window frames. my pergo floor was soaked to the point if u stepped on it water came out. i filed a claim that day and had a contractor come the next day. the report was an ice damn. this ice damn ruined my upstaris bathroom wall all the way to the kitchen walls, ceiling and floor. two seperate estimates where done by seperate contractors each around 12,000. this includes the siding wich was damaged from the ice. adjuster came and questioned wether the walls where STILL wet. he then said he didnt think the walls where still wet and that he had to have them tested. meanwhile my bathroom walls are open with the planks exposed and no insulation and so is my kitchen ceiling. The ice has all melted and the siding doesnt look to bad. pictures where sent the dayafter the incident showing all damage. the adjuster had chemdry come to my house 3 days ago to measure if walls where wet. we just recieved there estimate for the whole damage at 2,555, thats a big difference. i dont understand why such a difference and what should i do. i really dont think that will cover it when the other estimates where so much higher. its almost a 10,000 difference… please advise.. very confused
April 3rd, 2009 at 12:30 pm #yolanda
also forgot to mention the walls where opened for 2 months before chem dry came to see if they where wet.. of course there dry now theres no snow or ice and they have been open for a couple months.. please help
April 3rd, 2009 at 1:21 pm #Bhoffa24
My mother in law’s house caught on fire a few weeks ago and she is staying with us in the meantime until her house can be repaired. (maybe up to 6 months) Her policy has Additional Living Expenses included in it. My wife and I are not trying to get money out of the Insurance Company but all of our bills will be going up not to mention we are saving them money by not putting her up in a hotel. My question is would we be allowed to charge her rent to recoup some of the cost of her living with us? Or would she have to actually be staying in a hotel for that part of the policy to kick in? I just wanted to check before I asked the adjuster.
Thanks
April 3rd, 2009 at 11:19 pm #admin
Evangela,
It may be that Preferred Auto is denying the claim because your state does not allow victims to sue if they have no insurance themselves, regardless of who was at fault. It’s a way that some states penalize drivers without insurance. This may also be why the two lawyers would not take your case.
You may also be a risk of being sued by your friend who you loaned the car to.
Please let us know what state you are in, and if this is indeed the reason so that others may learn from your very unfortunate experience.
April 3rd, 2009 at 11:42 pm #Evangela
I live in the state of Tennessee and I’ve been in an accident in which someone hit me and I didn’t have Insurance then either and they paid for all the repairs through their Insurance. I was laid off Recently and that’s why I haven’t had Insurance.
April 3rd, 2009 at 11:43 pm #admin
Hello Yolanda,
Well the good news is that at least its covered and all you are arguing is damages.
Is the $2,555.00 the repair cost “after depreciation” and deductible, etc.? Make sure you know the repair cost that includes no deductions. Most home policies pay replacement cost, “after” the repairs are completed.
Try to get the adjuster to “reach an agreed cost” with the contractor of your choice. And try to get your contractor to call the adjuster also. If your contractor thinks he has a chance of doing the work, he will be motivated to help with this part of the insurance claim.
I don’t recommend going to appraisal. You are better off in small claims court in front of a judge.
For that amount of money, $10,000.00, you won’t find a lawyer or public adjuster to help you. But if you want to know how a good public adjuster would handle your situation, consider the eBook at UClaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe).
You could also have a mold situation. Consider asking the adjuster for a mold test.
April 3rd, 2009 at 11:58 pm #admin
Hello Bhoffa,
For ALE, the policy will say you have to “incur the expense”. Some policies give you a choice of ALE or FRV (fair rental value). So check that first. With FRV, you don’t have to incur the expense.
Bill your mother in law for what it would cost for a rental house or what a motel would charge and submit that bill to the adjuster. The expense is “incurred”, even if your mother in law has not been able to pay the bill yet.
For a detailed answer to this question and all the other issues you will encounter, consider the UClaim.com product “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”.
April 4th, 2009 at 12:12 am #admin
Evangela,
Check to make sure the law has not changed. Laws get changed all the time and often the public never hears about it.
If indeed you can legally file suit and the situation is as you said, then there has to be dozens of lawyers who would love your case. Feel free to email a copy of the insurer’s denial letter to info@insuranceclaimhelp.org if you want better advice.
April 4th, 2009 at 10:15 pm #Peter
My 14 yr old son collided with a car while riding his bicycle. Both he and the driver where approaching a blind corner and didn’t see each other. He collided with the drivers door creating several small dents and scratches. The insurance adjusted for the driver determined that it is my sons fault and is billing me for $1400.00 in repairs. The driver is suing me for $1000.00 in small claims court (her deductible). I don’t feel that it is 100% my sons fault, and that I should have to pay the driver and the insurance company twice. When I ask them for 3 estimates of the damage, the adjuster tells me that they used a reparable repair shop to get their estimate. I feel like I’m being bullied by the Insurance company. What can I do?
April 5th, 2009 at 5:58 pm #f. michael conte,CPIA
yolanda,
i think it is important to name the carrier so that if others are having the same problem they can learn from your anwers.
April 5th, 2009 at 6:01 pm #f. michael conte,CPIA
bhoffa24,
this is an acceptable alternative and you should not have a problem getting the adjuster to agree to help offset the expenses.
go for it. good luck.
fmc
April 6th, 2009 at 10:24 am #admin
Yolanda,
Adding to Michael’s suggestion, you can rate your insurer and any of their representatives in the Consumer Ratings page of this website. You can leave your name as “anonymous” if you fear making a rating, but at least it will help all of us, as Michael says.
April 6th, 2009 at 11:07 am #admin
Hello Peter,
1. If you have auto insurance, you may have coverage for your son on the bicycle (I’m no expert on auto damage liability). Check your own auto policy and consider making a claim. Check with your agent. I believe the definition of “occupying” a motor vehicle in most policies includes “upon” a vehicle, which includes you as a pedestrian or bicycle rider. Perhaps a visitor to this website can comment on this?
2. Regarding who is at fault and percentages, look at the police report first (if there is one). Then get witness statements (if any). See who your own insurer’s adjuster says is at fault, (if you turned it in). Then look in the phone book or google “accident reconstruction” in your area. If the cost of an expert is too high, he may give a little free phone advice. Ask a traffic cop his opinion. And in the end, it may be the small claims judge who decides the fault issue.
Common sense would say that if the car was in its lane of travel and your son hit the side of the car, as opposed to the front, it was your son’s fault. Make a diagram of the street and the positions of the car and bicycle before, during and after impact. A number of factors should be considered, like speed, obstructions to vision, etc. One key to who is at fault is “negligence”, ie “was your son negligent?”.
3. You should not have to pay twice and I believe the law in most states would support that. If the damage is $1400.00 and the deductible is $1000.00, then the insurer should not be looking for over $400.00 from you (assuming you are 100% at fault).
4. If they want you to pay the cost of repair, I would think you would have a right to see the car. At the very least, they should give you a copy of their estimate and some photos, so you can show them to another shop for an opinion. You only owe the “reasonable” cost of repairs. Obviously they cannot charge you 1,000,000.00 for a broken headlamp.
April 7th, 2009 at 4:44 am #Mags
Hello,
Thank you guys – your information kept me sane in my claim processing. State Farm (SF) finanly settled my claim, however, I still noticing item was missing since my initial police report. I still forward lost item to the detective – but I am not sure if SF will considered them since they already settled them.
Another question I have – if 1 item on the settlement I strongly desagree in there settlement amount could I decline that 1 item eventhough it was included in original settlement checks.
Any information will be a big help-
April 8th, 2009 at 8:56 am #admin
Mags,
As long as you did not sign a “release” paper with State Farm, you can turn in additional items for the next couple of years as you remember stuff. It’s illegal in most states for your own insurer to make you sign a release, unless it’s a “compromise settlement” and you both agree to the release.
Even if SF paid you what they estimated the one item was worth, you can still request more money on that item (or the entire list of items for that matter). If they “closed” the file, then they have to “reopen” it. For the best detailed information on how to increase your contents claim settlement consider the UClaim eBook entitled “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP” in the Homeowner’s section at http://www.uclaim.com/products.asp .
April 10th, 2009 at 12:30 pm #DC
Hello,
I am the recent victim of an extremly large and very old oak tree which fell on my house. According to the guys hired to remove the tree it would seem that it was about 125-150 years old. I have never filed a homeowners claim with my insurer before but i am already not getting a good vibe about this already. i had the adjustor arrive at my home and he did his intial inspection during this intial inspection he told me “this is the largest claim i have ever done” because my one entire side of my home was pretty much obliterated. After a couple of days passed i got a call from another adjustor to let me know that he had been put on this case because the inital adjustor did not have the experince to handle this claim. Well after a that he gave a check to cover some of my internal goods (which was an advance) within my home so i could buy some basic items to move into an apartment. well after all this i have only seen adjustors but i have concerns about the structual integrity of the home being comprimised and i don’t think the insurance company has any intentions of hiring an engineer to inspect it. from what i gather they are dead set on fixing it. Can i request that an engineer look at the house before they start telling me what there gonna do? and will i have to pay for that myself to get a truly honest opinion of weather the house will ever be the same again. i know that the insurance company will want to bid it as low as they can but how can they say lets start fixing it now after a tree that was 8ft wide and 15ft in diameter lands on the house and not even have a enginner look at it to say weather or not the foundation is good and it would be worth rebuilding. My fear is that with this economy the way it is and the fact that housing contractors are not in high demand right now due to the housing market. That a contractor will “low ball” the bid to get the job and then after the insurance company has put 40 or 50 grand into rebuliding it they will discover more problems and the insurance company will keep paying out more because they have too much invested not to fix it at that point when it should have been written off as a total loss to begin with and i get stuck with house that will never be right. i feel like my concern of the structual viability will not be addressed properly as i feel like it should. any advice you could offer me would be great
Thx
April 10th, 2009 at 8:45 pm #admin
Hello DC,
I will try to answer your questions in order, then give you the best advice at the end of this reply
If the adjuster refuses to hire an engineer to inspect the house before a repair estimate is made, fax a letter to the adjuster and whatever contractor who writes an estimate to repair the house that if he does not hire an engineer and architect to review the plans prior to doing the repairs, that you will sue him if any problems develop because of not using an engineer and architect. Also notify your local building inspector. The building inspector can insist that that the plans have engineering and architect approval.
Will their engineer be biased? Probably yes. Unless you want to hire your own engineer, then you are stuck with theirs. But do the same thing with their engineer if you think he “cut corners”. Fax him a letter saying you will sue him if problems develop while you own the house or if you sell the house and the new owner sues you.
If you fear they will waste your insurance money trying to repair the house, then run out of money after they discover it should have been totalled out, then do this, NOW: fax the adjuster a letter stating you prefer the house totaled out, but if the adjuster insists on repairing it, that your policy limits will be increased by the amount the adjuster wasted trying to repair your house. Now you have a record you can use later in court, if necessary. You also put pressure on the adjuster to total out the house. And if you really want the house totaled out, Cc the letter to the CEO of the insurance company.
Now my best advice. For the money you are talking about, you need more than a couple of paragraphs of advice from this website. You need professional help. You could pay an attorney who knows nothing about property insurance claims 30% of your entire settlement. You could pay a “public adjuster” 10% of your entire settlement and maybe get an unknown result, or pay him 50% of anything he gets over what you got on your own (as a “guarantee” of no unearned fees). Get advice at UClaim.com on how to hire a good public adjuster.
Or you could get all the information and techniques that a good public adjuster would use in an eBook in the Products page at http://www.uclaim.com entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” .
PS, if the house has not been covered temporarily while the negotiations proceed, get it done (and at their expense). Good luck.
April 13th, 2009 at 4:30 am #Debra
Hello,
We had a flexible spending account in 2007 which we used to pay for approved medical expenses. We provided the fsa company with receipts which they say they did not recieve. They did not notify us about this denial until August 2008, at which time they asked for receipts again, which we provided again. In March 2009, they demanded money, claiming that they never recieved our receipts. We sent them proof (a dated fax receipt) that we did indeed send the receipts to them when requested.
The fsa company is not denying the viability of the medical claims. They are denying recieving the receipts.
After several conversations with the company’s service reps, who agree that we provided the company with everything they asked for, their “review board” still denies our appeal and is asking for money. I spent much of last week on the phone with this company and am at a loss as to how to proceed. What now?
April 13th, 2009 at 8:08 am #Gary
Great site–valuable information.
When were the ISO Homeowner policy forms most recently updated? The most recent ones I’ve found were 2000. Is that right?
April 13th, 2009 at 12:34 pm #admin
Hello Gary,
Thanks for the nice comments.
It’s an ongoing process for each form. The latest editions I have seen are 2002 on some dwelling and commercial policies. And there are later “ISO” custom made forms for some insurers.
April 13th, 2009 at 12:50 pm #admin
Oh Deb, you can have some real fun with this one
I normally suggest faxing documents to insurers (as you have already done) in order to get the “transaction report” as proof of delivery. And you can still use this in court if you have to. But in your case, I think I would scan the receipts and save as PDF’s, attach them to an email sent to whoever you are talking to at the insurer and Cc the email to several other addresses and get the insurance rep on the phone and ask him to open the email and attachment while you are on the phone. If you don’t have a scanner, have Office Depot or a friend do it.
And the fun part, Cc the email to your state department of insurance, 60 minutes and whoever you want to add.
And do this too, fax a copy of the receipts to the CEO’s office for the insurer.
April 16th, 2009 at 3:58 pm #patrick
ok here is my situation
i was out of town for ester break, friday through sunday night and when i took off i guess my garage didn’t close, the sensor must have triggered it back up.
now i work out of my garage which i am not really suppose to do but its the only space i have left to work in. i buy computers from apple and upgrade them and i had over $30k in units on the shelf in there that are now gone!
when i got home it was very late and i just drove 8 hours and the last thing i wanted to deal with was the cops there so i waited till the next day to deal with it. i live right by the manager and wanted to go into the police station to do the report because i didn’t want them making a major scene at my apartment. i didn’t want the appt. manager coming over and seeing whats going on and see that i have been working in my garage which i could get evicted for!
also i didn’t want my neighbors coming over or asking whats going on because then everyone will know what i do and keep in there. that would put me at risk even more with everyone knowing whats in there.
i got all the documents needed, the receipts, and went to the police station and waited to do the report and when the officer came out, a young rookie, he stated that i should have called them out when it happened and there is nothing he can do. i told him it was late and it didn’t just happen since i was out of town the whole weekend. i also explained my situation with the fact i am not suppose to be working in there and didn’t want to get in trouble with my complex manager who lives right by me!
his response to that was, well whats more important you place or your things? i said BOTH ! i dont want to get evicted and i also want to be covered for my things so yea
i said he can come out to investigate it as long as he can keep it quiet so i don’t get in trouble with the manager and draw attention to my garage. he said that is not possible and would talk to the manager and knock on my neighbors doors and make a scene.
now without a report and them not caring i have to deal with my insurance company who wants a report to file my claim. i might be screwed now since i can’t provide a report….
can the police do that and say no to making a report for me?
can my insurance company deny my claim if i CAN’T get a report for them because the police department wont make one?
if i try to get a report and can’t because the police wont do it then i think the insurance company should still cover me because its out of my hands and not my fault they won’t take the report…
any ideas or thoughts on the subject or help for me here
April 18th, 2009 at 1:22 am #admin
Hello Patrick,
Well, your story sounds “reasonable” to me. And that is a very important word in insurance law and in your insurance policy.
1. No, the insurer can’t deny your claim based on your story. But they may try like crazy to delay their “decision” for a couple of years until you just give up. Maybe they will deny it for “failure to cooperate.”
2. Nothing in most policies says you have to make a police report. Your policy says you have a “duty to cooperate”, “within reason”.
3. If the police refuse to make a report, then try to get that in writing, and sent that to your insurer. In fact, you should make your request for the report in writing and fax it. Any failure on their part to respond can in itself be an admission.
4. The insurer may make a false issue of this since they know you want to keep a low profile.
5. But consider this before you spend a lot of time pursuing a claim, unless you have a “business” policy, or an endorsement on your renters or homeowners policy to cover, or increase a small limit on “business property”, your renters or homeowners policy may not cover business property.
If you decide to pursue the claim, consider the eBooks “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP” and “INSURANCE CLAIM PRACTICES LAWS WITH UCLAIM COMMENTARY, ADVICE AND HELP” on the product page at http://www.uclaim.com/ .
April 20th, 2009 at 3:22 pm #Idola
thanks !! very helpful post!
April 21st, 2009 at 11:58 am #patrick
they tried to give me the lower business coverage which is only 2500 leaving me screwed on the 40k plus worth of lost equipment!
i told them that its not technically a business since i haven’t sold anything yet, don’t have a business name or license or web site. the lady who was not even in California said it doesn’t matter and told me that since i mentioned a business that there is nothing i can do about it.
i told her that we haven’t even done the recorded interview and that i will not state its a business because its not one yet and may never be one. i told her that its all mine and that i was thinking of selling some of the units or all of them but they are mine. same as buying a lot of furniture and turning around and selling it all for newer pieces.
she also said that i can’t get anything or continue with my claim unless i get a police report. so i am up sh#t creek here and very very upset!
so i have no idea what to do now and feel very taken advantage of by this insurance company being esurance
they wont even return my 266 dollars i paid 5 months ago for a year up front of coverage. i demanded it back since i am not getting the coverage i am paying for and they refuse to do it. they said i would get 160 back and thats all…
i really want to sue them but i don’t want to deal with it really but its a lot of money i am loosing that they aren’t covering!!!
can anyone help me out here?
April 21st, 2009 at 3:32 pm #admin
Hello Patrick,
1. I still don’t think they can insist on a police report.
2. If their claim denial is valid, then I don’t think they owe you a full refund.
2. Read the definition of “Business Property” in the definitions section of your policy. If it does not exactly fit your situation, then they can’t deny the claim. If there is no definition, then look up the legal definition in Blacks Law Dictionary. Short of a clear definition, I think a judge could consider what the property was “intended” for. On the other hand, if the property was never offered for sale and you filed no business papers, then maybe technically it was not a business.
3. If the policy definition is not clear, then the benefit of unclarity goes to your favor.
4. If you want us to review your policy for no charge, scan it or have Office Depot scan it and email it to info@insuranceclaimhelp.org .
April 22nd, 2009 at 1:32 pm #PJean
Our house was in NYS. We were renting it out while away on temporary, long-term assignment. Due to the tenant’s negligence, the house was destroyed by fire. We hired a public adjuster due to our locale and the extent of damage (total loss). We are wondering if we can go after the tenant’s liability insurance to recoup the PA fees, which are in the area of $25,000-30,000.
Also, the tenant’s liability insurance was shy the required $500,000 by $200,000. We are hoping the fees can come out of that, or from the property management company that did not ensure proper coverage per the lease.
Any thought you have on this are appreciated.
April 23rd, 2009 at 11:26 pm #admin
Hello PJean,
1. The public adjuster will probably not be able to pursue the liability claim since in most states PAs are limited to handling property damage claims. But, he can “work for free” on this, if you get my drift.
2. To cover myself, I will first say consult with a lawyer on this. In my opinion, the tenants liability insurance will not extend coverage, unless as you say there was negligence, and to meet the New York definitions of negligence.
3. As to the property management company, you or your lawyer need to see if there is case law in New York on their responsibility in this matter. And the language of the lease itself is also very important. Have a lawyer look at it. You can also email us a copy of the lease language on the insurance, or cut and paste it here. Our email is info@insuranceclaimhelp.org .
April 24th, 2009 at 10:30 am #f. michael conte,CPIA
pjean,
also keep in mind that the carrier who paid the claim may be persuing the tenant through subrogation. if you go to an attorney he should attempt to coordinate with the carrier. i would also review the fire report to see what the cause and origin of the fire was. the will give a better clue as to who caused it. if it was something apparent like using an outdoor grill inside(we had such a loss) you may attempt to contact the carrier directly to see what their humor is on this topic. be carefull though you cannot collet on the same loss twice.
fmc
April 26th, 2009 at 2:13 pm #Bob
Dwelling Policy 3 Special Form 08 08
Dwelling is a total loss. Is there additional coverage for debris removal?
April 26th, 2009 at 2:18 pm #AR
Hi,
I just had a slab leak in my home. Some of the areas effected by this slab leak overlap with some damage we had incurred with a wildfire a few months back. Now the wildfire damage has not been replaced or repaired because the claim on that was just settled a few days ago.
Now with this new water damage claim, I was wondering if the overlapping items will be covered by the water damage claim? Some of these items have already been covered for replacement from the fire claim, but this (water damage) claim is a separate incident.
April 26th, 2009 at 5:47 pm #Dora
What a great site and very informative posts. I will add a backlink and bookmark this site. Thanks
April 27th, 2009 at 2:48 pm #admin
Bob,
Maybe.
We don’t have a copy of that policy. But you can scan and email a copy to info@insuranceclaimhelp.org if you like and we will review it.
April 27th, 2009 at 2:56 pm #admin
AR,
While you may technically and legally be able to claim water damage to a fire damaged carpet that was not replaced, I suspect the adjuster will resist your efforts. But hey, give it a shot. it’s what you pay premiums for.
Now had the carpet been damaged from fire and water on the same day, during the same loss event, I don’t think you could collect twice.
April 27th, 2009 at 7:35 pm #PJean
fmc,
Thanks for the input. Interestingly, the same insurance company represents both us and the tenant. Not so sure how hard they will try to recoup our fees for us, since they would be taking their own money…except that I believe his liability insurance was exhausted through subrogation for both our claim and neighbors’ claims who sustained damage to property and vehicles due to debris.
On another note, the property management company failed to ensure that the tenant obtain a set amount of liability insurance. They were shy by $200,000 per the lease terms. If this amounts to gross negligence on the part of the property management company, I think we could sue them for the fees if the tenant’s insurance is shy.
We would not be collecting twice….the fees of the adjuster go above what we have settled for. Thanks for that tip though.
Finally, the cause of origin indicates cause to be unattended candle or smoking, both a liability on the tenant’s part. Our fees are in excess of $25,000, so we will be looking to work with a lawyer to recoup. I just did not know if it is standard practice to pay out on someone’s public adjustor fees, since it was our choice to hire him. Only problem was that we are not local to where the fire occurred and were geographically disadvantaged to pursue the insurance process on our own. It necessitated our hiring of the adjuster (esp since we were both covered by one in the same carrier). I just hate to pay a lawyer $200/hour to potentially lose. Ouch…
Thanks for your comments.
April 29th, 2009 at 5:11 am #f. michael conte,CPIA
PJEAN
seems like the managing agent dropped the ball, i would go that route surely they have proffesional liability coverage.
good luck
fmc
ps i trust deductible was waived?
April 29th, 2009 at 7:41 pm #DC
Have a question? After reading all these problems with the insurance companys, rebuilding (or trying), pay, not pay, brings us to the question whether all this is really worth the effort.
Our house burned down a few months ago, and we are experiencing the same problems that others are facing with the insurance company’s. The lender called last week and asked what was going on with the insurance company and I explained where we were at. By the time the insurance company gets around to settling the claim, our home may be in foreclosure. I told them we plan on rebuilding, but now that is in question.
Neither of us really want to even rebuild if we are to face the problems like we are reading, and the insurance company at max. will only pay out barely enough to rebuild. (We lowered our coverages, last year due to our resources at the time). Big Mistake!
Here is the question. Our lender knows of the fire, and is telling us if the insurance does not act soon that the LETTER (foreclosure) will be generated. Im now unemployed, have spent all monies towards getting resettled, and being told we would be compensated accordingly by the ins. company. Now they are not paying.
If we just drop the claim, let the house go to the lender, and move on…..
Will we somehow be held liable to the lender for the house if they foreclose? Or will it haunt us later?
At max our contents would pay 60K and we have the depreciated value.
Sure we lose our contents, and alot of hurt, but is it really worth fighting the insurance company to the points of total loss of self, being angered, frustrated, humiliated,………..among a whole lot more? Listen to what they are doing! Its absolutely Insane. Yet, they ask for more money and percentage increases……………..
After Months of this, we are OVER IT! AND FED UP!
April 29th, 2009 at 9:34 pm #John
Hi,
I was involved in an accident that occured in a parking lot. I was driving in a designated driving lane and was struck on the driver’s side, front quarter panel. The damage is on the side front. The police accident report clearly states that the other driver failed to yield right of way. Now, after several attempts to reach the other driver’s insurance adjustor, she returns my calls, and claims that her company has ruled that the accident was contributory because their insured, claimed that I had reasonable ability to stop and avoid the accident. We were at a slow speed and the other driver hit me in the side of my car. The accident report claims the other driver failed to yield right of way. I argued this to no avail. By the way, I filed the claim with my insurance and the other driver’s insurance. What should I do? Should I file small claims on both the driver and their insurance company, or get tough with the other driver’s adjustor and threaten to sue, since I have the proof of failure to yield in the accident report. Thank you for your time and attention to this matter.
April 29th, 2009 at 10:48 pm #annmarie
We had parked our brand new Lexus in a commuter rail parking lot from 930AM to 905PM. When we returned the rear side of the car had been hit. We took it the next day to the body shop that the Lexus dealership uses and the insurance adjuster viewed the car I believe a day later. There was over $4000 of damage, being a new Lexus it is expensive to repair. The insurance company is trying to deny the claim, saying that the car was moving when hit. The car was in perfect shape when we parked it in the morning and damaged when we returned. Can you give me any help in what to do next.
May 1st, 2009 at 10:33 am #admin
Dear DC,
1. Get yourself the ebook at UClaim entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” for $79.95. It currently has a 30 day money back guarantee. Look at the table of contents online there http://www.uclaim.com/products.asp .
2. If your house burned and you have not at least been paid the ACV (depreciated value) upfront, then either they think you burned the house or they are one of those “low quality insurers”. In either case, you can’t handle this on your own. You either need the direction in the ebook recommended above, if you want to “do it yourself”, or you need a good public adjuster. The Free Stuff page at UClaim will give advice on how to get a good public adjuster. Get a public adjuster who will let you keep what you were offered and apply his percentage fee to any additional recovery. If a PA can’t help you, then seek out a lawyer. Lawyers are more expensive.
3. As to whether you should “walk away”, definitely consult with a lawyer who handles foreclosures and bankruptcies. Pay the lawyer for an hour of his time.
You don’t want to be penny wise and pound foolish here. It could haunt you for years to come, even if you declare bankruptcy.
May 1st, 2009 at 10:43 am #admin
Hello John,
I would say turn it in to your own insurer, pay your deductible and let your insurer settle up with the other insurer and get back all or part of your deductible for you.
If you are determined not at fault by your own insurer, then your premiums should not go up.
May 1st, 2009 at 10:54 am #admin
Hello Annmarie,
I don’t know what difference it would make if your car was moving or not. Most auto policies cover collision damage to the car whether it was moving or parked. And if you have comprehensive coverage, most insurers require collision coverage as well. I would also think that you have uninsured motorist coverage with a Lexus?
Ask the adjuster to put the denial in writing and to quote the policy language that says collision to a moving vehicle is not covered. If they have more reasons for the denial, then it should state why.
If you don’t have your policy form copy, you can get a sample at UClaim.com.
May 1st, 2009 at 11:16 am #f. michael conte,CPIA
dc,
not sure what state you are in i would suggest contacting the insurance department for that state. also i am not sure that the bank can move to forclosure in your situation. i would ask the bank to have their attorney get involved and i would also list the name of the carrier you are dealing with so people learn who not to do business with…….
i would not walk away from this it will haunt you for a while.
you might also ask you agent or broker to get involved afterall this is exactly why we earn a commision.
May 2nd, 2009 at 10:24 am #christopher
hello,
i need some help>>>
i purchased a 2006 toyota tacoma brand new. recently i had my truck stolen. i had done a lot of upgrades to the vehicle, but i feel they are undervaluing it. heres the details.
truck only had 14,000 miles on it from me
i purchased an extended factory 100,000 mile bumper bumper warranty. ($1900)
car was in mint condition inside out (seat covers, floor ,mats, wax jobs)
added the following…
premium tires, upgraded rims, grill, brush guard, toyota seat covers, top of the line sound system that didnt alter the vehicle. everything was mounted and made for this specific truck. ($4500)
now i know these are accessories, but they were specificaly for this truck and it did make my truck the best. of course if i were to sell my truck, it would be worth more than the same one stock with zero upgrades or warranty.
so they are valuing my truck like an average joe vehicle. i have AAA.
does any of this ad value? does the warranty ad value? is there anything i can do?
thank you.
May 2nd, 2009 at 12:12 pm #admin
Hello Christopher,
1. In my opinion, if you take a cash settlement instead of replacing the truck, I don’t think the insurer will add for the warranty. However if you tell AAA to replace the truck with exactly what you had and use the same dealer you got the warranty from, you would have a better chance of keeping that warranty? Read your warranty agreement to see what it says “in the event of theft or total loss” to the vehicle.
2. As to the other options/accessories, unless the AAA policy says it will only pay for a “stock” vehicle, then they should add to the value.
3. All this aside, the chances of you still being lowballed are pretty high, especially if AAA used CCC or ADP to value your truck. I suggest you consider the eBook “TOTAL LOSS AUTOMOBILE INSURANCE CLAIM ADVICE AND HELP – FOR INSUREDS” at http://www.uclaim.com/products.asp .
May 5th, 2009 at 8:14 pm #BH
I have recently filed a Home Owner’s Insurance Claim. The insurance company has cut me a check to cover the estimated value of the items damaged. I went to replace the items and was able to replace them at a cost less than estimated. My insurance company is requesting that I fax over the receipts to prove that I have replaced the items. My question is, if I did not spend the total amount alloted for the item, is the insurance company going to require that I give them back the money I did not spend? I have heard that I would have to and that I would not. Any help would be appreciated…
May 6th, 2009 at 2:59 am #admin
Hello BH,
When you say “estimated value”, I assume you mean the depreciated value, not the replacement value. The only reason to turn in receipts is to prove you paid more than the depreciated value, so you can get the difference back (assuming you have replacement cost coverage). If you don’t turn in the receipts, then they don’t know how much to “collect back”. This is not something that adjusters waste their time on investigating or pursuing.
One option to increase your contents settlement in your situation would be to renegotiate the depreciation taken on your contents.
Take a look at the money back guarantee eBooks in the homeowner section of the product page at http://www.uclaim.com/products.asp .
May 6th, 2009 at 7:25 am #Roger Poe
The timeless information, coupled with data specific mining software, should help others for many years to come.
Good for you.
-RP
May 6th, 2009 at 11:18 am #Zedition
We have a standard homeowners policy with a company that has an exclusion for “collapse”. A while back, we noticed damage to our well, and immediately contacted the insurance company with a claim. They denied it outright without sending out an inspector, and because the well was within 5 feet of our home (and a safety risk), we filled the well in. After contacting the State Department of Insurance, we learned that common practice is for a company to send out an adjuster/inspector before denying a claim – in our case it is possible that the well did not collapse – nobody really knows what happens because the only damage was the subsidence of a few cubic feet of soil and very dirty water in the pipes.
Now it sounds like they want to deny it based on several other factors, primarily that it “probably was a collapse”, “flooding”, and inferior construction because the well was brick-lined, not cased in modern concrete tiles. The brick-lining was state of the art before WWII when the well was probably built, and I just can’t see that “inferior construction” applies just because technology got better over the next 75 years.
My argument is that the company did not exercise due-care in investigating the claim, and that they should have either sent out an inspector before denying, or recommended that we have the well professionally inspected before we began to fill it in. What kind of responsibility to exercise due-care in the investigation of a claim does a company have?
May 7th, 2009 at 12:14 pm #admin
Roger,
Thanks for the nice comments. Your input is encouraged on this website.
May 7th, 2009 at 1:26 pm #admin
Hello Zedition,
Lots to consider here. Was the denial in writing? Was there a tape recorded statement? Is the well a “structure” below the casing or bricked in part? Or is that lower part just a hole in the dirt or clay or rock below the casing? Is this a wide well that you drop a bucket down?
The insurer has a duty to do what is “reasonable” in deciding how much investigating to do. And that depends on what information you gave the adjuster on the phone to describe your well and what questions you were asked. Well construction may vary considerably. At first I assumed you had a submersible type well with a steel pipe casing at the top. But when you said “brick lined”, then I started to wonder if it was a well like you drop a bucket down.
A collapsed well is a very unusual insurance claim, and in my 30 years living in a farming area, I have never has such a claim.
Most adjusters know nothing about how wells are constructed in different parts of the country. And if they do have knowledge, it is probably about how wells are built in their own area.
Even though you filled the well in, it may be possible to “exhume” enough of it to determine the cause and origin by an engineer.
As to denial for “inferior construction”, that sounds like an over zealous wishful thinking adjuster. Most policies exclude “negligent construction”. That’s not the same as “inferior construction”. If “inferior construction” was not covered, then there would be no coverage for old homes, right?
Read your policy wording and check it against the denial letter wording.
I think you could also say the well was an “appurtenant structure”, if part of the denial is that the well is not a structure or that the well is a hole in the land and land is not covered.
You can learn the basics of dealing with denied claims in the eBook entitled “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP – STANDARD VERSION (W/O APPENDIX)” at UClaim.com http://www.uclaim.com/products.asp .
May 7th, 2009 at 2:03 pm #Zedition
The well is a ground-water well, very common in older rural homes in the Midwest. My research on this tells me that today’s common drilled wells (diameter 12” or less) didn’t become common until the late 1940’s, and hand-dug tiled wells like mine were still being put in up to the early 1970’s. Concrete ring-cased wells become common to line the wide, dug wells like mine once truck-mounted dolleys and cranes were available.
The well was larger than 36 inches wide, and I bet you could drop a bucket down it. But mine had a submersible “push-pump” resting on the bottom – similar to a sump pump in a home, but designed for this kind of wide but shallow well.
I personally did not tape record the claim denial, but when I bypassed the claim adjuster and spoke with the claim manager, I heard the tell-tale pauses and clicking of a recorded conversation. I’ve documented that I was informed of the denial on day 1 to the company and the State Insurance Commissioner as well. What I do have is that the letter notifying me that they intend to investigate the claim is dated almost a week after I first contacted the company.
The entire well casing from top to bottom was “clay tile”, similar to field tillage tiles, but squared off and made for use in a well. The top 6 inches was a poured concrete cap. I believe the bottom of the well was sand, because it tapped into a subterranean mineral water spring. Putting concrete over this would stop the spring water flow.
It would be difficult to exhume the well, as it was within a few feet of my home’s foundation. One of the key problems right now is that what caused the well to malfunction is “unknowable”. It’s kind of like having your house bulldozed before the claim adjuster arrives to evaluate the fire damage. Maybe it was a total loss, maybe a partial loss, maybe the fire was not accidental, now that the house is gone – it’s impossible to be certain what happened.
Thanks for the link, I’ll check out the eBook!
May 7th, 2009 at 3:36 pm #admin
Zedition,
If it was “legal” (admissible in court) tape recording, they would have to have asked your permission.
1. What would it cost to replace the well:
A. exactly as it was built?
B. With current replacement to code?
2. What was the current “market value” of the well?
3. What was the demo cost?
Feel free to post the exact denial wording from the letter here if you like, or email a copy of the denial letter to info@insuranceclaimhelp.org for our review. Black out any id info. if you like.
May 7th, 2009 at 3:41 pm #admin
Zedition,
One more thing. Check out the wording on collapse exclusions in your policy. Some policies don’t clearly exclude “eminent collapse” (a sagging, leaning, slumping, cracked, etc. structure).
May 9th, 2009 at 7:12 am #Ingrid
Would you have a copy of the ISO HO3 or know if there is anywhere that it can be downloaded from the web?
May 11th, 2009 at 9:55 am #Tiffany
I recently had hail damage to my roof. Well we just found out that our home loan was put in our bankruptcy so we aren’t going to be keeping the house. My question is can we keep all the money and not fix the roof or can we just do minimum repairs and keep the rest?
May 12th, 2009 at 3:46 pm #admin
Hello Ingrid,
There are 5 editions of the ISO HO3 listed above from 1988 to 2000 (latest HO3). They are available for download at http://www.uclaim.com/products.asp .
May 12th, 2009 at 3:59 pm #admin
Hello Tiffany,
If the check is only in your name, then keep the money. Now as to your bankruptcy, you have to find out if the court requires you to report insurance claim proceeds as “income”. FYI, The IRS does not consider property insurance claim proceeds to be income. Check with your bankruptcy lawyer.
If the insurance claim payment check includes the mortgagee, your bank, named on the check with you, then you will have to do the repairs. If you get the repairs done for less or do it yourself, then the bank may sign off on the check.
If it’s a two party check, do not sign the check and mail it to the bank. Hold onto the check. Do the repairs first, then call the bank to have their inspector verify the repairs were done, then, mail the unsigned check to the bank for them to sign and return it to you so you can now cash or deposit the check.
May 13th, 2009 at 10:32 am #alphanumericone
I have a truck that is a couple years old. It received minor damage from my garage door to the front bumper. I received 2 estimates in the $700 to $800 range. My deductible is $250.
What are the implications if I file a claim? Increase in premium? For how long?
I have multiple vehicles, and this one is for “recreational” use, < 5000 miles per year. I have not had a claim in 15 years.
Brian
May 14th, 2009 at 7:28 am #Virginia
I was in an auto accident about a year ago, and my vehicle was totaled. We had gap insurance to cover the cost of the difference between the value and the loan amount; however, the gap insurance company, did not pay the entire amount. They claimed that the vehicle was worth a different amoun than our primary insurance company. We have been trying to resolve this issue for over a year. I believe one of the two companies is trying to rip us off. The gap insurance company said they used a different “book” to get the value than the primary insurance company did. This doesn’t seem right to me…Have you ever heard of this type of discrepancy?
May 14th, 2009 at 5:13 pm #chris
HI We had a House fire on March 13, 2008 on brand new property. The fire started in the garage went into the roof and we lost half the house and 3 cars any everything in the garage. We were completly hounded by public claims adjusters even while the fire was still burning. We signed with one and that has been a night mare. They have been worthless there only concern is to get there 15%. The items that were saved need to be cleaned before they go back into the house. We had to contact Departmetn of Insurance for the State of California to get beds cleaned. Right now my sons mattresses havent been cleaned. Do you know of stories of public claims adjuster that have really help consumers? We havent been payed yet for the contents and the builders has place a len on property for the extras that werent on the scope by the insurance company. We had to get a attorney
May 15th, 2009 at 12:11 am #admin
Hello Virginia,
Of course. Insurance companies and government tax assessors use whichever guide book suits their purpose whether its to lowball or to highball a valuation. Anyway, your first goal is to deal with the underlying insurer first, and the gap insurer later. You usually have 3 years to file suit on property damage, in spite of what the policy says.
Get yourself the eBook entitled “TOTAL LOSS AUTOMOBILE INSURANCE CLAIM ADVICE AND HELP – FOR INSUREDS” at UClaim.com http://www.uclaim.com in the Products section. Use the techniques in that eBook to discredit the insurers valuation. And use the gap insurers valuation also. (But if the gap insurer used a book, and not CCC or ADP, then the primary insurer will not likely be influenced).
Win or lose with the primary insurer, you can use your new valuation against the gap insurer. If that fails, you will have plenty of evidence for small claims court (no lawyers).
May 15th, 2009 at 12:58 am #admin
Hello Chris,
If your story is even half true, then it makes my stomach turn. I feel shame for the PA profession in California.
We all know there’s good and bad in every profession. Unfortunately there are more bad PAs in California because the biggest player years ago thought he could wipe out the competition by forcing the “solicitors” to become licensed as public adjusters. Well, it backfired, because now you have people with PA licenses whose experience “working for insurance companies” consisted of sucking water out of carpets from toilet overflows. (And in fairness to the PA profession, there are excellant PAs who have never worked as insurance company employees, but they are few.)
Now if you want to know how to hire a competent public adjuster (or any professional for that matter), go to the “Free Stuff” page at UClaim.com http://www.uclaim.com and click on the line entitled “About Public Adjusters”. Scroll half way down to the yellow highlighted part and read those two paragraphs.
And if you and your lawyer want to know specifically if your PA followed reasonable PA procedures, get the PA’s “Bible” entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” at UClaim.com, top of the Product page. It was written in layman’s terms, for the common man. It will teach you how to pick up the pieces and do a better job than the guy you hired.
Good luck to you.
If the PA you hired was at your house as it burned of after hours, you may have a legal way out of the contract. Also, go to section 15006 of the California insurance code for a list of illegal PA practices. Go to Findlaw.com to access the codes for free.
May 15th, 2009 at 1:15 am #admin
Hello Brian (Alphaone),
This is a better question for an agent. Find out if it will increase the premium, and if so, how much and for how long. If you don’t want to alert your own agent, call one in another town, but for your same company.
If you are not at fault in an accident, then your premium should not increase. Was there some negligence or fault by you or your family in this little mishap?
May 15th, 2009 at 7:19 am #alphanumericone
Yes,
I failed to back the truck in far enough and when I closed the garage door it scratched the front bumper. So yes, I suppose I was negligent.
I’ve put in an inquiry w/ my insurance company but have not received a response yet.
My personal opinion is that it would be a travesty if the insurance company increases my premium for a single non-driving incident after 15 years. They’ve made a ton of money from me over the years.
brian
May 15th, 2009 at 11:38 am #Sarah
If person seeking health coverage is family member of active duty military personnel, Uniformed Family Health Plan (USFHP) is the best choice for him/her with best coverage and very competitive rates.
May 16th, 2009 at 11:13 am #Rob
On March 14th 2009 my home burned. About half of the house was completely destroyed, and the other half was severely smoke and water damaged. The insurance co. started off by playing nice. They put us up in a rental house, got us rental furniture and housewares, and even got us a couple thousand dollars for incidentals.
But lately, the adjuster has become impossible to deal with. He takes days to return an e-mail, a week or more to return a phone call, and he is condescending. He gave us the contents forms to fill out to start processing our contents claim, then after about 20 hours of labor on my part to fill it all out, he sends me a 5pm on Friday email saying that it wasn’t done correctly and quoting sections of my policy. This A: doesn’t help me correct it and B: is a slap in the face considering all the work I have already put into it.
Should I get a public adjuster to deal with this? or maybe a lawyer? or just ride it out?
May 17th, 2009 at 5:44 am #Tom
Hi,
I was involved in an auto accident. I was on my bicycle at the time.
Question:
Can I get my bike replaced? It is a high end bike – $ 3,000 msrp, $2400 paid. It is an 2006.
I was traveling along the side of the road and the driver hit me. It is basicly totaled in my eyes. The carbon frame is not visibly cracked or damaged. BUT I feel that the frame has been hit hard enough that I do not trust it to give me the longevity that I expected when I bought it.
The repair estimate is $2000. New bike is $3300.
Now will the evaluate it at the $2400 or the msrp of $3000. Or will they replace it.
Thanks
May 17th, 2009 at 7:48 pm #admin
Brian,
Let us know what they say.
May 17th, 2009 at 7:52 pm #admin
Sarah,
Thanks for that. You should list USFHP in the Consumer Ratings page of this website and give a 5 star rating with your comments. Thanks
May 17th, 2009 at 8:01 pm #admin
Hello Tom,
The insurer owes the least amount, to repair or replace.
You need some expert opinion on your side, and you need it in writing. If you can get a bicycle dealer to say that the frame will not last as long because of the accident, then that is where you start. Hopefully the insurer won’t hire their own engineer to refute your expert. This will give you a clue as to whether this is a low or high quality insurer.
Oh, and if they do pay to replace the bike, then they have a right to the salvage. So keep that in mind. Also, if it’s some one else’s insurer you are dealing with, if they do agree to total it out, they owe the used market value, not the replacement cost. If its your own insurer and you have Replacement Cost on contents, then you get RCV, if you replace it.
May 17th, 2009 at 8:12 pm #david
Hey Chris, the best website to find a good PA is http://www.napia.com. It is the self governing organization for PA’s. They mandate continuing education and heavily scrutinize new and existing members to ensure they conduct themselves in a professional manner. Just my two cents. Good luck.
May 18th, 2009 at 12:56 am #admin
Hello Rob,
Sounds like your adjuster did what many are trained to do now days – be super nice in the beginning to keep you from hiring a public adjuster or attorney. And actually that’s not so bad, because it does help to discourage some of the lower quality PA’s using hard sell tactics.
I suggest hiring a PA (a good PA) before you hire a lawyer. Don’t shop for a lawyer unless the PA can’t get a fair settlement for you. For advice on how to find a good PA, look on the Free Stuff page at UClaim.com http://www.uclaim.com for the link “About Public Adjusters”, scroll down to the yellow highlighted area and read those 2 paragraphs. To find PAs in your area, look in the Yellow Pages and check http://www.napia.com. You can pay the PA a percentage of the entire settlement (10-15% is typical), or a percentage of the amount over and above what you were already offered (not over 50%). And read the post of 5-14-09 by Chris about public adjusters on the home page here.
If you are inclined to continue to handle it yourself longer, consider the eBook entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” on the Products page at UClaim.com . You can also use that eBook as a guide to see what your PA or lawyer should be doing for you.
May 18th, 2009 at 1:38 am #admin
David,
Great advice and thanks for your “two cents”, which is most welcome here!
I might add for the visitors here that if one is looking at the Napia website for a PA, give preference to the ones with the designation “SPPA”, which means that PA has passed a number of college level type classes and exams in claim adjusting. While this is no “guarantee” that they will do a good job, it raises the odds that they will. And don’t necessarily rule out non SPPA members, or non Napia PAs. You have to take a good look anyone you are considering contracting with.
May 18th, 2009 at 9:48 am #Kelly
I live in Wisconsin. My name is on a mortgage with my ex-husband who recently set fire to the home and is being charged with arson. The insurance company has agreed to pay the mortgagae comany for partial losses but has not yet due to lengthy investigation. Meanwhile the home is being foreclosed on and I am being told that I will be sued by the mortgage company’s private mortgage insurance. I am completely innocent. Is this even possible? Thanks.
May 19th, 2009 at 4:53 am #Young
While I am traveling for business, my wife discovered a lot of water on the basement floor. The entire floor was soaking wet. There was some evidence of water on the drop ceiling. The 1st floor floor right above the basement (hardwood) got buckled up. She immediately contact our handyman to find out what’s going on. Upon inspection the house, he raised two possibility: (1) rain water could have come through the wall or (2) there is some type of plumbing failure. He was leaning toward plumbing failure as there was no sign of water coming through drywall, and the buckling seem to become more severe. It also smelled really bad. Furthermore, he suggested the amount of water is too much for rain water coming. (For your information, our basement was never wet.) He suggested that we should get professional mitigation company to restore the basement and ask their opinion. The guy came and immediately suggested that it is some type of plumbing failure, based on the smell. He also pointed out the buckling. He suspect that it cannot happen because of water coming to the basement. Again, he did not see any sign of wetness or water stain on our drywall in the basement. He said we should get a plumber and claim to our insurance.
Later a plumber came and looked. But, he could not find any plumbing problem, saying that everything is dry. He said, that water must have come from outside. He was not able pinpoint where it came from. But, he said our plumbing is fine.
We called the insurance to make a claim. Insurance guy told us that they would not cover the damage if the water came from outside. But, he also agreed that it is strange to have severe damage on the first floor and no sign of water on the wall, given the amount of water we had on the floor. So, he said, “we will cover it if you show us plumbing problem. Hire a plumber and show us what he fixed. Then, we will cover it”.
The mitigation came back yesterday. After hearing the opinion of the plumber and the insurance, he still believed that water must have come from inside. So, he tracked the damage area and found wet area in our basement ceiling which is connected to the vent from 2nd floor bathroom. The vent is on the floor. So, now he suggested that some water might have come from that vent. However, my wife did not see any overflow in the bathroom. But, he said, he is going to put it as a statement that we can submit to the insurance company to show as evidence of water coming from inside. However, we don’t have a broken pipe.
What we now have is two theories, without any positive proof for either of them. We don’t have clear evidence of outside water coming (our sump pump is fine) – no stained wall, water mark or wetness of the wall. At the same time, we haven’t been able to locate the broken pipe. Yet, we have clear damage of water on the 1st floor and the basement. How should we present our case to the adjuster? Is this kind of case that we should get public adjuster?
Any suggestions?
May 19th, 2009 at 4:36 pm #LFR
Hello,
I’m in California. My husband was riding down the freeway on his motorcycle when a pickup one lane over ran over a large piece of metal (about 3 feet by 2 feet) and launched it. It slammed into the side of my husband’s motorcycle, causing some extensive damage. When I went through all of my insurance paperwork I realized that the company had never sent me the full policy. My question is, how should this be covered? Under comprehensive or collision? Thank you.
May 20th, 2009 at 1:12 am #admin
Hello Kelly,
Check with an attorney in your state. Most states have laws protecting innocent spouses. Look at your policy to see if it says the claim will be void if there is fraud by “the insured” or “any insured”. “The insured” is the “named insured” on the declarations page, and may not include “non named insureds” like other relatives in the house. So “the insured” would assume that there would have to be fraud by all the insureds.
Educate your bank foreclosure officer. Advise them that they will be in a better financial position to have a repaired house as collateral than just the amount of their loan. Also advise them that the insurer owes “replacement cost” to the homeowner, but only ACV (depreciated value) or loan value whichever is less to a mortgagee. Most policies don’t give RCV to the mortgagee.
May 20th, 2009 at 1:25 am #admin
Hello LFR,
If they won’t give you the policy or delay it, see if its listed on the Policy From Copies page of this website.
I would think collision. And most insurers don’t write comprehensive without collision already being covered. Most policies also define comprehensive as “non collision”, except for specific listed things, like impact with an animal in the road.
If they deny it, get the denial in writing stating the specific reasons and policy language.
I assume the pickup truck got away. If not go after them or your own UM coverage, as long as you can identify the truck.
May 20th, 2009 at 1:59 am #admin
Hello Young,
It sounds like a small claim and I’m not sure a PA would be interested, but you can try. Definitely hire a PA if the claim is denied, and consider hiring a PA before a denial. Read “About Public Adjusters” on the Free Stuff page at UClaim.com http://www.uclaim.com .
You probably have an “all risk” policy on structure. It says “we cover everything except …” with named exclusions. That means the “burden to disprove” your claim is on the insurer. That means they, not you, have to disprove the cause of loss if they want to deny the claim. That means they, not you, have to hire an engineer or leak detection service or whoever to find the water source.
Has anyone cut a hole in the ceiling or opened the vent to look for water stains etc?
May 20th, 2009 at 5:43 am #f. michael conte,CPIA
Kelly,
wow what a nightmare, get an attorney, i do not think they will persue you for arson, however i think they will be looking for their money as i assume you are a co-signer on the loan. fmc
May 20th, 2009 at 5:52 am #f. michael conte,CPIA
young,
you mentioned you were away on business how long were you away?
also was their waste in the water or was io t clean? finally a buckled floor is not a surprise, as wood acts like a sponge so in a condition of high humidity wood will absorbe the water in the air and then buckle.
ideally you must pinpoint the problem. is it possible that some left a faucet on?
finally keep in mind that overflow from a plumbing system may be an exclusion as well.
May 20th, 2009 at 8:19 am #alphanumericone
Re: Garage Door Damage.
Insurance company says it is a comprehensive claim and will have no affect on my premium. They said it is no different than having a tree fall on the truck. It’s outside my control and doesn’t make me any higher risk to insure.
BTW, I found out you can request your A-PLUS and CLUE reports under the Fair Credit Reporting Act here in California. I’ll be doing this in the near future to see what the insurance company puts on it. These are the insurance equivalent to your credit report.
Brian
May 22nd, 2009 at 9:51 am #kym
may 19th our beach house had a pipe burst and flooded, the neighbors realized there was something wrong and used their key to enter. Upon entering the house they realized the mess, falling ceilings, mold up the walls and bucked hardwood floors just to name few. Currently the insurance company has a company serv-pro removing everything down to the studs, we do not have a mortgage and with current home values we might be better with a total loss. Can we suggest that? The mold is everywhere and they are saying that it may take days just to get the mold to an accessible range. I also have asthma and severe allergies and the thoughts of a home possibly having mold in the walls freaks me out. What should we do.
May 23rd, 2009 at 4:05 pm #admin
Hello Brian,
Please let us all know exactly how you access CLUE and A-PLUS. I wonder if you can get them for free if you were denied coverage or something adverse, as in getting free copies of credit reports?
May 23rd, 2009 at 4:34 pm #admin
Hello Kym,
This is one reason why I shut off the water valve to my house anytime I plan on being gone, even if for 1 night.
1. Consider that your policy may have a limit for mold coverage, possibly as low as $5,000.00. Insurers got tired of trying to deny mold claims, so they found it easier to cover it, but put a dollar limit on it. Make sure that any agreements you signed with Servpro don’t leave YOU with the bill if they run over cost.
2. Get as much covered or replaced using “non mold” coverage. For example, if wall paper is stained and molded, claim it as stain damaged, not mold damaged.
3. If you prefer the house be “totaled out”, then put that in writing to the adjuster. Tell him the house is a total, in your opinion, and you don’t want your insurance money wasted on Servpro or others. And fax that in writing also to Servpro. This will force the adjuster to be the one to authorize Servpro to attempt remediation (and it is his right to do so). In other words, any failed attempts to repair or “remediate” your house will now not be applied to your policy limits.
4. If Servpro screws up the remediation, now you have a liability claim against both Servpro and your insurer. And such a claim would not be subject to your policy limits.
5. Is Servpro using blowers AND dehumidifiers? Most insurers are too cheap to cover dehumidifiers. So if they did not use the dehumidifiers, then you may have a liability claim against both Servpro and your insurer for negligence if your coverage on mold depletes.
I suggest you run this strategy by an attorney, as the final decision will be yours. Insurance claims are often like a chess game and you may want to consider a “good” public adjuster and or attorney. See “About Public Adjusters” on the Free Stuff page at UClaim.com.
A great reference for handling this claim is the eBook entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)” at UClaim.com http://www.uclaim.com/products.asp .
May 26th, 2009 at 7:15 am #alphanumericone
I found this article which makes it seem you can get your CLUE and/or A-PLUS under the same circumstances as your credit report. Denial of coverage and/or once per year in California.
http://www.privacyrights.org/fs/fs26-CLUE.htm#5
http://www.privacyrights.org/fs/fs26-CLUE.htm#6
Brian
May 28th, 2009 at 7:44 am #Denise Lattin
My insurance company denied my claim by saying my loss is due to long term leakage at the water heater which is not true. I hired a plumber and the hot water heater is not leaking it is the pipe and valve that started to leak. At the first sign of water on my floor I contacted the insurance company they sent out an adjuster who just took pictures and didnot even check so see where the leak was. The hot water heater is in the wall in the bedroom so how am I to know something is wrong until I see water on the floor?
May 29th, 2009 at 2:48 am #admin
Hello Denise,
Unfortunately it does not matter if the damage was hidden from view. And it does not matter if the water leaks from a pipe, valve, or the heater itself. They are all “appliances”. But all is not lost.
Adjusters often mistake a black wood floor or buckled floor for “long term” damage. The key is whether you can push your finger or a dull butter knife through the “damaged” floor. If you can’t push your finger through the “rotted” wood, then it is not “long term” damage. A plywood floor can buckle over night and can turn black in a couple days. That’s sudden and accidental, not long term.
May 29th, 2009 at 4:26 pm #jackc21
What is definition of vacancy under a DP3 policy. The dwelling was being repaired after tenants damaged it. insured was doing repairs himself but not living there. Water loss occurred but was discovered and mitigated within 48hours.
Florida
May 29th, 2009 at 10:25 pm #david
i was t boned by a taxi driver who ran a stop sign; there insurance in nationwide in ny. they wont pay claims as person was using car as a taxi and only had personal insurance on it, isnt there a way to get some payment for my car. i cant work as i use it for work
May 30th, 2009 at 10:48 pm #admin
Hello Jackc21,
The ISO Homeowners Insurance Special Form Policy DP3 7-88 (available at UClaim.com product section) does not define the word “vacant” in the Definition part of the policy, but it does say “a dwelling being constructed is not considered vacant” in the Perils Insured Against section of the policy. I would argue that this includes repairs and remodeling.
May 30th, 2009 at 10:56 pm #admin
Hello David,
Most personal auto policies exclude liability coverage if the vehicle was used as a taxi. Did the “taxi” have any passengers during the accident? If not, there may be coverage if the taxi driver argues the accident occurred during personal use of the vehicle.
And of course, you are still free to sue the driver and taxi owner, regardless of whether his insurance covers him or not. That could motivate the taxi driver to pressure his insurer to cover your claim.
June 1st, 2009 at 9:56 am #James
In order to collect the balance of a claim which ins. adjuster referred to as “applicable depreciation balance” withheld by my insurance co., my insurance company is asking for receipts for the restoration & cleaning work completed by the contractor after a fire in my home. I have a final invoice from the contractor, however the contractor is refusing to provide receipts, says he does not have to and claims their demand is redundant and that the itemization for everything is in his estimate that the ins. company has already sent payment for (less depreciation). He says it is evident that ins. co. is attempting to get out of paying remainder & that they are acting in bad faith. Now the contractor has threatened to put a lien on my home for non-payment. If I am unable to provide these receipts the insurer is refusing to release the final monies of which I need to pay the final invoice. The work is complete and I am very happy with the work and my mortgage company is happy as well and have released the balance of the money in escrow for payment to contractor. I still owe the contractor money which I thought I would be getting from the ins. co. after contractor completed job. What is my recourse here?
June 2nd, 2009 at 12:00 pm #jaws5738
We had a storm come through our town on June 4, 2008. I immediatley called the insurance company who sent an adjuster out. I received a check from the insurance co on June 26th for the amount of $3676.00. I contacted a couple of contractors to replace the roof, however, there were so many roofs in town needing repair that they were all busy. They told me it would be a couple of months until anyone could look at my roof. Finally in September, a contractor did look at the roof and asked if I had any leakage. I told him no, I did not. He advised that because it was getting late in the season, that the roof would probably be ok through the winter. He told me that shingle prices would probably be lower in the spring and said since I had no leakage that I should probably wait until then to have the work done. That is exactly what I did. The contractor contacted me last week with an estimate of the repairs…$5865.00 to be exact. I still have the original $3676.00 that the insurance paid me. This is a difference of $2189.00. My question is, can I send the estimate to the insurance company and see if they will pay more on the claim, or will I have to eat the cost myself since the claim is now a year old? I understand that I will be responsible for my $500.00 deductible and depreciation costs, but those together only equal $1365.69. Am I responsible for the difference because I waited until spring to have the repair work done? Also, my insurance policy says the depreciation costs are not recoverable…is this right?
June 2nd, 2009 at 12:01 pm #jaws5738
This was a hail storm, by the way. I left that out of the original post!
June 2nd, 2009 at 6:58 pm #admin
Hello James,
Your contractor is right, and since “he” is not “the insured”, he does not have to cooperate with your insurer. And if all you have is one general invoice from your contractor, then that’s all you can give them, and you have fulfilled “your” duty to cooperate with your insurer.
Your insurer is really looking for a back door to cut down or completely eliminate the “hold back amount”. There are ways to verify the job is complete without looking at the contractors invoices, etc.. Have the contractor give you one piece of paper that states “Job complete, amount due $xxx.” Then if the adjuster wants to verify repairs were done, let him do his own inspection. How to handle this “safely” and all your possible questions is included in the eBook entitled “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (standard)” at UClaim.com http://www.uclaim.com/products.asp .
June 2nd, 2009 at 7:14 pm #admin
Hello Jaws,
1. If the original check was for 3676.00 and your deductible was 500.00 and your policy does not pay Replacement Cost, how much did your original adjuster figure for RCV of repairs, before depreciation? If that’s over 5865.00, then the only thing you can argue about is the depreciation, if you think that was too high.
2. As to the time limit, most policies say you have “12 months to sue”, but the question is from when, the date of loss or the date payment was made? Also, most states laws override the policy language anyway and give you up to 3 or 4 years to file property damage claims (you can check that with your local small claims court or a lawyer).
In my experience, you should not have a problem reopening the claim, unless you are with a “low quality” insurer.
June 5th, 2009 at 3:58 pm #Michelle
I have HO insurance in Florida. I experienced a flood due to a crack in my home’s concrete slab. Since I am new at being a landlord, as soon as my tenant told me about the flood, I had it fixed. I sent out a licensed and insured handyman to fix the crack, and later had a flooring company to repair the flooring. I did not call the insurance carrier prior to having the repairs done, nor did I make the workers take pictures. Like I said, I’m new at this.
So I called my insurer and told them what happened. They wanted to send our an adjuster. But I told them the work was already done, so I wasn’t sure if they needed to send out an adjuster. Next thing I don’t I have my insurer calling me, asking me to fax them my invoices. I did so. Right afterward, they called me to tell me they were going to pay my claim minus my deductible, since it was a “small claim amount”. So they faxed me a “release to sign” that has to be notarized, which basically say that they will pay my claim, but I waive my right to future claims directly related to this claim/incident.
Now, I might just be naive or too skeptical, but I feel this was too easy. I feel that there is an underlying reason they are so quick to pay my claim without ever having seen the property. Are they afraid of something? What do they gain from this? They have more experience than me, and I almost feel they have an feeling there will be more to this ordeal. Why???? Mold claim maybe???
June 6th, 2009 at 11:29 am #nicole
We have a Foremost Policy in Calif. We had lightning hit a tree near our house, which also transferred the energy into the house. We are contemplating putting in a claim, but are trying to assess if it is worth it. We would like an estimate on how much our insurance will go up without the claim free discount. Is there any scenario that can just give us an idea? ie, if our damage is only $5000, our insurance will go up approx $xx this much per year for 5 years?
We are also concerned about putting in a claim because we are in a high fire area and are wondering if they could drop us. Many ins. companies are dropping people like crazy in our area (zip 92382). They are able to do this by stating any brush and trees need to be removed anywhere near the home by so many feet – but most peoples lots aren’t even that large and they can’t cut their neighbors trees. So they are able to do it with their exclusion that they invented after the last round of fires. Fire season is coming and we don’t want to lose our insurance for something like this lightning damage which is something we would struggle with, but could deal with – unlike fire damage or something more extreme.
Another concern: will they cover removal of the tree that has been damaged and weakened from the lightning (it is 10′ away from the house and did not fall on the house)? The tree did transfer the energy to the house through another tree, which then touched the roof and went from there. It is a danger (broken branches are still hung up in the top of it) and could break off at the weakened point.
Just trying to be educated in our decision and appreciate any help and incite. $1000 deductible and losing the discount- is it worth it?
June 6th, 2009 at 9:24 pm #Denise
I had a significant amount of items taken from my auto after our daughter was in an accident in January. Because of the amount of items stolen or missing the insurance company conducted an under oath investigation of me verifying my loss. No problem with that at all I realize that is within their rights. I was just wondering under Pennsylvania law how long can they take to make a decision? Also do I have the right to suggest or force them to investigate others under oath? Thank you for any info..
Regards
June 6th, 2009 at 11:43 pm #admin
Hello Denise,
Most states have laws stating how long the insurer has to accept or deny a claim, usually 30 to 60 days. The problem is that the time can be extended for years if the insurer simply advises the DOI that they are still investigating and suspect fraud. So the law is worthless here. Your only way to fight on that ground is to show “unreasonable delay in investigation”.
I don’t know Pennsylvania law, but you can see the California laws in the Miscellaneous Product section at UClaim.com. Pennsylvania is relatively consumer oriented and likely to be like California on these laws.
You can’t “force” your insurer to take someone else’s EUO or do investigation. But you can suggest, in writing, that they do this or that, and if they fail to do it and it adversely affects your claim, you can sue your insurer for bad faith breach of contract.
June 6th, 2009 at 11:59 pm #admin
Michelle,
Not enough info. to answer. Water source? Dollar amount of damages?
1. Where did the water come from? If from a broken pipe under the slab, then its covered. If from ground water seeping through the cracked slab, its not covered. This is how most policies read.
2. Unless there was a broken pipe, you are lucky your insurer is covering the claim, so sign the “release” and be happy you slipped through the cracks.
3. If there was a broken pipe, don’t sign a “release”. Only sign a Proof of Loss, but safely. How to do it safely is outlined in the Homeowner Loss eBooks at UClaim.com.
June 7th, 2009 at 12:23 am #admin
Nicole,
You will have to ask your agent about what would happen to the premium if you make a claim. We are claim adjusters here and adjusters are not trained in this regard. Get your answer in writing from your agent or Foremost, because I doubt they will “guarantee” what they tell you.
When I worked claims for Farmers (who owns Foremost) in the 1980’s, they would not cancel a policy if you had 1 claim, but they might raise the deductible if you had 2 claims. If you had a third claim, then they would non renew the policy.
They cannot cancel the policy if you have had it for so much time. But they can “non renew” it. So that gives you time to get insurance with another company before Foremost gives you notice of non renewal, 2 weeks before it comes time to renew. So if you do turn in the claim, consider shopping for another insurer in the meantime.
Regarding the tree. Insurers will only pay to remove a tree that has fallen on a building in order to access the repairs. They will only cover fire damage to trees, and even then only to a stated amount, like $500.00 each, up to 5 or 10% of building structure limits. You have to remove the potential hazardous tree, the insurer won’t do that. And furthermore they could use your failure to remove the hazard as reason to deny the claim if it does fall on the house.
June 8th, 2009 at 4:39 pm #Daniel
I got a claim check for hail damage over a year ago and never repaired the car. The check was made out to me and the lien holder. I assume that because the check is more than a year old it is now stale and a new one has to be issued. However, the car was returned to the leasing company about three months ago. Will the insurer issue a new check to just myself?
Thanks
June 8th, 2009 at 7:59 pm #Connie Johnson
Some lady rear ended me last month. I own my car. Insurance adjuster came out inspected the obvious damage and a week later sent me a $500 check. Bent sides, A trunk that wont open, The whole bumper is messed up, and The paint is messed up. An $500 is suppose to cover that? Um nooo, I don’t think so. So I took it to the body shop today and called the adjustor to let him know they are going to “tear the car down”. In a few days the adjustor will come out to inspect and negotiate with my body shop. He is making is sound like, after he inspects the other damage, he won’t right a new check to me, ONLY to the body shop. He is making it sound like I HAVE to get it repaired. What if I don’t want to get it repaired? what if I want the check written to me? It is my money after all! How do I get around this? I have a feeling he is going to be pushy on the issue.
June 10th, 2009 at 2:53 am #admin
Daniel,
You would have been better off to get the car repaired cheap, then the lien holder would have had no choice but to sign the check and return it to you for you to deposit.
Look on the claim check for words that say if it expires in so much time.
Good question about who the insurer will issue the check to, now that you have returned the car, but I suspect that they will issue the check to the lien holder, since you currently have no insurable interest, unless … the lien holder charged you a penalty for the hail damage to the car?
You have nothing to lose by asking the insurer to send you another check. And if it has both names on it, don’t sign it. Mail it to the lien holder to try and get them to sign it and return it to you. And call them first to see if they will do that. And don’t volunteer what the check is for if you don’t have to.
And read your lease agreement provisions regarding loss to the vehicle.
June 10th, 2009 at 3:10 am #admin
Connie,
You may want to get a few estimates, before the car is torn down.
If there is no lien holder on the car, then he has to send you the check, in your name. I doubt that there is any clause in your policy saying the shop gets the payment. But play nice for now and DON’T sign any authoriztion for the shop to start repairs (except teardown). But you will have to pay the shop for their tear down time if you decide to repair it elsewhere or not to do any repairs. If you reveal your intention not to repair, the shop and adjuster may conspire to lowball the estimate.
If the shop and adjuster are “good friends”, they could low ball the estimate, so you don’t take it elsewhere, and then do a “supplement” for more money if the shop does the repairs. So be nice until you have a check or satisfactory estimate in your hand.
June 10th, 2009 at 8:53 am #Tracey
My question is regarding health insurance, I have a claim that was denied stating that a procedure was “investigational”. My doctor did not inform me that the procedure was investigation and would not be covered by my insurance, if he had, I would not have had the procedure done. Shouldn’t the doctor assume the risk on any “investigational” procedures, or at least have the procedure pre-approved by the insurance company?
June 11th, 2009 at 5:33 am #Cinde
I have been in Insurance for 30 yrs and I have been an adjuster/Claims processer, Underwriter and Agent and the bottom line is…they will tell you anything to not cover a claim…The biggest one is “the damage is not bad and under your deductible”…I just had my first claim after being a homeowner for 30 yrs. The first adjuster came when I was out of town and he said my roof did not have much damage and under my $500 ded (surprise)…well I then had him come back out and he admitted it was bad storm damage and for me to get 2 estimates. A week later w/estimates in hand…I called him but he was no longer w/the company and my claim was closed…”how sneaky”…Got new adjuster and my claim now is up to him paying $5200…is that not a big difference…but I still am not accepting that…its a low ball estimate because my 3 estimates were range $5800 to $6600 so where did he get $5200 less my $500 ded he plans on giving me check for $4700. My two friends accepted their adjuster saying under $500 and they are sick now…Please NEVER accept the adjuster’s estimate if you feel you have a true claim…If you have wear and tear and not a direct physical loss from storm like me…thats a different story…wear & tear is not and should not be a covered claim.
June 12th, 2009 at 12:09 am #admin
Hello Tracey,
In my opinion, common sense and decency would say that the doctor should have pre approved the procedure with your insurer, even if you did not ask them to pre approve it. They should know better because they do this every day. While you probably had no choice but to sign a paper that says you will be responsible for the doctors bill if the insurance company denies the claim, I say that a patient should have a “reasonable expectation” that the service provider will pre approve whatever their service is. “Reasonable expectation” is a legal concept that can be used to override an unreasonable or deceptively written contract.
Considering the unfriendly nature of explanations of medical procedures, coverages and billings, policy holders should not have to jump through a thousand time consuming hoops that no reasonable person can understand anyway, and therefore should get the benefit of the doubt if litigation ensues.
We all know that most medical providers grossly over bill for their services and “suck us in”, giving us as little information as possible when we are at our most vulnerable, when we have a health problem. When they engage in negligence and deception for the purpose of sticking you with the bill, they should be fined and have their license to practice revoked. Period! But the system is broken when our legislators are getting “contributions” and free game tickets from the medical lobbyists.
Want a little satisfaction? Go to http://www.RateMDs.com and rip your doctor up so everyone can see who not to go to. Medical providers hate this website, but it gives consumers power that failed government and the media lack.
June 12th, 2009 at 12:21 am #admin
Hello Cinde,
Thanks for your bold comments and please give your comments on any posted questions on this website. And please consider making ratings in the “Consumer’s Ratings” page of this website to help do what government and the media fail to do. You can always give your name as “Anonymous” if you are not comfortable identifying yourself there.
June 12th, 2009 at 7:54 pm #mitch
Bristol West admits their client is at fault and offers me $800 For my old car despite my having over $2000 into it. They call all that engine rebuilding “routine maintenance.” I have proof of the work done. Does anyone know howthey value cars?
June 12th, 2009 at 11:55 pm #jason
ok here it is…..HELP!!! 2 months ago my 2007 toyota highlander was stolen. it was completely a show car. very expensive accessories. i had upgrade coverage put on the car. specifically i had custom rims and tires. i had no receipts but i did have a bill of sale and specifically asked when i insured my vehichle that if anything happened was that good enough. i was told yes. after 2 months of inquires and the standard “the investigation is ongoing” my car was recovered. of course it was in bad shape and whoever took it put some junkyard tires and rims on that didnt even fit.. to top it all off it doesnt start. ive exhausted myself with phone calls and inquires to no avail of a satisfactory answer on whats happening with my claim. im coming up on a third car payment with no car, and recently the car mechanic who is friendly told me that it got it from the insurance guy that they are trying to just throw factory tires and wheels on there. i got 8000 worth of extra coverage not to mention the storage and towing fees i incurred after it was recovered. thinking about getting a lawyer. what are my options????? my insurance is unitrin direct.. ok everybody laugh at once…..HELP
June 14th, 2009 at 2:09 am #admin
Hello Mitch,
Sorry to tell you that in most areas, the value of a vehicle is based on the ACV (Actual Cash Value) or Market Value (what it would sell for), not what you put into it. And the Market is defined by “the average buyer”, not that one in a thousand buyers that matches your likes and dislikes.
Usually putting a new motor that costs $2000.00 in a 20 year old car will not raise the resale value by more than 200 to 300 dollars. That is what a used car dealer will tell you. And that is why used car dealers don’t put new or rebuilt motors in used cars for sale. Don’t put $2,000 into an old car unless you plan keeping it for yourself for a long time. And money spent on maintenance like new brakes or alternator will not raise the market value at all. Valuation guide books like Kelly Book and NADA Book will tell you the same thing.
Now if you want to see if the $800.00 was a lowball appraisal (and it probably is) check out the Total Loss Auto for Insureds on the product page at UClaim.com.
June 14th, 2009 at 2:33 am #admin
Hello Jason,
Ok I’m assuming they are repairing your vehicle instead of totaling it out. If you got special insurance or endorsement for the tires and rims, then they owe you for that, less depreciation. Read your policy and endorsement and see if you can find out who has the burden of proof. I think in your case, the insurer has the burden to disprove you owned those tires and rims, not you giving them the proof. You can check that with a lawyer in your area.
If you got an endorsement for 8k extra, and you have a bill copy, I think that’s proof enough. You can also get affidavits from people who saw the car before it was stolen. Consider small claims court. Note that the insurer owes the used value of the tires and rims, not new value.
June 17th, 2009 at 6:36 am #Mike
Two weeks ago my wife was rear-ended in an auto accident. The other ins co accepted fault. We subrogated for repairs. The car was deemed totaled and settled with our insurance co. As part of the accident, my wife’s shoulder was injuried by the seatbelt restraint due to the impact. She also had some lower back and leg pain. A week later bruises showed on her arms and legs. We sent photos to the insureds ins co. Unfortunately she did not seek medical care. She has had over two weeks of sleepless night because she keep replaying the accident in her mind to the point of hearing the impact of the crash. Because of sleep deprivation, she has missed 20 hours of work (used her paid leave). She also has the fear on being rear-ended again. I was a passenger with her the other day and she ended up going through a red light because of this fear. As a matter of fact, the other ins co has never really contact us to see how thing are. Without medical bills, what recourse do we had? Will we get any settlement from the insureds co.?”
June 17th, 2009 at 8:53 pm #anonymus
Could you please give me your input, I had a claim for flood insurance, we had a bad storm and did bad damage to a rental property, the claim adjuster did a good job, was very professional and sent all the documentation to my ins. co. right away, now my insurance company, all they say when I ask them for an update, when I am going to get the funds, they say: “each claim is different, we got the final report, it is being reviewed, we don’t have a specific date to give you an answer when you will hear from us”, the tenants had to move out, it got 5 to 6 inches of water inside, it’s being two months, I had to pay the mortgage May and June out of my pocket because the tenants had to leave, this affected my bills, I am behind, overdrafted, you name it,
Do you know if the insurance company has to pay me for these 2 months of rent that these tenants could not pay because they had to leave?
I will call my ins. co. tomorrow to ask them, but still I would appreciate your comments.
June 18th, 2009 at 4:19 pm #PJean
Have you ever heard of anyone prevailing in getting reimbursed Public Adjuster fees? We are temporarily living 6 hours from our family home which was being rented out. Tenant burned the house down by leaving a candle unattended. Tenant did not have the $500,000 liability insurance that was required by lease, but that was also not verified by the property management company listed as the “Landlord” on the lease. Such verification was to take place within 7 days of lease signing. Anyhow, we have been told that we will never get the fees refunded b/c we chose to hire a P.A. Is this true? If so, we are out $27000. Yes, we probably got a better settlement by having hired the P.A…just hurts to have the loss. Would suing the tenant get us that fee back (provided they have the cash)? Would a court award us the P.A. fees if we sue the property management company that was negligent in its review of lease requirements? How about out-of-pocket expenses? We have made 5 trips to follow-up on rebuild and such for a total of almost $1500. We anticipate another 5 trips, at least. Anyway to recoup those losses? Our property is in NYS.
Thanks!
June 19th, 2009 at 5:42 am #Mary
My laundry room floor caved in. Farmers sent an agent who said it was due to a leak from the A/C unit which was in the room. I received a check for partial repairs, but when the A/C was removed we discovered the floor was a 3 1/2 inch slab of concrete on a pier foundation in the laundry room (house is 65 years old) As my agent asked me to do I sent him a copy of the new proposal as the cost increased for the repairs due to the concrete and the size of the area to be fixed. No word…call…no word..call… agent on vacaton for 2 weeks. Meanwhile we have no A/C and in south Louisiana it is in the 90’s, the room is half way torn down, and the floor is tilting more each day. I called Farmers who sent another agent and he was a total jerk with an attitude. Told me if they had seen it I wouldn’t have gotten anything due to decay, and that I was lucky to have gotten what I did. In my policy under the collaspe cause it mentions hidden decay, water damage, weight of object. Now they say there was a change in the policy that I should have recieved due to some H114 endorsement which will not cover repairs for any decay no matter what the cause, and are refusing to cover the additional 5000.00 to fix it. What recourse do I have? It seems to me that since collaspe is a covered loss, that maybe the cost to repair the A/C that cause the damage would not be covered, but the damage to the floor should be. Should I file a complaint with the insurance commissioners office, or is the insurance company right?
June 19th, 2009 at 11:09 am #KC
I had a house fire almost four months ago. I met with state farm a week after the five and answered a lot of questions. I then received a letter from a law firm asking me to provide a great deal of information such as bank statements and tax records to them on the insurance companies behalf. I had to meet with them in person and under oath answer more questions. My lawyer told me to provide everything that was asked for. I know that this is normal in a case with a suspicious fire. However I do not understand why they never verified any where I was yet have questioned me about it several times. I know from the insurance investigator that me and my exhusband are suspects he told me that himself yet is this a normal tactic. I do not know what to expect next. Are they trying to find a loop whole in the contract and why so long. The house is now in foreclosure yet they still have not made a decision one way or another. I could use any advice that lets me know what they are doing or is going to happen?
June 20th, 2009 at 1:17 am #admin
Hello Mike,
We are not experts on auto injury claims here. Consider the eBook on claims like this at http://www.autoaccidentclaims.com .
That being said, if the other drivers insurer is ignoring you, then its time to get a lawyer (on contingency fee) or file suit against the other driver and car owner. Pay attention the the “statute of limitations” in your state to file suit. It is often only 12 months from the accident date.
If you have no medical bills as proof of your wife’s new injuries, get some pictures. In fact get pictures anyway. A good accident lawyer will send you to doctors he works with.
To insure you got a fair settlement for your totaled car, consider the product entitled “Total Loss Auto for Claimants” at UClaim.com.
June 20th, 2009 at 1:35 am #admin
Anonymous,
Questions like this should be posted on the Home Insurance Claims page.
Most rental policies cover loss of rents if your claim is covered. It pays for the time to do the repairs as well as the time it takes to reach an agreed cost on the repairs. So if your insurer wants to delay their investigation and drag their feet, then they owe you for that time (as long as they don’t deny the underlying flood claim). Read your policy or get a copy at UClaim.com.
If your insurer is dragging its feet, you need to start building your own file. Your word against the adjusters word will be of no help 6 months later when you discover that some adjusters tell lies and mislead. You should consider the eBook entitled “LANDLORD RENTAL PROPERTY INSURANCE CLAIM ADVICE AND HELP, HOW TO PLAY THE GAME – DELUXE VERSION” at UClaim.com. Read it’s table of contents.
June 20th, 2009 at 1:54 am #admin
Hello PJean,
I think you may have a chance of getting the PA fees in a liability claim against the property manager, but not from your own insurer. You have nothing to lose by including the PA fees in the claim (and litigation if it goes that far). I don’t personally know of any case law on that, but your attorney could check that. Most PAs would not know, since they only handle 1st party claims.
And yes, include all your expenses. You are not limited by any policy provisions in a “3rd party liability claim”, as you would be in a claim against your own insurer.
I have no idea what a court would award. Judges and jurys are unpredictable. It sounds like you need to hunt for an attorney to take your case on contingency. That can be a chore.
June 20th, 2009 at 2:13 am #admin
Hello Mary,
When you said the AC was leaking, I thought you were going to say the claim was denied. But you said they covered it. The policy covers “sudden and accidental” not long term damage over time. And policies cover collapse, but there are more limitations and endorsements being attached to that kind of claim every day. The policy and endorsements that apply are the ones in effect on the date of loss, not after the DOL.
Without arguing over that issue, your best argument is that Farmers waived their right to deny any supplemental claim since they already decided to cover the claim and issued payment and told you to proceed with repairs. You relied on their actions and instructions. In insurance law this is called “estoppel”. An insurer can’t take back what it already paid, even if in error. And an insurer can “change its mind” after it already said it would take a course of action. I assume you have documents to prove that the insurer initially covered your claim, for example a check, cover letter, adjusters estimate, etc.
Yes, make a commissioner complaint
June 20th, 2009 at 2:34 am #admin
Hello KC,
Go to the UClaim.com Products page under Miscellaneous and consider the eBooks entitled “DENIED HOME AND BUSINESS INSURANCE CLAIM ADVICE AND HELP” and “EXAMINATION UNDER OATH (EUO) INSURANCE CLAIM ADVICE AND HELP”. If things get dirty, you may also consider the eBook “INSURANCE CLAIM PRACTICES LAWS WITH UCLAIM COMMENTARY, ADVICE AND HELP”.
Note, most attorneys know nothing about the differences between an EUO and a deposition. Most will handle your EUO as if it were a deposition. But even so, an attorney with you during EUO is far better than none at all. And the insurer can recall you for more EUO’s. So don’t assume its all over with.
If after all this “stuff” they put you through they put in writing that they will cover your claim, then you will need the eBook “HOMEOWNERS INSURANCE CLAIM ADVICE AND HELP – ALL ASPECTS (deluxe)”.
If they deny your claim, you need to have an attorney and or good public adjuster take a look at your claim. In fact it’s a good idea to get them working for you now. The UClaim eBooks will also show you what your PA and or attorney should be doing. You can also get advice on hiring a PA on the Free Stuff page at UClaim.com.
Good luck.
June 21st, 2009 at 10:05 am #PJean
Thanks for all the advice. To clarify, would we ask the property management company who insures them, and then contact their insurance company to file a third party claim? We are confused right now, since our insurance company (and the liable tenant’s insurance company–one in the same) wants us to sign a joint prosecution agreeement for the subrogation. They have said that there are anti-subrogation rules in NYS that preclude them from doing this, but no one has caught on yet, so they hope to prevail. We are afraid to do that, since we will only get pro-rata after the atty’s fees are paid, which at best would be $5000, when we are out of pocket close to $40,000 including the PA fees. If we go that route, we will surely get something, but if we file a third party claim with the property management insurance company, we may get denied. We are not gambling folks…we want to minimize our risk due to all we have been through thus far and for our childrens’ sakes. We are unsure how misleading our insurance company is being by saying the more they get for us, the less loss is showing for our policy and therefore, the less affect it will have on our future premiums. In other words, if we help them, it will help us. They have all the info they need to go ahead and subrogate on their own, while we take our own route. Note: the property management company, as “Landlord” failed to make sure the tenant secured the $500,000 liability insurance required by the lease. The $300,000 they did acquire will be exhausted by neighbors’ damage and the cost paid to us already. We are left with uninsured loss of $7500, personal out-of-pocket travel expenses…($1200 so far with anticipated $1200 more) and the PA fees of $28,000. We are afraid to file the third party on our own, get denied and then have to sue with the risk that the lawsuit could cost more than we could potentially recoup. Does any of this make sense? And we had to pay the deductible since the tenant’s policy limits were exhausted. We are living in another country, and had to retain the PA services, since the property management company could not answer any of our questions immediately after the loss. We had no other choice. We could not be present for the insurance process, claim, etc… due to our residence abroad. Many have said it was our choice to hire the PA, while we see it as having had no legitimate choice based upon the circumstances.
Confused, angry, frustrated and ready to be done with all of this…
Thanks for your site…and all of the great advice thus far.
June 22nd, 2009 at 8:59 am #Corey
Hi,
I relocated to the DC area from the SouthWest. I hired a moving company to move my things. The truck carrying my things got in an accident. Much of my major furniture was damaged and/or demolished.
The moving companies insurance company (Progressive) contacted me to begin the claims process. I am in the process of filling out their form. The form asks for items damaged, date of purchase, amount paid, etc…
My questions are:
1. for items that I don’t have a receipt for, how do I go about putting a price on them?
2. Because my furniture is demolished, I’ve needed to store it elsewhere. I had to rent a truck to move the furniture. Can I include the cost of the truck rental in my claim?
3. One of the pieces of furniture that was damaged was a living room couch. I’ve already purchased a new couch so that I have something to sit on in my living room. How (if at all) will that affect my claim?
4. One of the items that was demolished was a high end bedroom dresser that was part of a set (bedframe and dresser). The set is no longer available, so to make my furniture match, I’d need to buy a new bedframe/dresser combination. Can I add the cost of a new bedframe to my claim?
5. any other words of advice?
Thanks in advance for any input.
June 23rd, 2009 at 4:16 am #admin
For PJean,
If someone else out there wants to take the torch and give PJean some advice, please jump in.
If no one jumps in here, PJean, you probably need to consult with an attorney and or a good PA in your area. Our admin time on this website is really intended for short questions and answers since it is all volunteer time. Thanks for your nice compliments.
June 23rd, 2009 at 4:30 am #admin
Hello Corey,
I could write an book on this, but it’s already been done. The eBook entitled “CONTENTS INVENTORY LIST INSURANCE CLAIM ADVICE AND HELP
Subtitle: How to Maximize Your Contents Claim Settlement” at UClaim.com will answer most of your questions in great detail and provide sample inventories. And it has a money back guarantee.
While the EBook was intended for claimants making claims against their own insurer with a policy contract, most of the information and techniques in there will also apply to you as a 3rd party (if they consider this as a liability claim which is governed by the law in the absence of a policy contract). If they treat you as “an insured” and start quoting policy language, for example a “pairs and sets” limitation clause, then be sure to insist on a complete copy of the policy. Whatever denial they make, insist that they put it in writing and that they quote the policy wording or the law that they rely on.
June 23rd, 2009 at 11:51 am #G Willmann
Hello,
Any help/advice appreciated.
I rented a truck from Penske with the cargo insurance. In the truck was my motorcycle which was attached to the cargo “ribs” in the truck via very secure ties. (Drove from VA to RI). When I opened the back the “ribs” were broken and the bike was down with a very dented gas tank. After going through Penske I was eventually sent to Zurich (Empire Fire and Marine) who told me this wasn’t covered for 2 reasons:
1) Section A. Coverage – “We will pay for all direct and accidental loss or damage if caused by cyclone, ….upset or overturn of “truck”". I told them the truck was upset and resulted in the damage, they say NO.
2) Section E: Exclusions – We will not pay for damage sustained by 4-wheel, licensed vehicles to include motor vehicles, motorcycles…
– My issue here is that the contract says “Damage done by”, in my case it was damage done to…my motorcycle. They told me I didn’t know legal definition of “to” and “by”. My response was “If a crime is done BY domeone they are a criminal, if it is done TO someone they are a victim”. Am I wrong? Any advice is appreciated as I feel I am getting the once over. Thanks in advance.
June 23rd, 2009 at 1:43 pm #Michelle Moore
In 2004 rear ended at stop sign, the police office at scene and in the E.R advised the other driver was insured and presented a valid insurance card.
Attempted to file claim the next day and was required to leave VM in the claims office and my call would be return asap. After several days I recieved a call advising this claim is being reviewed for validity and I would be informed of the decision asap. Concerned and hurt I retained attorney, formal request for coverage status was sent by attorney and the reply was uninsured. Attorney persued UIM claim with my auto insurance. Several issues surrounding the at fault drive did not add up, when my concerns were ignored by attorney, I personally requested a formal investigation by the Colorado Division of Insurance to insure the denied claim was valid. Early in 2007 the denial was reversed and the UIM claim was dropped and case was sent to drivers insurance and settlement for personal injury awarded.
The question concerns “consortium”. My UIM policy allows for “bodily injury” only so “consortium” was not allowed. When the liability changed my right under “consortium” was valid? Yes. If so how do you calculate the time limit for filing claim – the accident was 2004 but reveral of claim was 2007.
thanks
Michelle
June 25th, 2009 at 10:25 am #james b
We had a house fire Christmas eve 2008 and luckily we we at church.
The fire started in the basement and was contained there except for all of the smoke damage throughout the entire house. I will spare you with some of the details and get rigt to the point. Our insurance company has paid us for
the dryer ( the fire source) washer, and water heater . The heater is what I have been denied on. Our heater stopped working when the water heater did
and they paid for that and the heater is next to the dryer.
Is it worth pursuing?
June 26th, 2009 at 1:08 am #admin
Hello G,
1. Find out the definition of “upset”. If it is not defined in the “Definitions” part of the policy, then look in a Websters Dictionary, and look in a Blacks Law Dictionary (at your local county free law library, usually at the court house). Look for the legal definition before the common man definition, because that will carry more weight with a small claims court judge. If you want to see how court cases define “upset” either get the law librarian to help you search, or go to Findlaw.com “professional section” and search for case law in your state first. If none, check other states. To learn how to research the law for insurance claims consider the UClaim.com product entitled “INSURANCE CLAIM PRACTICES LAWS WITH UCLAIM COMMENTARY, ADVICE AND HELP Subtitle: Save HOURS of Research Time”. View the table of contents.
2. Your thinking about “damage to” and “damage by” is logical and reasonable. Theirs is what I call “brainwash brainlock” or intentional stonewalling (gambling you won’t sue them). In either case you will get nowhere with the individual who denied the claim. Advance to the supervisor, if no luck advance straight to the CEO. If no luck, then small claims court. You can learn the techniques in detail in the “standard” versions of UClaim home and auto eBooks.
(And we can thank George Bush and his supreme court for effectively getting rid of punitive damages against insurance companies.)
June 26th, 2009 at 1:23 am #admin
Hello Michelle,
1. If you are talking about time to file a claim:
Look at the policy requirement. If it says report the claim as soon as reasonable or possible, then you have already done that long ago.
2. If you are talking about time limit to file suit:
Most states have “statutes” defining the time to file suit, eg. 1 year for injury, 3 years for property damage. However these limits are extended usually by case law in your state which will say something like “1 year from the date of loss, where “date of loss” is not the date of the accident, but the date from which your claim was finally approved or denied. There is “no loss” until the insurer refuses or accepts liability.
You better find out the statute of limitations on bodily injury ASAP. Call your local small claims court for a quick free answer. California just raised theirs from 1 year to 2 years.
June 26th, 2009 at 1:33 am #admin
Hello James,
1. Most policies are “All risk” on structure, stating “we cover all perils except …”. This means the insurer has the burden to disprove your claim. So let “them” hire the engineer to find out why your heater failed. And they are supposed to give you a copy of the report. And the heater is part of the structure, not “contents”, like the washer and dryer.
2. Get a written statement from an HVAC person that the heater could have been damaged from the heat and or smoke.
3. If the insurer still denies it, go to small claims court for around $25.00 and no attorneys allowed in.
June 29th, 2009 at 6:07 am #kris
Hi All,
I my jeep had an engine failure, the shop i had it inspect did not want to touch it and informed me to take it to the dealer incase there was a warrantee that exist for 2002 jeep liberty. I took it to the dealer and only way to find the proble was disassemble the engine which cost me 600 bucks. I the engien was completely destroyed due to coolant fluids was getting inside the engine. All in all my jeep is dead and i’m in need of another transportation. I call an insurance agent told my situation and asked for MBI (mechanial breakdown) claim, which i was denied due to i do not have collision insurance. I was told to get back with the dealer and perform a “f14 function” chrysler extended “Home for the holiday” warrantee, that was effective back in 2001 – 2002. Dealer mechanic had informed me that he had run my jeep’s vin# and had performed F14 function. The jeep was not covered due to first owner was a company, not a private owner. I did my reseach on chrysler’s extended warrantee where, it stated first buyer gets 100k miles 7yrs extended warr.
Q. how could i definitely be sure that my jeep is really not covered for such extended warr.?
Q. I wasn’t any collision, its a complete engine break down, is there any claim i can make for these type of loss?
June 29th, 2009 at 8:11 pm #Jack
I have a question. I was driving to get something to eat and a car came in to my lane to avoid something in their lane or because they were not focusing. I don’t know. It caused me to go on the side walk and damage my under carriage. I did not realize anything was wrong. As I gathered my senses and started to drive the oil light came on. I turned the car around to start to head back home. It was in the middle of the night in a not so populated part of town. As I started to head back the car lost power and I was able to park it off the street. Will the insurance company pay to have the engine replaced? My friend told me the engine was locked. Will they replace with a used engine or will they just try and total the car out. The KB value is about $2800. Car has just about that much left to pay off.
Thanks,
Seriously Sad!
June 30th, 2009 at 8:36 am #Ella
What if I wish to file a claim but have surpassed the time for presenting a claim ?
June 30th, 2009 at 11:41 am #Scott Reich
I have home owners insurance with two questions.
1-I have a patio door that had leaked about a year ago, fixed the leak with minimal damage to the carpet and subflooring, recently began leaking again ad carpet has started to mold and leak still countinuing. Is this a valid claim.
2-Believe televison was hit by lighting during a storm was a pop and burning smell. Would this be covered and how would Iprove that was the case?
July 1st, 2009 at 11:28 pm #admin
Hello Kris,
I’m no expert on warranties, but I would say start with reading a copy of the warranty.
July 1st, 2009 at 11:49 pm #admin
Hello Jack,
Turn it in and see what they say. Most auto policies have “collision” coverage and “other than collision” coverage (which is called Comprehensive). A low quality insurer may say that YOU caused the engine to lock or seize by driving with low oil pressure. A good company might say it was a consequential loss to the collision and cover it under collision. I don’t think any insurer would cover it under comprehensive coverage.
If they cover it, they will either pay the full cost for a used motor or rebuilt motor, or pay for a new motor less depreciation. If they total the car out, make sure you get a fair settlement with one of the auto total loss eBooks at UClaim.com. It will also tell you how to keep the salvage without getting short changed.
July 2nd, 2009 at 12:15 am #admin
Ella,
Assuming you are talking about making an insurance claim, most policies say you should report the claim as soon as possible. Some say as soon as “reasonably” possible. If there is no time limit stated, then I think the law or a judge would insert the word “reasonably”.
If you are talking about filing a lawsuit, then the statutes of limitations for filing different kinds of complaints, like for injury and property damage, will have different time periods.
If they deny your claim, get it in writing with the specific reasons stated, and go from there.
July 2nd, 2009 at 12:42 am #admin
Scott,
1. If the water is from a broken pipe or plumbing fixture, then it should be covered. But if it is from rain or flood or sprinkler water, that’s called “surface water” and excluded in most policies.
2. Most policies cover electrical surge, but not to appliances (so what good is it right?). And lightening damage is covered, but I suspect the adjuster will say it must be a “direct hit”.
Ask an electrician to read that part of your policy to see if he can come up with a creative explanation for the lightening damage that is not electrical surge.
July 6th, 2009 at 10:12 pm #Susan
I have a serious situation. My 16 year old daughter took my brand new car without permission and proceded to wrap it around a light pole totaling the vehical. AAA is saying that because she was excluded from my policy the car is not covered, but because she took it without permission I feel it should be, do I have any recourse?
July 7th, 2009 at 2:01 am #Mary
Our home was a complete loss on October 27, 2008. We were out of town, thankfully. Our insurance company, State Farm, had an engineer sent out to determine cause of fire and we were informed that he could not determine the cause because there was not enough left of the home. We rec’d a couple small checks early on for neccessaties but that has been all. We hired a PA early on and we also have an attorney (due to issues with the structure claim….our mortgage company foreclosed on house 6 weeks after fire and sold it for amount owed. When SF cut the structure check to us and mortgage co., the mortgage co said we did not owe them anything so SF did stop pay on check and are now saying they just don’t know who to pay for that portion of the claim.) My question is more on content portion. We did the EUO, content lists, and every other thing asked of us. The ins. company attorney stated he could see no grounds for not paying the claim but all we get from insurance co. is “we are still investigating”. What could they possibly still be investigating? We are getting close to being 3 months shy of 1 year and they have not denied but they are not letting us know anything either. Is there anything we can do to light a fire and get them to do something? anything? this life of limbo is getting to be almost too much to bear.
Thank you for any advice
July 7th, 2009 at 1:51 pm #Archana
Hello
any help is appreciated.
2 weeks back my retaining wall (which retains my pool) collapsed. On the day of and the previous day there was severe rain and hail. The Insurance company(Nationwide – which is NOT on my side!) sent in a structural Enggineer to check it out and ultimately today I received a letter of denial. The reason being, no earth movement, faulty construction, etc is covered. The retaining wall has taken down a whole chunk of the fence, concrete patio, landscaping, irrigation system and landed on my basket ball court. The engineers report also mentions that it is not clear whether there was a leak in the irrigation system that might have caused it.(in which case, I think, the insurance should cover the peril). Since they are not sure of the reason, shouldn’t I reply back with the above said points and ask them to reconsider. Please let me know what you think. Thanks for your time.
July 8th, 2009 at 3:15 am #admin
Hello Susan,
We are not experts on auto coverage, just total auto loss valuations.
Turn in the claim and insist that they put their denial in writing. It must state specifically where your claim is excluded in the policy or the law. If the policy or endorsement says “excluded” but does not specify “with or without” your permission, then you may have a claim. If they persist in the denial, check with an accident lawyer. There may be statute or case law on this issue in your state.
Consider turning it in as a theft claim under comprehensive coverage? If the insurer insists on a police report, ask the police if you can report your daughter as the thief (for insurance claim purposes), then later drop charges after the claim is paid? And it may be good for your daughter to get arrested and spend a night in jail if she does not want to buy you a new car.
Now if the car was brand new and you had a loan on it, then the insurer would probably have to pay the lender’s interest. Just an idea.
July 8th, 2009 at 3:35 am #admin
Well Mary, on the structure part, State Farm should issue the check in both your’s and the mortgagee’s name. You send the check to the mortgagee (without your signature), the mortgagee signs off and mails it back to you. Any competent public adjuster or attorney should be able to handle that for you, unless there is more to the story here. State Farm’s excuse is no good.
I think the mortgagee may have screwed up by foreclosing too soon not allowing you to claim full RCV benefits, if SF only paid the ACV (depreciated cost). But then, State Farm is the only company I know of that normally pays full RCV up front without requiring replacement.
Regarding the contents, if they put you through an EUO, and all is as you said, you have too many issues to address in a paragraph or two here. I suggest you consider one or more of the eBooks (currently on sale) at UClaim.com and learn how a competent public adjuster plays the game. They will also help you find out if your PA and lawyer are doing their job or just looking for an easy buck.
July 8th, 2009 at 3:53 am #admin
Hello Archana,
Yes of course reply, and put it in writing. You have to build your own file so if you have to sue, you have good evidence, not just your word against theirs.
Get your own expert to state the cause in writing. Start with a plumber, or pool tech and if you can afford it, get your own engineer. Sadly, many experts will conclude whatever you want them to and make the facts fit their conclusion.
Your policy probably says “we cover everything except …” on structure items. That means the burden of proof is on the insurer. So if their engineer can’t rule out a plumbing leak, then the insurer has to pay you. Consider one or more of the products (currently on sale) at UClaim.com to teach you how handle this situation.
Is your insurer really Nationwide or “Allied in disguise”. Nationwide is normally generous. They bought Allied, a low quality insurer, for their claims infrastructure (see Recommended Insurers link on this website).
July 8th, 2009 at 4:50 am #Archana
Thanks. I I have sent a letter to the insurance. We’ll wait and see what they have to say about the claim. will keep you posted. Thank you.
July 8th, 2009 at 6:06 am #f. michael conte,CPIA
Got to say it “like a good neighbor” guess who’s not there…….
This story make my blood pressure go to 1000. I would consider filing a complaint with the Ins Dept of your state, Insurance carrier’s pay attention to these complaints you might include thm names of the comapny reps you have been talking to, i promise they will make this get resolved quicker than you can imagine. In my mind this has been mishandle from day one. This claim should have been closed about 7 months ago. Has your agent offered help? He is your first advocate in matter like this.
fmc
July 11th, 2009 at 1:51 am #Mary
I’m not sure what agent you are asking about? If you are talking about our insurance agent….then the answer is a BIG NO. We cannot get any one at state farm to even return a call. We sent a letter to them via fax on the 8th stating we expected payment immediately, and just today, we rec’d one back from the attorney for state farm stating it was “still under investigation” and we would be notified when a decision has been made. (whatever that may mean). They also informed us in this letter that no more payments of any kind will be made until a decision has been decided upon. The ONLY payments they have been making are our additional living expenses for the home we rent and the furniture we are using. Are they honestly trying to inform us they are not paying these anymore? What grounds would they have to stop paying additional living expenses when they have not settled nor denied the claim? I am so stressed at this point, I just want to sit in the floor and cry…(but I guess that is exactly what they are hoping to cause.) Is there anything else I can do besides filing a complaint with the ins dept? We live in TN & I’m not sure how that works. Thank you so much for your help.
July 11th, 2009 at 11:02 pm #admin
Mary,
I think Michael was referring to your sales agent.
The good news is that at least SF is paying your additional living expense while they “consider/investigate”. Some insurers would resist doing that.
If you have a competent PA, you should be getting answers to all your questions.
July 14th, 2009 at 1:38 pm #pat
My daughters house was damaged by a neighbors fire. My daughter filed a claim with her insurance company and they told her that she would have to pay the $1000 deductible. The insurance company told her that they would not subbrogate against the neighbors insurance because the cause of fire was ruled an accident. This does not seem fair. Why should my daughter be out money because of a neighbors accidental fire.
July 15th, 2009 at 12:10 am #admin
Hello Pat,
Your insurer could only subrogate against the neighbor if there were “negligence” by the neighbor. Negligence is the requirement in most states for “legal liability” (something you can sue for).
But here is a possible tidbit for you. Ask the neighbor if she would mind asking her homeowners insurance company to pay your daughter under “fire non legal liability” coverage. Most homeowners policies pay a small amount $500 or $1,000 under the liability part of the policy for “non legal liability” for fire damages to neighbors, such as in your daughter’s case. But note, the neighbor does not “have to” turn it in. He or she, the neighbor, should confirm with their agent that it will not increase her premiums.
July 15th, 2009 at 5:44 am #Roger
How exactly is general contractor overhead and profit values calculated into limits-of-liability/homeowners insurance premiums?
July 15th, 2009 at 9:53 pm #Rita
We have a 2009 GMC Sierra Crew Cab with 8,000 miles that was hit on the passager side, at first the damage looked cosmetic. But once we had it towed to a AAA certified body shop, we were advised the frame was bent(front end). The body shop manager and AAA adjuster say the vehicle can be fixed by cutting the front end and welding back…we have refused their fix and now we are being told they will replace the entire frame.
The AAA Adjuster will not total it because it only has 8,000 miles and the cost to repair is less than the value per KB.
Do we have to accept their solution in replacing the entire frame? Wouldn’t this fix have to be disclosed should we trade in?
Will replacing the entire frame reduce the value?
July 16th, 2009 at 9:15 pm #admin
Hello Roger,
As a claim adjuster, I have no idea. This would be a better question for an sales agent or an underwriter. However I can tell you that claim adjusters usually estimate 20% for contractors P&O when they are writing a repair estimate on a homeowners insurance claim. Hope that helps a little.
July 16th, 2009 at 9:42 pm #admin
Hello Rita,
First of all, you are right that the market value of the vehicle would be diminished, perhaps 10%, if you disclosed to a buyer these repairs. Check to see if that is required in your state. Getting compensation for that from an insurance company is not likely, in my opinion. But try anyway since you seem to be a good negotiator.
You should be happy that you got them to replace the entire frame. I have never seen an insurer agree to replace an entire frame when they could weld on a new piece. In fact frames are often straightened and the wrinkly part is often covered up with trim parts so the owner never sees it.
Keep up the good work.
July 22nd, 2009 at 6:59 am #Bill Green
My wife and I purchased our home in July 2006. Our home was destroyed by fire as a result of Hurricane Ike on Sept 14, 2008. We were not at home at the time to save anything. Our home and contents was a total loss. Scott county was declared a federal disaster area. Ten months later we are still living in our RV. Is it ethical and legal for Cincinnati Insurance to file two claims for the same occurrence then cancel or “not renew” my policy, preventing me from acquiring insurance, making it impossible for me to rebuild my home at replacement cost and forcing me to take their “fair market value”?
July 22nd, 2009 at 4:00 pm #Rick
Hi, don’t know if anyone can help or if this is the right place…but to make a long story short…. I hit an uninsured motorist(his fault)… He had just purchased a used vehicle from a dealer, is it possible to sue the dealer for not “Verifying” proof of insurance on that vehicle??? Thanks Rick
July 22nd, 2009 at 5:42 pm #admin
Hello Bill,
If the fire is directly connected to the hurricane, for example the wind blew a tree into a transformer that fell on your house and fire ensued, then that should be one loss and one deductible. Or if the wind knocked a tree into the house smashing the roof and cutting wires that later shorted and fire started, I would call that one loss, one chain of events.
In most states, insurers need no reason to “non renew”. But they can cancel midterm for example due to fraud or change in risk of loss.
I personally advise my clients to start looking for insurance after a major loss since its easier to get insurance while you have insurance than after cancellation. Insurers often cancel policies after major losses. And its not too ethical, IMO, for an insurer to only give 15 or 30 days notice of non renewal.
If your house was a total loss and you are handling this on your own, consider the eBook on that at UClaim.com, currently 75% off on sale and guaranteed!
July 22nd, 2009 at 6:14 pm #F MICHAEL CONTE
HEY BILL,
DID YOU HAVE A REPLACEMENT COST POLICY, WAS THE LIMIT ADEQUATE TO REBUILD, DID THEY PAY THE POLICY FACE AMOUNT?
THE ONE CALIM TWO CLAIM ISSUES SEEMS IMMATERIAL, THE CANCELLATION PART, IS TO BE EXPECTED. HAVE TO ASK WHAT DOES YOUR AGENT OR BROKER SAY ABOUT ALL THIS?
MIKE
July 23rd, 2009 at 1:05 pm #michael
I just received my check and my property damage estimate for a claim that I filed about 3 yrs ago. My house was burglarized and a great deal of tools and electronics were stolen. The total value they came up with was a couple thousand off and I intend to fight that. My question is on recoverable depreciation. Is there any way to fight this since this over 34% of my claim. I have replaced some of the stuff in the last 3 years but was only recently told of this and have not really kept my receipts? Or would it be possible to move or combine the depreciation on tools onto only select tools? Any help on this would be great. A lot of the stuff I had, I rarely used and do not necessarily need it all now that my life has changed some and I would like to get back most of the money I had to pay out on this. Also, would it be wrong to buy something and then return it for the receipt? An example would be movies, I lost a lot in movies and they are giving me only about %25 for the dvd’s I owned. i know do netflix, so I do not buy them anymore. Thank you for your help.
Michael
July 23rd, 2009 at 8:58 pm #Bill Green
The high winds blew trees down on the power lines. Before power was fully restored, it reportedly came on and went back off several times. The fire marshalls suggested that this may have caused an electrical item in the home to overheat and eventually catch on fire. After posting this complaint, I was contacted yesterday by the Indiana Department of Insurance and informed that they were investigating why there were two claims filed.The independent adjuster has not made us an offer for the contents loss, but wants us to say what we are willing to accept, so that they can come back with a lower offer, i’m sure. Our last meeting with he and our attourney seemed more like a mediation, because he wanted us in a different room.
July 24th, 2009 at 8:55 pm #Melissa
My niece had an accident involving her car and a tree. Anyway, when they reported it to the insurance company they were told that she had not been added to the policy. My sister and brother-in-law spoke with the agent to add the car and my niece to the policy over a year ago. They were even advised by the agent to list the teen as the primary drive of another vehicle in the household to get a better rate. Anyway, it seems that the agent dropped the ball and didn’t notify the company to add the driver but did add the car. If the claim is denied is there a course of action for my sister to take.
July 24th, 2009 at 11:45 pm #admin
Bill,
I would say Indiana could save some tax dollars by trimming their Department of Insurance if they are wasting time on simple stuff like this. Glad to hear you have a lawyer helping you. I hope he is doing good for you.
July 25th, 2009 at 12:04 am #admin
Michael,
1. I don’t know of any of any policy clause that says you cannot return an item you purchased.
2. Since they did not tell you about supplying receipts to prove replacement, let them physically inspect the replaced items, and let them track down the receipts from vendors if they want receipts.
3. For items not replaced, you can negotiate that 34% depreciation.
Detailed information on how to properly do all this is included in one of the eBooks on Homeowner’s losses at UClaim.com.
July 25th, 2009 at 12:17 am #admin
Melissa,
If the agent denies he was asked to add the daughter, try to find some proof that the newly added car was used mostly by the daughter. This would be circumstantial evidence that a car was added for the daughter and the agent was probably aware of it and either forgot or doesn’t want to look bad to his company.
If the insurer still denies the claim, sue the agent and the insurer.
And I guess now everyone knows from your sisters experience to look at their declarations page (with the bill) to see who is a named insured.
July 26th, 2009 at 9:18 am #Bill Green
On the contrary, we don’t believe our lawyer is very skilled in this area, and it’s too late to hire a new one. That’s why i’m posting here, trying to get some straight answers. She had to call up the isn agent to ask what A.C.V and R.C. meant? If we have replacement insurance and the dollar figure on the declarations page for contents is $216,000, is that the maximum that they will pay even if the cost of replacing the contents excedes that? Also, if the dollar figure on the declarations page for structure is $288,000, the builders bid to replace the home is $316,000 and the insurance co’s estimated “fair market value” is $164,000, what is the maximum amount they have to pay to rebuild.
Also, can you give me an example for normal depriciation of contents of different ages and types.
Thanks
Bill
July 26th, 2009 at 9:24 am #Bill Green
Hello Michael
Thanks for your curteous response.
Yes, we have carried replacement insurance with them for 18 years.
They are not wanting to pay us the face amount of $288,000, they want to pay us their “estimated fair market value” of $164,000.
Thanks
July 26th, 2009 at 9:28 am #Bill Green
Is their a difference between a policy limit and a policy face amount? If so, where can i find these figures?
Thanks
July 26th, 2009 at 6:55 pm #F MICHAEL CONTE
please bill green, tell me who this inusrer is? are you saying that they are telling you they can pay the fair market value regardless of the rebuilding cost? if that is so it must be said in you contract. there must be an endorsement that gives them the right to do so. if that is the road they choose then i think it would be fair for you to ask for your premium back that was paid over the years for the replacement cost option. also did you use and agent or broker? if so have they excersised any influence here?
i understand the state ins dept is now involved, put all these issues on the table and use the term”unfair claim practices” thats a buzz world that everybody is afarid of. do you have the policy and did you give it to your attorney? the question she had would have been explained in that document ask her if she read it, it is afterall a legal contract. finally here in NY we have a tv guy that does an spot called “shame on you” maybe you have a similar tv guy out there if so get him on the phone this sounds like a story for the six o’clock news. it is not supposed to be like this, unfortunatly my peers forget that we are in a business to help people when they need us most. good luck!
July 29th, 2009 at 6:31 am #State Risk Manager
A covered building experience a theft loss of several items one of which is a set of keys that fit 13 locks. The keys of course are covered subject to the deductible but would the cost of re-keying the locks be covered under a standard ISO commercial property form?
July 30th, 2009 at 5:09 pm #admin
Hello State Risk,
Great question! Just my opinion, at first thought I would have to say no, since the policy is basically a “property” policy. Unless there are “additional coverages” or “extensions of coverage” type clauses in the policy, or endorsements adding re-keying, I would again say no.
However I suppose an argument could be made that if the locks came with keys, the locks are now not working because part of “the assembly” or “package” was stolen and so the insured would be entitled to completely new locks with keys and the insurer would get the salvage? So perhaps the insurer would be wise to pay for the coding ($20-$30 per lock normally, but perhaps a discount could be given by the lock smith for 13 locks?) instead of replacing the locks and keys.
The only reason insurers cover re-coding door locks in automobile policies is because the entire lock is being replaced on one door, for example, and the vehicle owner should have a reasonable expectation that all the door locks should match without having two sets of keys.
August 1st, 2009 at 7:00 am #Honest Guy
My roommate called me while I was in school and told me he just got home and noticed the apt was broken into.I left school came home and called the cops and filed a claim.Allstate took 5 months to investigate my claim,including giving me a EUO with their big Attorney ,Looking at my bank statements for the last two years,incomtax records for the last two years,cell phone records,Renters history of 5 years,credit reports,loan history,school grades and attendance,and everything inbetween.After five months of finding nothing to discredit me….they still deny my claim stating….1.On the police report the officer said”The porch balcony door had pry marks on the outside but appaired to be in random places” and “the door jam was broken outward apairing as if it was kicked outward.”…2.My policy canceled in January and was reinstated less than 48 hours before the burgulary..3.Most of the items that were stolen from apt were bought with cash from local sellers on craigslist.org and I have no receipts so they say I didnt prove I owned the items(even though I have a video tape inventory of my entire apt specificly incase something like this was to happen)When the police was at my apt taking the report they couldnt conclude as to how the perps got into myapt….they say it could have been my roommate,maintnance,or anyone else but they couldnt conclude who or how.But Allstate concludes from reading the report.Allstate never came out tomy apt to see the door or anything.Early in the investigation,Allstate asked for my roommates phone number and they called him and asked him whatever…then coming to the end of the investigation they when I keep asking for a status on the claim,they start telling me that they need to talk to my roommate again and they been trying for over a month and he never answers the phone or reply back.Its very clear that Allstate simply doesnt want to pay.I plan on sueing them for handling my claim in bad faith.
August 2nd, 2009 at 12:55 pm #Roger Poe
As a claim adjuster, and possible homeowner/policyholder, it seems it would be important and beneficial for you to know the core indemnified values of a structure that ones are paying premiums for, so that claim settlement values will be “adjusted” truly appropriately.
No matter what various carriers instructions are to adjusters, the daily and historical fact exists that structures contain first and foremost, general contractors business overhead and profit costs, coupled with all of their specialty trade subcontractors’ business overhead and profit costs.
Since general contractor + subcontractors’ costs are customarily woven into every component of a residential and/or commercial structure that is built by a G.C., insurance agents need to account for those costs for the anticipated future replacement costs of a structure.
When a hail/wind storm creates a insurance covered loss, the roofing system, like every other component on the structure, has prospective general contractor replacement costs values to account for, fairly and equitably.
A general contractor using a roofing contractor is the fair market construction value/actual cash value of the roofing component “loss”
that a policyholder needs a insurance adjuster to understand.
The same is historically true for all other components of a structure, from the roof to the foundation, inside and out.
A insurer that only wants adjusters to pay for the roofing contractor business overhead and profit value of a roofing system is involving adjusters in their undervaluation / underpayment practices.
They also place adjusters at real (litigation) risk of defending unfair and unjust construction market manipulation conduct against general contractors in a given area.
So, now you and other adjusters, and consumers/claimants, have an idea why, when insurers want adjusters to support their contrived construction market myths that claim a structure needs a certain damage “complexity” or requires “three or more trades work” to qualify for general contractor overhead and profit costs/involvement, you should separate yourself from such unfair claim settlement practices.
You also can also help others with the question…
How exactly is general contractor overhead and profit values calculated into limits-of-liability/homeowners insurance premiums?
http://www.tdi.state.tx.us/bulletins/1998/b-0045-8.html
http://www.tdi.state.tx.us/bulletins/2008/cc70.html
And for further verification regarding adjusting roofing “loss” values, ask any general contractor if their roofing system on their projects customarily contains roofing contractor business overhead and profit only.
Also, as you drive by a structure, or are responsible for assessing/
adjusting the intrinsic loss value of one, remember the general contractor + specialty subcontractor overhead and profit value that is built into every component of the structure.
With those points in mind, claims can be settled for their actual and fair financial loss.
-Roger Poe G.C.
August 3rd, 2009 at 10:42 am #Harry E
I had a fire with total loss of dwelling and contents. There is no house to insure, and I find companies reluctant to offer liability, etc coverage that I would expect would satisfy the mortgage company during the long period that it is taking the old company to settle. Am I correct that “liability, etc” is the kind that I am likely to need, and that the mortgage company will require such, or is there a name for the kind of insurance needed after a loss and before rebuilding while property is in limbo during settlement? If it will be required, is there any ‘insurer of last resort’ that would offer such insurance. The property is in Massachusetts.
August 3rd, 2009 at 5:57 pm #admin
Hello Harry,
Yes you would need liability insurance only, in case some kid, for example, gets hurt on the property. A good insurer would leave the liability coverage on and take off the fire property coverage. A low quality insurer would leave you in the cold. Talk to an independent agent to see if he can find liability only.
Also note that most insurers will add “liability only” for a second property location, at no charge, if you have a homeowners policy. But you have to advise your agent that you want that and the property location. Its not automatic.
For the best information on maximizing your rental or home structure insurance claim, consider one of the eBooks at UClaim.com. They are guaranteed and currently 75% off. You can also view their tables of contents before purchasing.
August 7th, 2009 at 12:06 am #admin
Hello Honest Guy,
Well you are right, its suing time.
FYI, on a contents loss, the burden of proof is on the policy holder, whereas on a structure loss, usually the burden is on the insurer to disprove your claim. But Allstate has gone too far, IMO.
A court may have to decide whether your videotape is reasonable proof of ownership. I think it is. You could also get affidavits, written statements from people saying they saw the property in your home. If Allstate still denies your claim, it’s that much more angry it will make a court.
August 7th, 2009 at 12:10 am #admin
Good comments Roger, and thanks for your contribution.
August 10th, 2009 at 6:48 pm #michelle
Hi I need help and some advised. I was hit the other day on the on the back door of my vehicle the person who hit me has progressive when i call them and started the claim they told me they will do an investigation and call me back within two weeks. To make the story short I waited and the adjuster never call me I call him 20 times, left him messages and he never return my call , finally I was so frustrated and fed up that I call the progresive customer care and told them i wanted to check the status on a claim, the csr from progresive told me that my claim was denied b/c their insurer said that he did not hit me and that my claim was a word against word claim so basically it was his word against mind and they believe their insurer. I told my husband and gave him the number of the adjuster that determine the denial of my claim, since the adjuster did not have my husband number on the list he answer right away when my husband told him taht he was calling about my claim and start to complain about the decison he told him there was not enough proof and when my husband told him well if my wife hit your insurer car why he gave her his information and he never ask for hers and the adjuster from progressive started to evade my husband question and told him that my insurance will have to call them and dispute the claim. What should I do???? what if my insurance does not help me?? can i get progressive to pay for my damages? or should i sued the guy that hit me?
August 11th, 2009 at 8:44 pm #admin
Hello Michelle,
Turn it in to your own insurer. They have to pay your claim regardless of fault. You may have to pay a deductible, but your insurer will attempt to collect all or part of that back for you. It could take them a year or two. If you get tired waiting for your insurer, you can sue the other driver in court and see what the judge says. But it will be binding, so your insurer will have to accept whatever the judge says. What does the police report say about fault?
August 13th, 2009 at 7:26 pm #admin
Hello all,
Check out our new discussion forum here at insuranceclaimhelp.org!
August 13th, 2009 at 7:29 pm #admin
Take a look at our new discussion forum!
August 13th, 2009 at 7:31 pm #admin
Please visit our new Discussion Forum!
August 13th, 2009 at 7:35 pm #admin
Check out the new Discussion Forum on our website!
August 16th, 2009 at 10:26 am #Danny
Hi, a few months ago our house in Colorado suffered severe hail damage to the roof and siding. We at the time where filling for a home loan modification, and was told to sign our insurance check for the repairs and send it in along with three bids on the repairs. Since then we have worked out the modifications however never sent the check in. I was concerned because some of the repairs I would be able to do myself however without the funds from that check I could not afford to do so. Once I asked Litton Loans( the Mortgage company) on what funds I would get in return they stated they would keep them until I submitted receipts on the work plus labor. It’s a catch 22 on this so someone told me don’t sign the check, and just contact the insurance company tell them I can’t get the work done because the mortgage company will not release the funds. How do I handle this is there some sort of law I can send in with the check or should I just contact my insurance company and return the check to them? Thanks Danny
August 16th, 2009 at 6:01 pm #Denise
My truck was stolen, when trying to file the claim the adjuster states that my rims are not covered by the insurence, she also said that they do not go by the blue book value. I do not undestand how can she said that when we purchase that truck the rims came with it and at the same time we purchase the full coverage for it is there anything that I can do?
August 17th, 2009 at 5:58 pm #admin
Hello Denise,
Are the rims original or aftermarket? Have the adjuster quote the policy language which says aftermarket stuff is not covered.
As to the value of the truck, if it was low balled, get the UClaim.com eBook “Total Loss Auto for Insureds”. Its guaranteed and currently on a 75% off sale at around $6.00.
August 19th, 2009 at 4:14 pm #admin
Hello Danny,
You and the mortgagee have to treat this as 2 separate business transactions. The insurance claim damage and repair should be separate from the remodel and corresponding loan. The mortgagee should have a “loss draft” department that holds your insurance check until the repairs are done. It does not matter if you got the repairs done for half the amount of the insurance payment, the mortgagee has to send you all that money when the job is done. They can send their inspector to verify the repairs were done. You don’t have to supply receipts or a contract for repairs. Go ahead and get this in writing from your lender “before” you sign over the insurance check.
August 21st, 2009 at 5:25 pm #Amber
I own a 4 unit apartment building in Arizona. A parked tow truck rolled down the hill and hit the building. The building is about 35 years old. Because it is 4 units the local city inspectors consider it commercial. Being a commercial building all work done is required to have architectural plans, permits and a structural engineer. The tow truck companies insurance carrier is tell me that because the building is so old, the new code requirements (that were not in place when it was built but now are required) are not covered by them. They say they are only responsible for the depreciated value of the building repairs not the actual value. Do I have a leg to stand on? And to extent is their liability?
Thanks
August 21st, 2009 at 7:26 pm #Barb
Hello hope that you may be able to help me. I have a Hail claim with Safeco ,called in the claim Aug. 6th shortly after the storm stopped and was advised that a adjustor would contact us on Friday the following week a adjustor came and was at my home approximately 45 min. he was from out of state and mentioned that he was headed to Yellowstone Park for the weekend to at least get to see some of Montana. He did not take the time to go over any of the claim, my home has number 1 hand cut cedar on the roof, and number 1 clear cedar siding (lap) my home is insured for over $350,000 we have replacement . My siding on one side of the home was ripped off and on another side plummetted with hail the size of lemons. We lost 5 windows, damage to a cedar deck with dents the size of a golf ball,a Barn metal roof, it put holes in the seats of our boat,busted a truck windshield , destroyed hot tub cover and almost all yard ornaments, a contractor came out directly after the storm and said you have at least $63,000 in damages that I can see. The roof has 46 squares of cedar. After calling almost each day to the point of almost exploding the 2nd claims department said oh we are send out a payment today(this was Friday at 5pm) for $29,000. The adjustor that was here said that he thought the roof needed replaced and one side of home, and a few boards here and there and they would pay to have it stained. Cedar does not match up after stained and new. Oh and all gutters were destroyed with holes the size of a softball. Also we have a natural pond that has canadian geese, well they were about 30 in the pond when the storm hit and now we have two with broken wings, this will tell you how bad our storm was. I need so advise on what to do, Help Thank You Barb
August 22nd, 2009 at 10:00 pm #admin
Hello Amber,
Yes, they are right, because they only owe you what is required by the law, not an insurance policy. You are better off to turn in the claim to your own insurance. Most insurance policies pay full replacement cost without depreciation. And many policies now days have “code upgrade” endorsements. Your insurer will try to collect back from the other insurer and get all or part of your deductible back.
The tow truck owner is only liable if there was negligence on his part. For example non maintained brakes, but not for example if some vandals pushed it down the hill.
August 22nd, 2009 at 10:28 pm #admin
Hello Barb,
You need way more help than I can give in a few paragraphs. You probably won’t get a public adjuster in your area. But if you do, take the advice offered at UClaim.com on how to hire one on the Free Stuff page. You could hire a lawyer as a last resort, but most lawyers will not know how to make the insurer pay more without litigation.
My best advice is to get the eBook at UClaim.com entitled “Homeowners loss Deluxe” currently on sale for $20.00, 75% off, with a money back guarantee. Read the description and view the table of contents.
August 23rd, 2009 at 7:48 pm #Kay Mixson Jenkins
Not sure if this makes sense but this is our timeline for what has happen with Foremost since our house was destroyed by fire.
ON THE AFTERNOON OF SATURDAY NOVEMBER 10, 2007 KAY AND COLTEN WERE AT HOME WHILE MARTY WAS HUNTING IN SCREVEN COUNTY. KAY HAD SPENT THE DAY WATCHING CARTOONS AND PLAYING WITH THE COLT.
AROUND TWO THAT AFTERNOON KAY STARTED WORKING ON CHRISTMAS ORNAMENTS IN THE KITCHEN. COLT WAS WATCHING TV IN THE LIVING ROOM. KAY HEARD A NOICE AND LOOK TO SEE WHAT IT WAS, SHE WALKED IN TO THE LIVING ROOM WHERE SHE SAW COLT STILL SITTING ON THE FLOOR WATCHING TV. AS SHE TURNED AROUND SHE SAW WHAT APPEARED TO BE SMOKE.
ENTERING THE BEDROOM, SHE CONTINUED INTO THE MASTER BATHROOM WHERE SHE SAW THE CLOSET ENGULFED IN FLAMES. SHE DOES NOT RECALL FEELING HIT FROM FIRE.
KAY TURNED BACK AND RAN TO LIVINGROOM PICKING UP SON SHE STARTED BACK INTO THE KITCHEN WHERE AT THIS TIME IT WAS FULL OF THICK BLACK SMOKE. THE SMOKE ALARMS WENT OFF.
SHE COVERED COLTEN’S MOUTH AND NOSE WITH HER HAND AND RAN THROUGH SMOKE OUT BACKDOOR.
RUNNING TO NEAREST NEIGHBORS HOUSE SHE SAT COLT DOWN AND ASK NEIGHBOR TO CALL 911.
SUNDAY NOVEMBER 11, 2007
ARRIVING BACK TO HOUSE KAY PLACED CALL TO FOREMOST INSURANCE LETTING THEM KNOW OF FIRE. SHE WAS ASKED IF THE HOME WAS LIVEABLE SHE ANSWERED NO. WAS TOLD ADJUSTER WOULD CONTACT HER WITHIN A FEW DAYS.
TUESDAY NOV 13, 2007
MET DEBRA CARRAHAN ADJUSTER FOREMOST INSURANCE AT HOUSE. SHE WALKED THROUGH HOME TAKING NOTES AND ASKING QUESTIONS. MARTY, KAY & MS CARRAHAN WALK TO BACK POARCH WHERE MARTY’S GUNS WERE LAID OUT ON TABLE.(PICTURE 1 & 2). SPOKE BRIEFLY OF HOW HOT FIRE WAS TO HAVE DONE THAT MUCH DAMAMGE TO GUNS.
WENT TO SIDE ENTRANCE OF HOUSE WHERE MS CARRAHAN EXPLAINED TO MARTY & KAY THAT THEIR HOME WAS A TOTAL LOST. TOLD CLIENTS TO NOT WORRY ABOUT SERIAL OR MODEL NUMBMERS BECAUSE OF THE AMOUNT OF DAMMAGE TO PERSONAL PROPERTY.
GAVE MARTY & KAY CHECK FOR $3,000 AND SAID SHE WAS GOING ON A FOUR WEEK VACATION.
RENTED HOUSE FROM JOE RICHARDSON FOR $600.00 A MONTH.
NOVEMBER 13 – DECEMBER 12 UNABLE TO GET IN CONTACT WITH MS. CARAHHAN OR HAVE ANYONE FROM FOREMOST RETURN CALLS.
DECEMBER 12, 2007
RECEIVED CALL FROM CUNNINGHAM INVESTAGATIONS ASKING FOR DIRECTIONS TO HOUSE. STATED HE WOULD BE OUT THE NEXT DAY AND IT WAS NOT NECESSARY FOR US TO BE THERE.
WENT TO HOUSE THAT AFTERNOON AND SAW THAT SOMEONE HAD BEEN IN HOUSE, CALLED THE INVESTIGATOR TO TELL HIM ABOUT DOG IN HOUSE. HE INFORMED KAY HE HAD MET THE DOG THAT DAY. KAY ASKED HIM WHAT HE FOUND. HE STATED THERE WAS NO SIGNS OF ACCELLERATE IN HOUSE.
KAY ASKED HIM IS THIS WHY FOREMOST WOULD NOT RETURN OUR CALLS, HE SAID “NO, THEY ARE NOT GOING TO TALK TO YOU BECAUSE YOU HIRED AN ATTORNEY”
KAY STATED THAT WAS NOT TRUE, MR DOZIER IS OUR BANKRUPTCY ATTORNEY AND WE HAD TO LET HIM KNOW.
INVESTAGATOR SAID “SOMEBODY TOLD THEM, YOU NEED TO CALL AND GET THIS STRAIGHTEN OUT” I WISH YOU THE BEST OF LUCK MRS. JENKINS
JANUARY 4, 2008
DEWITT INSURANCE FAXED 32 PAGES OF RECEIPTS TO MS. CARRAHAN
TOTAL $ 7,313.00
JANUARY 22 2008
CALLED TO GIVE DEPOSITION TO MS CARRANAH AT MR DOZIERS OFFICE.
KAY ASKED “IS THE INVESTIGATION OVER” WAS TOLD THEY SHOULD HAVE IT TODAY AND WOULD CALL THIS AFTERNOON OR IN THE MORNING”
(LETTER TO INSURANCE COMM. STATES FOREMOST RECEIVED REPORT JANUARY 23, 2008.)
KAY ASKED “WHEN ARE WE GOING TO GET OUR ADDITIONAL LIVING EXPENSES” MS. CARRAHAN REPLIED “MY BOSS SAID YOU WOULD NOT RECEIVE ANYTHING UNTIL INVESTIGATION WAS OVER”
(LETTER TO INSURANCE COMM. STATES FOREMOST RECEIVED REPORT JANUARY 23, 2008.)
GAVE MS. CARAHANN RECEIPTS FOR ADDITIONAL LIVING EXPENSES.
NOV – JAN
DID NOT HEAR FROM MS.CARAHAN UNTIL FEB 2008 SHE NEEDED SERIAL NUMBERS FROM GUNS AND ITEMIZATION OF FOOD LOST.(REFER TO NOVEMBER 13, 2007, ADJUSTER STATED HOME AND ITEMS WERE DESTROYED
RECEIVED CALL FROM MS CARRAHAN:WAIITNG ON BOSS TO SIGN OFF
RECEIVED CALL FROM MS CARRAHAN:STATING SHE WOULD FINISH CASE BY WEDNESDAY AND OVERNIGHT CHECKS.
MARCH 10, 2008
RECEIVED CALL FROM MS. CARRAHAN STATING WAIITNG FOR BOSS TO SIGN OFF AND WOULD CALL WHEN CHECKS WERE OVERNIGHTED THAT I HAD NOT UNDERSTOOD WHAT SHE SAID IN PREVIUOS CALLS
MARCH 11, 2008
FILED COMPLAINT WITH INSURANCE COMM.
RECEIVED LETTTER FROM INSURANCE COMM.
MARCH 25, 2008
FOREMOST CLAIMS CHECK FOR 83,905 ISSUED MARCH 14, 2008
AND CHECK FOR 4,195.27.
PERSONAL PROPERTY CHECK DATED MARCH 26, 2008
ADDITIONAL LIVING EXPENSE CHECK DATED APRIL 3, 2000
NOVEMBER 2007-FEBRUARY 2008
LETTER FROM ADJUSTER, APRIL 10, 2008
STATING FOREMOST WAS STILL WORKING ON CLAIM
LETTER FROM US BANK STATING NON RENEWAL OF POLICY 02/26/2009
LETTER FROM DAVID HARRIS, ATTORNEY FOR FOREMOST DATED APRIL 1, 2008 STATING FOREMOST WAS CANCELING INSURANCE. REQUIRED THAT WE DISMIISS ACTION WITH PREJUDICE,SIGN A POLICY HOLDERS RELEASE AND CANCEL POLICY IN SIXTY DAYS. (LETTER FROM US BANK STATING NON RENEWAL OF POLICY 02/26/2009)
Letter March 14, 2008
Debra Carrahan
$83,905
Additional 2% 2,095.00
Replacement Insurance is 20% $16,781.00
Letter Dated March 26, 2008
Personal Property Total:
62,585.00
tax 4380.95
Total: 66,965.95
$45,037.12 Policy
Depreciation 16,781.00
Is it not strange both amounts are $16,781?
Is there bad faith involved?
August 26th, 2009 at 12:48 pm #Jaime
I’m going to make this as short as possible, but detailed.
Two vehicles in my own driveway were wrecked into by drunk driver w/ no insurance.
Both paid-off, but I kept full coverage on both under advisement from my agent.
Simply put she asked “If I was able to easily replace these vehicles if anything was to happen to them, then yes take off full coverage.” So I kept it.
Car 1 = Totalled / Car 2 = Minor damage.
Car 2 is undergoing repairs
Car 1 is again totalled
My insurance is giving my only 1400 after ded. for car1. My issue is that I don’t need the money, I need the car. If money was the issue I would have sold the car a long time ago and got more for it then. I dont expect a spanking new car but I would expect a car guaranteed to give me what I know car1 would have continued to give me and I cant afford to buy another car payment. Adjustor will not budge. Do I need an attorney? What can I do?
State of Texas / American First Ins (Liberty Mutual)
August 26th, 2009 at 11:36 pm #admin
Hello Jaime,
You can hire an attorney who has no experience on this subject for 150-250/hour who will waste your money or you can spend $6.00 (current sale price) on the eBook at UClaim.com entitled “Total Loss Auto for Insureds” that will teach you how to get most or all of your money in dispute simply, the way a good public adjuster would do it.
August 31st, 2009 at 6:13 pm #Larry
I have a 2nd story outside deck (attached to the house) which has two drains at deck level. One of the drains drained into the supporting column and developed wood rot. This also spread to the entire deck under the concrete and tiles so that it was not noticed. It also spread to the other column and horizontal wood beam. The entire deck needs to be replaced. There was no way to know there was a leak. The way I found out was the one supporting column suddenly one day showed a sign of compression in the stucco. Should State Farm cover this and to what extent if so?
Thank you.
September 1st, 2009 at 4:02 pm #admin
Most insurers don’t cover rot, even if it was hidden from view. First try the sympathy route. If that fails, try to find a “concurrent cause”, another covered cause of loss that could have contributed to the loss. Be creative if you have to. Most home policies say they cover “everything except”, so this puts the burden and cost to disprove your claim on the insurer. If it cost more to hire an engineer to disprove your claim, it may be cheaper for your insurer to just pay you for your damages if you sign a release. Its called a “compromise settlement”.
September 3rd, 2009 at 6:55 am #Trish
I have a rental property in Pittsburgh where the tenants destroyed my home. From allowing their dogs to urinate and crap all over the floor, kitchen cabinets ripped off, carpeting torn off, superglue to put on walls, holes in doors, ect. And my insurance company denied my claim based on normal wear and tear, deterioration and maintenance. Maybe for a zoo but this is my home. What should and can I do?
September 3rd, 2009 at 3:11 pm #Mary
OK. Here’s a question! My husband and I had filed a chapter 13 banckruptcy April 08. By August 08, we had a mtg with the trustee due to unexpected circumstance we were unable to pay the monthly payment. The trustee assured us due to circumstances, we should refile when the circumstances were resolved, and she would approve for us to be re-entered into the chapter 13. Our bankruptcy attorney advised us when doing our personal property inventory to only list major items in the home (ie. living room furniture, bedroom furniture, jewelry, & clothes as a whole) and to list them at a price we would get if we put the items in a yard sale. Before being able to refile the bankruptcy, our house burned and was a total loss. We jumped through all the hoops and got all the paperwork. The insurance company paid nearly 10 months of additional living expenses and even paid the policy limit on the structure but did a stop pay soon after. Now 1 month short of a year they have denied the claim due to misrepresentation on the contents inventory because of the difference with the bankruptcy. I understand the difference but honestly with the bankruptcy, we were only following our attorney’s advice, and to my understanding they don’t require you to list everything down to curtains, food, etc. Is there any case law where this has been overturned in court? We are sueing the insurance company because we feel this is ludacris. But I am not naive to how all this must look but do honest people really suffer because so many try manipulation the system. We had every intention of keeping our home and no fear of loosing it because of the trustee mtg. This was a terrible thing….is there really nothing we can do now?
September 4th, 2009 at 1:57 pm #Jessie
I was parallel parked about 10 feet away from an intersection where only 2 of the directions were required to stop.
I signaled, checked my mirrors, and did the once-over my shoulder and proceeded since it was clear. As I was pulling away, a man hit me. Now I believe he must have been coming around the corner (on my right side) and floored it.
when we got out of the vehicles, he was apologizing up and down saying “I’m so sorry, I wasn’t paying attention, I was looking at the light up ahead and couldn’t slow down in time.” He then proceeded to sway me to not call insurance/police. I thought this was fishy so I called my boyfriend. When he arrived, the man began telling my boyfriend his car was fixable (By a buffer) but he suggested a friend of his who would only charge me $150. I thought that was strange as well.
Now my insurance won’t cover my damages, is it reasonable to go after his since he hit me? I feel he was negligent in not paying attention and possibly speeding around the corner in a residential neighborhood.
September 5th, 2009 at 4:36 pm #admin
Hello Trish,
You have to approach this as a vandalism. Make a police report, even if only by phone. You will have to argue each and every item claimed with the adjuster, preferably on site. Be prepared to give in on some items. For more details on how to handle this kind of claim, consider the eBooks at UClaim.com Homeowners Loss Deluxe and possibly Denied Claims. Look at the tables of contents for each product.
September 5th, 2009 at 7:17 pm #admin
Hello Mary,
If you are saying the insurer is denying the claim saying you misrepresented the inventory because you listed more stuff than was on the inventory for the bankruptcy, then I think the insurer is wrong (and I would gladly give expert testimony to that effect). Make sure you get their denial in writing stating the exact reasons. In addition to suing the insurer, consider one of the eBooks on handling denied claims at UClaim.com. They are on a 50% off sale with money back guarantee.
You and or your attorney could easily resolve this claim before a trial if you play it right. If the facts are indeed as you say, any insurer would be crazy to let this go to trial. But hey, there are some low quality insurers who will run up your legal costs and play you up to the morning of the first day of trial, just to see if you will go away.
September 5th, 2009 at 7:27 pm #admin
Hello Jessie,
I don’t know why your insurer won’t cover your damages, unless its under the deductible. You may have to sue the other driver in small claims court and see who the judge believes. If the other driver wants to lie to a judge after swearing to tell the truth, then he will have to live with himself. Do a diagram of the accident scene showing where the cars came from and where they impacted. And get witness statements if there were any. And see if the police will take a “late report.”
September 10th, 2009 at 2:58 pm #Laurie
I am getting a new roof from a Hail Storm. I don’t really need a full new roof, but they don’t make the same roof so I get a full new one. What If I want to use the money for other home improvements instead? Can I do that or would I get in trouble?
September 10th, 2009 at 9:26 pm #admin
Hello Laurie,
You can use the money they gave you to go to Hawaii if you like. But keep in mind, that if they deducted depreciation from your settlement, and if you have replacement cost coverage, you can’t later recover that depreciated amount if you don’t do the repairs, and there is usually a time limit like 180 days to do the repairs.
Now for you other readers, sometimes you can “shift” money around if there are several trades in the repairs, and you get the adjuster to agree in writing before doing that. But in the case of a single item, like a roof, most adjusters won’t agree to it. Of course it won’t hurt to ask the adjuster, but make sure you have the money in hand before asking, because the adjuster could “change his mind” on the depreciation if he thinks you will “cash out.”
September 14th, 2009 at 2:41 pm #Darek
Hi. I’m a Restoration contractor in NY and I have a question as to how a denied claim affects “mitigation”.
We performed the mitigation on a water damaged home for a customer that has Insurance. The cause was determined to be a frozen/ruptured pipe in the bathroom sink. (water supply line)
Anyway, the claim has been denied due to lack of due diligence on the insureds part for not insuring his LP tank was full. (He was staying at his relatives due to being temporarily disabled from a previous car accident)
Now I believe that on most policies it is required for the insureds to “mitigate” their damages. If they do not, than the claim is likely to be denied. If they do, but the claim is then denied after mitigation has been performed by a contractor, wouldn’t the “mitigation” portion of the claim still be covered being that the insureds did what their policy (and an insurance rep)directed them to do?
I mean, if the insured did not mitigate, and the claim was valid and not deniable, then once the insurance company discovered all the additional damage from the insureds failure to mitigate, than I’m sure the insurance company would be very quick to now deny the claim. So, am I crazy to think that Mitigation would still be covered on claims that are later denied?
I can see the build back/restoration/repairs being denied, but the mitigation?
What say you?
Please allow me to thank you ahead of time…
Thank You……….
Darek
September 14th, 2009 at 3:29 pm #admin
Hello Darek,
Well first of all, to simplify communication, you should not refer to restoration services or mold remediation as “mitigation”, because that word has different meanings. In insurance policies, the word mitigation means the insured must do what they can to reduce their damages or chance of damage, for example, cover a roof if it has a hole in it and it’s about to rain. So if the homeowner in your case had a good reason (that a court judge would agree with also) for not keeping the heat on, or the propane tank full, then his claim cannot be denied. While insurance policies say “mitigation”, they are overridden by the law, which says “mitigation, within reason”. But it sounds to me like your client (and his relatives) just forgot, unless he was in a coma or mentally incapacitated from the accident.
I see no difference in “build back” and “mold remediation” (if that’s what you mean by mediation) when it comes to denying a claim for mitigation. Consider the UClaim.com eBook on denied homeowner claims if you need to play hardball with the insurer.
September 14th, 2009 at 4:02 pm #Darek
Thank you. Insurance companies have specifically divided “restoration” from “mitigation” and we are directed to refer to our services as either “restoration” or “mitigation” when either calling the claims center/dept to update the adjusters on the status of the job or to ask the adjuster questions,or even when submitting our emergency service estimates.
On most of our jobs in Florida, when we performed the “initial emergency services” ie: water extraction, contents manipulation, initial structural drying, etc, we were for lack of a better term, “protected” on performing those services even if the claim was later denied. It is those services that we refer to as “performing the emergency mitigation”. ie:stopping the damage from getting worse when it is above and beyond what most homeowners could perform themselves.
I guess the key here is when you stated “While insurance policies say “mitigation”, they are overridden by the law, which says “mitigation, within reason”. That, I think, answers my question..
Thanks again…
September 14th, 2009 at 8:00 pm #Jacqueline
Someone ran into the front of our house and broke a gas line.To fix the line we had to call a plumber when he gave us the estimate he said he had to bring it up to code the codes have changed in our area and he said it would not pass city inspection. who is responsible for the repairs the estimate was for 4700.00 the insurance offered 100.00 to replace the piece of pipe? What should I do?
September 16th, 2009 at 12:10 am #admin
Hello Jacqueline,
Well first check the endorsements to your policy to see if you have a “code upgrade or improvement endorsement” that covers replacement of “undamaged” parts of your home required by building departments. That would make it easy. You could argue that the insurance company bases its premiums on current construction, which includes bringing structures up to code, but it will be a fight.
Now one option is to make the claim to the drivers insurance, which would not limit you to “policy exclusions” like your own insurance would.
September 17th, 2009 at 11:39 am #Stephdc66
What negotiating power does one have to push for a salvage settlement? I have a 2005 Dodge Magnum with a market value prior to the accident of approx. $10,000. The two quotes to fix the damage are around $7,000. Even though the car is driveable, it does have some ambiguous suspension problems that I am not convinced will get covered under a repair as part of the settlement. Most of the questions on this forum are on how to keep from having your car totaled but mine is how to force a salvage settlement?
September 17th, 2009 at 6:33 pm #Larry
See previous question dated Aug 31st.
The wood rot on the decks was caused be a breakage in the “hot-mop” which was per code in 1989 when the house was built. With the tile flooring over the hot-mop, one cannot see the damage. I would therefore think that the insurer would be responsible for all wood rot and water damage since it was caused by this breakage. What do you think?
September 17th, 2009 at 7:35 pm #admin
Hello Steph,
It sounds like the question you mean to ask is how do you force the insurer to total your car out? Because you can’t “force a salvage settlement”. If your car is totaled out and you keep the salvage, then they deduct the salvage value from your settlement. If they take the car, then there is no deduction.
The insurer’s rule of thumb is that if the cost to repair gets close to 80-90% of the repair cost, then better to total the car out since supplemental repairs could end up costing more than that 10-20% margin.
If you want your car totaled out, then insist that they check out the suspension at a suspension shop before any body repairs. They have to. Now some body shops may be reluctant to do that first, because they could lose a repair job. If you have to, get the car to a suspension shop yourself and pay them to check it out and give you an estimate. The insurer has to reimburse you for that estimate cost.
And if they still fail to total it out, then take the repair money and sell the car.
September 17th, 2009 at 7:46 pm #admin
Larry, go ahead and make the argument and hope for the best. If they deny the rotted wood, ask them to cover what it would have cost to access the repairs (which could include replacing the tile floor, etc.) and what would have been “non rot” damage at the time of the break. What could have caused the hot mop to break, something other than “wear and tear”, like a 400 pound guy walking on the deck?
And make sure the hop mop break occurred within your State Farm policy period. If not, go to the prior insurer.
September 18th, 2009 at 2:58 pm #Ken
Greetings Admin,
The air handler in my house was somehow tilted the wrong way and ended up leaking out in my attic and down my walls rather than down the condensate line. I have no idea how long it was going on for, but I first noticed damaged when the carpet in my hallway was completely soaked. I called a contractor to come look at the damage. He saw the water damage in my walls and immediately recommended I open a claim with my insurance company. I called the same day and opened a claim. The adjuster wasn’t able to make it to my house until 8 days after I opened my claim. I tried to escalate the issue with my claims handler, stating that due to the closed-in environment and extreme amount of moisture, the water damage and mold would exacerbate. They were only able to send the adjuster a day sooner so it took a week for him to arrive.
By the time the adjuster arrived, my walls were covered in mold (it was a lot worse than at the time I opened the claim) and it had spread to the vanity cabinet in my bathroom. The adjuster concluded that due to the mold damage, the water must have been a constant seepage and must have occurred over a period of weeks, months or years. His verbiage was direct verbatim from the policy under “Losses we do not cover.”
I have filed a complaint with my state’s department of insurance and am in the process of appealing to my insurance company. The department of insurance has reviewed all documentation of my claim was not able to assist me.
I had an air quality expert inspect my house and state that there is no possible way to determine the genesis of the event and confirmed my suspicions that the issue was exacerbated due to the adjuster’s unwillingness to change his schedule and arrive sooner.
I am getting a written letter from the contractor and air quality expert that should help contravene the insurance company’s results, however, from conversations over the phone, I have a strong suspicion that it will still not be covered.
My question to you is, will this be worth pursuing in court as a bad faith claim? My arguments would be that the insurance company took no action (via hiring professionals) to prove that the damage has occurred over a period of weeks, months or years. The policy is also a contract of adhesion and the ambiguity of the policy should be refuted in court. The damage to my home is only about $5,000, so would it be worth the money to get a lawyer? I’ve gotten a quote from a lawyer already and he stated that $5,000 is usually the minimum for court fees, lawyer fees, etc.
I appreciate any assistance you can provide. Thanks.
-Ken
September 19th, 2009 at 5:46 pm #admin
Hello Ken,
You may want to condense this question. Way too many details for most contributors to take the time to read. You may also want to post it in our Discussion Forum and change a few words to avoid Google penalties to this website. And take a look at the “Denied Claim” eBook at UClaim.com.
September 20th, 2009 at 5:19 pm #jim
Hi,
My son was hit going through a green light. The officer did not interview all the witnesses, and cited my son for failure to yield. Both cars were totaled. We both have liability only. They have 2 witnesses that say it was red. We have 2 witnesses that say it was green and their is another witness that said both lights where red and only the turn single light was green. Both insurance co. have denied all claims. We have not gone to trial for the ticket yet. If the other party takes my son to court and wins will our insurance co. pay that? Does it seem likely anyone would sue? The insurance companies win.
Thanks jim
September 22nd, 2009 at 7:24 am #Ken
Which words do I change to avoid google penalties?
September 22nd, 2009 at 5:25 pm #admin
Ken,
Thanks for asking. It does not matter. Make one word or grammar change for every 10-20 words. It could be a spelling change (like a misspelling), adding a comma or parenthesis, capitalizing a letter, changing a “the” to an “a”, etc.
September 22nd, 2009 at 5:40 pm #admin
Hello Jim,
It’s all a matter of which witnesses are more believable as to whether who wins in court, imo.
1. If the other party wins in court, your insurer has to pay.
2. If you get served with notice of a lawsuit, you must report that to your own insurer, so they can defend you. That’s part of your liability coverage. If you don’t advise your insurer of the lawsuit, they may not pay if you lose.
3. In the end, one or both insurers will pay. IMO, if the witnesses are equally believable, I would say the insurers should just pay half of each others damages.
4. “Will anyone sue?” That depends on the amount of their damages, their chance of success in court, and your assets.
September 22nd, 2009 at 5:49 pm #Ken
I’m confused… I have a little bit of experience with search engine optimization. Would the penalties be coming from the use of repetition?
September 22nd, 2009 at 5:55 pm #admin
Ken,
Not worth hiring a lawyer. Go to small claims court if suing. And no lawyer is going to take such a small case, even if it has bad faith. Punitive damages in property claims in recent years are now limited 3 to 10 times special damages, in all states. So those days are over, thanks to the George Bush supreme court legacy. Big business can do whatever the hell it pleases.
If you policy does not cover mold up to a stated amount, usually 5 or 10 thousand, then your only option is to sue the insurer for negligence, ie. their delay caused more damage. The eBook at UClaim.com on denied homeowner claims will coach you on how to build a liability claim against your own insurer on denied water damage claims.
September 22nd, 2009 at 5:59 pm #admin
Ken, you wrote:
“I’m confused… I have a little bit of experience …”
Answer:
Yes, absolutely.
September 23rd, 2009 at 10:22 am #Abisoye
I have farmers renters insurance. My apt had a fire accident some days ago and the insurance company is saying they cancelled my policy in Aug 10. I didnt know this change because i didnt think i had any problem with them as i had sent out a check for my premium for additional 6months way back in May. They are sying they didnt get the check hence the cancellation. What should i do in this situation because i have property damage.
Thanks
September 23rd, 2009 at 9:11 pm #admin
Hello Abisoye,
Well the easiest first step is to see if the check cleared. Look at your bank statements. If it cleared, then there is your proof.
If it did not clear, then there are other ways to show how the insurer screwed up. You can get details on how to pursue this kind of denial in the eBook at UClaim.com entitled “DENIED AUTO AND MARINE INSURANCE CLAIM ADVICE AND HELP”. Check out the table of contents. The eBooks are 50% off and have a money back guarantee.
September 25th, 2009 at 1:24 pm #chad
I was recently hit by another driver in CA while riding my 1987 Yamaha motorcycle. I only have liability coverage on my policy. The other drivers insurance is probably going to total the vehicle for $1000 or so. This is my primary vehicle and I will not be able to purchase another reliable vehicle for that amount. Do I have any other options to get the vehicle replaced or a more appropriate sum of $ to get a replacement?
September 25th, 2009 at 5:25 pm #Larry
I live in PA. Got cold out and clicked on thermostat for heat ( oil furnace, steam heat regularly serviced) I heard a, I guess i’ll call it a small explosion, in the basement approx. 15 to 20 minutes after turning heat on. Went in basement , felt furnace unusally hot, and noticed no water in water tube. Opened lever to fill and water gushed out from under furnace. Immediately hit cut off electric switch and called a furnace technician. He diagnosed low water cut off malfunction, burner “dry fired” , water tank ruptured ( no water in tank) and deemed furnace NON repairable.Need new furnace. Put in claim to my homeowners insurance State Farm, was denied, told not covered. Explanation was told to me like this ” well you have car insurance right? if the motor goes we don’t replace the motor?” I said we are not talking about a car we are talking about the heating system of my home !! Said i’ll recieve denial letter in mail. Does this sound right to anyone? I thought homeowners insurance, especially in a winter state, that would be a covered item> Is there any law in PA. that would say that the heating system is one of the basic items that would be covered, i’m confused on State Farms denial, considering the heating system is an intregal and necessary part of the home to be able to live in.
September 29th, 2009 at 12:30 am #admin
Hello Chad,
They have to pay you for something comparable to what you had. If the check has a release on it, line it out. And don’t sign a release. The same principals for settling a car total loss claim apply to motorcycles. You can get an eBook at UClaim.com entitled Total Loss Auto for Claimants currently on sale for around $12.00, 50% off and money back guarantee.
September 29th, 2009 at 12:54 am #admin
Hello Larry,
If the furnace was damaged by a covered peril like fire, then it would be covered without question. They will probably deny the claim saying the thing broke down due to inherent defect or malfunction.
Another angle for denial is this, in property insurance, the cause of the loss is never covered. So if a television malfunctions and catches fire and the house burns down, the house is covered, but not the television.
The UClaim.com eBook on denied home and business claims has a detailed discussion on how to get around this “cause of loss and inherent defect not covered” issue. It’s currently on sale with a money back guarantee.
September 29th, 2009 at 5:42 am #f. michael conte,CPIA
Larry,
if it is ok with moderatorr of this board i would like to review your policy, the last time i read a home owners policy the boiler portion was pretty broad, i would be looking for exclusions pertaining to the boiler itself. i agree with the moderators comments however, i am preety sure we have had similar claims paid. You might ask your agent to do some reasearch, to find out how the other carriers he represents would handle such a situation.
f micheal conte
ny,ny
September 30th, 2009 at 1:47 pm #Roberta Ricco
My son was hit by a drunk driver in Los Angeles California, he was sitting at a red light and a drunk driver hit him from behind, it has been a 1 1/2 and the
case has not settle yet, the driver was convicted and arrested that night at the scene of the but the insurance company is trying to find all types of
clauses to not pay for my son pental damages he has a spinal tissue damage and a football player in college he was on his way back to college when this
accident happen, the clause know after they want to reach an agreement to settle the insurance company say’s no they want to back out of the settlement
small statement because he was not coveraged on the policy. my understanding if you have insurance or not that he was hit from behind and the driver was arrested that night and taking to jail for being under the influence and now the insurance company does not want to pay for damages, what law is this I need to know the law that defensive drunk drivers so I can bring to MADD to investigate this more and we shall look into this matter. Help my son was the victim.
September 30th, 2009 at 11:30 pm #admin
Michael and Larry,
If you guys use the Discussion Board on this website, you can communicate with each other without displaying your email addresses to everyone. Larry should make a post there, from which you Michael can PM to him. Otherwise Michael you could post your email address on this blog and hope that Larry is following it.
September 30th, 2009 at 11:40 pm #admin
Roberta,
I can’t understand your English grammar enough to answer your question. Unless another visitor wants to try to answer your question, you may have to get someone to rewrite your post. Sorry …
October 1st, 2009 at 10:31 am #belinda
Hello and thank you for taking time to answer so many questions. Recently my car was hit by a drunk driver and thankfully minimal damage was done. I had an estimate done at the auto body shop my insurance appointed, and the other parties insurance had an appraiser come out to do an estimate as well. Since the damage is minimal- no one at work even realized my car was in an accident- I would like the insurance company to write me the check instead of taking it in to this auto body shop for repairs. How do I go about requesting this from the other parties insurance company?
October 1st, 2009 at 11:45 am #admin
Just ask the adjuster to send you the check with only your name on it.
October 1st, 2009 at 4:10 pm #Brandon
I recently had some issues with water damage in the downstairs of my bi-level home. I have hardwood floors and (rain) water seemed to have come through the door frame (underneath) and went under my floor and rotted a section of it. I had an estimate done and was told initially by the State Farm that if it was storm related, then it will be covered. I submitted my claim to State Farm (pennsylvania) and they are stating this is considered flood damage, since the water sat under the wood floor and rotted it. I do not have flood insurance.
From what I can tell, our gutters overflowed from heavy rains and splashed down on our deck and made its way to the door frame.
Anything I can do to get this resolved without having to pay for a new floor myself?
October 3rd, 2009 at 3:16 pm #admin
Hello Brandon,
If you read the policy for yourself, under exclusions where it talks about rotted wood not being covered, it does not specify the cause. Most policies just say rot is never covered regardless of the cause. So it does not matter if it was from flood (surface water) or from rain leaking from the roof or window or door.
Now where most adjusters confuse themselves and the policy holder is in what they deem to be rot. If you can push your finger through the “rotted” wood, then it is rot that occurred over time and therefore not covered. However if the wood is just black or discolored and or delaminated, but it is still too hard to push a butter knife through, then it is not rot, even though it may look gross. And if the water that caused that came from a source above ground or a leaking pipe, then it should be covered.
It takes a lot of water over a long period of time to rot a hardwood floor, unlike pine framing. Hardwood floors usually buckle before they rot. And buckling is covered damage.
October 6th, 2009 at 10:23 am #Don
I have a question about a mother-in-law unit and landlord policy. I currently live in a single family home in Seattle, WA with a legal mother-in-law appartment/accessory dwelling unit in my basement. I put the unit into the house in 2001 with full permits with the city of Seattle.
Now I’ve purchased another home and want to rent out the upstairs part of my old house along with the MIL unit. The issue is that the City of Seattle requires at least one of the units to be owner-occupied for the MIL unit to remain legal. Once we move out and have not lived in the house for 6 months in a given year, the certificate of owner occupancy is invalid and the MIL is an illegal unit.
My question is about a landlord homeowner’s insurance policy as it relates to an illegal unit. I’m not concerned about the City of Seattle comming to fine me for renting an illegal unit, but the risk of my landlord policy being invalidated because of the illegal unit is not a reasonable risk to assume. Am I at risk of invalidating a landlord policy if I move out and rent both the upstairs unit and the MIL?
October 6th, 2009 at 11:10 am #F MICHAEL CONTE
don,
this is a topic that i have preached on for many years, and i am happy that i have not had first hand experiance. i believe that any carrier in their right mind would deny a claim for any situation that was a result of an illegal occupacy. the exclsuion in the contract clearly excludes illegal activity, it also has wording about prior knowledge of a situation…. i would not take such a risk and i have held this opinion for years .the situation that i have seen more often is a legal two that is then turned into an illegal three. in the event of a wrongful death claim i cannot imagine how the carrier could offer a defense for an illegal occupancy, and as a result would be better served simply offering a denial.
i have waited a long time to answer this question, and i thank you. excellent question!
October 6th, 2009 at 11:11 am #admin
Don,
Just so a potential claim is not denied for misrepresentation, fax a note to your agents office advising you are moving to another location, and add that your mother in law is staying in the mil apartment. Or if you get insurance for your new location with the same agent, then he is now aware of the change in risk.
October 7th, 2009 at 11:02 am #mimi
I would try to help translate Roberta’s post as it seems I am in a similar position, though there are some bits that I can’t quite figure.
However my problem – my dad was injured over 2 yrs ago by an uninsured driver speeding at 2.5x the limit of our residential street. He was since convicted, did his three months in a cosy cell and is apparently back home beating his wife (:/ nice system we have.)
my dad has been left with severe cognitive difficulties that most of the medical experts have been able to identify, although some do acknowledge some form of brain injury. We’ve actually just found out that his doctors have actually been making somewhat derogatory remarks in his notes suggesting he’s been making it all up anyway, and as a result of this, he has not received the treatment he needed to get back on his feet, to date. It is only now that some specialists are disputing these comments, and through them, we found out what had been said.
meanwhile the insurance process is turning out to be a nightmare – the accident claim, in the UK is handled by the MIB as the other driver was uninsured. To date, their policy with our lawyer has been to avoid communication as much as possible. The 2 are now trying to establish some middle ground on treatment and possible interim compensation, but the brick wall is relentless. It has been 2 years of struggle, both medically and financially, and we need to get this resolved!
My dad also had insurance claims to cover illness and accident – however these guys are now playing up too, as they keep trying to draw out the process by asking for information over and over again.
There is also another (non)issue that they keep using as an obstacle – a yr previous to his accident my dad used to be a company director, which I then took over. He remained as an employee as he had other commitments. However because of this history, his insurers are insisting on seeing all the company’s records, although I have been advised repeatedly by business legal reps that as the current director, they have NO RIGHT or NEEd to this information, and are using it as a tactic. They are essentially asking my dad to take confidential information “under the table” as it were.
When trying to communicate with them about any of this, they fob us off with a lot of jargon, ultimately saying, “we can’t really say what info we need as we don’t know yet – just give us evrthing we ask for and we’ll figure it out”.
none of this is acceptable – the mess my dad has been put in should not be happening were it not for a system riddled with incompetency and greed.
Please, if you have any advice at all, it would be much appreciated.
October 7th, 2009 at 4:22 pm #Jennifer
Travelers: be warned not to use Access America for travel insurance. After my bad experience with them- I then found the pages and pages of negative reviews from dissatisfied customers who were victimized by their “reverse insurance fraud”. They do not pay claims. I purchased travel insurance with them through US Air. My aunt died two days before I was scheduled to leave for a vacation. I called Access America and was assured that this would be no problem-just fill out the claim forms. In addition to the claim forms, I also mailed a copy of the death certificate as well as a letter from the funeral home. They are now saying that if there was a pre-existing condition that they will not pay. Travel insurance is meant for unplanned, unforeseen events that cause a consumer to have to cancel travel plans…and that’s exactly what happened. My aunt’s death was unplanned and unforeseen. Be warned…. I have read hundreds of other complaints made by victims raped by Access America Travel Insurance and Assistance. Someone needs to stop them!
October 7th, 2009 at 4:45 pm #Carl
I was in an auto accident in Florida. I went to the hospital and am now in physical therapy. The other car caused the accident and was cited for it. Their insurance carrier has now send me a letter that they will be denying all claims for this accident because their insured has not assisted in the investigation (which they say is required by their policy). What can I do? Is this allowed?
October 7th, 2009 at 10:12 pm #admin
Hello Carl,
Well then you will have to pursue your damages directly from the other driver, and sue him if necessary. And if he looses in court, then his insurer may not reimburse him. Its his loss. If you have insurance, then you should make your claim with them and let them chase the other driver. I’m not sure if your uninsured/under-insured coverage would kick in on this. Maybe someone else here knows.
October 7th, 2009 at 10:24 pm #admin
Jennifer,
But did you save 15% on your premiums ??? (I’m joking of course).
You should give them a rating on the “Rate Your Adjuster” page of this website. You will reach more people that way.
Thanks for taking the time and having the guts to speak out.
October 7th, 2009 at 10:50 pm #admin
Mimi,
All I can say is document your communications and find out what the unfair claims practices laws are in your area. Sometimes, regardless of the merits of a claim, you can get coverage if the insurer screwed up with a negligent investigation.
The most common unfair practice is “delay”, so find out what the time limits are for answering letters and to deny or accept coverage. You can view typical claim practice laws in the UClaim.com publication “Claims Practices Laws With UCLAIM Commentary 2007″.
October 9th, 2009 at 8:10 am #Tom
I have Homeowners Policy H03 with endorsement H04 32. Rain water most likely enters my home where roof meets the side of the house and in a 2nd location where the deck meets the side of the house. Water runs down inside the walls of the house and rots the siding, sheathing, studs, sub-floor, joists, etc. The rot dammage most likely occurred over some time and was hidden until a rotted window was discovered. The highest estimate I have received from a Contractor is $44K. Insurance adjuster and insurance company indicate that this loss is subject to the $10K limit of the H04 32 endorsement which provides “Additional Coverage” for Fungi, Wet or Dry Rot or Bacteria.
The endorsement adds paragraph 2.e.(9) to Section 1 – Perils Insured against, which basically states that Constant or repeated seepage or leakage of water… over a period of weeks, months or years… and the resulting damage is “covered” if unknown to the insured, i.e. hidden within walls or cielings, etc.
That would indicate to me that my dwelling is covered for such a Peril under section 1 – Property Coverages. However because the “resulting damage” is indeed Rot, am I limited to the maximum of $10K as indicated in the Additional Coverages, which would appear to be “coverage ” in addition to the “Main Coverages” for the property? If this is the case, how can a home owner insure against the full extent of damage from hidden Rot? Also because of the limit, the adjuster indicates that my loss is $10K when it is actually significantly more and perhaps not eligible to be referred to a three member board of referees. Please help this is really bugging me!
October 9th, 2009 at 2:40 pm #admin
Tom,
Insurers have wised up in recent years and found it cheaper to just pay a stated nominal amount on what used to me non covered claims instead of fighting and risking an adverse court judgment and costs of litigation.
You have to be creative to get coverage with these type claims, and you write like a “creative guy.” Keep us posted, and email a copy of that endorsement to info@insuranceclaimhelp.org and Cc to info@uclaim.com, if you want a more “creative” answer
October 11th, 2009 at 10:03 pm #goodneighbor
Hi,
My townhome was recently damaged due to my nextdoor neighbor’s fire. I was not home when the fire took place. In attempt to rescue the neighbors who were trapped on the third floor, the fire fighters smashed through my windows on the 3rd floor to get to the neighbor’s unit and sledgehammered a hole in the wall to get through to the next unit. As a result, there is a huge hole in the drywall, 2 windows gutted out, smoke damage, and debris left behind by the fire fighters/rescuers.
I have made a claim using my insurance (All State) already and they have assured us of standard coverage including construction, accommodations(as I cannot stay in my townhome due to strong smoke residue), food, and cleaning. Are we entitled to any other claims? Should the firefighters /police be contacted for the damage done in my home and are they responsible for any or part of the damages? Any advice would be appreciated. Thanks.
October 13th, 2009 at 11:28 am #NFIP adjuster
As far as FLOOD INSURANCE goes, the adjuster does not have control over the process. He is provided as a courtesy – read the policy. Actually, it is not even a typical policy – it is written into the US code 42. All flood insurance goes back to the federal goverment and there is no coverage for such things as loss of use, even for commercial properties. In fact, with a rental property, you will get Actual Cash Value, not replacement cost. It is the way the feds wrote the policy. There is no additional living expenses, no loss of use, no replacement cost for commercial properties, second homes, or rental properties.
It is a “bar bones” “policy”, but it is the only one available, and they are all the same. Additionally, the feds give the crrier/insurance company/WYO 60 days from the day they receive the Proof of Loss/Final Report to send the check.
October 13th, 2009 at 1:08 pm #admin
Tom,
In the case you sent and quoted from, rot was not excluded in that USAA policy. Most policies do exclude it and or limit it specifically. But in your case, you are right, your endorsement gives you coverage.
I don’t see much room for creativity after reviewing your info. The only way to get past the dollar amount of the limit would be to show your insurer was negligent in its investigation by delay or other unreasonable handling that would have “added” to your damages. This would be looking for coverage via negligence, which is not covered in the policy, but does give you recourse against your insurer in the courts.
And as I said in an earlier post on this website, make sure what you have is indeed “rot”. If any part of the wood “looks” like rot, but you can’t push your finger through it, it’s not “rot.” It’s sudden and accidental damage, and you can claim that under the main policy.
Don’t waste time or money on “policy appraisal” (the referees you referred to) unless you get the insurer to agree to go over the 10k limit. Policy appraisal is not for coverage disputes. It’s for dollar amount of damages. don’t feel cheated, the 10K you got is way better than what most people have been getting for the last 50 years or rotted wood claims.
October 13th, 2009 at 1:20 pm #admin
Goodneighbor,
I don’t know of any claim you can make under your insurance policy against the fire/police. If they were negligent in what they did, then you can sue them.
As to your claim with Allstate, I can’t tell you what you are entitled to in a paragraph. You not only are entitled to a lot more items than you mentioned, but you are entitled to a fair dollar amount for those items mentioned. I suggest you get the eBook “Homeowners Loss Deluxe” from UClaim.com, currently on sale with a money back guarantee. You can view the table of contents online to see a bit of what you are in store for. And “Goodneighbor”, you are going to need help since you are in the “good hands” of Allstate
October 13th, 2009 at 1:33 pm #admin
NFIP,
Yes, we are so spoiled today, living off the fruits of the labor of “The Great Generation”. But its coming home, as our roads, bridges and infrastructure crumble around us. We may all soon have those bare bones policies if our government and economy can’t get back to the basics and stop trying to save the rest of the world and every freeloader and corporate swindler here at home.
October 13th, 2009 at 6:51 pm #f. michael conte,CPIA
here is one for me…. i recieved a denial of coverage for a toilet back up. the adjuster cited exclsuion for back up of sewer and drain. any thoughts.
f. michael conte
October 13th, 2009 at 7:18 pm #John
uclaim charges about $10 for each policy document. I have 9 policy documents listed in the Declarations Page = $90. That is really shady of them to charge for docs they’ve pilfered from others.
October 14th, 2009 at 5:20 am #Jay
We are planing to file insurance claim for the inventory we have lost either from our customer and/ or by our yard/ trucking partner.
Can you please help me with the procedure indetail for both instance…
October 15th, 2009 at 10:28 am #admin
What caused the toilet to back up? Tree roots, stopped up toilet, backup from a septic tank on your property or backup from the city sewer? If from the toilet, call it a “toilet malfunction”, not backup. That’s always a tough one.
October 15th, 2009 at 10:46 am #admin
John,
It’s MISLEADING the way you explain it, and that’s why UClaim has a disclaimer for customers purchasing those policies. Most policyholders have ONE policy per Declatations page and “endorsements” added to that.
UClaim does charge $9.95 for the main policy booklets, and they charge 3.95 extra if the buyer wants the endorsements, and that is for ALL of the endorsements UClaim has available for that policy, not “each”. The typical buyer purchases one policy form copy, without endorsements. Why? Because something is better than nothing, and most buyers are “penny wise, pound foolish” when it comes to insurance claims (that’s why this free website is so popular).
If you have a Declarations page with 10 policy forms (not endorsements) we would very much like to see that. You can email a copy to info@insuranceclaimhelp.org and Cc to info@ulaim.com.
As to whether its is a ripoff, most visitors know full well that they can’t even get a copy of “their own policy” from “their own insurer” after a loss, at least not when they need it. They may get it weeks or months after a loss, too late to help the policy holder.
And John, “pilfering” is not a wise choice of words. Sorry if I sound harsh, but UClaim.com is a gift to the insurance claim consumer by a semi retired public adjuster, Ron Cercone. And as the saying goes “you are looking at a gift horse in the mouth”.
October 15th, 2009 at 10:59 am #admin
Jay,
If you have a full business policy, it should pay you for what you paid (wholesale) for your inventory and retail for your business personal property (eg. tools, furniture, fixtures, etc. Your customers should get the “market value” (used value) of their property lost. I suggest the UClaim.com eBook Businessowners Loss Deluxe to guide you through it. Its on sale 50% off with a money back guarantee.
October 16th, 2009 at 10:14 am #Peter
My wife was in an accident. We tried to file a claim with the other party’s Progressive insurance company. They had to conduct investigation because the other party denied it was their fault. The insurance company came back saying it was my wife’s fault due to a security camera footage. I have asked my wife many times to make sure that she was 100% not at fault. I know it is in human nature to not accept our own faults and to place the blame on others. My wife really believed she didn’t do anything wrong. In any case, we really want to dispute their finding. They are saying it is 100% our fault. I don’t believe the video showed that. I have not seen it though. What do I do next? There was a police officer involved but I have not seen the report, if there’s any. Please help. My wife and I are very distraught. I wish people would just admit when they made a mistake.
October 20th, 2009 at 10:46 pm #admin
Peter,
First, get a copy of the police report and see what it says. Then ask for a copy of the video tape and if they decline, then ask to view the video tape. Put your request in writing and fax it. It would cost them more money to sue you in court than to simply show you the video tape. And if they won in court, I doubt the judge would award them costs since they withheld the evidence.
If they still decline to show you the tape, then they are either lying or misrepresenting the evidence. You might also make a complaint to the state department of insurance and let them get the tape.
You could also turn in the claim to your own insurer and let the two insurers fight it out.
You could also ask to speak to a supervisor at the other insurer since the adjuster may be out of line.
October 21st, 2009 at 8:13 am #Peter
Admin,
Thanks for your suggestions. After talking to my agent, it looks like the insurance companies will duke it out. But we have to put up the $500 deductible in order for State Farm to have a reason to go after Progressive. Another fishy thing they did was to have their own adjuster give me a quote, instead of the car shop give me a quote. Is that illegal? I found out my insurance company got a statement from the other driver admitted to fault.
Should I still tried to contact their insurance company to scare them a little bit so they would give in? or do I leave it to the insurance companies?
We don’t have $500 to put it up but if I have to, I will.
Any suggestion?
October 21st, 2009 at 4:30 pm #admin
Peter,
You could continue to press the other insurer, but keep in mind that your insurer will get all or part of the $500.00 back for you after they collect back from the other insurer. But it could take 6-12 months. If the other driver was only 90% at fault, then you would get 90% of the $500.00 back.
The adjusters estimate is ok, as long as the shop agrees with it.
October 23rd, 2009 at 9:35 am #PR
I have only had my Geico insurance and truck for a few months before it was broken into on the street. I had a touch screen Navigation unit in the truck. The agent told me he could only compensate $400. I am not sure if it was aftermarket or not. He told me that if it was aftermarket the policy does not cover it, that you have to pay more for that coverage. I didn’t know that was an option as it didnt ask when i signed up online. What options do i have here?
October 23rd, 2009 at 10:42 pm #Dennis Bran
My dads house just burned down and the adjuster is trying to settle quickly. The maximum limit on the building is $343,580.00 and they are willing to settle at 335,000.00. However, there are endorsements and riders I am not familiar with such as OPT. OL, Debris Removal, Opt ID.
I am going to look for the policy however it may have been destroed in the fire. Have the Dec. Page and requested full docs but not expecting quick response.
Suggestions?
October 24th, 2009 at 7:04 pm #admin
Hello Dennis,
Three suggestions:
1. Get the UClaim.com eBook Homeowners Loss Deluxe (half price with money back guarantee). Look at the table of contents online free to get an idea of what you don’t know.
2. Get the policy copy and endorsements at UClaim.com, now. The longer you go without information, the harder it is to get “unscrewed”.
3. Consider hiring a good public adjuster either now or later. Read the UClaim.com advice on how to hire a good public adjuster to work on a percentage on the recovery amount for “over” what you got on your own.
Good luck to you
October 24th, 2009 at 7:38 pm #admin
Hello PR,
Most auto policies don’t cover aftermarket items. But they should cover “factory” options. Is the insurer obligated to point this out when you buy your policy? Not in America.
You could argue in small claims court that the agent or company was negligent in not pointing this out, and hope that the judge agrees with you?
Yes, there ought to be a notification of this when you buy your policy, but that might “kill the sale.” This is one of those “buyer beware” things in our unregulated economy that allows big businesses to screw the little guy.
Next time around, fax your agent or company a letter with a complete description of your vehicle and advise that you want it fully covered. If they ignore it and if you later have a claim, they won’t be able to deny it.
October 25th, 2009 at 5:27 am #Cinde
This post is to Dennis Bran regarding house burning down. First you are doing right by trying to get the policy forms to see what is covered and what is excluded. See if your father had a “Homeowner” policy or a “Fire policy”. Homeowner could have the Replacement Cost and a Fire policy is usually ACV (actual cash value, less depreciation) which is what it looks like the adjuster is doing. You possibly could have loss of use which is 20% of your Cov A amount which could pay for expenses while you or father could not be in house while repairing fire damage or loss or rents if its a fire policy. The policy makes all the difference. Also, remember you could have separate contents coverage. Be sure to look at type of policy, then coverage and forms for exclusions. Let us know what you find out. Also the State makes a difference as coverage could be different in another state. Good Luck!
October 25th, 2009 at 6:13 pm #lori damato
Can anyone help me…. I have h/o with additional collapse coverage. I have had the policy 8 years the house was built in 1977 and the family room adition in1984… I purchased in 1997 and the h/o company has been out 2 times in the 8 years to inspect and it was fine… My family room collapsed with 24 teenagers and sits in a state of collapse since 2/20/2009.. My claim was denied due to faulty construction… The company agrees it is a collapse and I am covered for weight, decay, insect…. I did not own the home when it was built and the building code says it only needed to be fastened??? I have had to get an attorney and now they have increased my policy by $1631.00
I have put complaints in and called my senators office…. I am wondering if a new insurance company would insure nme while this is going on?? and How can a insurnace company deny a collapse claim…when you have collapse coverage.
The homeowners expectation is they are covered… It is time the insurance companied are made to disclose and review entire policies to consumers before just handing a policy and taking a check….It is a total injustice and something needs to be done…… Can anyone help me….
October 27th, 2009 at 2:08 pm #Tammy
What is the differenece between a HO3 policy and a DP3 Policy? Can I buy a DP3 policy if I live in the house?
October 27th, 2009 at 4:44 pm #admin
Tammy,
Both are RCV and all risk with named exclusions on structure, and ACV and “named perils” with named exclusions on contents. DP3 is usually purchased by landlords and HO3 by homeowners. HO3 includes liability coverage, DP3 does not have to have liability? HO3 has more bells and whistles, fufu stuff.
How about some of you visitors elaborate more for Tammy …
October 27th, 2009 at 4:59 pm #admin
Lori,
IMO, the insurer wrongly denied the claim. Collapse like yours is covered, and the insurer can try to subrogate (collect back) from the builder for negligent construction. And your claim is for “collapse”, not negligent construction, so the claim can’t be denied for “faulty construction”, unless there is a specific clause in the policy saying collapse is excluded if faulty construction contributed to the loss.
Your claim was “sudden and accidental” which is what insurance is intended for. The intent of the collapse exclusion is to exclude coverage for dilapidated and rotting structures. If you have an attorney working on a contingency, he should be on top of it and perhaps should have filed a complaint in court? Ask the attorney for copies of EVERYTHING he has done, letters, pleadings etc. and show it to another attorney if you think your attorney has been doing nothing. And pay attention to the statute of limitations to file suit. Don’t let your attorney blow that.
October 29th, 2009 at 5:10 pm #Richard
I live in Northern CA and have Farmers Ins for my structure and interior contents insurance. While away on vacation back east,the supply line on my toilet in the master bath broke and leaked water into the room. This caused major floor and wall damage along with mold issues. Farmers said they won’t cover the damage as it was a leak and not catistrofic failure of the line. The agent then told me that even if they were to pay for the damage, that as I live in CA, there would be a 30% increase of my premium due for the next 3 years because I made a claim. He informed me that this was for all insurance companies in CA as it is a CA law. What is this and when did this go into effect? Not only would I have to pay the deductable, but this incease in premium, all for making a claim.
October 29th, 2009 at 9:30 pm #admin
Hello Richard,
Just my opinion, but it sounds like your Farmers agent is more interested in protecting his “loss ratio” than helping you. Ask your agent to cite the California law that he mentions. I have never heard of such a law and would be very interested to know of such a law.
As to the “leak”, your adjuster is just dead wrong. Your loss was “sudden and accidental”. Now if they want to deny or apply a small policy limit for resulting mold, that’s ok. But cover all the other stuff, like buckled floors, swollen drywall, stained stuff, etc. Consider the UClaim.com eBook on denied homeowner claims to pursue the claim on your own and properly document the claim for possible litigation. If you get nowhere, then start hunting for an attorney to sue them.
Oh, and FYI, every time I’m away from my home for more than one night, I shut off the water valve to the house, just in case … I’ve seen too many stories like yours.
October 30th, 2009 at 5:49 am #f. michael conte,CPIA
richard,
i agree broken pipe is a standard coverage. please review your policy form for perils, i am sure you will find this in the coverage portion. Better yet ask your agent to read the section on coverd perils sounds like this will be his first time reading it……….
November 2nd, 2009 at 11:44 am #km
My vehicle had minor rear bumper damage done to it in a mall parking lot. I filed a claim with a quote from a local body shop. My insurance company approved the quote. However, the body shop has now called me and stated that they have received everything necessary to repair my vehicle. I don’t plan on taking my vehicle to this specific body shop, I was planning on taking it to the actual dealer. My question is can I go somewhere else? I haven’t received the check from the insurance company would they have sent it directly to the body shop?
November 3rd, 2009 at 3:10 pm #BJ
What is the protocol an insurance company is to follow for an accident claim? We’re in NJ and Twin Lights is the insurance company. My daughter reported her accident and the insurance company sent all of her correspondence to her finance company not her. Though the typing of the letters make it appear to be sent to my daughter by the address information etc.. This completely took her out of the loop and gave her no opportunity to dispute the ‘total loss’ of her vehicle. Phone calls from the insurance company were only to confiscate the vehicle, which we did not release due to the lack of information. Phone calls made to the insurance company were answered with one lie after another seemingly to keep my daughter and us in the dark. To cut to the chase, we finally got the insurance company to agree to sell back the title, but they couldn’t find it (the title) until I handed them the tracking info I worked to get from the finance co. Now that they have the title in hand they say it will be a ’salvage title’!!! Is the finance company allowed to send the title to the insurance company w/o any consent from my daughter? Is the insurance co. required to retitle the vehicle as ’salvage’? My daughter would like to repair it as the only reason it is ‘totaled’ is financial not mechanical or safety. My daughter has very limited options due to poor credit, so she needs this car.
November 3rd, 2009 at 8:07 pm #Jennifer
I live in a manufactured home and my agent had our policy wrote up as frame built. I recently filed a claim and was wondering if this will cause us problems. i asked my agent and he said not to worry about it and he will just make some changes to the policy. I cant hardly sleep at night though. Should I be worried?
November 4th, 2009 at 6:12 pm #admin
KM,
You can take the car to any shop of your choice, as long as your policy does not say you can’t. By the same token, the body shop can’t just charge anything they like either. The insurer owes the “reasonable” cost. And you don’t have to get it fixed if no lienholder is named on the check. Yes, they could have sent it to the shop. Call the insurer and tell them to stop the check and mail it to you. If you did not authorize the shop in writing to order the parts, then they can return the parts.
November 4th, 2009 at 6:15 pm #admin
Anyone want to take a stab at Jennifers question?
Let the agent stick his neck out and see what happens? Just keep your own nose clean. Don’t YOU mislead anyone.
November 4th, 2009 at 8:03 pm #f. michael conte,CPIA
jennifer,
you shoulkd be ok depending on who the carrier is and what were the building choices, on the application. i wouldn’.t worry
November 5th, 2009 at 12:11 pm #Richard
Can Farmers Ins Group charge me a “surcharge” for filing a claim? This is the “law” that the agent refered to when he told me that Farmers would charge me 30% of my premium for 3 years for filing a claim. I was told that it probably would be in my best interest not to claim this damage and “save” the surcharge for a larger claim, if and when that happens. I have found nothing that relates to a fixed or sliding charge for filing of any claims in my paperwork. What can I do? Any thoughts?
November 5th, 2009 at 6:01 pm #Jeff
Hello and thank you for taking the time to read this. I was involved in an accident about a week ago. I was turning left onto my home street and a 16 year old girl was turning left onto the street I was leaving. She had a stop sign and was determined to be at fault for the accident. She hit me on the side of my car on the drivers side back door. She ran for 4 blocks and pulled over after realizing I wasn’t going to stop following her. She told the police that she was trying to find a non-busy street to pull over at, she didn’t have her drivers license on her but was licensed she said. They were insured and was at fault for the accident. She was not issued a ticket. The mother doesn’t want to go through the insurance company but after being told that I want the money from the $840 estimate of damage, she decided that she would. The insurance company called me and told me that they would not issue me a check but would only issue it to the repair place. I do not want to have the work done at this time, what should I do? I own the car outright, no liens are on it. Is it not my choice on where/when I get the work done and shouldn’t the insurance company be required to pay me?
November 5th, 2009 at 10:54 pm #admin
BJ,
You need to read your loan agreement papers with the finance company to see if it takes you out of the decision process if there is an insurance claim. If there is no “insurance clause/s”, then I would think it unreasonable that you have no say or rights in the claim.
And you have a right to letters that are addressed to you. That also indicates to me that the insurer should be dealing with you, not the lienholder. Yes, sounds like they are trying to keep you in the dark.
November 5th, 2009 at 11:05 pm #admin
Richard,
Does this “law” have a statute number? I think it is probably just Farmer’s own policy, not the law, to charge the 30% extra for 3 years. Check with some other insurers to see how their premium compares to Farmers. If the accident was not your fault, you should not be surcharged anyway.
November 5th, 2009 at 11:21 pm #admin
Jeff,
Fax your insurer telling them to mail you the check. If they want to put in writing that they only send the check to the body shop, make a complaint to your state department of motor vehicles/consumer affairs and or department of insurance. Maybe the adjuster is getting kickbacks from the shop? You can make a complaint to the president of the insurer. And you can sue in court.
For those with lienholders, the insurer should still send the check to you, even if they put the lienholder on the check. Once you get the car repaired, the lienholder has to sign the check. Read your loan papers to see conditions about an insurance claim.
November 6th, 2009 at 2:34 am #admin
Hey folks, there’s some good people with claim problems needing your input in the Discussion Forum. Please jump in.
November 6th, 2009 at 6:02 am #f. michael conte,CPIA
richard,
first lets do the math, what will the claim pay out?
what will a 30% surcharge do to your premium?
finally, go to your states ins dept web site and ask them the question, i think the whole comment is balony, as many agents use this type of scare tactics for some strange reason. the state will have a filing on the carriers practices that they should be able to review and explain.
November 6th, 2009 at 11:05 am #Jennifer
Thanks! The adjuster came out this morning and it didnt appear that it would be a problem that our home had the incorrect rating. I have Allstate. He said that they will pay me a depreciated value and then after the items are repaired and replaced they will cut me a check for the actual cash value. Will I have to show them the costs of the repairs? I plan to try to get it done cheaper than they estimate to help cover my $1000 deductible.
November 6th, 2009 at 6:24 pm #Cortley
Hello,
My car was hit in the school parking lot. I took the estimate to their insurance and i want to know if they will write me a check with my name on it and not the auto repair shops or if they will pay the shop directly? What if i don’t want to get it repaired, can i still get the estimate check for compensation? How can i get them to give me the money?
November 7th, 2009 at 5:46 am #Tony
I am actually writing for my 78 year old mother who recently had a renter’s claim denied. The living arrangements there sound like something out of a bad soap opera, but need to be explained. My mother lives with my sister (her daughter) and her 3 kids as well as my sister’s ex-husband (yes, ex-) and his new wife and 6 year old son. My mother has her own renter’s policy. My sister has her own and the ex-husband’s family has their own (3 separate policies, 2 different companies). Told you it was weird. Anyway, my mother started her policy in January 2009 and it was in good standing in July when a fire destroyed the house they were renting while they were all away over the July 4 weekend. Although arson is suspected (and, IMO, probable), there is no evidence any of the residents are still considered suspects or had any involvement (residents are frequently the initial suspects). The apparent reason for the denial (she hasn’t received a written explanation yet) is inconsistencies in her “testimony” as to the location of various objects within the house. She claimed an item was in one room when it was apparently in another, for example. My questions: can an insurance company deny a claim based on an elderly client’s faulty memory? Can they deny based on lack of knowledge regarding an item’s value? How about lack of knowledge on the insurance company’s part. When told there were at least 2,000 DVDs in the house, one interrogator claimed “there aren’t 2,000 DVD titles available” (despite the fact that Netflix claims over 100,000 titles are available on their site). As an outside party, I realize my information on the case may be incomplete, but I have tried to give you what I have been told. Is there any info you can give me (or more you need) that I can pass along to her/them. P.S. the other 2 claims, which are both with the same company (but a different one from my mother’s) are still open.
November 7th, 2009 at 7:48 pm #Andy
About six months ago, my wife and her side of her family were on vacation in Florida. Her mom pulled out of a parking space after a White SUV passed and the coast was clear.
While she was pulling out, the White SUV stopped and reversed direction, hitting my wife’s car, which was only about two to three feet out of the parking space (we have the pictures to prove it).
There were multiple witnesses and the police report indicated that the driver of the White SUV was at fault. No citations were given since it was on private property.
A claims agent was working with us on the claim and we did get an estimate done at the shop of USAA’s choice, for around $650. USAA’s claims person indicated that the other driver was at fault at some point during the multiple conversations we had.
Since then, the claim was transferred to another claims agent who says the file did not show any history or claim that the other driver was at fault. They then indicated that they were working with the other driver’s insurance company and would contact us soon.
USAA claims that the liability is 50% our fault and 50% the other driver’s fault since my mother-in-law was supposed to wait until there was ‘reasonable’ safety to exit the parking space. It is quite reasonable to believe that the driver of the white SUV would not throw it in to reverse and go in the wrong direction in the wrong lane without looking, which is exactly what happened – as evidenced by the testimony of the passengers of the white SUV.
Since when is it ok for an insurance company to contradict a police report that states the other driver is at fault?
We have pushed this for months now and are at our last resort, and are considering arbitration. However, USAA says that they only offer 0%, 50% or 100% liability. In other words, if the arbitrators say that it is 51% our fault, then it rounds to 100% our fault and then our rates hike and it stays on our records for a few years. With the 50%/50% option, that would not happen.
However, if we take the 50%/50% option, we must pay our entire deductible and wait for USAA to obtain the other driver’s half of his deductible prior to us then getting a refund of half our deductible. Is this common insurance practice?
Is it even legal for them to contradict a police report?
November 10th, 2009 at 1:20 pm #admin
Jennifer,
That was the easy part. Now if you want to come out of this with money in your pocket and not get outsmarted by your adjuster, and hate your adjuster for it, and stay within the law, I can’t tell you how to handle all the possible moves to make in a couple paragraphs. It’s like a chess game and the moves change with every new letter and call from your adjuster. If you want to learn how to play the game, get the eBook at UClaim.com Homeowners Loss Deluxe.
You can also try the Discussion Forum in this website for ongoing help from other visitors.
If any of you visitors want to give Jennifer some advice here, please join in.
November 10th, 2009 at 1:24 pm #admin
Cortley,
They should make the check out to the owner of the car, you. And also possibly the lienholder if there is a loan on it in some states.
November 10th, 2009 at 1:42 pm #admin
Tony,
Way too complex for a couple of paragraphs of answers. You either need a lawyer (if you can find one or afford one) or get two of the publications at UClaim.com: Homeowners Loss Deluxe (it covers renter claims) and Denied Home and Business Claims. If the insurer is going to do an EUO (Examination Under Oath) then you need the eBook on that as well. The insurer will slaughter your mom in a EUO, so don’t go through it without a lawyer or the UClaim eBook on that.
Any visitors to this website are welcome to counsel Tony on this, either here or in the Discussion Forum, if Tony wants to post without delays.
November 10th, 2009 at 1:54 pm #admin
Andy,
I don’t know the liability laws in Florida, but that is possibly correct, on the 51% part. Call one to those big yellow page ad accident attorneys in Florida or the Florida DOI.
If it was me, I would just go into small claims court with my evidence and tell your insurer to drop the claim so you don’t risk the premium increase.
November 12th, 2009 at 9:17 am #Andy
I guess my main question is about the deductible. Is it normal to pay an entire deductible to the insurer, then wait on them to obtain the funds from the other insurer before giving half of it back to us?
November 12th, 2009 at 10:17 am #Sherella
My Automobile insurance company denied my claim, stating that the fire was intentionally set. What should I do?
November 12th, 2009 at 11:49 am #Alison
I have travelers home insurance. My home had a fire. I hired a contractor. The contractor did not evaluate the plumbing in the whole house. The contrator drywalled over problems and installed new flooring. Well now there is leaking and damage. The contractor ask me to open another claim. I do not want to open another new claim. My premium went up $600 annual for the first came. I have only made 2 or 3 payments to the contractor. I have contacted the insurance company and told them I hold the contractor responsible for not checking the plumbing. No sure what to do if I have to open a new claim my deductible is 2500.
November 12th, 2009 at 8:01 pm #admin
Andy, yes, that’s normal. And it can take months to get it back from the other drivers insurer or years or never to get it from a driver without insurance. That right of “subrogation” to your insurer is in your policy contract. Now if you can find a way to “encourage” the other driver or his insurer to pay up sooner, then go for it.
So take some kids with drippy ice cream cones into their plush claim office and let em run wild while they “find an adjuster” or manager to find your file and discuss it with you. You may not have to wait very long
Or sit outside their claim office, or their best agents office on the “public” sidewalk with a sign saying you got screwed by xyz insurance company
Oh, and you may as well put a hat out there for donations while you are at it 
))
These “Guerrilla tactics” are one kind of minimal effort “last resort” strategy, short of litigation, you will find in the eBooks at UClaim.com.
November 12th, 2009 at 8:13 pm #admin
Sherella,
Unless they have evidence it was YOU who set the fire, they can’t deny the claim. All they can do is drag out the investigation in hopes that you will just fade away. Short of hiring a lawyer and or public adjuster, get the eBook from UClaim.com on denied auto claims. And if they demand an EUO (examination under oath) both you and your attorney should get the eBook on that subject. You can view the tables of contents online free. The eBooks are on sale with a money back guarantee.
November 12th, 2009 at 8:21 pm #admin
Alison,
If the contractor was one you chose, your insurer will probably deny your additional claim if the damage was due to his negligence. But it if the damage was part of the original loss and just overlooked, then it should be covered as a supplement to the original fire claim with no more deductible or premium increase.
The sooner you turn it in the better, before the water causes “rot”, which is not covered.
November 13th, 2009 at 10:48 am #Alison
The insurance adjuster, who recommended them, stated I needed to open a new claim. I taked to his supervisor who said she would look into this further. This is the original statements from contractor when asked why they did not inspect plumbing prior to drywalling. “We would not normally check the whole house plumbing for a fire this size. We did inspect the plumbing that is in proximity of the fire. It appears the leak from the third floor might have been ready to leak for some time. We are assuming this due to discoloration around the pipe. The leak on the second floor looks like a problem from the original construction.” my home showed no visible signs of leaking prior to the fire. After the fire by house leaked water for days. How two unrelated leaks started at the same time is beyond me, both causing damage to newly installed floors.
I have not heard from anyone in a week. I asked contractor to update check list questions on the status of the original work to be done including Electric, AC, Sprinkler system etc inspections. They have not answered me. Any suggestions of what I should do at this point? I don’t plan on giving them any more money until I am back in my home with everything completed to my satisfaction.
November 14th, 2009 at 10:27 pm #admin
Alison,
IMO, unless you can get another contractor, plumber and or engineer’s opinion contrary to your contractor’s opinion, then you are in a tough spot.
Anyone else want to chime in on this?
November 17th, 2009 at 8:55 am #Dawson
Our home sustained some damage due to a water leak. The insurance company quickly settled the claim and sent us a check to cover the repair work. The amount was based on an estimate from the contractor. However, the actual costs turned out to be lower than the estimate. Do I need to notify the insurance company and return the difference?
November 17th, 2009 at 3:39 pm #toyia
i receive a insurance claim check for storm damage it had my name mortgage company, and the contractor. I sent it to the mortgage company to see if they would endorse it first can they hold the check if they refuse to endorse the check if so for how long.
November 17th, 2009 at 3:59 pm #chad
Admin,
Thanks for all the great info, you are very helpful to us poor accident victims. I am currently negotiating a total loss settlement, I had casually notified them I had a rental car on my credit card that I was expecting them to pay for. They took 7 weeks to make an initial offer for the loss and I have prepared my desired settlement over the past 2 weeks. I reminded them I have the rental car and they said I should be turning that in since they made an offer. Today I received a call from the rental company saying that the last day the insurance would pay for it was 4 days ago. I will be sending my request to them tomorrow, but since we haven’t settled I am in need of the rental still. Are they just trying to push me to accept or do they have the right to cut the rental as soon as they have offered me something? Thanks again.
November 17th, 2009 at 8:08 pm #admin
They can end the rental if their offer on the vlaue of your car is reasonable. But the offer will probably be lowballed, so if you fight it and get them to pay more, then they owe the rental during the negotiation. Consider one of the eBooks on Total Loss Automobile at UClaim.com to get a fair settlement on the car. They are on sale with money back guarantee.
November 17th, 2009 at 9:26 pm #admin
Well, even though the policy says the insurer owes the lowest amount actually spent, I have never heard of an adjuster checking back to see what you actually spent, unless you were claiming held back depreciation. There is nothing in the policy that says you have to return any unused money. But if it makes you feel good, go ahead and return it.
November 17th, 2009 at 11:30 pm #admin
Toyia,
I don’t think they are allowed to hold onto the check, but its worthless to them if you have not signed it. Once the repairs are done, tell the mortgagee the job is done. After they send their own inspector out to confirm the repairs were done, THEN, legally they have to sign the check and return it to you.
November 18th, 2009 at 7:20 pm #Joe S
My motorcycle was stolen and recovered. The police called me on Thursday and told me I could pick it up. I didnt want to pick it up without an adjustor looking at it first. I tried to call Progressive on Friday and Saturday but I couldnt reach my insurance agent and no one else would help me. I finally spoke with my agent on on Monday. He sent someone out to the impound lot on Tuesday. Today (WED), they called me and told me to pick it up and I owe the Police Department for towing and storage. I owe $34