Home Insurance Claims
Have a question about home insurance claims? Post it here for our contributors to answer. Questions under 100 words are more likely to receive an answer.
Have a question about home insurance claims? Post it here for our contributors to answer. Questions under 100 words are more likely to receive an answer.
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 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 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.
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.
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 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.
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 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 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 1:52 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 3:59 pm #Kelly
Kuykendall,
Would your insurance allow you to rebuild on a different piece of real estate?
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 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 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 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.
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 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 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 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 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 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 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 4:21 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)
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 11:43 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 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 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 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 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!
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 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 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 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 3:59 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 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 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 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 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 1:59 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 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 4:34 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 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 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.
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 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 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 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 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 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.
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 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 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 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 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 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 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!
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 13th, 2009 at 7:26 pm #admin
Hello all,
Check out our new discussion forum here at insuranceclaimhelp.org!
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 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 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?
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 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 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 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 12:54 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 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.
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 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 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 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 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 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 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 6:15 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 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 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 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 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 8:21 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 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 20th, 2009 at 1:05 am #WS
Hi:
We just suffered some water damange from malfunctioning washing machine. Basically, the insurance company is covering everything for the replacement value. But, I am finding out that when they do the estimates for the flooring replacement, they discount by 15% because their vendor can do it for 15% below the estimating software. In addition, they will not pay out 20% of the estimate for the overhead and profit (O&P) for the general contractor if I don’t do the work or if I manage the work myself. They are really pressuring me to use their vendor; but I don’t trust the insurance campany to do a quality job or identify
Can you please tell me if the insurance company can basically knock off 35% if I manage the work myself? This doesn’t seem right to me. I read some postings that say that insurance comapnies cannot withold O&P. But, I didn’t see any postings from California. Do you know if the insurance companies can do that in California? I really don’t like them holding back 15% of the flooring cost either…. Thank you. I would appreciate the help.
November 20th, 2009 at 1:50 pm #admin
WS,
In California, it is not against the law for insurers to withhold P&O from “owner builders.” However, the only major culprit, Farmers Insurance, ceased the practice in California in the late 1990s after settling
a class action lawsuit out of court over this issue. Farmers feared they would lose and that the result would create a new legal and binding precedent for use in California and other states. There is statutory law in other states prohibiting the withholding of P&O, but not California.
Its tricky and you can screw yourself if you don’t handle it right. For a detailed discussion on how to get your P&O in California without suing your insurer, consider the eBook at UClaim.com entitled Homeowners Loss Deluxe, on sale with a money back guarantee.
December 7th, 2009 at 12:42 pm #Rachael Stuart
Hello,
I live very near (300 yards) from the “Station Fires” in Southern California. Although my house was not evacuated and we weren’t in immediate danger, there was tons of smoke ash.
I was approched by a lawyer type who wants to “help” us make a claim to our insurance company for the smoke and ash. He says we should get a large sum of up to 10,000 for clean up, basically, and he will take 25%, but wont take any money unless we are granted a settlement. He also calims our rates will not go up, due to the damage source being a natural catastophey.
Is this a scam? Also, is it true the insurance co. won’t raise our rates?
Thank you for your help.
Rachael Stuart
December 9th, 2009 at 12:12 am #TRB
I live a a 4 home townhouse complex covered by Allstate Commercial Policy for HOA and State Farm Insurance for personal property.
In Nov 2007, our shared wall neighbor’s hot water outline broke in the 3rd floor attic. Water ran for up to 3 days down through the second and 1st floor of our home, as both parties were out of town and the leak was not noticed until then. A claim was filed and the loss was covered by Allstate and depreciated and personal property covered by second carrier, State Farm, including additional living expenses and replacement cost of many items. Work was complete that remodeled our entire kitchen, and living area as well as carpet on both floors and wall repairs in Feb 2008 and the claim closed in June 2008. We were out of the property for 3 months while being repaired. Repair and living costs = almost $50, 000.
Recently (September 2009) our foundation cracked and settled in the kitchen. Allstate was notified and they hired an engineer. The engineer determined that he could not rule out the cause of the foundation crack being from the expansive soil under the slab being suddenly saturated at the time of the original leak and it taking up to 2 years to dry out, causing settlement and cracking. Allstate had no choice but to cover this loss under the original claim. The problem now lies with State Farm. Allstate states they will only cover to replace items original to t he building. We had travertine tile floor which replaced our previously tiled floor. Both companies bore the cost when the tile was replaced two years ago (Allstate for original to building and SF for actual replacement value). To repair the crack about 70 % of the tile must be removed. Allstate says they will only pay up to what is original to the building, and SF is saying they do not cover settlement damage regardless of the cause. So i am stuck with Allstate paying about 20% of what it would cost to replace the floor and SF saying it past 1 year to reopen the claim and they don not cover damage from settlement for any reason. This same response was given to other items that will need to be removed and replaced in kitchen. Basically, at this point I will end up with a settlement that wont even replace what they covered the first time around for a legitimate claim and a covered loss. Is this legal for both companies to do? Not pay for what they already covered if new damage is found based on the original leak. I doubt the engineering firm will get hired by Allstate again, since they basically forced them to cover the loss, but now they are throwing the cheap talk around…..
December 9th, 2009 at 1:03 pm #Maureen K
Just was denied a claim for water damage that has been hidden behind a wall for at least a year (studs actually rotted out)
They claim the damage is considered “long term damage” and they don’t cover that. I can understand that, but if no one could SEE the water damage - hidden behind a wall, until one day when the hardwood floors near the wall start to show damage, how is anyone supposed to know to fix it?
Storm damage and loose flashing let the majority of the water in and once the moisture barrier was compromised, water started coming in behind the dry stack stone outside.
It just seems unfair to punish a homeowner for something they can not see. Any thoughts? I really want to fight this!!!
December 10th, 2009 at 1:49 am #admin
Rachael,
1. You will have to ask your agent if your rates will go up or not. Not all companies are the same in this regard. I can tell you that many insurers raise rates and cancel policies after homeowner claims regardless of whether the damage was due to your fault or not.
2. If the “lawyer type” you refer to is not a licensed lawyer or a licensed public adjuster, then they can’t legally represent you. And you can check for complaints on public adjusters at the DOI. I’m not sure where you go to check for complaints on attorneys, possibly the California BAR?
3. And I would be real suspicious if your “lawyer type” was a really a lawyer. Most lawyers are not interested in such low dollar amounts.
December 10th, 2009 at 2:21 am #admin
TRB,
The volunteers at this website are more likely to answer short questions if you want to condense it, but I’m posting your question anyway.
Does anyone want to take a crack at TRB’s post?
December 10th, 2009 at 2:32 am #admin
Maureen,
With most policies and insurers, you cannot fight this since this exclusion, although seemingly unfair, is clearly worded in the policy.
However in recent years, some insurers have added wording in their policies that extend coverage if the damage was hidden from view. So read your policy to see if there is “an exception to the rot exclusion.”
December 10th, 2009 at 11:21 pm #TRB
TRB Condensed Version
I live a a 4 home townhouse complex covered by Allstate Commercial Policy for HOA and State Farm Insurance for personal property.
Questions
1) What is the Statute of Limitation in California to open a previously covered claim when new damage is found. Original loss date Nov 2007, new damage found Dec 2009?
2) New damage is foundation cracking. Allstate (primary) sent out engineer who could not rule out original leak did not cause soil saturation, hence settlement of foundation. They are covering loss under original claim, State Farm says the 1 year lawsuit period has passed and they wont cover it even if I file a new claim. Do they have an obligation to cover what they already paid for since new damage is from original cause? A second independent engineer determined the same as first, SF still wont budge.
3) Allstate had an adjuster come and estimate what it would take to repair damage in Sept 2009. They withheld this estimate, even after asking in writing 3 times for a copy of it, until after a contractor estimate was submitted by myself. The contractor estimate did not cover to repair everything and was 1/3 of their adjuster estimate. Aren’t I entitled to the entire cost for repairs that their adjustor’s estimated at minimum. Even if I don’t do all the repairs at once?
December 11th, 2009 at 6:32 pm #admin
TRB,
1. IMO, statute to sue is 3 years on property damage and 4 for breach of contract. I would say the statute runs from the time the claim is denied or paid. This is why most insurers will let you reopen a claim even though the policy may say 12 months from loss date.
2. If that’s how Allstate wants to play, get a lawyer and and let Allstate have a bad faith lawsuit
3. Well, you got outsmarted on this part, and legally, by Allstate. Now you have an uphill battle. If you want some detailed advice on how to proceed on this part, consider the eBook at UClaim.com “Homeowners Loss Deluxe”. (And a lawyer won’t be able to help you on this part).
December 11th, 2009 at 9:55 pm #TRB
3. How could it be legal, if even after being asked in writing 3 times over a 1 month period Allstate failed to provide the estimate that they prepared, and stated to me in writing they needed a written estimate from me before they would evaluate and pay on the claim? They ignored the request and never responded to it in writing or verbally. Basically they withheld information being used to evaluate the value of the claim and required an estimate from me to even evaluate and pay the claim. This seems like a double standard.
As an update though, the claim representative left out the word “exterior” in her coverage letter and originally only stated “will return the interior and foundation to its pre-loss condition” The exterior was supposed to be included and it too here 3 weeks to rewrite the letter, and after my submittal of course. A revised letter was sent to me literally 2 hours after I submitted the contractor estimate. In her response email to the contractor estimate she included their estimate at 3 times as much.
How is all that legal? I will check out the UClaim material. GREAT site by the way, best I have seen in my searches!
December 11th, 2009 at 9:58 pm #TRB
Last question
3. Can’t I get another estimate legitimately, and submit it? To be honest, for all I know the contractor could be incompetent, his estimate was very vague. There estimate made me question the contractor and his estimate in all actuality….
December 13th, 2009 at 11:29 am #Bill Green
This would be a great website if not for the fact that you want to sell a book for everything. Your greed takes all the personality from your website.
PS, Please don’t respond with another smart ass answer, and don’t tell me i need a book to read.
December 16th, 2009 at 9:28 am #Julie
Can you tell me what “applicable depreciation” is? What does it mean?
I have a Full replacement/repair cost of 18940.00, Applicable depreciation is 5257.00, minus our 1,000 decutible gives us 12,682. Do we have the ability to claim that 5257.00? How do we go about doing so?
Sorry if this has already been covered here somewhere - this site is very helpful.
Thanks!
Julie
December 16th, 2009 at 7:07 pm #admin
Mr. Green,
Don’t dish it out if you can’t take it.
1. It’s the folks who buy those eBooks that put the bread on our table, so we can take the time to answer questions for the ungrateful freeloaders like you. “Personality” (your words) doesn’t pay the bills.
2. I recommend the UClaim eBooks because there is nothing out there even close in the quality and depth of information. I can say that after having purchased everything I could lay my hands on over the years. You and any visitor to this website are welcome to recommend and comment on other insurance claim eBooks and resources.
3. And if you are an insurance claim expert … and … philanthropist, who is willing to give freely of his time to those in need, PLEEEEZE help me out here and add your comments to any of these Q and A’s.
And even if you are not an expert and just want to voice your opinions and experience, please help get the forum going. We created the “Discussion Board” especially for people like you.
4. And what about the “Rate Your Adjuster!” page? With all the problems you have had with your adjuster and insurer, why not alert your fellow consumer to those bad boys? If you fear your insurer, you don’t even have to use your real name. C’mon Bill, give us a bit of your time, for free, and don’t be, in your words, “greedy“.
December 16th, 2009 at 7:16 pm #admin
Julie,
Depreciation was taken on your structure repair or on your contents. Either way, if you have RCV coverage, you get reimbursed that amount “after” replacement or repairs are made. If you want to be sure you don’t get outsmarted by the adjuster during the process and end up with nothing or far less than the depreciated amount, the topic is covered in detail in the UClaim.com eBook Homeowners Loss Standard.
December 16th, 2009 at 7:26 pm #admin
TRB,
Anyone want to chime in on TRB’s situation? How about you Mr. Green?
December 21st, 2009 at 11:39 pm #TRB
Mr. Green
I have to side with admin. The honest truth…I went to purchase the eBooks at UClaim. I did not complete my transaction with Paypal one day and the following day I received a very nicely worded email requesting any information of why I didn’t purchase the product (such as Paypal issue, or processing problem etc). The email was from Ron who assisted me with selecting the appropriate ebooks and they are tremendously useful and full of very good information.
Ron and I communicated via email about 15 times and he was very helpful with many questions as well. Given the fact that at first I thought I was getting scammed or something, I truly believe Ron is out there trying to help consumers such as myself…and he is very honest and willing to help where he can…..and I an not in any way affiliated with this web site or Ron, I stumbled upon here accidently one day a few weeks ago and there is the story
email from Ron
Troy,
You are welcome. People like you make my efforts worth while.
And yes, please let me know how your claim ends up. And once you find that the cost of your purchase has paid for itself many times over, please leave some feedback at the Feedback link on the UClaim homepage.
Best Regards,
Ron
January 4th, 2010 at 11:27 am #Alan Buckner
I found your very helpful website and have a question. I had a leaky pipe in my slab and Allstate says my policy does not cover it. The plumber and a water damage contractor think that maybe it would not cover fixing the root cause, but should cover the water damage regardless of where the leak came from. Also, they mentioned that the slab leak exception was originally meant to exclude sewage issues yet mine was fresh water (hot). Do I have any grounds whatsoever to get Allstate to pay for anything? Thanks for the advice.
January 4th, 2010 at 4:32 pm #admin
Alan,
The slab leak exclusion applies to fresh and waste water, any water that causes long term damage like rot and mold. Sudden and accidental damages are covered. Delaminated and black plywood subflooring can be “sudden and accidental” if you can’t push a butter knife through it.
As to cause of loss, If you say the cause was the 50 cent piece of copper pipe, then the insurer should cover the plumbers 50 dollar or 500 dollar bill to get access to that 50 cent pipe. This is the kind of info you will get in the UClaim.com eBooks. Good luck.
January 5th, 2010 at 6:17 am #f. michael conte,CPIA
sorry to sound like a broken record, you need to review the exclusions section. If there is no specific exclusion, then look for the perils section to see any broken pipe limitations. You might also as your agent to do this research for you. If it is exluded then typically damage as a result will be excluded as well. Sometimes the exclusion will exclude the repair cost of the pipe but cover the coss of opening and closing.
Good Luck
FMC
January 11th, 2010 at 4:31 pm #Alan Buckner
Admin and Michael,
Thanks for your responses. I finally received my official copy of my insurance policy (Allstate Texas Lloyd’s HO-A Plus Homeowners) and it is very clear that it excludes water damage due to leaks at or below the slab. I thought I may find a loophole some where, but the lawyers did a good job of being very comprehensive and clear. Thanks again for trying to help!
Alan
January 12th, 2010 at 2:15 am #admin
Alan,
Its unusual for a policy not to cover a sudden and accidental water “supply line” leak anywhere in the house, including under the slab, in most states.
I just looked at a Texas Safeco HO3 policy and it has the same exclusions for plumbing leaks under the slab as your Allstate policy. But the ISO generic HO3 does not exclude it.
I wonder if any insurers in Texas cover pipe breaks in the slab?
January 12th, 2010 at 3:27 am #admin
Attention please you Visitors who monitor this website via RSS feeds or other methods. Due to the increasing number of visitors with questions, your help is greatly needed. Questions will be posted, but Admin response may now be either delayed, or not given at all. Your involvement in the Discussion Forum page of this website is also necessary to its success or failure. Thank you.
January 12th, 2010 at 9:32 am #Alan Buckner
In an initial discussion with my Allstate agent, she mentioned that they had other policies that included this coverage. I’ll be checking on this and will report back.
I heard that Texas was hit hard with mold claims before these policies were rewritten so maybe that’s why Texas companies are being more conservative in their coverage than other states. Just a guess.
January 15th, 2010 at 3:12 am #mandy
my daughter sat on the sofa and busted it can u claim of the house insurance
January 15th, 2010 at 9:48 pm #Tina
My rental property was vandalized and I have some questions because I have not been able to get the adjuster to return any of my calls, after he sent the initial check dated Oct. 6 2009:
1. Can the insurance company make me return any unused amount from the initial check?
2. Is the loss of rent paid separately or is that calculated as part of or deducted from the holdback amount? The adjuster estimated only 2 months as loss of rent, due to delays by the bank in their piecemeal disbursement, the construction completed on 1/13/2010. Can I request payment for loss of rent for the remainng months the property was under construction, as the contractor already let them know it would take much longer than the adjuster had estimated?
3. The remediation took 3 weeks for cost of $6,000 directly paid by insurance company. Is this amount deducted from the holdback?
4. The adjuster asked us to turn on utilities for the reconstruction and submit bills for separate payment. We called Metlife tonight and were shocked to learn that the case had been closed two days after the check was sent. We never received any letter advising that the case had been closed. Is this normal procedure for insurance companies?
5. The adjuster did not pay for the fridge and garage door opener which were also vandalized. I have replaced these out of pocket after notifiying adjuster. How can I get reinbursement? Can I add the receipts of these items to what have to send to the adjuster?
6. Can we be our own contractors because the man we hired wanted to be just a handyman to avoid tax issues? What are the implications and what do we submit to the insurance company?
I would appreciate getting your number for more detailed explanation, if required. Thank you for your time
January 21st, 2010 at 6:32 pm #joe
We had a total loss house fire last year. Like many of the above post, our adjuster was great and compassionate at first, but now, is being a pain. I have many questions but will start with one. For our contents, there are several items such as clothing, that we had multiple of. We are not receiving any of the depreciated funds until the total given is reached. Example: we have 20 pairs of jeans. They valued them at $20 each for a total of $400. The depreciation was 50%. They gave us $200. We may not replace the 20 pairs. The way I look at it, they should break each individual pair and give us 50% of each pair of pants. They are saying if we only buy 10 pairs, we have just reached what they gave us so will not give us anymore. I look at it as if they should give us an additional $100. What is right? One other quick question: It has been suggested by some people for us to purchase items we dont intend to keep, turn in the receipts to get the depreciation amount and return the items. Is this ok to do.
January 27th, 2010 at 3:12 pm #Chrissie
Hired a PA to handle water damage in NYS. Received check for contents and rebuilding. The check for rebuilding also has mortgage company on it. Husband is a contractor. Mortgage company stated if we “self contract” we need to provide receipts. If we put our company as contractor receipts are not needed. Please advise if this is correct.
January 27th, 2010 at 6:39 pm #admin
Chrissie,
It’s a very delicate line you walk when you do that because you don’t want the insurer to with-hold the “RCV holdback” because you did it yourself, even if you are a contractor. A good PA should be able to guide you through this. For $79.00 you can get the guaranteed eBook at UClaim.com “Homeowners loss Deluxe” that will guide you through the process and make sure your PA doesn’t screw it up. I’m sure you have a lot of money at risk.
January 27th, 2010 at 9:25 pm #TINA
Still patiently waiting for your response to my post of 001/15/10 @9.48pm.
Thanks for your anticipated response.
January 29th, 2010 at 4:41 am #admin
Tina,
No disrespect, and its like beating a dead horse in this website :), but like most forums, you are asking for way too much information for Admins and other visitors to give you in one or two sentences. You can get very detailed discussions for your needs in one of the UClaim.com eBooks. You can’t beat the guarantees there.
January 29th, 2010 at 6:05 am #f. michael conte,CPIA
Ditto!!!!!!
fmc
February 11th, 2010 at 8:05 pm #Kelly
Hi, my home was vandalized about 2 years ago. The only thing taken was some jewelry, and two doors/frames were damaged beyond repair. I called the police immediately, have a case #, and called my insurer (Travelers) right away. The person at the insurer wanted super-detailed information on what was taken, which it took me quite a while to figure out because the jewelry belonged to my daughters who were away at college at the time. She sent me a large stack of forms, and wanted photos of the items (which I did not have) and receipts (which I did not have, most of it was gifts from out of town family). I told her it was going to take me a long time to try to assemble as much info as I could. In 30 days, she sent me a letter saying my file was being closed since they didn’t have the forms back. I called and told her it was going to take me several months (till my daughters came home at least) to figure this out, she said that was fine, they would re-open the file automatically when I sent it in. Well, none of it was urgent, we were busy, and I know it’s my fault that time got away from me, but I figured I would eventually get it figured out. When I finally sent all the paperwork in, yes I know, 2 years later, they didn’t respond, and when I called they said the claim and been closed, too much time had elapsed, and therefore they had no obligation to pay anything toward the claim. They also said they never received the package I mailed, which I don’t believe. The total claim is about $5,000. Does this sound right? Do I have no recourse even though I called them within the first few days? I still have the same insurance by the way. Thanks for your advice!
February 12th, 2010 at 9:27 am #Harry E
At what point can insurance company ‘mistakes’ be used as proof of intentional or negligent Unfair Claim practice. For example, the company tried to pay Living Expenses at approximately 50% of actual expenses {the problems included (1) their crediting themselves with having made a ‘lost’ payment that they neither a. they described to me, b. had me sign the standared proof of loss for, c. had any evidence of having sent etc; (2) delaying payment by making the check out to the wrong recipient; (3) withholding approximately 2-3 times the actual dollar amounts for ‘now unnecessary utility costs’; (4) simply leaving out groups of invoices covering long hotel stays for which invoices were properly submitted; (5) not acknowledging receipt of invoices and waiting as long as 5 months to pay the parts of the invoices that they proposed paying. etc} In addition, strategies like agreeing to accept one type of follow-on policy, then charging the Escrow account for an unnecessarily more expensive policy — the unnecessary additional expense amounting to hundreds of dollars — and then making a refund very difficult to obtain. I think that a company would refuse to process a claim on the grounds of ‘fraud’ if a policy holder would try this kind of thing. Again, would the above mistakes and reluctance and slowness to prevent or correct them amount to Unfair Claim practices at some point?
February 15th, 2010 at 7:23 am #F MICHAEL CONTE
i always sugest that the person asking the question advise the name of the carrier. i do this for two reasons the first, it is easier to i dentify a pattern of poor claim practices when cites like these are available, hey you never know someone out ther may be getting the same treatment and now you can prove that this is no accident. Second i sell insuance all day long, and i know that as the consumers become more savy they conduct searches to determine how others are treated at claim time. Insurance carriers spend a lot of money to make you believe that they are concerned. an experiance such as yours speaks volumes, would you reccomend this carrier to someone else?
i would suggest that you identify the regional vp for claims for whatever company you are dealing with and bring this to his/her attention. also mention that you will be alerting the media, i am sure there is some consumer oriented reporter that will grab this one. i would also suggest alerting you states insurance department and make the allegation of unfair claims practice, they will at least have to investige the complant.
fmc
February 15th, 2010 at 1:41 pm #Jeannine
I think I have a slab leak in my garage. I live in So. Cal and have Farmers ins. I have been told, call your ins co., don’t call your ins co., get a plumber to look at it, don’t get a plumber to look at it, get a techinician that can listen for the leak…etc.
I have had no previous claims on this homeowner’s ins policy. There is no water coming up but there are cracks in the garage floor which have always been there but now there is white powdery substance that has appeared on each side of the cracks and dark areas along side that a friend said was moisture.
I don’t know if I should call ins co or not or start with a plumber, general contractor or ? I am most grateful for any advice you can give me. Thank you. Jeannine
February 16th, 2010 at 11:29 am #Jon Dean
I was recently married and went overseas for my honeymoon. While away my home was broken into and burned (apparently to hide the evidence according to the police). My new bride NEVER took residence in my home as we were planing on moving her in after we came back form our honeymoon. It has been going on 7 months now and Farmers has not settled. They requested and EUO from me which I complied, then came back requesting one from my wife. My question is if my wife never established residency, is listed no where on my policy or claim, can they request her testimony and can they deny the claim if she refuses?
February 16th, 2010 at 7:33 pm #Destiny
i was wondering if frozen pipss and water damamge covered bt insurance , my house was on the market with an agent who never weatherized the house and i moved out of state , came back to the home and the pipes were all broke, ceilings was down and mold everwhere
February 17th, 2010 at 12:28 am #admin
Jeannine,
Call your agent and ask him/her what the current consequences are with Farmers for turning in a claim. When I worked for Farmers in the early 1980’s, your first homeowner’s claim did not change anything. Your 2nd claim got you an increased deductible, and your 3rd claim got you a policy “non renewal” (cancellation). Its probably tougher now.
February 17th, 2010 at 12:41 am #admin
Jon,
Your policy probably says they can do an EUO as often as “Reasonably” Required.” Therefore this also means it must be relevant. You and your attorney should consider the eBook at UClaim.com about EUO’s. It comes with money back guarantee and information guarantee and with consultation.
February 17th, 2010 at 12:52 am #admin
Destiny,
Most policies say water from freeze damaged pipes is not covered unless you had the heat on or had previously shut off the water and drained the water from the pipes. Kind of a waste of words, IMO.
February 17th, 2010 at 7:12 am #Harry E
F MICHAEL CONTE: Your February 15 advice (to name Insurance company) seems good. My claim and situation is identifiable, and the company unethical-seeming and vindictive, enough that I will get my attorney’s ok before naming carrier, but as soon as enough of the submissions to state, insurance company appeal attorneys, etc are made, I should then. at the latest, decide that it’s prudent to name names. In the meantime, I’ll work with my attorney to follow your other excellent suggestions.
A detail that wasn’t crucial to the already long original post but which seems shocking to me: I am paying a Public Adjuster to ‘help’; he either hasn’t noticed or has tried to justify much of the insurance company misdeeds.
FMC and Admin: Probably it’s hard for question submitters to properly appreciate the great amount of time and effort you are contributing to answering posts on http://www.insuranceclaimhelp.org. Thanks for a *very* valuable service to folks often puzzled by such new problems and / or being jerked around by what seems to be a group which should be (actually or almost) subject to RICO accusations.
Original Post:
February 12
At what point can insurance company ‘mistakes’ be used as proof of intentional or negligent Unfair Claim practice. For example, the company tried to pay Living Expenses at approximately 50% of actual expenses {the problems included (1) their crediting themselves with having made a ‘lost’ payment that they neither a. described to me, b. had me sign the standard proof of loss for, c. had any evidence of having sent etc; (2) delaying payment by making the check out to the wrong recipient; (3) withholding approximately 2-3 times the actual dollar amounts for ‘now unnecessary utility costs’; (4) simply leaving out groups of invoices covering long hotel stays for which invoices were properly submitted; (5) not acknowledging receipt of invoices and waiting as long as 5 months to pay the parts of the invoices that they proposed paying. etc} In addition, strategies like agreeing to accept one type of follow-on policy, then charging the Escrow account for an unnecessarily more expensive policy — the unnecessary additional expense amounting to hundreds of dollars — and then making a refund very difficult to obtain. I think that a company would refuse to process a claim on the grounds of ‘fraud’ if a policy holder would try this kind of thing. Again, would the above mistakes and reluctance and slowness to prevent or correct them amount to Unfair Claim practices at some point?
February 18th, 2010 at 7:40 pm #F MICHAEL CONTE
thanks for the good words. please let us know the out come.
February 20th, 2010 at 7:44 pm #John
Can someone help me here?
My home was broken into back in october. I did everything that was asked of me, and at the end of january, I was told that the SIU had closed its investigation, and that the case was free to settle. I recieved a check for my renters policy, and I was told that I was entitled to more money when I replaced some of the items that were stolen. I also had a personal articles policy, but I haven’t submitted the proof of loss yet, so it has not been settled. Well I faxed over some reciepts the other day, and then the next day I recieved a call from SIU saying they reoppened their investigation and that they would not pay anymore money on the claim. They want me to come in for an EUO. What happens if I say no? I probably spent 30 hours on this claim, and honestly, I don’t care about the few thousand that is unsettled. I am sick of these people. Can they ask for the money they already payed me back if I dont’ accept the EUO? I’ve spent it already, which puts me in a really bad spot if they can…..but I am so sick of dealing with this I just want to tell them to get lost. Also, I was told I would be reimbursed for things, so I purchased them, and now they are saying they wont pay on those items- is that allowed?
February 21st, 2010 at 11:53 am #F MICHAEL CONTE
First of all please tell us who is the carrier that is doing this to you?
Second this is the old rock and a hard place. i am not sure but i do not believe they can ask you to sit for an euo at this time, as a proof of loss was presented and accepted. What is the issue they think that they should not have offered a selttlement. as far as i am concerned this is just an attempt to bully you into not persuing the personal article portion of the calim. if this is a legite claim then as a matter of conscience you must proceed. you might want to consult an attorney, in any event put your state insurance department on notice of this activity.
February 21st, 2010 at 10:50 pm #TRB
Alan
I also had a sudden and unexpected water leak in a water line on second floor and almost two years later had slab damage that a hired Allstate engineer determined could have been caused by the water leak that occurred over 3 days, seeping through the concrete slab and finally drying out causing the expansive soil to shrink and crack the slab. Allstate covered the claim and repairs to the foundation slab and resulting cracking etc within the property. But State Farm ,a secondary insurer as Allstate is an HOA policy, will not cover anything period, they state their policy excludes damage to foundation slabs regardless of where the water comes from, internal, external, above ground, below ground, whether sudden or over a period of time, and then they deny your claim and tell you to stick it where the sun don’t shine!
February 21st, 2010 at 11:03 pm #TRB
Admin
An update to a few posts I had several months back regarding the above mentioned water leak. State Farm denied my original request to re-open a Nov 2007 claim that they originally covered saying it was time bared by the 12 month policy verbiage that an insured has 1 year from close of claim to file suite. I was then told by my agent after his discussions with the claim representative’s manager that I should open a new claim for the newly discovered damage (foundation crack). I did so, and they denied this claim stating that is was time bared as it related back to the original leak and was past the 1 year period to submit new damage claims. They still denied coverage even after discussion regarding the LMI v Allstate Case. Question, if State Farm was required and did provide a Scope of Loss and an estimate for damages in the original claim and this damage was not noted or discovered by them is it time for me to sue them for breach? 3 separate engineers, Allstate, State Farm and personal have stated that water saturation from the original water leak or wood creep are the cause of the second floor sheathing sagging and other damage. SF said they also don’t cover floor sagging, even if caused by water damage (sudden or unexpected or not) if it causes floor “sagging”. They also said in writing the 3 year statute rule in CA does not apply as the 1 year suite language is in the policy. DOI said they could not assist as it did not have the legal authority over this portion of the law.
February 22nd, 2010 at 12:56 am #admin
TRB,
Well, IMO, if they were dumb enough to put that 3 year statute denial in writing, you should be able to find even a junior attorney to take your case. But keep in mind, litigation is a huge ordeal and should be pursued only as a last resort.
First, try faxing a letter to the State Farm CEO, Ed Rust, asking if State Farm always stands by their policy 1 year statute rule in California (He would be crazy to say yes). Unlike some other insurers, State Farm’s home office is usually good about correcting its claim department renegades at the bottom when they smell a possible class action.
In fact, now that I think of it, I believe that most SF homeowner policies state on the last one or two pages of their policy that their policy is over ridden by state laws. So show that to those local wing nuts you are dealing with. See page 22 of State Farm Homeowners FP-7955 CA 6-96 for the section “Conformity to State Law” in Conditions applying to section 1 and 2 of the policy.
February 22nd, 2010 at 9:54 am #TRB
Admin
From Denial Letter: “the damages you are currently claiming are related to t he November 12, 2007 loss, you claim is time-barred by th eone year contractual limitation period in your condominium Unitowners’ Policy. We have considered all the legal authority (LMI vs Allstate) in the Janaury 4, 2010 letter and other legal authority.”
We disagree with the assertion that State Farm has waived or is otherwise estopped to assert the one-year suit provision as a defense. We specifically informed you of the one-year suit provision and State Farm’s intent to reserve all of its rights under the policy.”
February 24th, 2010 at 12:19 am #admin
TRB,
I still stand by my previous comments. The excerpt you quoted is “stonewalling”, repetition without facts, and it sounds like it was written by some over zealous and ignorant claims people.
February 26th, 2010 at 12:18 am #Sam
Hi,
Thanks for this site!
I recently had wind blow a branch into a chimney on my roof. The chimney crashed down onto the roof and dislodged numerous shingles, which then blew off the roof, exposing the plywood underneath in multiple places in one general area of my roof. Water came in (we got 5 inches of rain that day) and did extensive damage to the interior.
Travelers is the carrier.
The problem is this: The shingles on the roof are very unique in design (tiger stripes), the manufacturer has long been out of business, and five professional roofing companies have tried to find shingles that come close to matching mine, with no success.
They all say that, due to that, as well as the complex architectural design of my roof (numerous hips, valleys, cupulas, dormers, etc), they would not be able to repair the damage such that it would not stand out like a sore thumb and make the house look like a jigsaw puzzle. All five put this in writing and I forwarded it to the adjuster.
Travelers is balking on a reroof but, according to these 5 professional roofing companies, it is going to be impossible to repair only the damaged areas and the areas that surround the damaged areas because one area leads to another and, no matter where you stand all around the house, you will see both the existing and the new contrasting shingles.
The adjuster mentioned “line of sight”, but he seemed to think it only applied to the view from the front of the house, which is where the damage is. However, as I mentioned, that area can’t be repaired without impacting other areas, which then impact other areas, and so on.
At one point, he said, “Well, what if we do the whole roof except for the back slope?” My reaction was to tell him I’d get back to him. It seems as though they are leaning toward replacing the roof, but are just trying to get a concession from me…?
In California, is there a “line of sight” rule and, if so, how should it read, or be applied, and is Traveler’s bound to abide by it?
Again, thanks for being here!
February 26th, 2010 at 2:11 pm #diana
I had move out of my house about 2 months, repainted and rent out. had a tenant ready to move in Jan. 2010. in Dec. 23 , freeze pipe was broken and water damage everywhere. insurance ajuster came out saw the heat switch was turn off, and immediatly said that because the heat wasn’t on so they will deny the coverage. The house was vacant and heat is the only that used gas , and gas bill still charge me during those months. I had forward my gas bill and the adjuster said the gas bill was too low so that meant heat was not maintained in home. what is your sugestion in this case.
February 28th, 2010 at 3:41 pm #admin
Diana,
Get an exert from the gas company to write that it was enough gas to heat the house. And get an expert to see if the valve was faulty or in the closed position leaked enough to heat the house.
And this occurred to me after my first post, perhaps the adjuster closed the valve then took the photo of the closed valve?
March 1st, 2010 at 1:08 pm #Shelly
My mothers house burned down a week ago. Allstate has not been exactly helpful. Her policy states that she has Mobilehome remplacement cost end form U10127. What is that? I called the agent and asked for a policy book and he stated that they did not have those in the office. I work in the insurance business I know that is not true. How can I get a copy of what all these endorsements mean?
Thank you,
March 2nd, 2010 at 2:26 am #admin
Shelly,
If UClaim.com does not show Allstate mobile home endorsements, consider the following. The UClaim eBooks tell you several ways to get the policies and endorsements from uncooperative agents and adjusters. Here is one suggestion, take some kids to the Allstate claim office lobby in your area. Give them ice cream cones, chocolate bars, etc. and let them play tag or hide and seek, etc, while you wait for the claim manager to get you a copy of that endorsement.
And find out if that endorsement is for contents or structure.